The USMLE Step 1 tests knowledge that's gained over about 3 years of full-time medical study and some background material from undergraduate learning. That’s a LOT of information. For those preparing (or re-preparing) for this test, the amount of material to cover is daunting. What if you’ve been out of school for a few years and/or are preparing to take the exam again after a lengthy absence? Here are some quick guidelines for how to prepare: 1. Know Yourself How much of the material have you retained since your last exposure? 50%? 20%? An easy way to find out where you stand today is to do two mixed blocks of questions in UWorld and average your score for the two blocks. Once you know how much you have to re-learn you will be able to plan a realistic schedule. 2. Know Your Lifestyle How much time do you have each day to devote to study? If you're serious about your Step, in an ideal world you'd be able to solely focus on preparing for said exam. If you're working full time and will only be able to squeeze in an hour or two of study each day, it's going to take quite some time to be fully prepared, and the longer your studies drag out, the harder an uphill battle you'll fight with retention and burnout. If your schedule doesn’t permit a review course then independent study is the best approach, but you must be consistent. Anything less than your best effort will not do. 3. Ready for a Review Course? Take a look at a review course's schedule and material, specifically the lecture notes. Is everything familiar? How long would it take you to review the notes for one week of class? (Time yourself reviewing a typical set of notes for a day’s schedule within the course.) Are you able to keep up this kind of schedule and stay ahead of the course? If not, you may need to adjust the other demands in your life to be able to do so (see #7). 4. Preparation is Key If you choose a review course, make sure you prepare at least the first two weeks of material before the course begins. You want to be in a position over the first two weeks of SOLIDIFYING knowledge rather than learning it from scratch in the course. And again, as I said above, you want to consistently stay ahead of the course. 5. Schedule Your Time If you are taking a course, one of the ways to stay ahead is to be sure to schedule time to prepare for upcoming lectures and to review the past ones. Another easy tool for success is to re-read your lecture notes right before and right after a lecture. 6. Keep Materials Simple and Few First Aid, BRS Physiology, and the UWorld question bank are more than enough for your initial run-through. Too many different sources often complicates study, and the last thing you want is resource overwhelm. Just like getting into shape, you can't just join a gym and have the pounds melt away. You have to show up, put in the effort, build muscie and sweat it out. The same thing applies to the USMLEs. 7. Make Room in Your Schedule Make a schedule that takes into account how much you have to learn and your expected rate of progress. For example, a very general rule of thumb is that a page of the First Aid could take an hour of study. And as I mentioned before, the more seriously you take this exam, and the more you're able to make it your sole focus, the better and swifter results you'll see. 8. Use First Aid as your Study Strategy Use a systems-based approach to learning. Work through organ systems, i.e. cardiology, using First Aid as a checklist. And remember: First Aid is meant to be a high-yield skeleton upon which you build your studies. It is not the end-all be-all encyclopedia for every single detail you'll need to know for your exam. Knowing this, and following these tips can help you maximize the Step 1 "Bible." 9. Use Your Tutor Wisely If you're working 1-on-1 with a tutor, save high yield questions that you do not understand for your sessions. Email your tutor the night before with some of your questions for the next day. We may know what you need to cover to be fully prepared for test day, but we cannot read your mind. Help us help you and always be honest with us. If anxiety's getting the better of you, or you really want to skip ahead to something, tell us, and we'll be able to either adjust accordingly or bring more perspective to the approach. 10. Celebrate Small Victories If you finally understand the ventricular volume and pressure loops after two hours of study you have done well! Congratulate yourself! The same thing goes with harder-earned victories. If you've been beating your head against a wall trying to master a difficult concept, and things finally click, celebrate! You're essentially running a marathon, so it's important to celebrate the little victories to keep yourself energized and to keep going, 11. Be Realistic Most students require several months to learn the material. If you’ve been away from the material or have limited time to study each day it will obviously take longer — possibly in the range of 6-12 months or more. Be patient with and kind to yourself throughout the process. Remember that you're not studying to take a driver's test; it's a beast of a medical licensing exam, and like any mountain worth climbing, persistence and determination are needed to persevere. After all, the harder the struggle, the more glorious the triumph. 12. Accept the Multiple Pass Approach You will not learn everything the first pass through. Period. The sooner you accept this, the better off you'll be. Instead of aiming for unachievable perfection on your first pass, try to focus on high yield material and make notes sparingly. You will have to review this material at least 4 times so don’t let your first pass through First Aid or UWorld take months. 13. One Foot in Front of the Other Learn something every day. Even if it is something small. Don’t lose momentum. Keep at it. You can do it. 14. Adjust Your Schedule Every 6 Weeks to Address Areas of Weakness As you make your way through your studies, you will uncover areas of weakness that you may or may not have expected to be there. Don't shy away from the tough spots. Lean into the challenge. The more you embrace the harder areas head on, the more empowered you'll feel as you chip away at them and slowly but surely gain mastery. 15. Stay Positive This is a difficult process. Allow for failure. When you stumble, pick yourself up, dust yourself off, and try again! You WILL make it. Now, go crush your exam. Or, as Julia Child said, "Whack the hell out of it!" Source
