How To Study For Step 1

How To Study For Step 1 [Study Like A Top Med Student]

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I know why you’re here. You want to know how to study for Step 1 and get an amazing score.

Well look at what one of my underclassmen told me a week away from the Step 1 exam when I gave them tips on how to study for their USMLE exam:

“I wish I would have listened to you sooner.”

In this post, I’m sharing those same Step 1 tips that can help you feel confident and prepared on exam day. You’ll learn how to study for Step 1 and how to crush the exam with minimal stress.

They will not only help you get a high score but will also keep you calm and relaxed throughout the process.

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What Is USMLE Step 1?

USMLE Step 1 is all about testing your grasp of the basics in medical science. It’s designed to ensure proficiency not only in foundational sciences but also in lifelong learning principles.

The exam is a computerized test comprised of multiple-choice questions (MCQs) and is structured into seven 60-minute blocks, totaling 8 hours of testing. Each block contains a varying number of questions, typically not exceeding 40 per block, with a maximum of 280 questions overall.

Step 1 transitioned to a pass/fail scoring system. Instead of receiving numerical scores, test-takers will now receive a pass or fail outcome.

This change aims to make the test less stressful and focus more on overall learning and choosing residencies in a well-rounded way.

How To Study For Step 1

Now, I’m going to give you plenty of practical tips that you can take away immediately.

I’ll also include things that you should avoid. They are mindset-based and I learned them the hard way. These are not only from my own experience but also tips from top performing students in my class.

If you want to be in the upper echelon, these Step 1 tips are definitely going to help you out!

If you want this post in a video format, you can check out my YouTube video below! Make sure to subscribe for weekly content if you enjoy this one!

Tip #1 Focus on Questions Over Reading

Typically, when you create a Step 1 schedule, you focus more on what chapters you are going to cover in a day or week. Then, you try to span that out over the course of four to six weeks.

But that’s the wrong approach!

The most improvement you can make in your score is by doing more practice questions over time.

Aim to spend about 60% of your time doing some type of practice questions.

That may be UWORLD, flashcards on questions you miss, pre-made flashcards, or anything where you’re just practicing with some type of question bank.

The other 40% should be spent on reading, gathering material and, perhaps, watching videos.

The usual mistake I’ve seen from the students that I’ve coached is they spend a lot of time trying to fit in as much for Pathoma or Sketchy with little time given to question blocks.

But it’s really the latter that gives you the most improvement in your grades, so focus on those more.

You’d also want to raise that percentage even more in the later weeks throughout your Step 1 studying.

If you’re spending 60% of your time on questions originally, then around week three, four, or five of your study prep, you can increase that to 75% or 80%.

Do more practice questions and focus on your weaknesses to help prepare you for the actual exams.

Tip #2 Use Reverse Learning

Step 1 Tips

This tip is one that I absolutely love and it’s definitely going to help you focus on doing more questions. The idea is called reverse learning. It works wonders for medical students.

Reverse learning is simply using a high-yield resource to quiz yourself. Then, you use that to direct you on what you’ll be studying.

The typical flow is to read First Aid, quiz yourself on some question blocks, then do more of First Aid, and keep quizzing yourself.

Instead, I recommend that you do your UWOLRD questions first.

While at it, keep track of the questions you’re missing through Anki, writing on a notebook, putting it in a Word doc, or keeping an Excel sheet (pick your method!).

Based on the topics you keep missing, refer back to First Aid, Pathoma or other resources that you enjoy using.

Basically, strengthen your understanding of that material. Focus on giving yourself as many opportunities to make mistakes through flashcards and practice questions.

This works better than other typical approaches where you’re just reading.

At the end of the week, you may have this “Oh crap!” moment because you don’t understand cardio, derm or micro.

It’s better to know now that you’re weak in a topic beforehand and not on test day.

Make sure you give yourself as many opportunities to make mistakes now, so when the test comes around you’ll be more prepared.

Tip #3 Do Micro and Pharm Every Day

Step 1 Tips

Micro and Pharm are the two topics that most students need a lot of repetition to nail down. It may not be well-taught in some medical school curriculum, but they can trip you up the most on Step 1.

But if you focus your time on mastering them by doing a little bit every single day, then I recommend the resource Zanki.

Your grades are certainly going to be much more likely to be higher than that of your peers. You can even get in that 250 to 260 range!

