JINDAL’S STEP-1 WRITE-UP

About me and my journey:

Hello, my name is Himanshu Jindal and I recently passed my USMLE Step 1 exam. As a medical student, I
have always been interested in pursuing a career in Medicine and, specifically, in completing an internal
medicine residency in the United States. Passing the Step 1 exam was an important milestone on that
journey, as it allowed me to demonstrate my knowledge and preparedness for further training in the field.
In this write-up, I will be sharing my personal experiences and insights into how I prepared for the exam
and what strategies helped me pass the exam. I hope that my reflections and advice will be helpful to other
students who are also preparing for the Step 1 exam.
During my preparation time at G.S.V.M. Medical College in Kanpur, India, I began my USMLE Step 1 exam
preparation in my 3rd year of medical school. While I had started to explore Kaplan study materials and
solve practice questions in my 2nd year, it wasn't until my 3rd year that I took a more organized approach
to studying for the exam. This is a common strategy for Indian medical students, as the 3rd year curriculum
typically includes subjects such as Ophthalmology, ENT, Community Medicine, and Forensic Medicine that
are relatively manageable in a shorter span of time. While recent changes introduced by NMC mean that
newer batches may not have ENT and Ophthalmology in their 3rd year, I still believe that there is no better
time to prepare for and take the USMLE Step 1 exam than during your 3rd year of medical school. This
period offers ample time to prepare and is unlikely to be matched by any other year of your studies. Of
course, it's also possible to start preparing in your 2nd year and then take the exam during your 3rd year.

Acknowledgments:
I would like to express my sincere gratitude to everyone who has supported me throughout my journey.
First and foremost, I am grateful to my family, consisting of my humble and supportive parents and my two
dear siblings, for their unwavering love and encouragement. I would like to extend my heartfelt
appreciation to the seniors at my medical school, especially Efa Khan ma’am, for their guidance and
inspiration. My professors have also been instrumental, and I am grateful for their dedication and passion
for medicine, which has instilled in me a strong work ethic and a desire to excel.
I am especially thankful for the invaluable guidance and mentorship of Dr. Ahmad Ozair, a postdoctoral
research fellow in neuro-oncology at Miami Cancer Institute. His expertise and insights have been of
immense help in my preparation for the Step-1 exam, and I am always grateful for his unwavering support.
Lastly, I would like to thank specific seniors, friends, and colleagues at King George's Medical University-
Vinay, Vibhor, Abhishek, Nikhil Verma boss, and Kaushal boss who have provided me with unconditional
support and guidance whenever I needed it.
Feel free to reach out to me or connect with me at:
@TheMedJindal
https://www.linkedin.com/in/himanshu-jindal-037094140/

@onasemnogene [The weirdest there is!!]

[email protected]

https://linktr.ee/himanshu_jindal [Personal Website]

Declaration:
I hereby declare that the contents of this Step 1 write-up PDF are solely my own opinions and thoughts. I
acknowledge that the information presented in this write-up is subject to variations and is provided for
informational purposes only.
I confirm that I have taken reasonable care to ensure the accuracy and integrity of the information
presented in this write-up, to the best of my knowledge. However, I make no representations or warranties
of any kind, express or implied, about the completeness, accuracy, reliability, suitability, or availability of
the information contained in this write-up.
I further declare that this work is unique and has solely been created to share information about strategies
and resources for USMLE Step-1. I acknowledge that I am solely responsible for the contents of this write-
up.

-HIMANSHU JINDAL
 Professors Speak
Prof. Dr. Goljan says- “Know the mechanisms and you’ll annihilate the test. The Step-1 guys like to go after
mechanisms.”
Prof. Dr. Sam Turco says- “Know your stuff” and “Know what you are dealing with.”
Prof. Dr. Ryan Harden says- “A lot of doctors are walking on this planet who do not understand the
pathophysiology of diseases they are treating and the mechanisms of action of the drugs they are
prescribing and I do not want you to be one of them.”
Prof. Dr. John Barone- Just as he likes to say it, Go and Slay the dragon :)

My Timeline

1st Year
•Got to know about USMLE. Planned to start preparing from 2nd Year.
(2019-20)

2nd Year
•Started preparing. Focussed on builiding foundational knowledge through Kaplan Material.
(2020-21)

•Planned to take the exam towards the end of 3rd year in December. Booked the eligibility period. Life had
3rd Year different plans. University exams and personal problems cropped up out of the blue. Decided to delay.
(2021-22)

•Decided to take the exam as soon as the 3rd proff university exams were over. Had to manage final
4th Year
year classes and postings schedule with Step preparation. Had extended the eligibility period to
(2022-23)
January-March.

