I am officially two weeks out from finishing Step 1, so I wanted to write this post while everything was still fresh in my mind to hopefully help others with this first medical board exam. I’m going to organize this post chronologically to help with organization. If you want more info on what I did earlier in the school year (Sept – March), just go back one blog post for that recap. Ok so grab a drink and maybe even some popcorn and tune in for all the info…
Main dates: started UWorld March 1st. Finished first pass UWorld April 23rd. Finished UWorld marked questions for a second pass May 19th. Dedicated study period began May 20th. Step 1 June 19th.
Pre-March, I focused on my course work and the organ blocks that were were in. I did use the USMLE RX question bank but only did questions on the topic we were covering at the time and definitely didn’t make a big dent into it. I had been through all of Sketchy Micro 2-3 times, and therefore I was pretty comfortable with micro. My curriculum still had not covered Heme, Onc, GI or Renal when I started UWorld.
March – Mid May:
From March through mid May, I still had classes 4 days per week and roughly 1-2 clinical afternoon sessions a week, so I was balancing Step 1 studying with my curriculum. My goal was to finish my first pass of UWorld as well as my second pass through marked questions before my dedicated study period started May 20th. I made it a goal to finish my first pass in 7 weeks, which equaled to 9 blocks per week. I did 40 question blocks on timed mode with all the subjects/systems checked off . I made this work with my schedule by getting to school at 5:30/6 am and working until class began at 8 am. I would usually get through a block of questions (about 45 minutes) and a third of the way through reviewing the block before 8 am. I tried to finish the review that afternoon/evening, but there were definitely some days where I wasn’t able to get through reviewing the entire block so then I would have to catch up later in the week. On Thursdays (we didn’t have class) as well as one weekend day (either Saturday or Sunday) – I would do two blocks and review them. That way,I was able to do 9 blocks a week. In the beginning, it took me around 2.5 hours to review one block, but within 3 weeks I had it down to 2 hours or less. During my first pass through UWorld, I took notes using the Note function that was built into the UWorld application. I tried to keep my notes short, about 3 sentences per question, and I would only take notes on questions that I either got wrong or was not confident with. These were the same questions that I flagged. During my first pass, I probably had notes written for roughly 65% of the questions.
So I was able to finish my first pass of UWorld in 7 weeks. I then had 4 weeks left of school until my dedicated period started, so my second goal was to go back through my flagged questions for a second pass (I called this my 1.5 pass since it wasn’t all 2,000+ questions again). I saw huge improvements on my second pass, and my time management and efficiency greatly improved. I took ~ 45 minutes to complete a block, but only around 1 hour to review a block – and this time I hand wrote notes. I organized my notes in a binder divided by First Aid Chapters. I would only write down a few lines per question that I got wrong. I ended up finishing this second pass on my last day of M2 which was right on target with my goal. During the last few weeks before dedicated as well as throughout dedicated study period, I also started really watching Sketchy Medical Pharm videos which was something I hadn’t done. My one regret was not starting this sooner. The last thing I did before dedicated was that I reset my UWorld account (but not before saving all my notes as a PDF!).
The last two weeks of classes I started planning out my 4 weeks of dedicated study period. I planned to take 4 NBMEs – one a week every week except for the last week before my exam, as well as both UWorld Assessments. I planned to do the NBMEs in order in such a way that I ended with the most recent exam, so I worked my way back 4 exams and started with that one. I took that first NBME on my last Monday of the M2 school year (5 weeks before my exam). I used the results of that NBME as well as the overall UWorld reports to plan out my study period. My plan was to start with my weaknesses in the beginning, hit my strengths in the middle, and then cover everything again at the end while dedicating more time to my weaknesses. I also planned to do around 3 UWorld blocks a day, but I also knew that I wanted to be flexible with this.
Dedicated Study Period: Mid May – Mid June (4 Weeks)
I studied a little bit the weekend right after school ended, but I also took some time to relax and refresh before it really started. I started that Monday with my second NBME and 3 UWorld blocks for a total of 7 blocks. During that first week, I covered Neuro, Cardio, and Biochem. I treated each day similar to a work day and studied with two of my classmates. We would carpool to school at 6:30 am, work in a study room all day – we wrote the date on the white board every day to help us keep track of time (trust me, it can feel like a time warp), and we also had motivation posters up around the room for some inspiration. In the mornings, I did 2-4 UWorld blocks (depended on the day), reviewed the blocks, and then started on my First Aid chapter of the day. Because I had already done so much UWorld, I made sure to prioritize content review – I prioritized getting through my assigned First Aid Organ System for that day over making sure I got through all of UWorld again. We would quietly work until lunch, take a 15 minute break and then spend the rest of lunch hour eating and reviewing 7 sketchy micro videos per day. To review the videos, we had a deck of study cards and would call out one bug name (ex: Staph Aureus), we then each wrote down everything we could remember about that bug in the span of a minute or two, and then we would review our Sketchy Notes to see what we missed. Actively quizzing myself really helped me to retain the little details I wasn’t remembering. After our lunch hour, we continued to work until around 6 pm (some nights it was 5, others went to 7:30, it just depended on how we felt). When I got home, I would either workout, do a little (1 hr max) more work, or just eat dinner and relax. I tried to be in tune with myself to see how I was feeling and decide what I needed that day. On average, I worked out 4-5 days a week doing 30 – 45 minute workouts. I truly believe this kept me sane and kept my mind quiet at night allowing me to sleep well throughout study period. I also kept a very strict sleep schedule – in bed no later than 10 pm (9 most nights), and up at 5:15 every morning. For the most part I tried to eat healthy but I definitely struggled in this area – I found myself using snacks as breaks during the day and also opted for easier food options like packing a sandwich over a salad. Speaking of breaks – I took a 5 minute break about every hour – either walking to refill my water bottle, using the restroom, or just looking at instagram and replying to some of yall’s sweet comments from that day’s post. I continued this every day. On weekends, we went to a different location (conference room at the hospital) to help keep things fresh – plus it had giant windows which was awesome.
