Study guide for USMLE Step 1, by Gustavo Tataje.

Disclaimer: The following suggestions are based on my experience and opinion, therefore, they are relatively subjective.
I scored 235 points on Step 1, so take that as a pro or con depending on your goal.

The guide is aimed mainly at foreign students, so the period of time for study is, in my opinion, the most appropriate for
us. I mention it because you may find some guides on the internet where they say “5-6 weeks maximum to study”, and it
is because American medical students are only given that much time to prepare for the exam.

I don't trust your guide, where can I find more guides?

 Well google…
 No lie, here are quite a few experiences from other people who also took the exam:
i. https://www.reddit.com/r/step1
ii. http://forums.studentdoctor.net/threads/official-2016-step-1-experiences-and-scores-
thread.1158915/
iii. http://www.usmle-forums.com/tags/Step-1-Experience.html

When should I take the exam, before or after I graduate?

 My opinion is that it is better to give it after graduating. The preparation provided by Latin universities is
quite different in its approach compared to American universities, therefore, the topics you are going to
learn are very different. That is why it will be necessary to dedicate a lot of time to studying the topics
well, which may not be possible with university schedules.
 PS: The ideal would actually be that you study the preparation materials for Step 1 while you are taking
the basic science courses. They are quite good and give you a good base of knowledge.

How many months should I prepare before taking the exam?

 Recommended time period: 7 months. +/- 1 month. Of course, some move faster, others slower. It is
best to give it “when you feel ready.”
 Keep in mind that there are 7 months in which you do nothing but study for that exam. Literally. Nothing
else. Don't work. Do not trip. The goal should be that you study at least 6 uninterrupted hours a day
(minimum). You have to see this preparation period as if it were a job. Make a schedule and stick to it.
Sure, leave one day free a week. And in the last few months, it is at least 10 hours a day.

My university did not give me a good foundation in basic sciences, am I lost?

 No. The best way to cover all the exam topics is with Kaplan or Becker classes. Both are academies with
good reputations that offer classes (both in person and online) where they cover all the subjects that are
included in the exam. There are a lot of them! It normally takes around 50 days to finish all subjects.
They can choose to take the in-person classes in the United States, which cost around $4000, or they
can be recontra Latinos and download them from here ( http://usmle4you.blogspot.pe/?m=1 )
i. Everything is on the internet! That's the best advice I can give you. Don't be stupid and learn to
use Google. Learn how to use torrents. Create a Mega account. You can find all the necessary
materials and more on the internet. They just have to go, write what they want and add
“download” to the end of the sentence and that's it.

What are the most important resources in general?

 FIXED: First Aid for the USMLE. This book is the bible for the exam. Every sentence you find there has
come from a real exam question, so learn it in great detail. Try to get the most updated version, as they
always add new and important things. All your notes should ideally go there.
 FIXED: Uworld Qbank. It is the most important question bank there is. The way they formulate them is
very similar to the real exam, and their explanations are quite detailed. Additionally, it allows you to
 evaluate how well you are progressing in your studies. Preferably get the original version, the bad thing
is that it is expensive, around $200-400 for subscriptions. But it's worth its weight in gold.
 FIXED: Pathoma: Consisting of a series of videos and a book that cover all the most important topics in
pathology. The way Dr. Sattar (the narrator of the videos and author of the book) explains each class
makes the most difficult topics easy to understand.
 FIXED: Sketchy Micro: Microbiology is very broad. It requires an immense memory. That is why this
resource is so valuable. It consists of a series of videos in which vignettes are presented that contain
characteristics of a specific microorganism. I did not make a mistake on any question on the micro part
thanks to this resource.

Ok, I have all the materials, now what do I start with?

 I am of the idea that it is better to start with Biochemistry or Anatomy. They are the two courses that
require the greatest amount of patience. If you have been able to find all the materials, start by
watching Kaplan's Classroom Anwyhere classes or Becker's videos. They are videos of around 4 hours
long. Try to watch at least 1 a day. Each person has their own speed. It all depends on your level of
English and how long you can sit and listen to classes.

What are the best resources for each subject?