•Took the exam. Done with it. (Final Year of Medical School Ongoing)
March 2023
 Resources used:
UFAP? Na. Not exactly. My preparation was a tad different. Definitely not ideal.
Below is a list of resources that I used (in partial or full) throughout my preparation:
1) Kaplan [Qbank + Books + Live lectures + Recorded Lectures]
2) UWorld [Qbank]
3) First Aid [ Read a few units only]
4) Dr. Been Immunology (considered the best-
https://youtube.com/playlist?list=PL_voXEIX5Xht_bZ3wIMwq_HUfv2hsThJG )
5) Amboss [Qbank + Knowledge library]
6) Sketchy Micro [for Microbiology]
7) Pathoma [Dr. Husain Sattar is a rockstar]
8) Dr. Goljan’s Pathology audio lectures [too lengthy to complete them all, listened to about 10
lectures)
9) Physeo – Physiology, Biostatistics, Psychiatry, and Behavioural Science
10) YouTube Channels
- Dr. Randy Neil, MD ( https://www.youtube.com/@RandyNeilMD )
- Dirty Medicine – aka Padho Utna, Chhaiye Jitna (study as needed)
( https://www.youtube.com/@DirtyMedicine )
- Mehlman Medical ( https://www.youtube.com/@Mehlmanmedical )
- Dr. Rahul Dalmia, MD ( https://www.youtube.com/@hyguruprep )
- The USMLE Guys ( https://www.youtube.com/@usmleguys )
11) Podcasts @Spotify
- The Rx Bricks podcast
(https://open.spotify.com/show/6difsNR0giFPpNfJM2e5l2?si=309a1251fb014626)
- Mehlman Medical
(https://open.spotify.com/show/43o3ya1SA0i1IBRtuRUZSS?si=OlD1e8TQQySV4ByBgKqODA)
- Lung and Heart Sounds
(https://open.spotify.com/playlist/1Hcfiz1ahPoncVvo5StR4B?si=YuQJfFYsRieeqS92tkDWKA&nd=
1)
12) 100 Concepts of Anatomy by Dr. Mavrych and Dr. Bolgova [Top Secret!!]
13) Osmosis [free videos + free questions available on the blog]
14) Anki (Ankidroid for Android is free and that for Windows is also free, you need to pay for ios
though)
 Resources in detail:
(If you are already aware of the resources mentioned above, you can skip
reading this section):
Kaplan- Since I took the Kaplan course, I relied on it heavily to build my basic foundational concepts in each
subject. I went in full (full as in Kaplan books) through Immunology, Pathology, and Pharmacology (really
amazing, taught by Dr. Harris). Partially studied- Biochemistry and Physiology. Solved around 500 questions
from the Qbank. And watched almost all live lectures during the course.
UWorld- The jack of all trades!! UWorld is the most crucial Qbank and study resource you’ll come across in
your Step 1 preparation. If you can go through this Qbank in full and solidify all the concepts taught herein,
you will be more than good to take any test!
First Aid- This is more of a review resource. Everything that you’ll need for your Step-1, only the most high-
yield stuff is written herein and like a cherry on top of the cake- you get cool mnemonics to remember stuff
too.
Dr. Been’s Immunology- Taught by Dr. Mobeen Syed. Until I watched it fully, I had only heard from peers
that his immunology lectures are really the gold standard. When I completed watching all his immunology
lectures, I finally could conclude the same. He teaches in a way that makes things stick in mind. The way he
teaches, utilizing cool cartoon characters to denote various cells of the body, it just helps a lot with
retention.
Amboss- Used both the knowledge library as well as the Qbank. Had the basic version wherein I would get
50 questions to solve per month. I found those were enough given I was using UWorld as the main Qbank.
Amboss gives you really challenging questions. Must try its five hammer questions!! (I didn’t get them
right) The Amboss Qbank really helps develop neural networks through its unique multi-step questions. The
amboss questions are the most unique I’ve ever seen and the hardest I have found in any Qbank I tried. I
