USMLE Step 1

Stephanie Goldstein, Class of 2017

Stephanie is a member of junior AOA and is applying for residency in orthopaedic surgery.

Basic Approach

Ironically, my strongest advice is to take everyone’s advice with a grain of salt! No one knows your study style better than you do, so adapt the advice you get here to a plan that will work for you individually. I am a big believer in working smarter, not harder, which for me means having a set time for studying (during daylight hours, never an all-nighter) and minimizing distractions so that I get the most out of the hours I spend studying. Being prepared to study (i.e. knowing something about pharmacology before attempting a block of UWorld questions about it) also helps make your study hours more efficient and valuable. Overall, while Step studying will be more intense than your average exam studying, keep doing the things that keep you happy and sane! Spend time with family and friends, work out, watch TV, eat reasonably healthy—you will have to take board exams for the rest of your life (sorry) so don’t make your life miserable every time you have to take one.

Pre-study time: Do well in your normal classes. Consider opening First Aid for relevant blocks and perhaps trying some UWorld questions. Priority should be learning things well the first time around via your normal med school classes. About 2 months prior to my official study time (spring break on the old 2 yr curriculum), I began a very casual read-through of First Aid that I finished by the time my official study period rolled around.

Study time: First, make a schedule that will work for you. Are you a streamer and rarely wake up before 11am? Don’t force yourself into a schedule where you wake up at 7 every day! A typical day for me was spending the morning reading half or a whole section of FA (depending on the length and complexity) and using the afternoon to do UWorld. I would usually do 30-40 questions related to the topic I had just read, then 40-50 more on random mode. I made sure to review the answers carefully, including the ones I got right, and annotate FA with any new tidbits that I had learned from the question. I took one practice test per week (5 total, including the one given by the school) and took 1 day off per week, plus an extra 3ish days to attend a graduation. I also knew that I was someone who burned out easily on studying, so I gave myself a relatively short amount of time to study—4.5 wks—knowing that if I gave myself longer I would tire out and not study the last week anyways. However, if you’re someone that feels more comfortable studying right up to the test, schedule yourself more time to study.


I am a bigger believer in only using the Trifecta of Step 1 study materials: First Aid, UWorld, and Pathoma. Do not use your syllabi from the year. FA and UWorld are absolutely necessary and I would recommend going through them multiple times (all said and done, I did 3 passes of FA and 2x through all of UWorld). Pathoma is useful for when you’re tired of reading but still want to be mildly productive. I personally think that any using other resources will pull you in too many directions and won’t add any value to your study experience.

Test Day

Ideally, take a very light day on studying the day before. Relax and get a good night’s sleep. Have a general plan for when you’re going to take your breaks (most people do after 3 blocks), but if you’re feeling like you need some time to collect yourself, don’t be afraid to take a 5 min break even after 1 block. Bring snacks and water for your break times. The testing facility will have noise canceling headphones. Trust in what you’ve studied, crush the test, then celebrate after! You’re done!


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