1. USMLE Step 1 Support Session
August 31, 2017

2. Updated Practice and Informational Materials for the Step 1 Examination Available Announcement posted to USMLE website February 21, 2017
Updated practice and informational materials for the Step 1 examination have been posted to the USMLE website. Examinees planning to take a Step 1 examination should read the following materials and practice with the updated sample items: Tutorial and Practice Test Items for Multiple-Choice Question USMLE Step 1 Sample Items Booklet (PDF) USMLE Step 1 Content Description and General Information Booklet (PDF) View this announcement on the USMLE website. Please share this information with students, faculty and appropriate staff at your school.

3. Test Accommodations
Test accommodations include but are not limited to the following:
Assistance with keyboard tasks 
Audio rendition 
Extended testing time 
Additional break time 
Enlarged text and graphics 
Permission for assistive devices 
Detailed information about test accommodations while taking a USMLE examination is available at the USMLE website.

4. Self-Assessment Services
The NBME provides a variety of web-based self- assessments to US and international medical students and graduates through the NBME Self- Assessment Services interactive site.
Comprehensive self-assessments allow you to evaluate your readiness to take USMLE® Step 1, Step 2 Clinical Knowledge (CK) and Step 3. 
Target your studies using diagnostic feedback highlighting areas of strength and weakness. 
Use your self-assessment score to estimate your approximate score on the USMLE score scale.

5. The average Step 1 scores for the last several years:
HMS
National
2012
239
227
2013
228
2014
243
229
2015
2016
                               
(This is interim data thru September 2016.)

6. Faculty subject reviews from 2015
Biochemistry Review USMLE Step1  with Randy King 2/19/15
NBME Step 1 Neurology Review  with Dr. Chang 2/26/15
NBME Step 1 Microbiology Review  with Dr. McAdam 3/2/15
Immunology Review USMLE Step1 with Andy Lichtman 2/17/15

7. General Study Tips Make a schedule and try to stick to it.
Try not to schedule any big events during your study time.
Take frequent breaks
Be sure to exercise
While studying, getting a good night¹s sleep is important to feeling refreshed and ready to study
The Week Before
Focus on the Qbank
Try to wake up around the time you would on test day, to prevent feeling drowsy during the test. 
Take a trip to the center to see how long it takes you to get there. 
The day before ­ do things that are relaxing Š watch a movie, go shopping, go for a run, etc. 
Try not to take any sleeping pills as this might affect you the next morning. 
Have your meals and snacks planned out.   
The day of the exam- breath, relax, think about a nice breakfast and then a healthy lunch. Know you are well prepared.

8. STUDENT PANELISTS Panel Aditya Ashok Enrico Ferro Gillian Horwitz
Tracy Makuvire
Eugene Vaios
Winona Wu
Travis Ian Zack
Support from Afar 
Severine Cao
Sean Fletcher
Diego Lopez
Christine Santiago
Laurie Schleimer

9. Enrico Ferro Step 1 Study Resources: Uworld Qbank Picmonic
First Aid for Step 1
Pathoma (with videos)\
Three full-length practice NBME’s
Kaplan videos specifically for biochemistry, embryology, some pharmacology topics (like the
mechanism of different anesthetics or anti epileptics etc.) and some anatomy (like the
lumbar/brachial plexus).
Selected textbooks from pre-clinical years (reviewed as needed for selected topics, however
this may not be as useful if you did not already use and become familiar with these
books during pre clinical years):
*** Lippincott Illustrated Reviews – Pharmacology
*** Clinical Microbiology Made Ridiculously Simple
Blumenfeld’s Neuroanatomy Through Clinical Cases
Licthman’s Basic Immunology
Schwartzstein’s_Respiratory Physiology
Lilly’s Pathophysiology of Heart Disease

10. Study Schedule
Enrico Ferro
I took the total number of questions on Uworld ( questions) and divided it by the number of study days, making sure to leave at least 1 week aside to review all the flagged Uworld questions, and 2-3 additional days to take the full length practice tests as described above.
Next, I divided the questions by topic (i.e. psychiatry, surgery, peds etc) and worked through one topic at a time. Every time I encountered a question dealing with a topic I did not feel comfortable with, I reviewed it thoroughly using all the resources listed above.
For step 1 only, I read through First Aid and Pathoma (with videos) before starting a given block on Uworld.

