Step 1: Get To It & Through It

Ahhhhhh Step 1, the right of passage for every medical student that seems like torture to get to & go through and the one thing that can affect the trajectory of your whole career in medicine.  It’s a daunting task but seems like everybody (for the most part) has gotten through it pretty well.  The Journey to it & through it can be UGLY but hopefully I can offer you some tips that will successfully get you where you want to be in preparation.  It seems like a lot but what you’ll mainly want to focus on is: A Schedule & What Resources to Use.  I will outline these topics, as well as offer the study and review techniques that I used & scheduling that was best for me.

A few things to note first:

  • Find what study method works for you
    • Figure out whether or not you do best with videos, reading a book, doing questions, or attending a Step Prep Class
  • Preparing for Step 1 is a Marathon NOT a Sprint
    • You will have to study + Review, Review, Review.  There’s no way around it and there’s no such thing as cramming for this exam.  You are essentially being tested on the FIRST TWO YEARS OF MEDICAL SCHOOL (I couldn’t even memorize material after one block if I didn’t commit to it.)
  • Some things will work for you and some things will not
    • If you find that something doesn’t make a concept stick, don’t force it.  Move on to something else.  There are tons of resources for that you will likely find a benefit from.  Something that worked for your classmate might not work for you at all.  That’s OK.

So, let’s get started!

Resources That I Used

  • First Aid
    • First Aid is the cream of the crop when it comes to HIGH YIELD information for Step 1.  It offers info in bullet-point format and gives you the meat and potatoes of concepts relevant to Step 1.  For certain concepts, I did find myself having to search out other resources to fill in gaps so I would have a complete understanding though.  Use First Aid to follow along in class during 2nd year.  When you get to your dedicated study time, it isn’t so hard to get through because you pretty much already know what’s there (AND your NOTES are there).  Most people recommend going through First Aid 2 or 3 times BUT AT LEAST ONCE (Keeping up with it for class, going through it when you first start ACTUALLY studying for Step 1, & then a quick pass during your dedicated study time).
  • UWorld
    • Just as First Aid is the cream of the crop when it comes to high yield information, UWorld is that for question banks.  Many recommend if you don’t do anything else, do QUESTIONS, QUESTIONS, QUESTIONS.  UWorld allows you to solidify concepts as well as review why an answer is correct or why it’s incorrect.  If you can afford it, start doing UWorld Questions early, but if all else fails, AT LEAST 3-6 months before your exam.  You want to finish all of UWorld by the time your test rolls around.
    • USMLERx is another great question bank that you can use.  Because this is ACTUALLY written by the people that write First Aid (and it pairs quite well), I used this to get through First Aid.  It’s a lot cheaper than UWorld so I had this a lot longer.  It helped to get through First Aid when I was just getting started studying.  These questions are a little more detailed because they’re pretty much testing if you know what’s in First Aid, where UWorld tests if you know the concepts.
  • Pathoma
    • Pathoma is the ULTIMATE video resource for Pathology in class as well as for Step 1.  Use this for your class study.  Make a point to note the differences between each disease.  Dr. Sattar does an amazing job at grouping diseases together for memorization purposes, then combing through each disease to delineate it from different disease processes.  It gives you a holistic view of pathology to include disease processes, histology, & pathology.  I never would have been able to identify different diseases simply by looking at Chest X-Rays, microscopic slides, or solid organs without the help of Pathoma.  This is good for Step 1 as well as for starting rotations.  I’m actually in 3rd year and still look at Pathoma from time to time.
  • SketchyMicro/Pharm
    • If you haven’t used Sketchy Med for didactics yet, I’m going to take a guess and say that you don’t have ANY problem with pure memorization of dry material.  Sketchy was my saving grace for Microbiology.  Sketchy is a video service that teaches material through cartoons, illustrations, & recurring themes.  It offers a way to remember material that you would otherwise have no way to compartmentalize.  After watching videos, even outside of the school setting, I’d find myself associating things that I learned on Sketchy to everyday life things.  For example, anytime I would see a cane or “staff”, I would think of “Staphylococcus“.  Even now I find myself going recalling facts from Sketchy.  I primarily used Sketchy for all of Microbiology and some Pharmacology, but they now offer Pathology as well.  I haven’t used it personally but have heard only good things about it from classmates.
  • KISS Pharmacology
    • I used KISS Pharm to give me a quick and dirty review of Pharm since it was kind of my problem child.  It’s not holistic but it definitely gives you a brief review before delving into the concepts of pharmacology.  It is a nice resource to use early on.

