USMLE Step 1: common pitfalls and how to make a study plan

My vision for the most effective, and least stressful, Step 1 study strategy is centered on the principle of balancing new material as you progress through pre-clinical courses while simultaneously maintaining your knowledge of past material in a time-effective way. It sounds simple, but it’s difficult to achieve!

Many students make the mistake of getting caught in the weeds, by trying to do hundreds (or thousands…) of flashcards per day or re-reading and re-highlighting entire chapters in Pathoma that they’ve learned earlier in the year. This effort to review old material can become tedious and take time away from your core coursework. Other students fall on the opposite extreme, neglecting to review, and by the time Dedicated rolls around, they no longer remember the difference between chronic bronchitis and bronchiectasis and spend precious time during these final weeks duplicating efforts from earlier in the year.

Read on for a more detailed breakdown of some of the most common pitfalls of Step 1 preparation…

Skimping on the “first-pass learning”

Think of each course in the pre-clinical years as a “mini-dedicated” period to master that organ system, whether it be cardio, pulm, renal, etc. Despite my emphasis on keeping old material fresh, there’s no substitute for first-pass learning. Although time-intensive, the strong foundation you build throughout the year is what will allow you to apply that information to novel, challenging scenarios encountered on test questions. Especially with the increasing popularity of the pass-fail curriculum in medical schools, many students learn “just enough” to pass their course, but this comes back to haunt them as Step 1 approaches!

Using Anki in the wrong way, or not at all

Full disclosure– I’m a huge advocate of Anki and “active learning” strategies in general. It was a big part of my Step 1 prep. However, I’m not claiming everyone should be learning every one of the 20,000+ cards in the Anki Step 1 deck! Far from it! Anki is ideal for the memorization-heavy parts of USMLE material: things like random gene mutations, key disease associations, mechanisms of action of different drugs, and the like. The key is to use Anki wisely, and not become buried under a mountain of reviews.

My goal is to coach all of my students into using Anki in a way that works well for them. To this end, I’ve developed customized and improved versions of popularly used Step 1 Anki decks, and I’m glad to share those with my students and get them started with incorporating this powerful learning tool into their study plan. A modest investment of time doing Anki reviews each day will return large dividends once Dedicated starts, since many Step 1 questions essentially come down to recalling a single fact that allows you to select the correct answer, even for second- and third-order test questions.

“Saving” UWorld questions until you’ve studied more

A common mindset is that students don’t want to “waste” UWorld questions too early in the months preceding their Step 1 Dedicated period, instead “saving” questions until they’ve studied more. Often, this idea is driven by the fact that, several months before the test, your UWorld percent-correct scores won’t be much to write home about, but this is totally normal and shouldn’t dissuade you! This whole blog post is about maintaining knowledge of previous material as you move through your pre-clinical years– doing UWorld questions on learned topics is the perfect way to retain knowledge while simultaneously familiarizing yourself with the test format.

Moreover, I also try to guide my students so that they finish their first pass of UWorld during Dedicated, with some time to spare for revisiting incorrect questions a second time. In order to budget time appropriately to reach this goal, almost all students will need to begin UWorld during their pre-clinical months.

Putting it all together…

I strive to help my students strike the perfect balance between maintaining old material and learning new information, with strategic methods for harnessing the power of Anki and using UWorld smartly throughout the entire academic year. My goal is for each of my students to arrive at their Dedicated studying period with a majority of the work already under their belt– with a solid fund of knowledge of all the main topics contained between the covers of First Aid and Pathoma. That way, we can then craft a Dedicated study plan that is focused on making their knowledge airtight, honing their test-taking skills, and building endurance that will carry them successfully through test day.

[MM1]Hyperlink to Anki Step 1 material