11. Enrico Ferro Overall Study Tips:
Identify as few study resources as possible, and try to go through them multiple times.
If possible, prioritize resources that you have already used during pre-clinical years or during the PCE.
Avoid skimming just once through a vast amount of resources, or relying heavily on brand-new resources that you have not used before.
Organize the test blocks on Uworld by specific topics (i.e. all biochem questions together forstep 1, all surgery questions together for step 2 etc), do not create mixed tests (i.e. mix ofsurgery and neurology) to “simulate the actual test”.
The NBME practice exams are the best way to simulate the actual test.
The advantage of doing Uworld tests by specific topic is that you will be able to identify recurrent themes and patterns within a given topic, which will guide your studying andreview process:
As you do your first pass through Uworld, flag questions that you got wrong, but also questions that you got right only because you became “habituated” to a topic point above): you want to review these very common topics as the test approaches, because they are most likely to show up on test day!
Make a short document of random factoids that you have trouble remembering
Use mnemonics/picmonics, especially for topics where you feel the weakest:
Especially for step 1, find a way to review and retain information as the weeks/months progress. Some people use Anki, others Firecrakers etc. For example, I made a list of biochem, microbio, pharmacology Uworld questions that I found particularly challenging or important,and every day I would set aside minutes to do 5-10 of those questions.

12. Aditya Ashok
Firecracker
Anki study decks
First Aid
Practice tests.

13. STUDY SCHEDULE
Eugene Vaios

14. Gillian Horwitz Wednesday 3/29 Thursday 3/30 Friday 3/31 Saturday 4/1
Wednesday 3/29
Thursday 3/30
Friday 3/31
Saturday 4/1
Sunday 4/2 AM
Uworld 40Q Block
OFF
11 AM - 1:30 PM
Pharamcology
Immunology
Biochemistry
1:30 - 2:30 PM
Pharmacology Flashcards
Biochemistry Flashcards
2:30 - 5:30 PM
8 - 9:30 PM
Pathoma/Memorize
Inflammation, Inflammatory Disorders, and Healing 131 min
Monday 4/3 - CL
Tuesday 4/4 - CL
Wednesday 4/5 - HS
Thursday 4/6
Friday 4/7
Saturday 4/8 - HS
Sunday 4/9
Uworld Self-Assessment 1
OFF - WORK ON PAPER
Pathology
Microbiology
Cardiovascular
Microbiology Flashcards
YOGA
Growth Adaptations, Cellular Injury, Cell Death 91 min
Monday 4/10
Tuesday 4/11
Wednesday 4/12
Thursday 4/13
Friday 4/14
Saturday 4/15
Sunday 4/16
NBME Exam 1 (Form 13)
Respiratory
Neurology

15. Gillian Horwitz 8 - 9:30 PM Pathoma/Memorize Cardiac 55 min
Vascular 41 min
Respiratory 80 min
CNS 56 min
Monday 4/17
Tuesday 4/18
Wednesday 4/19
Thursday 4/20
Friday 4/21
Saturday 4/22
Sunday 4/23 AM
Uworld 40Q Block
NBME Exam 2 (Form 15)
11 AM - 1:30 PM
Heme/Onc
Endocrine
MSK/Skin/CT
Biochemistry Flashcards
1:30 - 2:30 PM
Pharmacology Flashcards
Microbiology Flashcards
2:30 - 5:30 PM
Uworld 20Q Block
Neoplasia 81 min
Hemostasis 65 min
WBC 69 min
RBC 96 min
Endo 54 min
MSK 45 min
Monday 4/24
Tuesday 4/25
Wednesday 4/26
Thursday 4/27
Friday 4/28
Saturday 4/29
Sunday 4/30
NBME Exam 3 (Form 16)
Renal
Reproductive
Gastrointestinal
Skin 28 min
Kidney/GU 56 min
Female repro 96 min
Male repro 24 mi, Breast 35 min
Monday 5/1
Tuesday 5/2
Wednesday 5/3
Thursday 5/4
Friday 5/5
Saturday 5/6
Sunday 5/7
Review Wrong Uworld
Review High Yield Topics
Behavioral Science/Psychiatry
Flashcards
Uworld 22Q Block
GI 92 min
Panc/Liver/GB 38 min
Monday 5/8
TEST
DAY
!!!!

