My approach to studying for STEP 1 / USMLE (and how to get some sleep when stressed out)

Hi everyone! I have a final med school studying post and then will get back to my normal healthy life posts soon! In the mean time, please check out the FitMD instagram, I have been posting workouts, meals, and healthy life tips a few times a week. You can follow me @ thefitMD_

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STEP Dedicated Study Time

In general, everyone does the same thing for dedicated and stressing about the ‘perfect schedule’ is just that – stress. I traveled to Texas to study at home and my best friend in med school came with me. She was my study buddy and support system, and looking back, I can’t imagine having studied for STEP solo.

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My day to day looked like:

  • Wakeup and Anki my Uworld deck and/or watch a couple sketchy micro videos while drinking my coffee and having breakfast
  • 2 Uworld blocks, mixed+ timed always
  • Review Uworld blocks, making as select Anki cards as I could out of mistakes and important facts I didn’t know. This started out taking ~6 hours but I was able to get it down to 3-4 hours. I wish I had gone a little bit faster sooner (such as by moreso skimming questions I got right.
  • Workout! To save time, I did this from home. I also usually graded Uworld while walking on the treadmill, which was an awesome added stress reliever.
  • I took breaks to eat meals with my best friend and family, usually an hour each.
  • Read First Aid for the organ system I had designated for that day.  This required the rest of the day usually.
  • Maybe do extra questions in a different Q bank if I had time and was very weak in that system.
  • Sleep!!! 7-8 hours! I started having trouble sleeping from the stress so I bought the Kavana Kava supplement and it actually worked (also made my stress-induced tinnitus go back into hiding!) I also took 1mg melatonin with that. Each night, I stopped studying 1.5-2 hours before I wanted to go to sleep, and this gave me time to take a hot shower/bath, call my boyfriend, and watch an episode of Grey’s Anatomy to relax my mind.

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My actual dedicated schedule looked like this:

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I changed it up several times during dedicated based on my strengths and weaknesses and you likely will do the same!

I gave myself 2-4 days to get through each organ system thoroughly, which meant slowly reading First Aid while highlighting, making an anki deck for the last week of dedicated as I read, and re-reading my highlights once. I wanted the last week to be a back to basics review that wasn’t overloaded with material and cramming, so I made “select” decks for each system that were designated to be done on a day in the last week of dedicated, the questions came from reviewing FA for that organ system the first time around. Each deck had 60-120 cards for the system. While ‘reading First Aid,’  I’d read a title and try to remember as much as I could before looking at the text below. Depending on how much time I had left for that system, I might do the anki deck I made once, listen to a Goljan lecture, or skim another source.

Regarding my Uworld anki deck, it grew to be ~1100 cards. I made sure I kept up with it at least every other day, but sometimes this took like 3 hours. I suspended cards after Id seen then once or twice and then unsuspended everything 10 days before my exam. Then I went through it one final time.

Tabs I always had open and a few google searches: 

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The final week I did a 2nd sweep of everything, 1-2 subjects per day. I would read the Pathoma chapter and then do the anki deck I had made for that system. Since this was the first time I was re-looking at Pathoma (I’d done 1-3 times during the school year already) during dedicated, I also added some anki cards to my ‘select’ decks as I read. So, yes, part of the Anki decks I was doing that day I had just made. It would have been nice to have been able to look at Pathoma earlier in dedicated but I’m not sure where I would have found the time to do that. I figured I had already been through it a fair amount during the year and time would be better served trying to memorize as much FA as possible. However, I do think it was important that I read it once through towards the end of dedicated – a great review of the most basic, important path.

The way Leesa and I did practice tests was painful and I’m not sure I’d recommend. We didn’t do a practice test the first week and so we had to cram extra in later, which meant we had two days where we did the equivalent of 10 blocks. Killme. I wouldn’t bother with NBMEs older then 16, they seemed outdated and the questions could be absurdly vague. And don’t trust ANYONE with answers online, there were so many mistakes. Shell out the extra $ for the NBME to tell you what you got wrong and what is the correct answer. Everyone says that you’ll see NBME questions on the real thing, but I didn’t. They didn’t feel like a great use of time, but practicing testing was important. The other key thing about the NBME is it points out what you are weak in. The day after my test, I would dedicate mostly to studying whatever my worst topics were.

Regarding sketchy path, I only watched the videos for a few things that are impossible to memorize, AKA tumors and neurocutaneous disorders. My recommended list of “worth it” sketchy path:

  • 2.3 cervical tumors
  • 2.4 cervical tumors
  • 4.2 breast cancer
  • 5.1 testicular cancer  
  • Lung tumors – SO GREAT
  • Neurocutaneous disorders (Sturge Weber, NF1/2)

Other people on reddit also recommend, but I didn’t bother/have time:

  • Nephritic/nephrotic in renal – MEH

  • Cardiac ch 5 (heart disease)

  • Ch 3.1-3.3 cardiomyopathy

  • Vascular ch 3

  • CNS tumors

  • Ischemic heart disease, myocardial and pericardial disorders

  • AKI

  • Immunodeficiencies

Random tips: Keep a running list of things you suck at and active make a point to review and study this list. Don’t feel bad about google rabbit holes- they help you really learn and retain the material. Take practice tests seriously and simulate the real test as closely as possible (such as mimicking how long and how often you will take breaks, not snacking while testing, etc).

In the end: In the end, my studying over MS2 year and dedicated got me over my goal score. It’s hard to know what were the most important things I did and what I could have left out, but the bottom line is that hard work can get you there – even if you are not a natural test taker.

Most importantly, keep calm and study on! Never forget that the reason for all of this is to become a doctor, help and heal people. You will get there. 

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