How to Prepare for the USMLE Step 1 Before Your Dedicated Study Period

As you start medical school, you are faced with juggling coursework, early clinical exposure, independent shadowing and any clinical or basic science research that you are doing to set yourself up for success. Finding the time to prepare for standardized exams while learning massive amounts of material for the first time, on top of finding your footing in the clinic and the lab, can be a daunting task. For those not in the know yet, this is exactly the task you are faced with before your “dedicated study,” a period of no classwork towards the end of the preclinical curriculum where your school expects you to focus solely on USMLE prep, and at the end of which you take the all-important USMLE Step 1.

This isn’t to say that Step 1 prep should be your primary focus during the first few months or even the first year of medical school (depending on your school’s specific schedule). However, spending even an hour or two a week getting used to Step 1 style questions and reviewing high yield materials as you go through the preclinical curriculum can make you much better prepared to tackle the dedicated study period. Below, I detail the strategies I used during my pre-dedicated study period to help set me up for success on Step 1.

Resources to Use Early On

As you’re starting, you’ll hear a variety of study plans that worked for more senior students, or students in your year who are too keen on starting their test prep early especially if they are aiming for more score-conscious residency programs. It’s important to remember that it is still early, and that what seems to work for others may be different from what works for you. It is a marathon, not a race. Here are my suggestions in terms of materials that are beneficial as you go through the preclinical curriculum:

First Aid: It does not serve anyone well to delay their acquaintance with most students’ main reference for the USMLE. However, keep in mind that this is more of a study guide than a textbook: it will help you know what to study and recall what you’ve already understood and memorized, but may assume that you know some of the connecting detail. Therefore, use it to get an idea of what to focus on from your potentially “drinking from a fire hose” first med school year experience. If a bug, drug, or physiology or anatomy concept is in First Aid (or even has a whole paragraph, or, wait for it, a whole page!) dedicated to it in this all-important book, then make sure to understand it well and commit it to long-term memory. You will not have as much time to meditate over complex concepts or practice long-term recall during the last few weeks of USMLE prep, so take this as a golden opportunity to get a head start. Encountering a new/unfamiliar concept right before the exam is understandable stress-provoking (although it is alright to encounter a few of those), and thus minimizing such instances is good for your sanity as well as your score.

Electronic Flashcards: These are good for filling gaps in your schedule with beneficial long-term recall. Say you’re taking a flight home, waiting in line or attending a mandatory event that you are not particularly interested in, well-designed flashcards can help you make use of that time. At the very least, this will help you keep track of your weak spots and review the material later. I was personally not a fan of making my own, especially considering the amount of quality flashcards available online independently or as part of integrated platforms, but some of my friends found the process an effective stress reliever. To each their own. Another benefit of flashcards is that they allow you to combine medical school coursework content with high-yield test content, and better services may allow you to review specific test areas, say for an upcoming exam or an area in which you may be weaker.

Videos: From my previous test prep experiences (e.g. SAT, MCAT, GRE) I knew that I would not have the patience or cortisol levels to watch videos during independent study. While I ended up rewatching SketchyMicro (and indeed the “passive study” breaks were sometimes welcome in my overly ambitious study plan), I benefitted much more from recalling these videos and going back to rewatch specific sections during dedicated study. Furthermore, watching a Sketchy video early in the year, and then recalling it every time you face a question about its subject is much more effective, in my opinion, than watching the video five times.

Practice USMLE-Style Questions

It seems like this is a topic of controversy among the medical student community. While some think that early exposure is a sign of a mature testing persona, others like to “save the good questions” until dedicated study. I can only speak for myself, and I will say that it can never hurt to do more questions, and there are enough good test banks to go around that you will never run out of new questions. Furthermore, good test banks like UWorld have enough variety of unique questions that I was able to go through it multiple times while still having to think through the questions. Of note: as counterintuitive as it may sound, your score does not matter on these practice question banks (they generally had little correlation with my actual score). What matters is to read the explanations carefully and mark what you’ve missed and understand why you missed it.

A Final Word

Medical school is a competitive environment, and at times it may feel that everyone else is better prepared, doing something different, or focusing on higher yield material than you. Don’t panic! As long as you’re doing something on a regular basis, and getting good feedback, you will be setting yourself up for success!