16. Tracy Makuvire
USMLE Practice Exams

17. Tracy Makuvire
USMLE Practice Exams
2 UWORLD USMLE Tests – included with UWORLD 8 week subscription
6 available NBME Practice Exams - $60 per exam
How did I use practice exams?
Week 1: Baseline exam – 1 NBME exam, 200 Qs, 4 hours, timed
Week 3: 2nd NBME, 200 Qs , 4 hours, timed
Week 5: USMLE World Practice Test, 200 Qs, 4 hours, timed
Week 6: 3rd NBME + UWorld Q’s, 280Qs, timed

18. Tracy Makuvire
** 5 days before exam– 2nd USMLE Exam, 200 Qs, 4 hours timed – Skipped this exam
Reflections:
ALWAYS review practice questions, correct + incorrect
Would skip week 3 NBME exam, post-pone to week 4 after I had finished study material
Use both USMLE exams, included with subscription, answers provided
NBME exams best predictors of score. Use the most recent form right before exam
Give your brain some rest before actual exam. Would not do a full practice exam within 5 days of test.

19. Winona Wu
MAINTAINING ACCOUNTABILITY TO YOURSELF!

20. General Advice Eugene Vaios
It’s only a test – what matters is who YOU are as a person, not an exam score.
Don’t study for the score. Study for your patients and to master the material so you can be a great physician. Understanding the greater purpose behind your test prep will sustain you through your studies.
Try doing an NBME on the first day of your studies as a diagnostic – it will help you appreciate how much you’ve learned by the end of the study process!
Be flexible with your study program – take plenty of breaks when you need them.
Stamina is a major part of the exam. Use the UWorld and NBME exams as a tool to simulate the test taking speed and the length of the real exam.
Approach the question bank and practice exams as a study tool, not as an evaluation of how you will perform on the actual exam.
If possible, do the UWorld question bank 2x. Go through your 1st pass untimed and read all question answer keys as you go along (correct and incorrect questions). Your 2nd pass, try to do timed 40-question blocks. If possible, try to simulate a test day (ie. 7 blocks). Read the answer keys of only the questions you got incorrect or were unsure on.
*UWorld will reset your account if you previously purchased, but did not reset, your Step2 Qbank during PCE.
During your 1st pass in the question bank, focus the questions on content areas (ie. Nervous system). Your morning “didactic prep” should mirror the question bank subject (ie. Cover the nervous system lectures in pathoma and first aid, and review the drugs related to the nervous system on sketchy pharm).
Sketchy pharm is not as easy to learn as Sketchy micro. However, once you learn the images, the return on your investment is enormous.
Pick your study resources and stick to them. There are many tools for Step 1 prep, but it is better to select a small number and master them in depth. Do not lose faith in your study program, even if other classmates are using different resources.

21. Travis Ian Zack
MANAGING DOUBTS AND WORRIES!

23. Most of the hard work is already behind you
Congratulations!
Travis Ian Zack
Most of the hard work is already behind you
The vast majority of things you need to know for Step 1, you have already learned, before you have even started your dedicated time
You have already had multiple simulated practice tests that are much harder and more detailed than Step 1 will be (your shelfs)
You are already starting at such a great advantage

24. Support from afar

25. Diego Lopez Information on the Boards & Beyond resource!
They are extremely well-made high-yield lectures about almost every topic covered in Step 1.
Given that I was 1+ years away from preclinical courses, these lectures were extremely helpful in reviewing/re-learning a lot of foundational topics (it saved my life with Biochem!).
Relatively cheap compared to other resources.

