Why should I follow this schedule?

You have to realize almost everybody only gets one shot at this, so no one really has any other experiences to compare what they did to. However, I think my method is good because:

1) I got a great score (260) even though my memory I would classify as only average to above average among medical school students.

2) I was one of the few students in my class who significantly outperformed their performance in class with their Step 1 score (I wasn't slacking for class either). I think this reflects the effectiveness of my study schedule, both before and during the dedicated study period.

3) I went up from 220 pre-dedicated period to a final score of 260 using this method.

It's definitely not for everybody, and relies a lot on flashcards. If this is  not the right way for you, don't worry, there is no one right way, its the way that works best for you. If you are someone who can memorize things just by looking at it once, this is not the right method for you, as this would be way overkill. But if you are someone like me who doesn't remember everything the first time, but is ready to put in the work and your goal is to ace Step 1, then maybe this will help you maximize your potential. 

 I would like to point out that I think the score really does reflect the amount of work you put in, and it’s the total work put in over 2 years, not in the last 6 weeks before the test. If you don't need to get the highest score possible, you could do about 60% of the work that I describe and get about 80-90% of the score in my opinion. I say this because I don't think my score went up THAT much from the 3rd (out of 5 weeks) of dedicated studying. I estimate it went up about 10 points, so if that's not worth it to you, by all means do what works best for you.

Before dedicated period (M1 and M2)

Note this guide is geared towards those with an organ-system based curriculum. Adjust accordingly if your curriculum is different.

M1

Tl;dr

  1. Learn the material with Step 1 Simplified (SOS)/FA/Pathoma/school, apply the material with question banks (eg Amboss or Kaplan or Uworld). Figure out what you don't know, and hammer it in with spaced repetition (eg Anki).
  2. For microbiology use Sketchy Micro.


-Like I said, the work you put in even early on will still be useful for Step 1. Ideally, you would know your curriculum well, AND supplement with additional resources (If your curriculum is that bad, then just focus more time on the following).  

First, review the corresponding sections in my videos/notes, or in First Aid/Pathoma. The one thing I want to add is to not worry too much about memorizing and being able to list every symptom of a disease. The key is to be able to recognize symptom constellations, as usually they will describe the patient and their symptoms and then you need to be able to identify the disease. Occasionally you will need to know a specific symptom, and usually this will be pointed out to you or emphasized.

 After going through notes, use spaced repetition learning for that corresponding chapter/organ system. I recommend you use a premade deck (try Zanki, check out this site. There are many more decks on reddit, look at the right side bar.) This will help drill in the knowledge you need to know and help you identify what you missed from the lectures/notes. I recommend premade cards because even though making your own cards can be helpful, it is time consuming and not time efficient in my opinion. Reserve making your own cards for topics that you find difficult to remember.

Reinforce all the knowledge you have just crammed in by doing practice problems in the corresponding topic (practice problems are key for pattern recognition of certain phrases, key words, images. If you do enough practice problems, some of the answers on Step 1 you will just know through a certain intuition because you have seen so many similar problems before. They are also excellent tools to apply all the knowledge you have learned. After applying the knowledge, it will stick with you much longer. 

For question banks, if you made me choose, I would do Amboss during M1 and M2 and save Uworld for the dedicated period. In general, the best choices are Amboss, Kaplan, or Uworld. Uworld is the best question bank hands down, and has excellent explanations that teach you a lot. Many people do this during the first two years and it works for them, and then redid it right before Step 1. I personally did not and saved it for the weeks just before Step 1 because I felt like I recognize questions and don’t learn as well when redoing questions. Amboss I have not tried for Step 1, but have used for Step 2 and clinical year and it is great. They also have a really good knowledge section that helps explain things. Kaplan, I have heard good things about, but have read it can be a bit overly detailed. I personally would suggest trialing Amboss and Kaplan and seeing which one you like better, or just go for Amboss. I would recommend to really pay attention to the explanation and the details included when doing Uworld. I would say pay less attention to Kaplan's small details and just try to take in the key points. Don't stress yourself out when doing the other qbanks on figuring out what details are important and what aren't, just use the qbanks to apply knowledge you have learned in SOS/FA/pathoma and take away the big take away points. This is the knowledge that is high yield. 