 FIRST AID: in general the ideal is to fill out all the relevant notes directly to First Aid. That doesn't mean
FILLING all the pages with words, since every word in that book was taken from a real exam question
and if you fill it with a lot of information you are going to go over a lot of unimportant points. My
recommendation is that you fill out your notes in a notebook “to understand” and then just pass on the
most relevant information to First Aid.
i. First Aid is a REVIEW book. You're not going to learn anything just by reading that book. You are
supposed to already have all the basics to be able to get the most out of that book. This is
something you have to be very clear about.
 Every time you finish with a subject, remember to make a bank of questions. At this point it is still not
recommended to use Uworld, so use the USMLE-Rx, which is the bank provided by the authors of First
Aid. It helps a lot to learn this book, in addition to getting used to the format of the USMLE questions.
You could also use the Kaplan bench. This is much more detailed than Uworld and usually asks things
that are very far-fetched, however, it also helps you learn the format of USMLE questions, and it is a
very good resource to measure progress.
 Biochemistry and genetics:
i. Videos:
1. Kaplan Classroom Anywhere: They are of very good quality. I consider that they are the
best there is and they will explain all the topics that are necessary.
2. Kaplan 2010 videos: Some topics are covered quickly in the Classroom Anywhere videos,
but they are covered in more detail in the 2010 Center prep videos (the ones with the
green background), so if you didn't understand a topic, you can review it better in those
videos. This is especially true in the genetics part. The 2010 ones are much better for
that course.
ii. Books:
1. Kaplan Lecture Notes: It's more than enough I would say. It goes hand in hand with the
videos.
 Anatomy:
i. Videos:
1. Becker Online Classes: Personally, I liked the way Becker's teacher explained it better.
Kaplan's looked like he was going to have a stroke at any moment.
2. Kaplan videos 2010: Again, the ones with the green background. There are some topics,
such as lower limb anatomy, that are very well explained in those videos.
 3. Youtube: there will always be a topic that you do not understand, so YouTube will be a
faithful and productive ally.
ii. Books:
1. High Yield Gross Anatomy: very useful, especially the upper and lower limbs.
2. Kaplan Lecture Notes – Goes hand in hand with the videos, so it's a good source.
3. Netter: For references only.
 Neuroanatomy:
i. Videos:
1. Kaplan Classroom Anywhere: I personally really liked the doctor's way of teaching. He
made the most difficult topics in neuroanatomy simple. It is very important to review
the brainstem sections and they give very good detail to that topic.
2. Dr Najeeb: Dr Najeeb's videos are very good. Explains each topic VERY detailed. The
problem is 1) his accent is crazy and 2) they are very long videos and it takes a year to
get to the important part
ii. Books:
1. High Yield Neuroanatomy: equally good quality as the gross anatomy book. It is quite
spacious. I would say that the classroom videos are more than enough.
 Embryology:
i. Videos:
1. Youtube: the truth is that I learned more by watching videos on YouTube. They are a
little better designed, especially the gametogenesis and heart development part
2. Classroom Anywhere: are included in the Gross Anatomy classes. They seem pretty good
to me, especially the abdomen and heart part.
ii. Books:
1. First Aid: The most important thing in embryo is in First Aid. Just learn that. Anyway, it is
reviewed in Kaplan's videos.
 Microbiology:
i. Videos:
1. Sketchy Micro: Watch this video https://www.youtube.com/watch?v=ObxpYoeJkL8 .
Micro has too much information, it is inevitable. There are many characteristics that you
simply have to memorize. Fortunately, there is Sketchy micro, which summarizes
everything in ridiculous vignettes that remain fixed in the memory for a long time. Of
course, first you need a foundation of microbiology to understand the reason for each