Micro and Pharm questions are really easy money if you’ve seen them plenty of times. But if you haven’t, they’re the most difficult.

One of the resources to master micro and pharm is SketchyMedical as it includes Sketchy pharm, Sketchy micro as well as many other great resources.

Picmonic is great for anyone who likes short videos. Lange Pharm Flashcards are also amazing.

Definitely, when you’re designing your study schedule, focus a little bit of your time doing both pharm and micro every single day.

By following these Step 1 tips, you are most likely going to pick those low hanging fruits and raise your score pretty exponentially.

When I was wondering how to study for Step 1, no one told me the importance and effectiveness of studying micro and pharm. Make sure you learn from my mistake!

Tip #4 Be Ready For The Hills and Valleys

Tip number four is pretty profound because it can cause a shift of anywhere from 20 to 30 points in the wrong or the right direction on your final score.

Step 1 is hard as there’s a lot of information to take in. But the other part that’s difficult is that you typically can’t predict consistency.

It would be nice to say, “On week one, I had this score. On week two, I would have this score, and then I’ll keep moving up the ladder.”

But what most students will find throughout their days are some spikes where they feel really good about themselves, then a couple of days in a row, you’ll take some practice questions or tests and you’ll see your score dip.

That can lead you to be really hard on yourself.

But this is just part of the journey. It’s going to have its hills and valleys.

If you’re ready for that day in and day out, you’ll be able to move through it with momentum instead of having setbacks.

I learned throughout the first two weeks that my score was going up and then they would go down.

I would have two to three bad days where my scores on the practice exams and questions weren’t as ideal as I wanted to.

When I reflected on the questions that I was missing, I realized that the first question was pretty hard. I probably wouldn’t have got it on that track.

But the next question was something I was actually supposed to be able to get correctly. I knew that information, but I let the prior question dictate my mood and my momentum.

It stressed me out! That anxiety continued throughout those practice questions and let my score to dip.

So when I reflected on how many questions I should have gotten right, it would’ve been a raise in my points of anywhere from 20 to 30 points. The same thing happened on practice exams.

[Free Download] Want to have everything you need to be a top student on your medical journey? Get FREE access to our Med School Success Handbook to get 60+ tips including the best study, time management, mindset tips you need to be a top student. Download it here. 

Focus On Earning Points, Not Losing Them!

If you want to learn how to study for Step 1, listen up. This tip will help increase your score without much effort.

One principle I teach a lot is just to focus on earning points on every single question.

If your last question was difficult, just shrug your shoulders and say, “Maybe I wasn’t supposed to get that.”

But focus on the next one. If you know the topic, you’re going to feel good about yourself and you can take that momentum to the next question.

Step 1 is a journey and a challenge. You aren’t going to get through it unfazed and always have a success rollercoaster.

Be ready for the hills and valleys because when the test comes around, you’ll be ready for it.

Surely, you’re going to do better because anything that’s going to seem like a setback is just something you can shrug your shoulders on and move forward.

Take that as a mindset change!

Once you adapt and commit to it, you’re going to be able to get to the end of it with a smile on your face and a score you’re going be happy with.

Tip #5 Be Okay To Veer From Your Schedule

Step 1 Tips

It’s obviously important to have a steady schedule. And when it comes to studying for Step 1, it’s crucial.

But you’re going to wake up some days and not feel like studying. You’re going to wake up some days and need another extra hour or two of sleep.

Take it!

My study schedule starts at 8:00 o’clock. But sometimes, I wake up at 7:30 and realize I was not going to be functional to actually study.

So when it was 8:00 o’clock, I simply hit the snooze button and try to sleep for another two hours. Sure, my study schedule was a little bit shifted and I had to make some adjustments, but that sleep was worth it.

The fifth among the Step 1 tips taps on the simple principle of taking care of yourself: sleeping, eating correctly, and getting exercise.

If you have to veer away from your schedule to make sure you include more of certain things, such as sleep, do it! At the end of six weeks, you’re going wish you did.

An extra hour of studying is not going to lead you to a better score. But lacking hours of sleep every single day is going to impact your score.

Make sure to get some sleep when you need to, eat some food, and end your study day a little bit early if need be.

This is a challenge and it’s a journey. But if you want to get to the end unfazed, you have to make some compromises.

You may not be able to stick with your study schedule exactly to a tee, but that’s totally fine.

As long as you have the right principles in mind, the score will reflect it.

Tip #6 Have A Cut Off Time

Step 1 Tips

Many times I had classmates who are studying at the same time as I was.

But they would take their studying into the late hours of the evening because they wanted to get a little bit more done.

When we look at our scores, we all scored around the same. It’s not because I’m smarter or they need more hours, but because those extra hours where you’re fatigued don’t actually impact you very much.

Thus, one of the Step 1 tips is to have a cutoff time. Here’s the benefit of having one.

If I would end my study schedule at 6:30 or 7:00 o’clock, I could use an extra three hours to enjoy myself. I would be watching TV, be going for a run, or getting a workout if I hadn’t gotten one.

I learned magic tricks during my Step 1 because I wanted to entertain myself and get away from my First Aid book!

Find whatever you want to spend your time with. It can be doing absolutely nothing or getting some more sleep if that’s what you prefer.

Make sure you have a cutoff time and be strict with that. You don’t have to be exactly to a tee with the rest of your study schedule, but with your cutoff time, you should.

Those extra 30 minutes you think would make you more productive weren’t actually going to lead you to a better score.

You just have to be efficient from the time you wake up and start setting a cutoff time.

Tip #7 The Personal Tier System

Step 1 Tips

The seventh among my Step 1 tips is my home run hitter. It’s how you should be designing your study point.

This is going to help you so much if you’re asking how to study for Step 1.

I could give you a study schedule and many students of mine have gotten the ones that I recommended.

But why not create one that’s perfect for you?

Now, I’m going to give you a system on how to develop that for yourself. I call it my tier system and here’s essentially how it works:

When we go through week one or week two, we may already have a study schedule designed.

But after doing some of the practice questions and practice tests, we may realize that our weaknesses are heavy on certain topics and not so much on others.

If you go with the same study schedule every student puts on Reddit, Student Doctor, or even my website, you’re going to be structuring your study plan according to my weaknesses or somebody else’s.

You want your study plan to be personalized to you!

You can do it daily, though I recommend doing so on a weekly basis.

At the end of week one, you’re going to look at your UWORLD questions and the practice tests that you may have taken that week.

Look at what topics are causing you difficulties and what topics are you doing really well on.

Let’s use this scenario to help explain this. Let’s say at the end of the week you look at your percentages for each major category (cardio, micro, pharm, etc.) in UWORLD.

You would then break it up into tiers.

Tier One may say that for certain topics you were doing anywhere from 80% to 90%. That would be a topic that you’re pretty good at (e.g. biostats).

Tier Two may be a topic where you’re getting anywhere from 60% to 79%. Those are topics that you’re good at, but you still need some work on.

Then anything less than the 60% may be Tier Three where you need to do a lot of work on (e.g. micro, pharm, or biochem). This is a big weakness you hope to prepare for, otherwise, you’re going to be anxious when it comes up on the exam.

The numbers and percentages may vary for you. Adjust accordingly based on where you’re performing and create your three tiers.

[Free Download] Want to have everything you need to be a top student on your medical journey? Get FREE access to our Med School Success Handbook to get 60+ tips including the best study, time management, mindset tips you need to be a top student. Download it here. 

How To Use The Tier System

Now here’s how to use it!

So, things that are tier three are the most difficult ones. If you struggle with dermatology, micro, or pathology, do at least one of these Tier Three topics every single day.

You may do derm on the first day and micro on a second day. You may be doing micro every single day as I recommended earlier, but the gist is that Tier Three is dedicated every single day.

Things that are Tier Two would get dedicated for every other day.

Tier One are topics you do really well on, say, behavioral stats. Most students typically do well with these questions, so you just need to do those every three to four days.

Once again the tier system is personalized to you.

  • Tier Three Topics (Difficult) Will Be Done Every Day.
  • Tier Two Topics (Average) Will Be Done Every 2-3 Days.
  • Tier One Topics (Mastery) Will Be Done Every 3-5 Days.

Then, you’re going to reevaluate every end of the week to see what tier three, two, and one topics are for you.

You may have some former difficulty topics that have now moved up in percentage cause you’re doing better.

There may also be some old topics that are getting a little bit more difficult.

The tier system is going to help you personalize how you’re spending your time.

If you’re looking to know how to study for Step 1, give the tier system a try and let me know what you think!

Now, if you’re asking when you should start studying for Step 1, check out this article: How Early To Start Studying For Step 1?

keys to studying with Anki

Best Resources For USMLE Step 1

Now, after going through those 7 tips on how to study for Step 1, you may want to know what resources you will use. For USMLE Step 1 preparation, several resources stand out as essential aids in your study journey:


UWorld is widely known as the gold standard for Step 1 preparation. It offers a vast question bank with detailed explanations covering all disciplines tested on the exam.

To maximize its effectiveness, aim to complete UWorld at least twice, focusing on marking questions you miss and concepts you struggle with.

It’s advisable to start UWorld during your dedicated Step 1 study period. You can use other question banks on your pre-dedicated period to build foundational knowledge.

Sketchy Medical

Sketchy Medical provides visual mnemonic videos that help reinforce key concepts. It is particularly useful for memorization-heavy subjects like Microbiology and Pharmacology.

Consistency is key with Sketchy. Aim to study a bit of Microbiology and Pharmacology daily and watch as many videos as possible to solidify your understanding.


Dr. Husain Sattar’s Pathoma offers comprehensive video lectures and a high-yield textbook focusing on Pathology, a crucial subject for Step 1 success.

If time permits, it’s beneficial to watch Pathoma videos in advance, annotating and copying diagrams into your study materials for better retention.

First Aid

One of the most important study book for the Step 1 medical exam is First Aid. It’s great for learning the main ideas and the stuff you really need to know.

To make your study more effective, use other tools to test yourself. Flashcard apps like Brosencephalon and Zanki can help, or you can try question banks like USMLE-Rx, which goes well with First Aid.

Other Resources

In addition to these core resources, practice exams from the National Board of Medical Examiners (NBME) and UWorld practice exams are indispensable for assessing your progress and identifying areas for improvement.

For those with extra study time, Anki can be used to create personalized flashcards, while Goljan Pathology Audio Lectures offer in-depth insights into Pathology, especially beneficial for those needing additional reinforcement in this area.

Use these tools to build a strong study plan for Step 1 that fits the way you learn best.

For more info on these Step 1 resources, check out the YouTube video below:

Best Question Banks For Step 1

When it comes to selecting the best question banks for Step 1 preparation, consider the following options:


USMLE-Rx is designed to help build foundational knowledge and boost confidence. It’s an excellent choice, especially for those using First Aid as a primary study resource.

Created by the same team behind First Aid, USMLE-Rx offers affordable access compared to other question banks, making it an attractive option for many students.


Known for its detailed and challenging questions, Kaplan provides an excellent supplement to your Step 1 preparation.

While the questions may be more difficult, they offer a deeper level of understanding and are beneficial for students seeking to solidify their knowledge base further.


A lot of students use UWorld to practice for Step 1 because the questions are very similar to the real exam. But it’s relatively expensive and you only have access for a limited time, so it’s best to wait until your dedicated study period to use it.

Use other question banks first to build a strong foundation. Then, save UWorld for when you’re ready for the toughest practice questions and feel prepared for the exam.

Consider your study timeline, budget, and learning preferences when choosing the question banks that best suit your needs. Each of these options offers unique benefits that can enhance your Step 1 preparation journey.

Want to learn how to make the most of these question banks for Step 1 prep? Watch our YouTube video below for expert tips on using USMLE Rx, Kaplan, and UWorld effectively:

How To Make A Step 1 Study Schedule

Now that you know the high yield resources and question banks to use, you may be curious about what you need to focus on on your study prep.

Here’s a concise breakdown of how to create a Step 1 study schedule:

Pre-Dedicated Period

During this phase, you’re still balancing your regular coursework or other obligations alongside Step 1 preparation.

Focus on high-yield resources like Sketchy, Pathoma, Picmonic, OnlineMedEd, or Goljan Lectures. Just use one or two that resonate with your learning style. Aim to cover about 75% of your chosen resources.

Additionally, integrate question banks into your routine, answering a manageable number of questions weekly, focusing on weaker topics such as pharmacology, microbiology, biochemistry, immunology, and biostatistics.

Dedicated Period

During the dedicated study period, typically lasting 5-8 weeks, your sole focus is Step 1 preparation.

In the first two weeks, complete video-heavy resources that you have started in the pre-dedicated period and thoroughly review each topic.

Gradually increase the number of daily questions from 40, to 60, 80, and ultimately 100-120, mirroring the exam environment. Dedicate time for flashcard review and video resources.

Integrate weekly practice exams into your schedule, starting after the first week.

In your weekly practice exam day, simulate the test day conditions by taking back-to-back question banks, such as 1 self-assessment from UWorld and an NBME practice exam.

Pay attention to factors like your energy level, bathroom breaks, snacks, and staying alert, ensuring familiarity with the testing environment.

For more detailed guidance, watch the YouTube video below. Bonus! I’ll discuss one resource that can help you manage your Step 1 study schedule more efficiently.


Let’s answer some frequently asked questions about how to study for Step 1:

How Many Hours A Day Should I Study For Step 1?

It’s recommended that med students aim for 6 to 8 hours of intensive study per day during the dedicated study phase, typically lasting 4 to 6 weeks. Some may study up to 12 hours a day during this period.

However, individual study needs vary based on factors like baseline knowledge, learning style, and external commitments. Prioritize balance and well-being while preparing.

How many weeks should you really be preparing for the Step 1 exam? Learn about it in this YouTube video.

What Is The Passing Rate For USMLE Step 1?

The passing standard for USMLE Step 1 is set at 196 on the three-digit score scale. But note that the passing rate for USMLE Step 1, effective from exams taken on or after January 26, 2022, is reported as pass/fail only.

Step 1 results will no longer be reported in terms of a three-digit score. This change aims to provide a clearer assessment outcome and aligns with the transition to a pass/fail scoring system.

How Likely Is It To Pass Step 1?

According to the USMLE Step 1 performance data in 2023, there’s a 90% passing rate for MD degree takers from US/Canadian schools.

While the majority of MD degree takers pass Step 1, individual outcomes may vary based on factors such as preparation, study habits, and test-taking strategies.

What Happens If I Fail Step 1?

Failing Step 1 can be disheartening, but it’s crucial to remember that it doesn’t define your future as a doctor. The good news is that you can retake the exam.

First and foremost, allow yourself to acknowledge and process your emotions. Reach out to trusted individuals, including academic advisors at your medical school, who can offer guidance and support throughout this process.

Take time to reflect on your performance and identify areas that may have contributed to not passing.

Consider seeking advice from classmates who performed well and adjust your study approach accordingly.

When preparing for the retake, create a new, personalized study plan that addresses your weaknesses and incorporates different resources if necessary. Make use of available resources such as prep courses, question banks, and study guides.

Most importantly, maintain a positive mindset and focus on the goal of becoming a doctor.

Many successful physicians have faced similar setbacks in their medical journey, and overcoming this challenge can make you a stronger and more resilient student.

Can I Retake Step 1?

Yes, technically, every student who failed can retake a Step exam up to four times, but only three times within a 12-month period. If you need to take the test a fourth time, there must be at least 12 months between your first attempt and six months since your most recent one.

Keep in mind that if once you pass Step 1, you generally cannot retake it unless required to comply with certain state board requirements previously approved by USMLE governance.

When retaking the exam, focus on improvement and view each attempt as an opportunity to refine your skills and knowledge.

Hope you enjoyed this post on how to study for Step 1. If you have any more questions, comment down below or email me at [email protected]

Whenever you’re ready, there are 4 ways I can help you:

1. The Med School Handbook:  Join thousands of other students who have taken advantage of the hundreds of FREE tips & strategies I wish I were given on the first day of medical school to crush it with less stress. 

2. The Med School BlueprintJoin the hundreds of students who have used our A-Z blueprint and playbook for EVERY phase of the medical journey so you can start to see grades like these. 

3. Med Ignite Study ProgramGet personalized help to create the perfect study system for yourself so you can see better grades ASAP on your medical journey & see results like these. 

4. Learn the one study strategy that saved my grades in medical school here (viewed by more than a million students like you). 

If you found this helpful, then you can also check out the following posts!

Thanks for reading!

Until next time my friends…

3 thoughts on “How To Study For Step 1 [Study Like A Top Med Student]”

  1. Thanks for sharing the tips to hit STEP1. Some of them are really helpful and enlightening.

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