Studying for Step 1 is a lot like playing poker. It takes minutes to understand the basic rules and approach, but hundreds of hours of dedicated practice to improve your game. When it comes to Step 1, you are after mastery. If there were ever a time you wanted to know concepts and data inside and out, it is now. The test carries more weight than any college exams, more than the MCAT…in fact, your Step 1 score might be the most important exam result you receive.

Your USMLE Step 1 score follows you throughout your early career, so you want to do the job once and do it right.

So, how do you study USMLE Step 1? 

1. Do amazing in class. If class is lacking, bolster your own knowledge

2. Build a study calendar

3. Starting up: Do a once-through of First Aid

4. On day Zero, take an NBME

5. Day 1-30: The first Pass

6. Day 30-42. The second pass

7. The final countdown → Test Day
To fully explain how to study for Step 1 is a tremendous undertaking. While it pales in comparison to the actual amount of work that you will do in your study period, it is far too much to squeeze into a blog post. Therefore, we at MST have worked long and hard to deliver our ULTIMATE GUIDE on how to study for Step 1. This 7 part guide will take you from Day 1 of medical school all the way to Test Day, tell you exactly what you need to be doing, and when you need to be doing it. It should take away any worry, uncertainty, or indecision you have along the way. We will present you with the roadmap to get you to the finish line with a smile on your face and an excellent score on your score report.

Most importantly, remember, your job is to do the work. Merely understanding and appreciating the process is not enough. You will have to put in hours of preparation upfront, just to ensure you are ready to begin studying! It will be boring at times, and you will be forced to patiently wait until the time is the right to execute future steps. But our methods have worked for so many students in the past; there is no reason that they shouldn’t work for you…as long as you put the work and hours in. The efforts will be worth it; there are few more satisfying things than a hard earned, top-tier score that you can carry with you for the rest of your life.

Without further ado, enjoy our ultimate guide on how to study for Step 1.

Step 1: Do amazing in class. Bolster knowledge on your own, especially if class is lacking.

Step 1 mastery does not occur over the course of the 6 to 8 weeks leading up to the test. It starts on Day 1 of medical school. In building your basic science knowledge through classwork, what you are really doing is learning what you need to know in order to a) succeed as a doctor, and b) perform excellently on boards. Curriculums take different approaches in how much importance they place on each of these (i.e., “teaching to the test”). Your job is to absorb as much information and knowledge as you can from classwork, realizing that the first few months of school are not an “on-ramp” to the studying knowledge highway. Be ready to strongly come out of the gates from Day 1 of medical school with Step 1 completion as the light at the end of the classwork tunnel.This is not to say that you should start annotating First Aid on Day 1 of school. You should not do that. Merely strive to learn and internalize as much as possible.

The reality is that different medical schools fall on different points of the teaching spectrum, from glowing to abysmal. I’ve had students who have told me, “We never learned cardiac physiology because the intended lecturer took another job.” Some medical schools do students a complete disservice. It is unjust, but it is true. What can a student do when they are coming from a program that is under-preparing them for the task at hand? It is up to them, and all students, to be extremely proactive, and fill in any gaps in knowledge that professors leave them with. What guide can students use to figure out what they need to know? Is it First Aid or some other boards prep material? No. It is the almighty textbook.

In today’s world of instant-everything and study/life/brain hacks, heavy textbooks made out of paper and cardboard are falling out of favor. Their comprehensive and indubitably useful information is slipping through the cracks. Do yourself a huge favor, and pick up a copy of the seminal tome for whatever class you are in, and READ IT. Mark it up. Take notes on what you’ve read. Re-read it. Find the time, means, and desire to master your classwork so that when the time comes, you can master Step 1.

If your school does a solid job of teaching you all necessary concepts, it is still vital to exercise this proactivity and go the extra mile. Go above and beyond what it takes to merely pass your exams, and really strive to reach full understanding of your coursework.

All that being said, if your exams (and therefore, grades) are going to be based on lecture notes and slides, work these notes into your study plan, in addition to textbook studying. The best board scores in the world would do a poor job of covering up low grades in your classes, so getting good grades during your first two years is as important as a high Step 1 score.

The most important thing you can do at any point in medical school is to excel at what you are doing in the moment. On neurology clerkship, be excellent at providing care to neurology patients and familiarizing yourself with neurologic pathophysiology, diagnosis, workup, and treatment. During biochem lectures, internalize and commit yourself to understanding reactions and pathways. As long as you employ this strategy, and your school’s curriculum is on point, the only thing that stands between you and mastery is effort.