So as previously mentioned, the first two weeks were focused on my weaknesses, the third weak I zoomed through my strengths, and the last week I covered everything again with more time spent on the weaknesses. Every week (except for the last week) I took an NBME exam followed by a few UWorld blocks and reviewed them that day. I also did the UWorld assessments but I did them instead of my morning UWorld blocks on the days they were scheduled. Each week I saw my scores climb closer and closer to my goal. Each week reassured me that the hard work was paying off. I didn’t have to adjust my study habits or schedule during dedicated, but I was constantly assessing to see if it was needed.
Honestly, I think one of the things that helped me the most was having my two study partners. Find someone that works harder than you, and ask to study with them. That’s what I did and it was awesome. We had a no goof off study zone – we worked in silence for 97% of the time, and 3% of the time we were venting, laughing, crying, and cheering each other on. If one person was making a coffee run, they’d check to see if anyone else wanted something. We kept each other accountable and made sure no one went to nap on the couch unless it was absolutely necessary. There were several times when one of us swore we were getting dumber or going crazy, and the other two were the rock and made sure we didn’t drift away from the stress. Being with others that are going through the same process can be an amazing help – and this is one of my #1 tips!
Week Before the Test:
The week before the exam, I paid extra attention to my sleep, my workouts, as well as my studies. I hit every topic again (some days I went through 2-3 First Aid Chapters) and made sure to really focus on the things I struggled with rather than just rereading everything. Some tables/images I completely skipped because I knew I was comfortable with them. Other topics (for example: heart murmurs) I would spend 30 minutes on re-writing and studying. The other thing I did my last week that I would highly recommend is that I took the free 120 USMLE questions at my testing center (its not free if you take it at the center but its worth it in my opinion). I scheduled it for the same time of day as my Step 1 test to check out traffic, parking ect. I was able to see how the center functioned and learn how the process worked. This was a huge help and really made me feel calm on test day. If you’re planning on doing this before your test (highly recommended), do know that it takes some time to sign up and register for the practice test, so you have to do it a few weeks in advanced. Besides the free 120, I didn’t take any practice tests during the last week – I wanted to focus on material.
By midway through my last week, I had completed 90% of the reset UWorld questions. At this point, I decided to go back through once again and hit the ones I had missed during this last pass rather than making sure I got through UWorld all the way. There weren’t too many blocks and I split them up over 3 days, so it was pretty light on the quantity of questions, but there were also questions I was seeing for the 3rd or 4th time so I wanted to make sure I learned them since obviously those were concepts I really struggled with.
The day before my test, I read through UWorld notes PDFs, watched a few Sketchy Medical videos, got a workout in, went to the grocery store to get lunch and snacks for test day, gassed up my car, and then was home and in PJs by 6:30 pm. I tried to relax and got in bed at 8:30.
I woke up at 5:15 like I did every day, showered and put on my favorite outfit. I left my house 2.5 hrs before my test time to reach a test center that was 30 minutes away. I stopped to get a bagel and coffee – I filled my travel thermos up with coffee to sip throughout the day. I reached the test center parking lot about 1 hr and 45 minutes before my test, 45 minutes before the testing centered open (yes I am one of those people). I flipped through some First Aid pages in my car but that was more to quiet my nerves than to actually look at any material. So here’s a major tip – call your test center and find out when you are allowed to start your test. My test center said that you are allowed to start the test 45 minutes before the actual scheduled time, so I went into the office an hour before my test time and started shortly after. I was one of the first ones there, so it was quiet and calm. I also used foam earplugs during the exam – and this blocked out all the noise of people coming and going throughout the day. I proceeded to take the test, skip out of the building, go right to Dairy Queen and eat an ice cream before driving back home. After I finished the test, I was expecting a rush of relief, but I think I was still to jacked up on caffeine and adrenaline. I went home, ordered delivery for dinner, opened a wine, and started the new OITNB season.
So that’s my Step 1 journey. Truly the only thing I wish I did differently was start Sketchy Pharm earlier. The other thing that I really wanted to say was that all throughout M2, I had heard people say “Everyone wishes that had taken Step 1 a week earlier”. But here’s my truth: looking back – I don’t wish I had taken it a week earlier – although I don’t think the last week greatly increased my knowledge, I do think it helped my nerves and my confidence therefore helping my score. Regardless – 4 weeks was perfect for me and it allowed me to have two weeks of vacation to spend time with my loved ones and relax.
I’m happy to write a more focused post on specific topics – Utilizing UWorld, planning your dedicated study schedule, ect. Send me a message on Instagram with any suggestions!
Hi! My name is Caroline Franke and I am a second year medical student in North East Ohio. I love cooking, running, and playing with dogs and kids. I am on a mission to learn as much as I can about nutrition, mental health, and physical well being. Feel free to join along as I try to navigate the world of wellness.
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