26. Christine Santiago

27. Christine
Santiago

28. Christine Santiago
Attached are two schedules, a more detailed one with daily topics and another with general schedules for planning the day. For the first month I spent half the day reading first aid/ watching pathoma for the subject topic. For the second half of the day I did q bank questions, I tried to do 60 questions a day. I typically spent 2 days per topic, the first day was more pathology, physiology and the second day I focused on pharmacology (a weakness of mine). 
After I saw all the material once, I took an NBME to see strengths and weaknesses (NBME 16). The second month, I focused on weaknesses and q bank questions. I used my NBMEs and UWORLD to locate my weaknesses and hit those topics the hardest. My NBMEs were showing improvement however the last one I took 10 days before my actual exam, dropped which threw me off and I considered postponing. After consulting with Rich and some advisers I decided to take Step 1 anyway since I had an uptrend in the prior NBMEs, my UWORLD percent was increasing and lastly because the field I wanted to go into (internal medicine) does not require extremely competitive Step 1 scores. 
Resources:
1) Pathoma- went through once completely 
2) Sketchy micro- went through once completely
3) UWORLD- went through once
4) NBMEs- timed- good practice for the actual exam. These under predicted my actual score, the questions are easier than UWORLD and the actual exam but if you're not in the top percentile I believe they under-predict your score (from my friends scoring in the upper 240s and 250s their NBME scores were very close to their actual scores). 
5) Calculator for your STEP 1 score based on UWORLD percentage and NBME averages (gives a predictor if you are concerned about what you'll actually get, my score was within the standard deviation they predicted).
6) Dirty USMLE- Fun videos for when you're too tired to read or do any more questions.

29. Christine Santiago General advice:
Figure out your Step 1 goal. What is a competitive score for the field you want to enter into? (Step 1 goals for a vascular surgery program vs internal med/ psychiatry are quite different). 
Try not to get discouraged if you are not scoring where you would like (easier said than done!)
Consider doing Prometric Test Drive, this allows you to go to the testing center, check in with retinal scans/ finger print and get a feel for the testing center. It helped reduce exam day jitters for me.
Take breaks and maintain balance, I tried to take a half day off per week, Rich would probably recommend more. In any event I did end up burning out during the last two weeks because I stopped taking weekly breaks. 
Sleep: unfortunately I had some difficulty sleeping as I arrived closer to exam day and I think exam anxiety affects people in different ways. As Brigham says, "never worry alone"! Reach out to Regina and others if this is becoming an issue for you.
Lastly, be careful where you stay before Step 1! I decided to study in Berkeley, California with my significant other. The night before the exam we booked an airbnb close to the testing center to reduce the commute. I woke up in the middle of the night itchy with bites all over and ended up finding a bed bug! We had to pack up everything, find a hotel close by, it was a complete disaster. Moral of the story be careful where you're staying before exam day and second remember even if you prepare completely there are things that are outside of your control! 
"There are three elements to success: hard work, natural talent and luck. Unfortunately, we can only improve the first." 
Good luck! Feel free to contact me if there is anything I can help with!

30. Laurie Schleimer Schedule: no pre-made review calendar
My #1 piece of advice is that the best study strategy is the same strategy you've been using for exams all along - I've never used study schedules/calendars before and I didn't use one for step. I just studied as many hours per day as my brain would work with these goals in mind:
1) make it through all of Pathoma watching 1-3 videos per day, then test myself on the videos I just watched using a pre-made Anki deck I got from a friend
2) make it through all of UWorld, initially by taking subject-specific tests on what I had just studied and later just by treating it as a textbook (i.e. take a test, and learn as I go)
3) make it through most of sketchy micro watching a section of videos together at a time (e.g. all GNR one day, all RNA+ viruses another day)
4) make it through at least the autonomic drugs sections of sketchy pharm
5) review sections of first aid as they pop up on UWorld, and towards the end of the month go through and fill any glaring gaps in knowledge
You should alternate between the different resources to mix things up and keep your brain engaged during the day, and most importantly make time for exercise to reduce stress and keep your brain going.
Location: NOT BOSTON
I went home to stay with my parents  and this was the BEST IDEA EVER - Avoided the stress of being surrounded by classmates while having someone to make sure that you eat proper meals, take breaks and--most importantly--exercise. I took the test in Boston.

