Dedicated Step 1 study schedule Reddit

TL;DR UW Qs over everything (Anki). You don't need to know everything to get that Q right. Your practice scores are overhyped. Goal: get the Q right on test day. Maximizing ROI on study time is key. Confront your emotions at least once before test day. Hope for the best, plan for the worst - there is a life after STEP 1.

Better late than never, took my exam summer 2019. Even though everyone says not to read reddit because the gunners, I did anyway. And yes it was alarming at times, but the encouraging posts of people in a similar boat as me really kept me going.

• Something I want to stress is THERE IS NO ONE "GOLDEN" WAY TO DO WELL ON STEP!!

• I have tips I will suggest that worked and what didn't work for ME. If it doesn't work for you, that is 100% OK! Do not force yourself to read or do something just because u/gunner270orbust said that's the way to do it. I saved a lot of time and stress from immediately quitting what didn't work for me and picking up something else. No one knows how you learn the best except you.

• I know this statement is inherently cocky, but I genuinely am not trying to brag about anything. This subreddit really helped me out last year & I wanna keep it going. I wanna give others my experience so all that shit I went thru during dedicated does more than just what it did for me.

Dedicated length: 7 weeks

Goal 250, Actual 250

During dedicated and looking back, I was ready at 6 weeks. But i don't think the extra week negatively affected my score. I do think it added to my anxiety though.

Background stats:

• M1 - barely passed first semester. Improved second semester, but still average-student.

• M2 - stepped it up big time. Took the time to understand the material really well so that when dedicated came around, i could review it easier. Honored most of organ blocks and honored the 2 clerkships I had before dedicated.

• EDIT: Pre-dedicated - I did not do any "extra" studying for STEP 1. I prioritized doing well in my organ blocks because those grades are important too, especially if you are shooting for a competitive specialty, it never hurts to have as many honors as you can. What I think I did efficiently during M2 organ blocks was I made sure I was studying for both the block and STEP 1. For example, GI block: I watched all the GI pathoma, the GI sketchy pharm, and Sketchy micro for whatever GI bugs came up in lectures. For most medical schools, there is a significant amount of overlap between your curriculum and STEP 1 content - use this to your advantage. If you want to do more, do the Zanki cards for these organ blocks as well.

Edit: "Should I move my test date?"

• Been getting this Q a lot. When I booked my test date (5 months out or so?) I originally had ~ 6 weeks.

EDIT: I am a "traditional" US med student so my advice is best suited for US M2s who just got done with organ blocks with a dedicated study. A lot of these tips can still be used for students with longitudinal study time, FMGs, and non-traditional students. However, I'm not ignorant to the fact a many of you have families, jobs etc, but I my experience and I don't want to ill-advise anyone! Please reach out to other ppl on reddit in a similar position as you for clarification on any specific questions.

Resources used (in order of importance):

1. UWorld

   1. Every morning started with timed mixed question blocks. IMO, doing Qs by subject don't use the question efficiently. You gotta have it like how you'll see it on test day: timed mixed. Worked my way from 80/day to 120/day. Reviewing took me HOURS in the early weeks, but you will be able to go through faster as you learn more.

   2. UW explanations is THE best text. Use the search function to find topics and figures. Treat UW explanations like a textbook. If i needed a more detailed review I'd look it up in UW search bar. If I wanted a quick review, looked it up in FA

2. Pathoma

   1. you've heard it before so i'm not gonna repeat. One of the best resources out there and extremely high yield.

   2. **Pathoma Chapters 1-3** EXTREMELY HIGH YIELD. ~15-20% of my actual exam

3. Sketchy

   1. Pharm & Micro are gold. I didn't like sketchy initially but I grew to like it. To really memorize the images, I found Zanki Pharm and Pepper Micro decks to be very helpful. Knowing these sketches will get you so many of the recall questions on STEP. I do think if you wanna score 240+ you gotta get ALL of those recall questions right. Should be reflexive.