Resources That I Didn’t Use But Others Found Helpful

  • Picmonic
  • Firecracker
  • Kaplan
  • Doctor’s In Training

General Tips

  • Plan your calendar early (Plan when/what you’ll be studying AND Schedule time to catchup if something happens AND OFF Time)
  • Make A Schedule AND STICK TO IT
  • Make an effort to follow along with First Aid during Didactics
  • Learn to tie in various concepts and topics (Biochem pathways & Pathology is HIGH YIELD)
    • No book will give you every explicit “connection”.  Learn to think through concepts and how they COULD affect large scale disease processes
  • Those Pharmacology mechanisms of action and side effects are REAL and are tested like no other
  • I cannot stress doing QUESTIONS enough
  • Learn to pace yourself
  • Make every effort to learn in didactics.  You don’t want to be forced to attempt to learn a difficult concept 2 or 3 weeks before your exam.
  • Epidemiology & Physician’s skills questions are FREEBIES (Learn these concepts early)
  • This is Important:  No matter how difficult preparing for this exam is, make every effort to maintain your physical health, mental health, sleep, hygiene, & utilize your support systems.
  • THIS IS A MARATHON NOT A SPRINT.  THE TEST ITSELF IS LONG AND YOU WON’T BE ABLE TO BLAZE THROUGH IT.  Try to build up stamina during your study period.
  • Last, know that there will be a few things on your exam that you’ve NEVER seen before.  DON’T FREAK!! Sometimes you will be able to deduce the answer.  Sometimes you will have to make an educated guess.  Pick one and move on.  Don’t let it jolt you too much.

Study Strategy

The method that worked for me best was do questions, notate things that I didn’t know (it also gives you insight to what will be asked & how it will be asked), go through that specific First Aid section, & then do UWorld Questions.  Going through questions before reading gives you insight into what you should be getting out of each concept.


  • Do a Block of USMLERx questions for Cardiovascular Pharmacology
  • Take Notes from questions with emphasis on concepts that I’m unfamiliar with
  • Read Cardio-Pharm section of First Aid
    • Read with a purpose.  Use those Notes from above to curate your reading
    • Also there are supplements such as Sketchy or Kiss Pharm that you can use here to solidify material
  • Do UWorld Block for CardioVascular Pharmacology


With the above example in mind, I did this for every section of First Aid.

Monday-Friday, I did a section of First Aid. Sometimes I would do multiple if the sections were short, like Embryology & Anatomy for the most part.  So weekdays consisted of doing USMLERx + First Aid + Supplemental Resources+ UWorld every day for each section.

On Saturdays, I only did questions.  I did at least 2 UWorld blocks.  One was always the past week’s work (because I usually finished a specific subject like Cardio or GI in one week).  The other was always a cumulative block that consisted of ALL of my studying for the past weeks.

Sunday was my official DAY OFF

Dedicated Study Time

My dedicated time was 3 weeks prior to the exam, I did a quick run through of First Aid again but I mainly focused on tons of QUESTIONS.

So I took my test and got my results back.  I did far better than what I even imagined I would do.  Adhering to this schedule took DEDICATION and there were definitely some setbacks but I got through it and got the PASS!! I know if I did it, you can do it too!!

I hope this post sets you on the right track to successfully ACE Step 1!  Be on the lookout for a post outlining my experience about actually TAKING Step 1!!

It’s tough getting to the test and Even Tougher getting through it but you’ll make it!!  Keep pushing hard and set yourself up for success!!

~Student Dr. Kendra