often use the Amboss knowledge library to augment my studies in med school and especially in clinical
postings.
Sketchy Micro- Solved all my problems with microbiology. Never had to struggle with any question in
microbiology after a single round of Sketchy Micro. Revise it two or three times and find yourself solving
microbiology questions seamlessly on the practice tests, Qbanks, and the real deal.
Pathoma- Taught by Prof. Dr. Huain A. Sattar. What is the best thing about this resource? While teaching,
Professor Sattar speaks straight outta his head. This means, if he has made concepts stick in his mind and
he can teach them to you without looking at anything, then we can learn those concepts easily too.
Learning Pathoma means getting rid of your pathology burden for Step 1.
Dr. Goljan’s Pathology- Highly detailed audio lectures by Professor Goljan. He explains everything well but
the disadvantage with these lectures is that they are audio only [makes you prone to getting distracted] and
are very lengthy. Several hours per unit.
Physeo- A highly concise resource for physiology. Used it for a few units such as GIT, Endocrine, and
Musculoskeletal among others. Very short, crisp, and concise videos that deliver to you the highest yield
concepts. The best part is- Several questions are solved and explained in each video. Used it for Physiology,
Biostatistics, and Psychiatry.
100 Concepts of Anatomy- You won’t have too many questions on Anatomy on your step-1 exam (you
would have ample questions on neuroanatomy though). If you have already mastered this subject,
probably you’ll do without this book. But if you are someone who struggles with Anatomy like me, use
Pareto’s principle, and master this short yet very comprehensive guide of the high-yield anatomy concepts
that are most likely to be tested on the exam.
Anki- Most of you would already know about this application. It's an application to help you learn stuff via
spaced repetition. It has a built-in algorithm that gives you flashcards at specific time intervals based on
several factors that are computed by the algorithm. I used it mostly in the end. Did not use any pre-made
deck. It didn’t work out for me that way. What I did was, I created my own decks and revised them in the
last 15 days leading up to the exam. It was so very helpful.
Osmosis- Used the free videos as and when I liked to watch them. Also, a weekly question is made available
on the osmosis blog every week. Always tried to do it weekly.
The Rx Bricks Podcast- From the creators of USMLE-Rx. It will definitely help you with several concepts and
the best part is you can hear it while doing other stuff such as working out or jogging.
Dirty Medicine- The creator of this channel is very unique in the fact that he focuses only on the concepts
and points that will help you solve your questions on the USMLE Step-1. Just that. Only the information you
need to solve questions. Really a good resource when you are towards the end of your preparation. Helps
increase your score by at least some points. Special Mention- Ethics, communication, biochemistry, and
psychiatry playlist.
Mehlman Medical- His audio Qbank available for free on YouTube is totally awesome. Must try to listen to
it as much as possible. Also, he has created PDFs for several subjects/sub-subjects and topics which are
available free of cost on his website. I would highly recommend at least going through his HIGH YIELD
ARROWS PDF once before the exam. It would really help you with your real deal.
Dr. Randy Neil- Dr. Randy Neil explains stuff through questions. He solves questions so that you know
where to apply and what to apply. His biostatistics and ethics section is especially great.