31. Laurie Schleimer
Time: 5 weeks dedicated time, no prior review besides shelf studying. Halfway through I contemplated changing my test day by 3 days to give myself more time, but the final 3-4 days are the least productive because you just burn out on learning new information. Only change your test day if you're trying to buy yourself weeks not days. My days usually looked like this: 1-3 hours anki cards or Qbank 2-3 hours of video 5-8 hours of Qbank+reading - I could never sit down and just read FirstAid, so my reading was always directed by doing questions. I would put Uworld in tutor mode and do a single question, and if I got it wrong read on that topic and related topics. Then when I'd burn out on reading about that topic I would go back to another question, and so on. This means at the beginning it could take 6 hours to get though 40 questions and by the end I would speed through it in like 2-3.

32. Severine Cao For resources I primarily used: I supplemented with:
- First Aid
- UWorld
- NBME Practice Exams 
- Anki 
I supplemented with: 
- Pathoma
- Sketchy Micro 
- Notes from pre-clinical years 

33. Severine Cao 8:00AM-12:00PM 3:00PM-6:30PM AM Week 1 Day 1 Monday 3-Apr
Week 1
Day 1
Monday
3-Apr
Microbiology
65/Anki
Day 2
Tuesday
4-Apr
Day 3
Wednesday
5-Apr
Day 4
Thursday
6-Apr
Biochemistry
Day 5
Friday
7-Apr
Day 6
Saturday
8-Apr
UWorld Practice Exam- 1
Day 7
Sunday
9-Apr
Catch-up
Week 2
Day 8
10-Apr
Biochemistry/Immunology
Day 9
11-Apr
Immunology
Day 10
12-Apr
Pharmacology
Day 11
13-Apr
Pharmacology/Pathology
Day 12
14-Apr
Pathology
Day 13
15-Apr
NBME Practice Exam- 1
Day 14
16-Apr
Week 3
Day 15
17-Apr
Anatomy
Day 16
18-Apr
Embryology
Day 17
19-Apr
Embryology/Cards
Day 18
20-Apr
Cards
Day 19
21-Apr
Cards/Endo
Day 20
22-Apr
Public Health Sciences/Endo
Day 21
23-Apr
NBME Practice Exam- 2
Week 4
Day 22
24-Apr GI
Day 23
25-Apr
Day 24
26-Apr
Heme/Onc
Day 25
27-Apr
Day 26
28-Apr
MSK
Day 27
29-Apr
Day 28
30-Apr
NBME Practice Exam- 3
Severine Cao

34. Severine Cao Week 5 Day 29 Monday 1-May Neuro 65/Anki Day 30 Tuesday
Wednesday
3-May
Psych
Day 32
Thursday
4-May
Renal
Day 33
Friday
5-May
Day 34
Saturday
6-May
NBME Practice Exam- 4
Day 35
Sunday
7-May
Catch-up
Week 6
Day 36
8-May
Repro
Day 37
9-May
Day 38
10-May
Resp
Day 39
11-May
Day 40
12-May
Personal event
Day 41
13-May
Day 42
14-May
Review
Week 7
Day 43
15-May
NBME Practice Exam- 5
Day 44
16-May
Day 45
17-May
Day 46
18-May
Day 47
19-May
Day 48
20-May
Day 49
21-May
Try to relax
Day 50
22-May
Test day!