Try additional resources and see what you like best. Some recommendations: 

  1. Osmosis videos on YouTube: I think they explain diseases excellently with excellent drawings. They have enough detail for your school curriculum, but too much detail for Step 1
  2. Sketchy micro for microbiology. Just use it.
  3. Goljan’s audio lectures (you’ll have to find a bootleg version somewhere, this may be a bit outdated). I think bringing in so many different resources to learn the same thing over and over again is useful because it helps you see the same topic from many angles, really helping you understand it completely. You may think you understand a topic from say reading SOS/First Aid, but you may really not, and these other resources like question banks or lectures will help you see it a different way.

M2

Tl;dr

  1. Continue following above for new topics you are learning
  2. Pass through all of Step 1 Simplified (SOS) notes/First Aid once before starting dedicated study period 
  3. Continue doing practice questions for corresponding section you are either learning or reviewing, reviewing weaknesses with Anki.

For second year, I think the two things you need to do before the dedicated study period are:

1)Continue following the tips above for the new organ system you are covering. 

2) Starting around/after winter break, squeeze in review of previous organ systems between learning new material. Doing a first pass through SOS or First Aid will allow you to be much more effective during the dedicated period because then you can just focus on reviewing and shoring up weaknesses and practicing questions, rather than having to spend time re-learning all the things you had long forgotten. You want to time it so that you review most of SOS or First Aid once over before dedicated period. 

I started most of this review right after winter break  and got through everything except biochem and microbiology by March. As usual, I recommend passing through the chapter's corresponding flashcards when you have finished the review. When you are in this review mode, I recommend only a brief pass through, just answering all the questions once or twice rather than doing spaced repetition for an extended period of time just simply due to time constraints. 

This is a lot to handle. How I did it was I would squeeze in FA review chapters right after school tests, when I had more free time, and then do a pass through for that chapters flash cards. 


Dedicated study period

Resources: 

Step 1 Simplified (SOS) and Uworld (buy the 2 self assessment combo) (supplement gaps with First Aid and Sketchy Micro)

OR 

Do Uworld, First Aid, and Pathoma, and Sketchy micro (UFAP)

When I was in dedicated period, I used UFAP, but there is a reason why I created SOS. I have added information that I would have liked to know for Step 1 and I think it is an improvement over the standard of First Aid and Pathoma.

So everyone uses UFAP, so you may ask what else is there to know? The secret I think is the way you use these resources. The three keys are: 1) Use your time efficiently, 2) Constantly test yourself, 3) Use anki to note down and shore up weaknesses. 

1) Using time efficiently - I think that it is very important to pack as many hours as you can into period of time that is not too long. Some people study for >6 weeks, which seems like overkill as you start forgetting things, spinning wheels on what you are learning and forgetting, and then getting burnt out. More effective would be to study like Goldilocks, not too long, not too short, just right. This will depend on you personally, for me and many others it seems to be 5 weeks. The second thing is to make sure you maximize these 5 weeks—be focused, efficient, and study your butt off. I was studying 12 to 14 hours a day. I do acknowledge I was probably on the very upper end of the spectrum of hours that people studied. I realize some people may not be able to focus that long, just study the max you can study with actual focus and learning ability. So first tip is to maximize just the right amount of time. 