4. Boards & Beyond

   1. For things you need to be taught in more detail/ things not in Pathoma.

   2. I did not watch all of them. High yield ones i recommend: Neuro (lesions), Immunology, any Physiology, Biochem (sometimes too detailed, but his summary slides were good)

5. Anki: In hindsight, I spent too much time of my day doing anki cards. I inefficiently was doing wayyy too many new cards/day and for too much stuff. You cannot do all of Zanki for the first time during dedicated nor should you. If you're an M1, start Zanki now alongside your school curriculum. EDIT: Also basic Anki tips: if you are starting brand new fresh, suspend all every single card. Then use Browse to search for cards on topics you are struggling with and selectively unsuspend those cards. This will help you not get overwhelmed with the cards. You don't need to do all these full ass Anki decks to get the question right on test day. Sure it might help, but there are more efficient ways IMO.

   1. Zanki Step 1 deck

      1. Zanki Sketchy Pharm

      2. Pathoma Chapters 1-3

      3. Vitamins and other random straight memorization BS

   2. Pepper Micro (some Pharm) deck

   3. Dorian 100 Anatomy concepts deck

      1. This is the only resource you need for anatomy. No joke, 99% of my anatomy questions were covered here. The pdf is somewhere out there.

6. FA

   1. You do NOT have to read this book cover to cover to do well. Someone on here once said if you memorize the entire book you are guaranteed 250+ and that's fucking malpractice lol. Not true. I did read most of FA, but not all of it.

   2. Good for quick review of high yield topics. Does not TEACH you.

   3. Rapid Review is the most high yield part of FA. Review with friends close to test day

7. EDIT: Supplements for weakest areas

   1. BRS Physiology - personally really like the way this book reads. logical flow. helps me understand physiology which is commonly tested. You can't just memorize the basic hormones and functions. You gotta understand what happens if they tilt the system one way or the other.

   2. BRS Biochem, Molecular bio, Genetics - good review for biochem fed vs fasting. Detailed explanations of all those metabolic pathways - don't need to memorize. BUT by reading these details, it will help you understand and recall the big picture faster and better.

• So summary:

  • Qbank: UWorld

  • Quick Review: UW (search), Pathoma, FA

  • Detailed Review: Pathoma, UW

  • Comprehensive Learning: B&B, UW, BRS

  • Memory Aid: Sketchy, Anki

EDIT: Approach to Dedicated

• General algorithm of what I did:

1. UW

2. Pathoma (for todays topic/system)

3. UW

4. Identify my weak topics/systems on UW and/or past practice test reports.

5. Ask myself why am I missing these questions and pick b/w 3 options: quick review, detailed review, or comprehensive learning

   1. "I just forgot a couple of things" --> quick review of written notes (personal notes, FA, pathoma text, etc.)

   2. "I recognize these concepts, but not enough to answer a Q correct" --> detailed review with (Pathoma, textbooks, OME, Amboss, Osmosis, there are so many resources so use whatever you are already familiar with or have used before)

   3. "Never heard of this. Didn't know this was a thing. Covered in pre-clerkship but did not understand whatsoever" --> comprehensive LEARNING (B&B, UW explanations, textbooks, Pathoma, online videos etc.)

Golden Rules: ( I know I literally said there are no golden rules lol but here they are)

1. UWORLD UWORLD UWORLD

   1. If there's 1 thing you have to do, its practice questions. This is non-negotiable. You can sit there pressing spacebar all you want, but if you don't know how to apply it and get a question right, all that time was wasted. PERIOD. The end goal is getting points. How do you get points? Picking the right answer. You gotta practice this. You can memorize the rules of football backwards and forwards, but if you've never actually played, you're not gonna be happy lol.

   2. Important: When reviewing your questions (especially your incorrects), you should be reviewing the explanations so thoroughly that if this same exact question came up again, you will get it right. If you aren't reviewing with this much intention, then you're not efficiently using the question.

2. Take 1 day off/week & go to those big life events that you will regret missing.

   1. I took Sundays off, got groceries, exercised (this was very short lived lol), watch GoT with friends who were also in dedicated, called my family, watched Netflix.

   2. I truly think this helped prevent burnout especially for those going 6+ weeks.

   3. Yes I kept up with Anki, but thats it.

   4. Early on in dedicated, I missed a friends engagement party because I was studying and I regret it so much. I thought the same exact thing as you, but I promise that ONE day will not change your score.

Thoughts on Practice Exams:

• Originally, my advisor only had like 3-4 practice exams on my schedule. I know myself and I learn really well from practice test. I also am not the best with time management so I took every practice test I could fit in my schedule and I don't regret it at all.

• UWSA >>>>> NBME

  • UW

    • length and style of questions more representative of actual

    • UWSA2 predicted v well. UWSA2>UWSA1

    • better explanations

    • answer choices differ significantly from each other (like the actual)

  • NBME

    • 20% of the actual Qs were similar to NBME. Shorter questions, less detailed clinical vignette.

    • answer choices overlapped and you couldn't eliminate answers as easy

    • searched reddit, google and SDN for explanations

    • NBME 23 = 24 > 22 = 21 > 18 >>>>>>>>> 20

  • Free 120

    • good for common topics. I didn't get any exact question repeats but did get some repeat concepts.

• The reddit score predictor at the time i think predicted 244 +/- 6 or something

Words of Wisdom:

(easier said than done lol)

• YOUR PRACTICE TEST SCORES DON'T MATTER!

  • Or at least early on they don't and they don't matter as much as you think they do. What matters is what score you get ON TEST DAY. Your performance ON TEST DAY is what matters the most.

  • Just because you got 10 points lower than last week does not mean you are declining. Same goes for higher scores too. Yes when looking at all your scores as a whole, you gain some predictive value.

  • I emphasize this because you need to go in to the exam with realistic and wide expectations. The confidence with which they reported our scores was 66% at that time, so my score meant that if I took the test 100 times, 66 of those times I would get a 250 +/- 8. That means, 16.5(%) times I would score below a 242 and 16.5 times I would score above a 258. This shows the exam inherently, has plenty of room to fuck with your expectations.

    • so you get it. There's a lot of variability in your score that is out of your control. But you know what is in your control? THE KNOWLEDGE YOU HAVE AND HOW YOU ANSWER THOSE QUESTIONS. This is the one thing you can keep constant.

  • Prepare yourself before taking the test and again before opening your score report, for the what ifs? And make sure that you are at peace with the what ifs. Yes it is a very important exam score and you don't wanna choke. But before you take that test, you have to conclude with yourself that if things don't go as you planned, it. will. be. okay.

• Study next to someone, not with someone. At least not until the very end when you're too exhausted to compare yourself with friends lol.

Actual Exam thoughts:

• breakdown (ok idk if these numbers add up i got confused halfway but w/e lol)

  • 10% Gimmes that I knew I got correct

  • 40-50% Pretty sure I got correct (eliminated every other answer)

  • 20-30% between 2 answers

  • 10% educated guess, eliminated some answers

  • <5% completely guessed (short on time, didn't know, etc.)

• The questions are not trying to trick you. The questions are mostly straightforward, and if >51% of the vignette matches your answer/diagnosis but 49% you're like wtf? Odds are, you probably already have the right answer

  • The questions I got wrong, I probably got them wrong because I just didn't know the info. Not because the question/answers were tricky.

• EDIT: Weirdly enough, I ended up finish my sections with significantly more time than during dedicated. Even after going through my flagged. Kinda freaked me out at first, but when reviewing the Qs i saw that i really did eliminated all other answer choices and was very sure of my answer. Maybe I was just reading faster that day idk? I don't think everyone had the same experience, but if it happens to you, going faster or slower than usual, don't freak out. Just keep moving along like normal.

• Edit: I thought the actual was easier than UW. Way easier than NBMEs. I know you're like "easy for u to say you got a 250" and yes I agree BUT my point is these resources are inherently over-preparing you and that's a good thing. This just reiterates the Pareto principle. You want to feel like its easy.

Test Taking strategies:

I feel like everyone just assumes everyone knows how to take tests so no one talks about it. But in the beginning i did NOT know and was too scared to ask. So i'm just gonna break down some of my strategies, sorry if it seems basic.

• EDIT: YOU DO NOT HAVE TO KNOW EVERYTHING ABOUT A CONCEPT, IN ORDER TO GET THE QUESTION RIGHT. Something really important that I realized only after taking the actual exam. Keep in mind what the goal is: to get the question right. and get it right on test day. - seems obvious but I would forget this all the time. The goal isn't to memorize every single substrate of the figure in FA (which I caught myself doing many times). Yes that will help you answer the question, but it is not the most efficient use of your time. You could also get that same question right, by just knowing the final substrate.