data.
2. Becker online videos: I recommend Becker's videos better than Kaplan's. The doctor
who teaches these classes is much more didactic and the way the distribution is
designed is more logical in certain aspects.
ii. Books:
1. Clinical Microbiology made ridiculously simple: this book guides you by the hand to
understand each microorganism. It's perfect, seriously. I wish I had read this book in
basic science instead of trying to read the Murray. Online you can only find the 3rd
edition of this book, so I suggest buying the most current one since it has a lot of new
information about antibiotic resistance (I got a question about that in the actual exam
and I happily read that fact in this book and I got the question right)
2. First aid: the micro part is very well summarized. Even though it is a giant chapter, there
is all the information necessary to memorize. Use in conjunction with Sketchy and
everything will be fine.
 Immunology:
i. Videos:
 1. Youtube: these videos are all the immunology foundation that is needed:
https://www.youtube.com/watch?v=LSYED-7riNY&list=PLAB2FC119A2CA3C57 Thanks
to those videos I was not wrong on any question I had about immuno. They are short,
simple videos and help memorize each immunological process in a very organized way.
a. Personally, I didn't like the videos from either Becker or Kaplan for immunology,
but if I had to choose one it would be Becker's.
ii. Books:
1. First Aid: it is more than enough. Not much to say about it.
 Physiology:
i. Videos:
1. Classroom Anywhere: This subject is very important and frequently asked in the exam.
That is why I consider it necessary to watch these videos. The doctor explains quite well,
very detailed and at a good pace.
2. Youtube: the nephro part in particular.
ii. Books:
1. BRS Physiology: This book is best reviewed after finishing Kaplan's classes. It's quite
short, so it shouldn't take you more than 4 days to finish reading it.
 Pharmacology:
i. Videos:
1. Classroom Anywhere – All of these videos are very good. The doctor makes a lot of
effort to explain well the topics that do come up in the exam, such as the interactions of
adrenergics and their antagonists and pharmacodynamic formulas.
2. Videos Kaplan 2010: the doctor who teaches neuropharmaceuticals explains this topic
much better than classroom anywhere. It actually teaches everything in a very
interesting way, but it may be a little deeper than what is required for Step 1. Anyway,
look at the one on antibiotics and neuropharmaceuticals.
ii. Books:
1. First Aid: The information that comes in first aid is very relevant. In theory it is
everything you have to memorize for the exam and nothing more, but yes or yes you
need a good base to understand it.
 Pathology:
i. Videos:
1. Pathoma: The way Dr sattar explains each topic is amazing. It makes the most difficult
topics look simple. They are quite concise and at the same time detailed videos. It
should take a maximum of 3 weeks to finish watching the videos in detail. These videos
are much better to watch than Kaplan's.
2. Osmosis: These are new videos that you can find on YouTube. I found them in my last
week of preparation, but if I had found them earlier they would have been a
fundamental part of my preparation. I suggest you give them a check.
ii. Books:
1. Pathoma: Together with the videos, the book tells you the things you need to know for
the exam.
2. Goljan: It's basically a summary of the entire robbins. It goes together with some audios
that were recorded more than 10 years ago and, although some things are a little
outdated, the fundamentals and Dr. Goljan's way of explaining are great.
 Biostatistics/ethics/psychiatry:
i. Videos:
1. Classroom anywhere: Specifically for the psychiatry part, since it integrates the DSM-V
updates.
 2. Kaplan Videos 2010: for biostatistics and ethics. Dr. Daughertry explains everything
brilliantly. Highly recommended. And the psychiatry part is also useful to review in these
videos, even if it is focused with the DSM-IV criteria, the way it organizes the
pathophysiological explanations of each disease is quite good.

