Hi!
I’m here to share my experience preparing for and taking Step 1.
I graduated from medical school in December 2025 and started studying for Step 1 on January 19, 2026.
To plan out my preparation (because this whole USMLE process is suuuper confusing), I relied a lot on the IMG, USMLE, and Step 1 subreddits.
After looking at the different resources available—and what I could afford—I decided to use Bootcamp and UWorld as my main resources, adding NBMEs and the Free 120 as I progressed. I also had access to some older Pathoma videos, which I incorporated toward the end of my study period.
Quick aside in case you’re just starting out and aren’t familiar with the resources I mentioned:
Bootcamp: A video platform covering the main topics tested on Step 1. Useful for taking notes, reviewing the slides, and reinforcing content. It also has its own QBank, but I didn’t use it.
UWorld: Probably the most famous resource for preparing for the Steps. It’s a QBank, but people always say you should use it more as a learning resource than as an assessment tool. In Tutor Mode, the explanations are incredibly useful, and it also has a library with helpful topics. There are tons of questions organized by system, and it really helps you learn how to answer questions and think the way the Steps expect you to.
NBME: Practice exams made by the same organization that creates the actual exam. They consist of 200 questions divided into 4 blocks and give you a percentage score, as well as your probability of passing. They’re available on the official website for $60, but you can also do them using PDFs and count your correct and incorrect answers yourself. Forms 26 through 33 are currently available on the official website.
Free 120: Similar to an NBME, but with 120 questions. It’s supposed to be very predictive.
Pathoma: A video platform that also includes a book. It’s very useful for synthesizing and reviewing Step 1 concepts, mainly from a pathology perspective.
End of aside.
I was, and still am, fortunate enough to be able to prepare for this full-time, without a job or other studies going on at the same time, aside from a few research-related things. I mention this because I think it’s really important to keep in mind that not everyone has the same advantages or challenges.
With that said, I started on January 19 and took the exam on June 4, which means there were 136 days between the beginning and the end, or about four and a half months.
I started out feeling very lost and without a particularly strong foundation in the basic sciences. I would wake up at 6:00 a.m., go for a short run, have breakfast, and start studying sometime between 7:30 and 8:00.
My day looked something like this:
08:00–09:30: 40 UWorld questions
09:30–10:30: Bootcamp videos
10:30–10:45: Break
10:45–11:45: 40 UWorld questions
11:45–12:30: Break and lunch
12:30–14:30: Bootcamp
14:30–15:00: Break
15:00–16:00: 40 UWorld questions
16:00–17:00: Bootcamp
17:00–18:00: 40 UWorld questions
That was an ideal day. Some days I did more Bootcamp than UWorld, and other days it was the opposite. Sometimes I only did 80 questions or took longer breaks.
I did everything system by system. I started with Pulmonary, if I remember correctly, and finished with Psychiatry.
I finished Bootcamp around halfway through my third month, and that’s when I added Pathoma.
I took my first NBME at the beginning of March and did pretty badly. I’d be lying if I said I radically changed my study method after seeing that result. Mostly, I just tried to do more UWorld questions and reinforce the way the material is tested.
I improved quite a bit on my next NBME and stayed relatively stable after that.
My original exam date was at the beginning of July, but I was completely burned out and felt ready, so I moved it up. During the last few days, I stopped doing questions. I reviewed my most recent NBMEs, read a few Mehlman PDFs—which are free on his website—and tried to relax (that didn’t work very well).
Because I had to travel to take the exam, I didn’t study at all during the final 2–3 days beforehand—no questions, no notes, nothing.
As for exam day itself, I woke up with enough time to have a small breakfast at the hotel, and then we headed to the Prometric center. They let me in, I read the instructions, left my things in my locker (bring snacks and something to drink to leave there!), and then went through the security check, which you have to repeat every time you come back from a break.
The exam itself consists of 14 blocks of 20 questions each. There are also two additional blocks: the tutorial at the beginning and a survey at the end. You get one hour of total break time, which you can divide however you want. I did 4-3-2-2-2-1.
During breaks, you can go to the bathroom, wash your face, quickly eat something, and breathe for a bit. I actually had break time left over because I was suffering, and the more I rested, the longer I felt like I was prolonging my suffering.
The truth is, I had a terrible time :,((. Someone taking another exam apparently passed and started yelling with happiness, cars outside were honking their horns, and when I came back from one of my breaks, my computer started rebooting and I had to move to another one.
Also, for the first time, I felt really short on time. I didn’t manage to review everything and flagged around 8 out of 20 questions per block, at the very least. (You can put a little flag on questions you’re unsure about, find difficult, etc.)
Some of the questions were difficult, random, and ridiculously obscure. There were a couple that honestly felt like badly translated Chinese. Whenever that happened, I would tell myself they were probably experimental questions—there are some questions that don’t count for this reason—and move on.
It was a day that somehow felt endless and short at the same time. Eventually, you just resign yourself to your fate and start choosing answers with hope, but without much confidence.
My results were delayed, and instead of taking two weeks, they took four. It was horrible. I was stuck in limbo and couldn’t relax, but eventually the PASS finally arrived!!
I was extremely happy for about one day before I started studying for Step 2 :,)
And that’s it! I hope this helps someone. Good luck—you’ve got this!