The ECFMG Registration Process.

The whole process is explained from A to Z. Refer to this video here-
https://www.youtube.com/watch?v=43SDvxHYqos
 My Self-Assessment Scores
NBME 25- 67% 3 MONTHS BEFORE EXAM

IN CHRONOLOGICAL ORDER
NBME 28- 77%
NBME 29- 74%
UWSA1- 67%
Lecturio Self-Assessment- 234 (Predicted score)
Old Free120- 79%
UWSA2- 73%
New Free120(Online)- 81%
NBME 31(Online)- 82% 2 DAYS BEFORE EXAM

Snapshot from my NBME 31 scorecard

 Laws in life to live by
The Dunning-Kruger Effect:
The Dunning-Kruger Effect is a cognitive bias that affects people who overestimate their abilities and
knowledge in a particular area, while simultaneously underestimating the expertise of others. This can lead
to overconfidence, poor decision-making, and failure to recognize one's own limitations. To avoid falling
prey to this effect, it's important to be humble, open-minded, and willing to learn from others who have
more experience or knowledge.
Application: So, it’s been several weeks since you have been reading Anatomy. You now think you have
mastered the subject. You believe you’ll be able to solve any question one can throw at you. Stop there.
Know that ‘you only know what you know’. Ask someone who holds a PhD in Anatomy and he shall tell you
how vast the subject is and what more there is to learn. Be humble with what you have learned. Always
know that there is something more to learn and that you can never know everything of everything!
Pareto's 20/80 Principle:
Pareto's Principle, also known as the 80/20 rule, suggests that 80% of outcomes come from 20% of inputs.
This principle can be applied in many areas of life, from business to personal relationships. By identifying
the key inputs that are most likely to lead to positive outcomes, and focusing our efforts on those areas, we
can maximize our results and avoid wasting time and energy on less important tasks.
Application: If I were to ask you which subject would you focus on the most for your Step-1? The answer, is
yes, a big PATHOLOGY. Don’t get me wrong here. I know every subject is important and that in the end, it's
basically integration across all disciplines. But, the maximum share in terms of the proportion of questions
asked is held by Pathology. So, you had better focus on this subject than any other subject. Would you want
to spend months learning/cramming neuro-anatomy when you really don’t understand the
pathophysiology of basic diseases? That’s my point. Learning 20% of the topics (which are the highest yield)
will fetch you a greater score than focussing on 100% of not-so-important stuff.
Eisenhower's Matrix:
The Eisenhower Matrix is a productivity tool that helps individuals prioritize tasks based on their urgency
and importance. The matrix categorizes tasks into four quadrants: urgent and important, not urgent but
important, urgent but not important, and not urgent and not important. By focusing on the most important
and urgent tasks first, and delegating or eliminating tasks that are less important or urgent, we can manage
our time more effectively and achieve our goals more efficiently.
Application: I have integrated it permanently into my To-do list. Has
made my life a lot more organized and systematic. Here’s how:
 Snapshot of my to-do list from Notion

Noel Tichy's Three Zones of Learning:

Noel Tichy's Three Zones of Learning model suggests that individuals should engage in three types of
learning: comfort zone learning, stretch zone learning, and panic zone learning. Comfort zone learning
involves activities that are already familiar and comfortable, while stretch zone learning involves pushing
ourselves to try new things and take on new challenges. Panic zone learning occurs when we are pushed
too far outside of our comfort zone and become overwhelmed. By balancing these three types of learning,
we can develop new skills and abilities while avoiding burnout and stress.
Application: Here’s a possible way to think about it- Comfort zone learning-> Passively watching lectures,
Stretch Zone learning -> learning a topic that is your weak point, that is hard, and, Panic zone learning ->
Learning a whole new topic when an exam is just a week away ;-)
The Four Burners Theory:
The Four Burners Theory suggests that we can think of our lives as a stove with four burners: family,
friends, health, and work. In order to be successful and achieve balance in our lives, we need to turn off
one or more of these burners. This theory highlights the importance of making choices and prioritizing our
goals, as we cannot have everything we want in life.
Application: You cannot have the best of everything in your life. You cannot have all four burners burning at
a 100% but you can certainly optimize and carefully prioritize when to burn which burner.

The Four Burners Theory

William-Howell's Conscious Competence Model:

The Conscious Competence Model describes the process of learning and developing new skills. It suggests
that individuals go through four stages: unconscious incompetence (not knowing what we don't know),
conscious incompetence (recognizing our lack of knowledge or skill), conscious competence (developing
new skills through practice and effort), and unconscious competence (achieving mastery and performing
skills without conscious thought). By understanding these stages, we can approach learning and skill
development more effectively and efficiently.