2) Constantly be testing yourself. What I mean by testing yourself is to ask yourself to pull up all the information for whatever topic you come across in questions or in SOS review. For example, if you have a question asking to identify a patient with dyspnea, orthopnea, elevated JVD, peripheral edema, you want to not only identify that it is CHF, but also think through etiologies, how you would treat, and then KEEP testing yourself, for example test yourself on etiologies, like what is wet beriberi, or what else can Chagas cause, how do you treat Chagas etc. Doing this is very helpful to both solidify and connect your knowledge! Especially in the first half of dedicated, when you are solidifying all your knowledge. Especially important is testing yourself on what the other Uworld answer choices are and why they are the wrong answer. For example, if there is a bacteria question and one of the answer choices is strep pneumo, make sure you know everything about strep pneumo even if it isn’t the answer to the question. Also test yourself by testing yourself on EVERY chart in SOS/FA. You need to be able to fill in all the charts provided, this is high yield stuff. Usually you should be able to fill out the chart based on your knowledge of the concept, rather than memorizing it. 

3) Spaced repetition - I am a huge fan of Anki, and I would advise you to make cards for EVERYTHING you don’t know, be it from Uworld, SOS, FA, or Pathoma. For example, perhaps you realize you don’t know what problems strep pneumo can cause, you can make a card for that. If you choose to use Pathoma, make a card for EVERYTHING that Dr. Sattar says is “high yield for examination purposes”. This will take a lot of time, but I think it is very high yield. The key to Step 1 success is being able to identify all your weakness and patch them up, and Anki flashcards help you do this.

Details of the schedule

Regarding my schedule, I had 30 study days (6 days study, 1 day off, for 5 weeks). I used UFAP, so I basically went through FA and Pathoma twice, 15 days for each pass (smaller chapters I did in one day, larger chapters like CV, neuro, and repro I split into 2 days). The second pass helps you really solidify everything. First pass review took more time, so I was doing 2 blocks (80 questions) of Uworld a day. Second pass, I bumped up uworld to 3 blocks a day since reviewing was much faster. In addition, keep up with all the Anki cards you are making and reviewing. You will get through Uworld once with this schedule. Since you will have made Anki cards for everything you didn’t know in uworld, there is no need to go through it again. Note, in my opinion this is only feasible if you have reviewed SOS/FA one time before dedicated period.

I will describe 2 Sample days- A typical day during first pass would be 2 blocks uworld and going over all the questions (I did tutor mode, do you what you prefer) and making cards (5 hours for uworld and anki). Go over a FA chapter, or half a chapter if it very long (4-5 hours). Watch corresponding Pathoma (2 hours at 1.4x) (During this time, also making Anki cards for things that are tough to remember or high yield). Review anki cards (2 hours). I split my day into 3 hour blocks, switching both study method and study location.  For example, I would do about half of the Uworld questions at home, take a little break, go to school and review the FIrst Aid chapter for 3 hours, take a lunch break and play basketball, then do more Uworld at school, go home and do flash cards, and then rest my brain by watching Pathoma. Mixing it up made getting through all the material much more enjoyable and interesting, because I was constantly switching the study method. This was how I could get through 12-14 hours of study and still be focused. 

Second pass-3 blocks uworld and review (7 hours), Anki (3 hours, takes longer bc more cards now), 3 hours run through pathoma and then go through weak parts of FA. For a lot of chapters I stopped going completely through FA. I used FA more as a reference during second pass, looking at sections where I was particularly weak.

In summary, as you can see the keys to this schedule are the incredibly denseness (going to FA and Pathoma twice in 5 weeks), the repetition (FA and Pathoma twice, and Anki), and the constant self testing (Anki, and testing yourself). It requires focus (to be able to constantly test yourself) and endurance, but if you are able to do this, you will be doing well on your step 1.


Regarding NBMEs I just didn’t have time to do them (I prioritized getting through uworld). A lot of people like them though and it helps them prognosticate how they are doing. It wasn't worth it for me. Just go through the grind and trust in the process. I know they are supposed to be similar to the actual Step 1 questions, but I didn't find it as helpful because you don't know what the correct answer was, what you can learn from the question is impeded. I know there are communities that have pooled together answers for the NBMEs, but when I took a look in 2017, the answers weren't always accurate. Uworld alone is good enough.

Regarding anatomy and embryology, don’t worry about it. You will learn some in Uworld. Its just not efficient to learn all the anatomy for the few questions you may get. You only have so much time and brain space, save it for other higher yield topics.