  • The Pareto principle - says you can get 80% of the results, by just knowing 20% of the knowledge. This applies to many areas of life. (LET ME CLARIFY THO - I AM NOT TELLING YOU TO THAT KNOWING ONLY 20% OF PATHOMA/MEDICINE IS ENOUGH. IT IS NOT. KNOW IT ALL LOL. I'm speaking about a bare minimum and why it is important to know a little bit of every system.)

    • Here's an example: Question on rheumatology with 10 answer choices (yes that is a thing). You only know 20% about this topic. With your puny 20% of knowledge about rheum, you are able to eliminate 8/10 (80%) answer choices. You now have 2 left. WOW! Getting down to 2 answer choices is such a big milestone. You now have a 50% chance of getting the question right now which is significantly better than what you started with.

• Read the question stem FIRST (the last sentence)

  • Is it a basic question you can answer right now with >50% certainty? ANSWER NOW.

    • 100% sure? pick answer and move on

    • 50% sure/not sure? - pick answer, flag and move on

    • Need more info, not sure at all? Don't look at the answers yet. If you do, look at them ALL and not just one. (I get caught with the anchoring bias a lot. Practice to avoid this)

• EDIT: Use the strike out feature. Get used to it early on if you don't already use it. This is important for those questions that you don't know the correct answer, but you KNOW the wrong answers. This is also a good method of checking yourself when you are reviewing flagged Qs. Maybe you over flagged a question being careful. you see that you literally strike out all the other answers - most likely you are not going to see something in the stem that you totally missed and completely changes your answers. You got the right answer - unflag and move on. (At least that is what you are going to tell yourself)

• Read the question from the top, every single word.

  • I struggle with this even today. So many times I skimmed the question and picked an answer I wasn't sure of. When i reviewed the question in full detail, the question and answer were so obvious.

• EDIT: Use the highlighting tool sparingly. I used the highlight but it seemed like it was just to keep my focus on reading. At some point, I realized highlighting so much was slowing me down and started actually highlighting things that needed to be highlighted**.** Here are some examples:

  • highlighting what the question stem is asking. what is the "next step in diagnosis" vs "best next step" "underlying mechanism" "diagnosis" "screening test" "next step in management"

  • abnormal lab values that weren't obvious to me

  • the chief complaint

  • pertinent history things that are difficult to search for within the vignette - because when you ask a med student what's pertinent, the entire thing gets highlighted. You don't need to highlight hx HTN because that word is used a lot in questions and your eye is subconsciously being primed to pick that word out faster.

• EDIT: Once you've read the entire question, try to answer it WITHOUT LOOKING AT THE ANSWERS. Come up with your own answer. This will help you avoid anchoring bias and will help you not get distracted by the distractor answers. We all have talked ourselves out of the right answer because we looked at another one against better judgement. ~~ I can't believe I forgot this tip because I think it's probably the most important test taking strategy I learned in med school and it made a big difference for me.

• Don't spend more than 1min on a Q

  • if you stick to this rule, the times where you accidentally go over and times when you answer in 20 sec will even out and you will have time leftover.

  • you gotta keep an eye on the time and when you are approaching 1 min, go ahead an pick an answer, then at 1 min, deicide about the flag and move on

• Lab Values

  • open up the lab values at the beginning of every block. The split screen makes the question text width shorter so your eyes don't have to travel as far to read. Seems trivial but really helps with time.

  • Helps to memorize, familiarize yourself with common labs so you don't have to keep looking them up. Or at least familiarize yourself with the USMLE lab sheet format and know where everything is.

  • Memorize: Na, Cl, K, HCO3, pCO2, Hgb, WBC and breakdownPT, PTT, bleeding time, Ca, AST, ALT

• When in doubt, pick the answer that is most common

  • Ex: bleeding person? Von Willebrand's

• Flagging can be a gift or a curse - on test day, do what you have been doing and don't change it up

  • I tend to over flag because I'm psycho.

  • re-emphasizing: if you don't know at all, guess, flag and MOVE ON

  • the time you spend trying to all of sudden know something that you DON'T know could be used on another question.

• Ethical questions: pick the answer the test writers want you to pick, not the one that sounds good to you. You'd think it would be obvious but you'd be surprised

• "Refer to specialist" - rarely if never the correct answer.

• If a question is random AF and you've never heard of it before, it's probably experimental. At least that's what you are going to tell yourself. Guess and move one.