Adapted from The Anatomy of Success by Dr. Rakesh Sinha

Carol Dweck's Two Mindset Model:
Carol Dweck's Two Mindset Model suggests that individuals can have either a fixed mindset or a growth
mindset. A fixed mindset assumes that our abilities and intelligence are innate and unchangeable, while a
growth mindset recognizes that our abilities can be developed through effort, practice, and learning. By
cultivating a growth mindset, we can approach challenges with a more positive attitude and be more open
to learning and growth.
Application: Know that you can always improve no matter how far it seems right now. A growth mindset/
and an abundance mindset know that there is always a possibility to expand and improve. A topic that
might seem to be inconceivable right now, a few months down the lane, you may be solving questions on
that topic like it was nothing.
The Paradox of Choice:
The Paradox of Choice is the idea that having too many options can lead to feelings of overwhelm, anxiety,
and dissatisfaction. While having a range of options can be a good thing, too many choices can make it
difficult to make decisions and can leave us feeling regretful about the choices we've made. To avoid the
negative effects of the Paradox of Choice, it's important to focus on what's most important and prioritize
our decisions based on our values and goals.
Application: With so much information to learn and retain, it can be overwhelming to decide where to
focus the study efforts. One way to avoid the Paradox of Choice is to develop a study plan that prioritizes
the most high-yield topics and uses active learning strategies, such as practice questions and review
sessions, to reinforce key concepts. By focusing on the most important information and avoiding
information overload.
The Yerkes-Dodson Law:
The Yerkes-Dodson Law describes the relationship between arousal and performance. It suggests that there
is an optimal level of arousal for each task, and that performance will be best when arousal is at this level.
Too little arousal can lead to boredom.
Application: Use stress to your advantage. A little bit of stress about getting things done never did anyone
any harm. In fact, it is believed to improve productivity.
 Mistakes and Lessons from my journey
- Start solving UWorld as early as you can. We as humans often hesitate to test ourselves knowing
that we may under-perform. This really hits you hard with UWorld. If you do not start solving
UWorld early, you may not be able to complete it (like it happened with me, could only
complete about 55% of UWorld). Should you do it fully? Yes, in all ways. Must do it fully. If only I
had started earlier and I had the luxury of extra time, I would have completed it.
- Every question on the exam is almost worth equal points. So why waste more time on a
question that is hard but will you give you more satisfaction but is also consuming a lot of your
time!
- Don’t think you need to study all day during the dedicated to be able to pass the exam. I
personally believe no exam will ever demand from you that you give it your whole day. Take
breaks. If you like to work out at the gym or love jogging, don’t think about it twice. If it relaxes
you, it’s worth taking.
- You must solve NBME 25-31 at least, at all costs. I couldn’t solve all of them but it is totally
worth it to solve these NBMEs. You must do these so well that you are well aware of every
concept tested there. It is going to be worth it in the real deal. Also, do the free120s that are
available online but I would suggest that you do these once your exam date is closer.
- Lastly, don't be too hard on yourself. It's easy to get discouraged and frustrated during the
studying process, but it's important to remember that everyone makes mistakes and has
weaknesses. It's all about learning from them and improving for next time.

Instagram accounts worth following

• matcharesident (https://www.instagram.com/matcharesident/)
• humansofu.s.m.l.e (https://www.instagram.com/humansofu.s.m.l.e/)
• inside_thematch (https://www.instagram.com/inside_thematch/)
• insideusmle (https://www.instagram.com/inside_thematch/)
• projectimg (https://www.instagram.com/projectimg/)
• thegirlnextdoor (https://www.instagram.com/thegirlnextdoctor/)
• malkeasaad (https://www.instagram.com/malkeasaad/)
• _manikmadaan_ (https://www.instagram.com/_manikmadaan_/)

Top Secrets from Classified Files

• Watch Professor Marty Lobdell’s video – Study Less Study Smart
(https://www.youtube.com/results?search_query=Professor+Marty+lobdell)
• Ted talk, Tim Urban: Inside the mind of a master procrastinator
(https://www.youtube.com/watch?v=arj7oStGLkU&t=3s)
• Use Notion as your second brain space
• Learn to use Anki (pre-made decks didn’t work for me so I made my own decks, primarily
image decks)
• Knowledge is of no use unless you put it into practice. The primary factor that determines
exam readiness is the number of questions solved!
• If you constantly find yourself out of focus, a website called Focusmate may help you. Try it
out and see if it works for you- https://www.focusmate.com/dashboard
• Recommended reads- Indistractable by Nir Eyal, Limitless by Jim Kwik, and, The Power of
your subconscious mind by Dr. Joseph Murphy
How I use Notion
Notion is a powerful and flexible productivity tool that can be customized to suit the specific needs. It's
intuitive interface and versatile feature set allow users to organize notes, create to-do lists, track progress
on projects, and collaborate with peers. Whether you're studying for exams, managing clinical rotations, or
tracking research projects, Notion can help streamline your workflow and improve your productivity.
To take digital notes- I used to take notes from UWorld onto my notion. Notion really helps you keep stuff
organized.

To-do list- Below is my personalized to-do list that I found to be ultimately a very productive tool.
Final Words
As medical students, preparing for Step 1 can be both challenging and rewarding. I hope that this write-up
has been helpful to all readers as they navigate this process. Remember that you are not alone in this
journey, and that there is a whole community of students and professionals who are here to support you. I
encourage you to approach Step 1 with confidence and a positive attitude, and to use the knowledge and
skills you have gained through your studies to succeed.
Preparing for Step 1 was one of the most challenging experiences of my medical education, but also one of
the most rewarding. I hope that my experiences can help other students navigate this process more
smoothly. Best wishes to all of you as you continue on your path towards becoming successful physicians!
Feel free to pass this PDF on to anyone in need. Wishing you the very best.
Thank You.
Himanshu Jindal
G.S.V.M. Medical College, Kanpur, India