My USMLE Step 1 Study Strategy

I've been busy traveling for residency interviews, but I figured I should take some time to talk about my own strategy for studying for USMLE Step 1. While others have already posted study guides, I figured I would add my own two cents in, not because I have any revolutionary new ideas on how to study for the Step, but rather because I think there are a few suggestions I have that could make things a bit more efficient for you. Although I took the exam in early 2008, I feel this advice will be quite applicable for those of you taking USMLE Step 1 for years to come (haha, until they change the exam structure up, as they always do about every 10 years).

Before I get into this, I should note that I am simply describing my own experience and what worked and did not work for me. I hope you take away something useful from it, but do not feel that there is only one way to study successfully for the Step. Everyone comes into this with different strengths and weaknesses, depending on their medical school's basic science education as well as their own aptitude and experiences. Everyone also has their own learning style: some people are visual learners; others, aural. Another thing that people are less likely to admit, but is clearly true: while we all want to score well on the Step, not everyone shares the exact same goal as far as their score goes. Read as much advice as you feel necessary, but do what feels right for you, first and foremost. As for general advice on what subjects to study and how to budget your time, I feel these have been discussed quite well elsewhere, so check out 21+ Online Resources for USMLE Step 1.

My Daily USMLE Step 1 Study Schedule

If you do look at other sites, you'll see there are various study guides for people who have 4, 6, or 8 weeks to study for the exam. What some sites don't mention though is that the hours you're willing to study per day matter as well. Some people can go 8 hours straight; others can only be highly productive for an hour or two. Personally, I aimed to do three 3-hour chunks per day. I'd study one topic from roughly 9am to noon, take an hour break for lunch, study from 1 to 4pm, take 2-3 hrs break to exercise and eat dinner, then do practice questions from 7 or 8pm until I felt tired. Some days were better than others, but I think I averaged around 9 hrs a day, which seemed appropriate to me. I also took a half day or whole day off each week to catch up with friends and family. It is key to schedule in breaks in order to maintain your health and sanity. Jam-packing your schedule with unrealistic study expectations will only demoralize you later on when you cannot keep up.

My Six Week Strategy For USMLE Step 1

Due to the structure of my school's curriculum, in theory I had up to 10 weeks to study for the Step. However, in reality I probably spent about 7.5 weeks studying, and really peaked around the 6th week and plateaued after that. Sometimes I wonder if my score actually went down due to that extra 1-2 weeks of studying just because of burnout! Anyway, based on the general advice for Step 1 I found online as well as talking to upperclassmen friends who had recently taken the test, my basic strategy was to read through First Aid for the USMLE Step 1 in order to get comfortable with all the general topics covered in the exam. Some students try to start studying by picking a topic area and delving into it. 

I understand the rationale behind this, but the reason I avoided it is that there is so much information out there, you easily start to feel overwhelmed as you study one area, which leads you to become demoralized. By studying First Aid initially, not only did I get a general refreshed on all the major topics covered on the exam, but I also felt more comfortable in judging the depth to which I needed to study particular subject areas. Since the questions on the exam are integrative, having reviewed all the subjects was often helpful when I took practice tests, as I got more questions right as compared to studying one subject alone, which helped build my confidence. I budgeted about a week for this, which was sufficient for me.


After going through First Aid, I prioritized each major subject area covered in Step 1, and covered them week to week, starting with the subject I was least comfortable with, biochemistry. As I mentioned above, I'd spend about 6 hours per day studying the subjects, and then spend the rest of the time doing practice from Kaplan Qbank and then later on, USMLE World. While I do not want to belabor what subjects to study and how much they appear on the exam, I feel that in general, memorizing First Aid in its ENTIRETY and doing LOTS of practice questions from one of the qbanks is sufficient to get a great score on the Step. You don't need any fancy combination of books or vast detailed knowledge about esoteric zebra diseases. Just know the basics really really really well. That's it! But, of course, no one would feel comfortable studying just one book and doing questions so we all use other resources. If you're interested in the books I found useful, check out Books For USMLE Step 1.

I repeated this pattern of studying for particular subjects for about 6 weeks, but I made sure to reserve the last week before the exam to go through First Aid again. Doing so really helped solidify all the material in my mind. Also, as I had been taking notes in First Aid as I did review questions, I had a much richer resource to study from during that last week, and did not have to waste time hunting for notes in other resources. The day before the test itself, you really should try to just relax, watch a movie, hang out with friends. If you really feel the urge to study, just do some light review in order to calm your nerves and build your confidence. Do NOT try learning tons of new things. The rapid review section at the back of First Aid is good for this in my opinion.

The USMLE Step 1 Aftermath

After taking the test, I felt pretty good about my strategy and I think it prepared me well to answer most of the questions on the exam. There is no perfect strategy out there, and the test will always throw some real curveballs at you. But, don't worry, many of these questions are experimental and will not affect your actual score. Focus on answering the questions you know you should be able to answer and you'll sail through. The best part about taking the Step is that no matter how the test went, you have a great reason to CELEBRATE afterwards! All those weeks of hard work will have paid off. Go out and reconnect with all those parts of your life you put on hold!

If you have any specific questions about how to study for the Step, feel free to comment below or contact us.

Updated 2015-12-18