35. Severine Cao Question banks UWorld Step 1 Qbank 2500 Q's
NBME Practice Tests x6
Each 200 questions in 4 sets of 50
Pathoma total hours at 1.4x
Sketchy micro total 12 hours
Real exam
40x7=280 questions

36. Sean Fletcher Resources: First Aid Step 1 (2017)
UWorld QBank (Including the two Self-Assessment Practice Exams)
Pathoma book and videos
SketchyMicro
NBME Practice Exams (All 6 that were available online at the time) 

37. Sean
Fletcher

38. Sean
Fletcher

39. Sean
Fletcher

40. Sean Fletcher General thoughts
1.) I almost always did Mixed UWorld blocks -- generally 80 questions a day, never more than that but sometimes fewer. Some people preferred doing system based, but I liked Mixed to have a random mix of topics to simulate the actual exam. I did not want to get questions right based on knowing what block I was doing (For example, I found that it was easier to eliminate non-cardio answers when I knew I was doing a Cardio block). I did one pass through all of UWorld and then re-did my Incorrects afterwards. I did not feel like I would have benefitted from doing another Qbank; UWorld is great. 
2.) I did a total of 8 practice exams -- 6 NBME and 2 UWorld Self-Assessments. I would recommend doing as many exams as possible -- definitely all the NBME ones if you can, because you may (read: will) see at least a couple of questions that are very similar on the real test. 
3.) I did not stick to my schedule 100%. I tweaked things here and there as I found necessary based on my strengths and weaknesses. I would leave a bit of time each day or week for "catch-up" -- going through some First Aid or Pathoma chapters took longer than anticipated. I would recommend making some sort of schedule and trying to stick to it the best you can, but you will likely find that you need to deviate and tweak things as you go along, which is totally fine.
4.) I took a few hours each day to relax (an hour for lunch, 3 hours for gym and dinner, generally stopped working around 11pm and relaxed afterwards), and usually took most of Sunday evening off. If you have a fun event on a weekend or something, do it! Make sure to remember that you're still a person outside of all the studying. Find something that de-stresses you and take some time for yourself -- I watched Netflix almost every day. 

41. Sean
Fletcher
5.) Try to prioritize the QBank each day. It's better to be behind on reading than behind on questions. 
6.) I did one pass through all of Pathoma and the videos as well as one full pass through First Aid. In the last couple of weeks I did another pass over the things I felt the weakest on in FA / Pathoma.
7.) Don't overwhelm yourself with resources. I had a few books (First Aid Organ Systems, First Aid General Principles) and Flashcards (Microcards) that I never even touched, but in the end I didn't feel that I needed them. Try to pick a few you like the best and stick with them. It may take a little while at the beginning to get into a rhythm of studying, but it will happen. Find a study buddy if that helps you, and by all means stay away from people who stress you out!
8.) Remember that there is truly an infinite amount of information. The test is unlike many others in that you will never feel like you have totally mastered everything despite putting in tons of hours over your study period. That's normal for everyone who takes this test, though. Just try to learn as much as you can in the time you have. I felt that being on the wards and having taken the shelf exams was a huge help for some of the clinical knowledge the exam requires, so use that experience and knowledge as confidence when you are feeling doubtful!

42. Extra Materials

43. Enrico Ferro
Lastly, if schedule allows, consider taking the tests back to back:
The two tests share many similarities, especially with regard to the vast amount of core
knowledge that you need to master for both of them. Whichever test you take first, you will spend a lot of time solidifying the knowledge base so that you can immediately recognize the disease process described in the question stem/vignette. Many questions in both exams will ask you to diagnose the condition at hand; of course, step 1 will have many more questions on the basic science of certain diseases, while step 2 will emphasize clinical management. By taking the tests back to back, however, you will have the added benefit of retaining and solidifying the core knowledge, without having to forget and re-learn all the details. For example, think about congenital immunodeficiencies or lysosomal storage diseases – which are not just part of step 1, and may in fact show up on the pediatrics section of step 2.
Here is another example: