Studying for the USMLE Step 1 Exam

Studying for Step 1

The expectation to do well on the USMLE Step 1 exam is high. While you’ll likely do as much research as you can figuring out how to properly prepare, the best way to truly understand what taking it is like is by turning to a fellow classmate who has gone through the experience herself.

Ugo Udogwu, a fourth-year student applying into Orthopedic Surgery at the Icahn School of Medicine at Mount Sinai, remembers Step 1 well. She shares her studying process, as well as its ups and downs, with us.

How long did you wind up studying for Step 1?

It’s hard to say exactly how long I studied for Step 1. One of the sayings I recall reading or hearing about from upperclassmen is that “it’s a marathon, not a sprint.” My school’s curriculum is set up such that our first year is mostly dedicated to learning “how everything works,” while the second year is dedicated to pathophysiology. We start off second year with one of our most intense classes, so I dedicated most of my energy early on to learning that subject well. By the time October came around, I realized I needed to figure out a plan to prepare for Step 1. I spent the rest of the year (until December) preparing for a more intense, dedicated study period (January-May). If you count from October, I’d say I studied for nine months, with different intensities in different periods

What was the trickiest part about studying for the exam?

Step 1 is the most content-heavy exam of the three-part USMLE. It was tricky to develop a strategy to get through the content, and tricky to stick to said strategy. It’s also tricky to study for the exam while keeping up with your regular classes.

Was there anything easy about it?

I’ll preface this by saying that there’s nothing particularly easy about studying for this exam. The entire process sucks (for lack of a better word). However, it was nice to be able to dedicate my full attention to Step 1 during “dedicated time”—no classes to attend, no small group discussions to prepare for, no labs to complete. I woke up every day knowing exactly how I would divvy up my time during the day, and that proved to be a (small) relief.

What was the best advice you got about studying for Step 1?

You have to develop a plan and stick to it—trust your process. Sure, you can tweak things here and there (daily, weekly), but people get into trouble when they abandon their plan because of fear or anxiety about just not “getting it” or not getting through all the material. There will be times when anxiety gets the best of you, but taking a step back (and a deep breath!) and knowing you’ll be able to get to it all (or to adjust accordingly) will allow you to get back into your plan.

Plus: Questions, questions, questions—do lots of questions! And you do need to have some fun during this period, too—wellness is key!

What was the worst?

There’s a sentiment that if you start studying for Step 1 too early you’re a “gunner” but, at the same time, if you start studying too late you’re a “slacker.” Personally, I don’t think there is anything wrong with studying for the exam once second year starts, as long as you can successfully incorporate your studying into your classes (to an extent). However, as mentioned before, the intensity with which you study should be built up over time. Maybe, in the beginning, you’re just getting used to your resources, and then halfway in you pick up the intensity by adding more questions or flashcards. By the time you get to your dedicated study period, you can kick it up several notches and finish out strong. You want to avoid burnout (which is why you shouldn’t start off as intensely) and pace yourself the whole time.

Now that you've checked out AMBOSS’ Step 1 package, which of its features do you wish you had had access to back then?

All of it (haha). I mainly used UWorld to study and one of its downfalls, for me, is the lack of content within the software. There were many times that I’d get a question wrong and the explanation for it was not detailed enough for me to grasp a good understanding. So then I’d have to take time to find a better explanation in an external resource. The way AMBOSS incorporates Learning Cards into each question is an invaluable tool that was extremely helpful for me when studying for my Shelf exams and Step 2.

Ready to try a better resource for the USMLE Step 1?