• Switching answers on second pass

  • ah the age old debate. No easy answer to this. You've done the practice tests and it shows you how often you go from right to wrong, wrong to right.

  • my experience

    • if i have read the Q fully on the first pass --> don't switch

    • if i skimmed, needed more time, didn't give it a good quality thought --> switch

    • The default is: don't switch

My Biggest Regrets:

• Not having all of sketchy watched at least once before dedicated. (isn't that big of a deal but would have saved me a lot of time)

• Not starting zanki during preclerkships

• Spending TOO much time on biochem

  • i had like 3-4 questions total on biochem. The vignettes were long and gave you characteristic presentation of the one diagnosis. You don't need to memorize every substrate product etc. Don't need to recall but you do need to recognize biochem concepts and diagnosis. UW is the best resource and example of how they will ask biochem question. Yes memorize the specific enzyme or substrate that is deficient. Know generally what biochem pathways are activated and when (fasting or full etc)

• Spent too much time on Anki during dedicated. I'd say 60% of my anki time could have been cut out. Yes I knew a lot more facts than people who didnt do anki. But i don't think that necessarily got me any points that i wasn't already going to get. Try not to spend more than 1-2 hours on anki/day.

• Not taking the free 120 at the test center (who shall remain nameless).

  • I laughed at the thought of practicing at the test center and thought it was lame af. I regret it so much.

  • The environment was so unfamiliar and anxiety inducing when i got there on test day. The headphones were uncomfortable and i spent a good 30 sec during my exam trying to decide whether to use them or not.

• Not reading the USMLE test taking tutorial/instructions that everyone tells you to read before test day

  • so i actually did do this but i wanted to stress it to everyone. DO THIS. Holy shit like as i was doing the tutorial i realized they changed how to ELIMINATE ANSWER CHOICES. If I realized this on test day, idk what would have happened.

  • Take your time and read this shit please. You're not a nerd. And you will regret if you dont.

  • Edit: https://www.usmle.org/practice-materials/index.html

• Not going to my friends engagement. still regret it today. I don't remember what i studied that day but i would have remembered the engagement.

• Only focusing on the process of taking the exam and not focusing on how I would feel during the exam.

  • the difference (for me) between taking a practice exam at home in my pajamas and taking the real thing at the test center was inexplainable.

  • As soon as i started the exam my heart was racing uncontrollably and I thought I was going to pass out. But that's a story for another post....

  • My point is, take care of your mental health during dedicated and do not just suppress it. I suppressed the stress so much. I honestly never envisioned life after the exam. It didn't exist to me. I believed that as long as I studied, and knew all the material, I would do well on the exam. But i learned the hard way, its not just learning about the material, you gotta learn how to cope with your stress and emotions because the ARE in fact very real. And like the exam, if you don't practice with these, you won't know what to do with them on test day.

• Sharing my practice exam scores with friends/classmates

  • I loved taking practice exams with friends at the same time and then reviewing with them after. Great way to get explanations because everyone knows different things and tricks.

  • however, sharing scores was more damaging than reassuring. Comparing yourself to other people (that you know or even random people) can be very damaging if you don't know how to deal with that.

Schedules:

I'm posting just some examples of my schedule. If you want the whole thing let me know.

• Weekly Schedule:

• Daily Schedule: (example)

Edit: OS List = oh shit list. Suggested by my school advisor. While going through UW, I made a categorized google doc with a table of contents of all the different subjects (Heme, Cardio, Biochem, etc). Any concept/question I kept repeatedly getting wrong or struggled with, I wrote a BRIEF 1 sentence summarizing the HY points I learned from that Q. Then at the end of each day, I reviewed the OS List and deleted the sentence once I finally memorized it. I also WISH I added HY UW charts/tables to the list because they are very helpful. I say I WISH I could do this because obviously we aren't allowed to screenshot UW and I am a faithful rule follower.

Anyway, the OS List is helpful if and ONLY IF you review it every single night. Otherwise, you are literally just wasting time typing/writing up notes that you never look at again and it doesn't stick. If you wanna see my OS list example PM me or lemme know.

Final thoughts:

• Its been 2 hours and I officially have procrastinated long enough lol

• Take every piece of Step 1 advice as a suggestion not a requirement

• cliche If you do your best, there is literally nothing else you can do.

• There is a life after STEP 1

• PM me with any questions :)

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