And what do I do once I see all the Kaplan classes and the other subjects?
 Now is the ideal time to measure your knowledge. Give your first NBME, which are questions from real
exams from previous years. You can find them here https://nsas.nbme.org/home The most recent ones
are the best indicators, so save those for last. Start by giving 12 or 13.
 Well now it's time to learn First Aid well. What I did was watch the Doctors in Training videos, with
which you can review the entire book in less than 20 days. It consists of videos in which they explain
almost page by page all of First Aid, and they also teach you other topics that are not covered there.
 Ideally you should have already finished a bank of questions by this point. It is only now that you start
using the main question bank: Uworld. Do at least 2 blocks of 40 questions per day. If you follow this
pace you should finish it in 2 months. If you can move faster, good time. Personally I made 4 blocks a
day so I finished it in 5 weeks.

But how do I memorize so much information?

 Just like everything else in medicine: repetition, repetition and more repetition. Fortunately, Anki exists.
What is that thing? http://ankisrs.net/ is the salvation for your chicken memory. It is a (free) flashcard
program that shows you each question with a spaced repetition algorithm. That? Spaced repetition:
questions appear according to a formula that improves memory retention. For example, if a question is
easy, you can set it to be repeated in about 4 days, if it is very difficult, to repeat it the next day. This
way, if you ask a block of Anki questions daily, you will be able to gradually retain all the information.
And the cool thing is that there are people who have already made all the flashcards with the First Aid
information ( https://ankiweb.net/shared/info/2140532937 ) here is a video on how to use Anki:
https://www .youtube.com/watch?v=XyX0fvGeZ5I you can also take a look at this page:
https://www.yousmle.com/

So, in short, what should I do?

 The first 3 months: Forming a strong foundation
i. Watch Kaplan's videos mixed with Becker's in some subjects
ii. Solve one or 2 blocks of a question bank a day. USMLE-Rx preferred.
iii. Along with Kaplan's videos, check out First Aid.
iv. Make sure you have your paperwork ready by the end of the third month so that no
inconvenience happens.
v. *USMLE-Rx also offers some class videos that cover First Aid page by page, similar to Doctos in
Training. I recommend the Cardio videos and the neuro videos. I didn't have time to review the
rest.
 The next 2-3 months: banking, banking, banking.
i. Give an NBME to see how you're doing.
ii. Uworld begins. 2 to 3 banks a day if possible. The important thing is that you review all the
questions, not just the ones you got wrong. Always understand the reason for each explanation.
If you can do Anki for your wrong answers, that way you never forget.
iii. Watch Doctors in Training. It will help you review First Aid in less than 20 days.
iv. Check Pathoma again. If you can, check it twice in total. Also Sketchy micro.
v. Give another NBME every 3 weeks. Remember to review the questions carefully. I got several
almost identical questions from the NBME. You have to do number 16 and 17.
1. There are other assessment tests you can take to see how you are doing:
 a. Free-150: http://www.usmle.org/practice-materials/ are questions provided by
USMLE itself. They are quite similar to the real exam.
b. Kaplan Diagnostic exam: https://www.kaptest.com/medical-prep/usmle/try-us-
for-free/us-med-try-us-for-free#free-step-1-diagnostic-exam
c. UW-Self Assessment: https://www.uworld.com/step1/step1_exam.aspx
d. USMLE-Rx: They also have their assessment exam within the Qbank they
provide you.
 Last month:
i. Check Uworld one more time, especially your wrong questions.
ii. Gives the most current NBME (18). Review the questions carefully.
iii. Check out everything you can about First Aid. This is when you have to brutally memorize.
 Last week:
i. Uworld + First aid + Anki. Nothing else. If you can review the NBMEs questions, do so.
ii. Here you can find a summary of all UW questions (until early 2016 at least)
https://dl.dropboxusercontent.com/u/96451296/Medicina/USMLE.onepkg

How did it go with you?

 Test exams:
o NBME 7:224
o NBME 12:220
o NBME 15:235
o NBME 16:238
o NBME 17:245
o NBME 18:251
o UWSA 1:225
o UWSA 2:245
o FREE-150: 87%
o UW-1ST PASS: 71%
o Kaplan Diagnostic test: 245
 I started studying biochemistry, I dedicated a full month to it. That's why it was one of the best courses I
had. I watched the Classroom Anywhere videos + the ones from 2010. At the same time I saw the Doctos in
training ones. Then move on to immunology and micro. I didn't like at all the way they teach them in Kaplan
and that's where I found the other sources that I listed previously. Anatomy took me a long time to finish,
mainly because I started working and got quite distracted. I saw both Kaplan's and Becker's classes, so I can
say that watching Kaplan's guy's classes is more boring than watching the rubber dry. Then I saw neuro and
physio, all in 2 months. Pathology I started by reading the Goljan and at the end I reviewed the Pathoma.
This is when I decided to give up the places where I worked and dedicated myself fully to studying. I studied
from 8 am to 11 pm every day, so I was able to finish pharmacology in one week and behavioral studies in
another week. Plus, I watched the newest Doctors in Training classes.
 A good recommendation I can give you is to ask as many questions as you can. The more questions they see,
the more familiar they will be with the format and the more they will find the patterns used to ask the
questions. Read the last sentence of the question first, then look at the answer options, and then move on
to look at the text. This will help you save a lot of time.