It’s that special time of year, when 2nd year medical students across the country are gearing up for the biggest test in their medical career, and emergency room doctors are seeing a spike of patients with gastric ulcers. I myself am taking USMLE Step 1 in the spring. For those of you not familiar with this test, it largely decides whether or not medical students will be competitive applicants for hard-to-get-specialties. You can bet your debt load that the space doctor performing mohs surgery on the international space station rocked this test with style. Hyperbole, but you get the picture.
Since every student studies differently, there is no right or wrong way to prepare for this exam. You have to find what fits for you. However, businesses have taken advantage of our test anxiety by flooding the market with study products all guaranteed to “boost your test score!”. But you are money conscious, and want to get the best bang for your buck. That is why I, Mr. DebtAnatomy, took it upon myself to scour web forums, reading up on different study plans, examining reviews of products, testing out some of these products myself, and speaking with personal friends who aced step 1. I now give you Mr. DebtAnatomy’s top 9 resources for the USMLE Step 1:
1. First Aid for the USMLE Step 1. This book is unequivocally required for step 1. If you haven’t heard of it by now, you’re in trouble. First Aid functions as a prewritten notebook of most of the material covered in the first two years of medical school. Every year a new edition of First Aid is released, containing updated pictures and facts. The 2016 edition recently came out:
I annotated my 2014 edition on and off over the past year, so I am on the fence about buying the new 2015 edition. My cheapness is battling with my desire to have every weapon in my study arsenal updated and ready to go. After extensive online research, my conclusion is: You’re probably good with either the 2014 or 2015 edition. Just make sure you have one of them!
Another debate about First Aid is how to use it. Some approach it like a novel, reading it from the beginning to the end several times. If that’s your style, then great! I have tried this method, and while it is great for lulling me into a deep sleep, I haven’t retained much. The other approach is to use First Aid as both a reference and a compilation of your notes as you work through question banks. I have been doing this for the past month and a half, and have finally felt like I am learning all the dense tables and diagrams in First Aid. More on this later.
2. Uworld Q Bank: This is without a doubt the highest rated question bank for Step 1. Because of this, it is recommended that you don’t waste these questions at the beginning of your studying. Instead, you build up to these questions. One of the reasons they are so great is that they mimic Step 1’s multi-step questions. For example, instead of giving you a clinical vignette about a patient with rheumatic fever and then asking you to identify the microbe, they will instead give you the vignette that contains the symptoms, and then ask you what the side effects are of the treatment. This multi step question requires you to identify the symptoms as rheumatic fever, realize that it is caused by strep pyogenes, figure out the drug of choice, and then remember its side effects. Not only are the questions amazing, but their explanations afterwards are supposed to be top notch. Bottom line, Uworld is a must. The uworld site says there are over 2,000 questions in this qbank (reddit claims there are 2,209), and you can get a 60 day subscription for $179. Learn more by visiting their website here.
3. Uworld Self Assessment Exams: There are 2 self assessment exams available through uworld. Each contains 4 blocks of 46 questions, and is supposed to mimic the real exam (keep in mind that the actual exam has 7 blocks of 46 questions). These self assessments are highly rated, and will give you an estimated 3 digit test score. Reviews have been very positive, and some of the people I have spoken with reported that these self assessments predicted their actual score more accurately than the NBME self assessments. Purchasing both uworld self assessment exams is $60, giving you 2-weeks access to each test. Learn more at their website here.
4. NBME Self Assessments: Don’t get confused by all their acronyms. You are interested in their Comprehensive Basic Science Self Assessment (CBSSA) forms. Each self assessment has 4 sections, with up to 50 questions per section. You have 1 hour and 5 minutes per section, but you can pause your test, as long as you finish it within 20 days. There are 6 self assessment forms available as follows: 11, 12, 13, 15, 16, and 17. Each form has two purchase options. $50 gets you a form with very basic feedback, as shown in this pdf. $60 gets you the form with a little more feedback, including being able to view the questions you missed (correct answers not provided) as seen in this pdf. As you can see, the feedback isn’t great, which is the biggest con to these self assessments. That being said, they do a decent job of predicting your score, and they are a necessity for good test preparation. Learn more at the NBME Self Assessment site.
5. Usmle-rx Qbank: If you’ve got the time to do multiple qbanks (which is highly suggested), and you want to save uworld for last, then I recommend usmle-rx. In making this decision, it came down between kaplan’s qbank and usmle-rx. You really can’t go wrong with either. However, I chose rx for a few specific reasons. First, usmle-rx is made by the creators of first aid. Every question has detailed answers, including digital pages taken right out of your chosen edition of first aid. Remember how I said that I can’t read first aid straight through? Instead, for the past month and a half I have been doing question sets in usmle-rx and then studying the exact first aid segments covered by those questions. This has been extremely high yield for me. Usmle-rx has 2,267 questions, and is a pretty good deal. A 3 month subscription costs $149, but you can get a $30 discount for joining the American Medical Student Association (AMSA) before you make the purchase (joining AMSA if free and literally takes 2 minutes). Finally, usmle-rx has upgraded their questions over the years and they are starting to mimic the multi step thinking process required for step 1. At the very least, this qbank will get you intimately familiar with the content in first aid. Check out more at their site here.
6. Lange Pharmacology Flash Cards: Pharmacology is a huge part of step 1, and while first aid contains a lot of pharm, it is a good idea to get another source. The consensus of my research is that Lange Pharmacology Flash Cards are the best, due to their straightforward simplicity. The front of the card has a short clinical vignette, and the back contains similar drugs, mechanism of action, clinical uses, and other information.
I have used these during 2nd year and I think they’re great! I plan on using them extensively for step one. They cost around $30 and can be found on amazon:
7. Lipponcott’s Microcards: These cards have a fair amount of detail, but I really like how they are organized. The front side has a drawing of the organism, a clinical case, and a flow chart of laboratory tests. The back contains the clinical presentation, pathobiology, diagnosis, treatment, and quick facts of the organism. These can be found on amazon for around $40.
8. SketchyMicro: If you are really worried about memorizing all your bugs, you can look in to sketchy micro. I plan on watching these casually during lunch breaks to solidify the information from the microcards and first aid. These are fun videos that draw outrageous pictures in order to teach you the details of each organism. Currently they only cover bacteria. Some reviews say sketchymicro has too much detail for step 1, but I have already found it helpful on my qbank questions. While not a “required” resource, it may just give you those extra facts necessary to put you over the top. Learn more about their pricing at their website sketchymicro.com.
9. Pathoma: Last but certainly not least, is pathoma. When selecting a pathology review course, most reviewers come down to either pathoma or goljan rapid review pathology. I love pathoma. Let me say it again. I LOVE pathoma. $85 gets you 21 month access to all the pathoma videos online, as well as the pathoma textbook, which is incredible. Learn more at the pathoma site.
That being said, I have not actually tried goljan rapid review, so I can’t talk much about it. Feel free to check it out yourself:
I hope this helps you figure out what you want to use for the test. Comment below if you have found other awesome resources! Click here to read about Mr. DebtAnatomy’s strategy of tackling the Step 1 UWorld QBank.
EDIT: I have since received my score. As most of my class knows who I am, I do not wish to post my score, because I do not want to be accused of bragging, etc. However, I also realize that as a reader you might pay closer attention to my Step 1 advice knowing that I scored well. So here is a compromise: Whenever I listened to advice, I paid extra attention to guidance from people who scored >250. Using this bar of measurement, my pre-step 1 self would’ve paid extra attention to my post step 1 self. If that’s not clear enough for you, then I suggest you study extra hard! 🙂