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How to Study for Step 1 USMLE (Second of Two Posts)

Medical student researching material on the internet

Editors’ Note: This is the second of two blog posts that provide guidance on preparing for and developing a study plan for Step 1—an intensive exam that second-year students take on their road to becoming physicans. In part 1, we looked at preparing for Step 1 from the time you start medical school. Here we explore in greater detail five effective ways to study for Step 1.

by Kristina Petersen, Ph.D.

Your heart rate increases. Your palms are sweaty. You’re trying not to get overwhelmed, but you can’t stop thinking about the eight-hour cumulative exam that will cover information from your first two years of medical school. You stare blankly at a desk full of books and other resources you could potentially use to study for Step 1. Where do you start?

The good news is there is no one “right” way to study for Step 1, and wherever you choose to start is better than remaining in a state of anxiety or paralysis about the sheer volume of material you must master for the exam. Remember that you can’t approach Step 1 studying from a perfectionist perspective. The process of going through two years of dense material is going to be messy.  Half the battle is continually identifying your weak areas and working to improve those areas, without being too self-critical in the process.

Since each student has different strengths, weaknesses and learning-style preferences, it is important for you to tailor any study plan to best accommodate you. Below I provide five steps that should apply to every student, as well as many suggestions for you to peruse and determine what works best for you.

  1. Choose your resources wisely; make sure to include practice questions. Using too many resources will spread you too thin, and your time is limited. Most students seem to agree that you must use one central Step 1 review book, a few cross-reference books for topics specific to your weak areas, and a Q-bank. Other resources you may wish to add to your study plan include: videos, additional Q-banks, patient cases, online practice-question resources, flashcards, study partners and groups. Working through practice questions is absolutely essential to succeeding on Step 1. When students fail Step 1, it often can be traced back to the students not realizing the importance of completing practice questions.
  2. Determine how you learn best and capitalize on your strengths.  Over the first two years of medical school, you have collected evidence of how you study best. Do you have a preference in learning material visually, aurally, by reading/writing or through examples (kinesthetic)? Be sure to incorporate tools that help you learn best. For example, students who prefer learning visually may wish to use flashcards or draw diagrams to summarize pathways, cascades and how related concepts connect. Aural learners may wish to incorporate more online videos, lectures and study-partner meetings. Reading/writing learners may prefer to read material in books, write concepts down in words and do practice questions. Kinesthetic learners may want to incorporate patient cases to help them apply the knowledge to real-world situations. Many students are multimodal, and may choose to use a variety of these suggestions.
  3. Structure your time wisely, giving priority to your coursework. If you are still taking courses, remember to focus on your coursework first. You can parallel a first pass through material with your course (see part 1 of this post), but should not get so focused on Step 1 studying that you end up failing an exam. You don’t want to waste valuable time studying for a make-up exam! Once you enter your dedicated study period, creating and following a Step 1 study schedule are essential. Time should be allotted for weak areas first, and balance activities must be scheduled to keep you grounded. If you tend to have a hard time following a schedule, you may want to add meetings with study partners to help keep you on track. If you know you have to meet someone to go through metabolism in two days, you will be more likely to work through the material in time for the meeting.
  4. Do lots of practice questions and track your incorrect answers. Most Step 1 questions require a lot of reading; you are expected to extract key information and understand concepts well enough to apply them to a question. This takes practice, so you will need to get used to reading, extracting information and applying it to the question asked. I recommend tracking the concepts you got incorrect. This can be done within the Q-bank, but I also suggest keeping a document with a list of topics, concepts and details that you have gotten incorrect. This becomes your unique (and valuable!) list of weak areas to tackle during scheduled review time.
  5. Review, review, review! Tackle your weak areas during review time. By identifying them now and tackling them, you may avoid moments of regret when you take the exam. (Inner monologue: “I knew I wasn’t good at this topic; I wish I had spent more time studying it!”) Many students like to use flashcards online or on their phones, or old-school index cards, to review key information. Reviewing a particular topic may include setting a Q-bank to “tutor mode” and focusing on that topic alone, cross-referencing review material, and reading patient cases. In addition to individual review, meeting regularly with study groups can help you turn weak areas into strengths.

As you study for Step 1, do your best to remember why you are investing so much time, energy and brainpower in this exam. Don’t forget your overall goal: to become a physician. This is the first step toward achieving that goal.

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