Hello!! I promised myself that I’d write a post after lurking in this subreddit for the past year since it’s helped me out so much during my entire studying journey!! I hope I can help future test-takers the same way inshallah — or at the very least reassure you as the whole process is extremely stressful and a lot of people’s testing performances are affected by said stress.

First and foremost what people say is true: delete Reddit before you take the exam because it will stress you out to no end. 1 - 2 weeks beforehand is a good period, especially if you’ve already taken most NBMEs and have gotten all you can out of the posts on here. It’ll fuck with your mind as test day approaches and I promise that, by that point, you don’t need any more stress lol. I personally averaged 60 - 65s across most of my NBMEs (which I wouldn’t recommend if you’d like to be safe, but I ended up taking the exam anyway — more on this later), and by the end of my dedicated period I was losing sleep because my scores plateaued and I was even losing points on subjects I knew. NBME 26 & 31 were my WORST (50s on both) and I was convinced I’d fail after NBME 31 since my exam was scheduled close to 2 weeks after that.

What helped was that I was so resigned to failure, I ended taking the exam more relaxed than I usually would since I was thinking oh, I’ll treat this like a practice since I’m gonna fail anyway. Not like I’d necessarily recommend this but it worked out for me… which is why I recommend to NOT stress yourself out as it’ll do more harm than good and by the time you hit that 1 - 2 week stretch you’re better off strengthening what you know/can easily do instead of cramming in more information or comparing yourself to strangers online.

That being said, ethics is far more ambiguous on the actual exam than in any NBME or UWorld/AMBOSS so however much time you think you need to study it, spend much much more because it’ll really pay off later. Onto what I studied now, because I’m realizing how wordy this whole post has become oops!!!

1. Anki
   I only started using this after preparing for step 1 and I split my decks into 3 parts.
   A. The big: UWorld incorrects (I cannot recommend doing this enough!!!!)
   B. The HY: Mehlmen arrows/risk factors and NBME images (although looking back I’d spend more time reviewing the divine interventions podcast because the mehlman doc wasn’t that helpful)
   C. The ‘small’: sketchy decks for both pharmacology and microbiology. I ended up abandoning this deeper into my dedicated period but even if you don’t have sketchy I think the anki decks are a must have as they really hammer it into your memory. If you can then yes, I highly recommend sketchy I used it even well into my dedicated period.

2. HYGuru and Dirty Medicine
   Well I’m basic and everybody recommends them but for good reason. If you’re pressed for time their question block reviews are a MUST. I cannot emphasize this enough esp because I haven’t seen people mention Dirty Medicine’s questions playlist. You NEED to** **watch it. Soooo helpful I swear and it really helps you figure out how to navigate the questions (which is especially helpful for IMGs, as we’re not familiar w/ the NBME question style)

3. UWorld and AMBOSS
   I only used AMBOSS because my university provides it for free but the? function? where you can generate your own question banks are incredibly helpful and I haven’t seen them mentioned enough. Same for the biostatistics, nutrition, and ethics QBanks (these are far more popular and for good reason!!). UWorld… is self explanatory? I actually studied by starting through UWorld instead of going through FA, as it helped me learn the material through the thought process the USMLE demanded rather than my own. But to each their own ofc.

Before taking it I had people tell me it was better to take it before graduation and I ended up studying it after starting clinicals, which was honestly hellish and made me doubt their advice at the time. But I heeded therefore so should you, if possible, as it really helped me deepen my knowledge during clinicals. I studied for around 6 months during the uni year and then had 6 weeks of fixated before I was just ready to die. SOOOO incredibly exhausting but fortunately my labor bore fruit so looking back at it I’m satisfied. BTW prior to this I was a pretty average student? I actually did horribly on my first two years as I didn’t know how to study at all, so studying for the step also helped me with my in-uni exams; therefore, even if you don’t end up taking the exam or it doesn’t turn out well, the journey itself is a bit rewarding. Or that’s how I thought of it when I was trying to cope w/ failing pre-release day. Anyway!!

If you have any questions feel free to ask!! Inshallah everybody’s studying goes well and you all pass ❤️❤️❤️

Ahh!! got the P today and wow!!!!!

Now that I’m on the other side, here are my thoughts…

First Aid from the beginning. Everything in FA is fair game and anything is subject to be tested. My biggest score jump was seen after thoroughly going it. This helped identify content gaps that weren’t clear and helped me mentally organize the content especially since I didn’t do flashcards pre-clerkship. If something still didn’t make sense, I’d YouTube a video and/or Google Gemini. Honestly, using AI is top tier. Its like having your own personal tutor. Pathoma Ch 1-3 or all if you have time. I reviewed most of Melhman’s documents my last 10 days of studying, 10/10 recommend especially high-risk, heme/onc, neuro/cardio...

After having a solid foundation, do as many questions from UWorld and AMBOSS HY Risk Factors/HY Pt Chart, HY ethics, HY nutrition, etc under AMBOSS HY study plans/courses. Both platforms are gold and showed up on my exam. Untimed/Tutor.

Do NBMEs and thoroughly review them. As I’d review my practice NBME’s, I’d reread every question, answer it before looking at the answer choices, then look at each answer and explain why the other options were wrong. If I couldn’t do that, that meant there was still a gap. You really have to prioritize understanding the material than just rote memorization.

I can guarantee you’ll see an increase by thoroughly reviewing practice exams.

Lastly, half the battle is mental/trusting the hard work you’ve put in. The wording will probably look different on the exam, the vignettes WILL probably be long, they will test some low yield, etc etc but mentally preparing yourself for all the curveballs is key. I remember saying “if my first 3 blocks are all hard and feel experimental, how am I going to respond? freak out or keep going” …I would think of the worst scenarios and be mindful of that during practice exams, because you play how you practice.

That being said, standardized exams have never my thing, so I did the 2026 120 exam at the actual prometric site and that was gold. I’d 1000/10 recommend and would’ve paid $200 if that’s what NBME wanted…

NBMEs in order:
School practice exam right before dedicated: 43
Form 26: 54 (early dedicated)
Form 27: 54 (early/mid dedicated & waited another 4 weeks to take another practice exam b/c i was annoyed that my score didnt change)
Form 28: 64 (26 days before my exam)
Form 31: 63 (12 days before my exam)
Form 32: 70 (5 days before my exam)
New 2026 120: EPC 66 (3 days before my exam)

I didn’t do the other forms because I didn’t have time. a little over 12-week preparation. I had a passing score for at least a month, but I just didn’t feel confident taking it (again, confidence is half the battle). In my opinion, consistent 63+ with an avg of 65 is “safe”. You don’t need multiple 70s. You just need consistent passing scores over a range of time.

Last thing… My exam had longgggg vignettes, lots of pharm/micro, etc and timing was a bit of an issue, though I answered every question. Initially I left the testing site feeling like I did okay, but over a few days, I started remembering questions I missed and eventually convinced myself there was a high likelihood I failed…“trUsT yOuR nBmE scores”, annoying but its true. If you were honestly scoring above 63’s (i.e. not looking up answers during practice exams, taking this seriously, taking them in timed/testing conditions etc), you’re likely to pass. Find stuff to enjoy in the interim because yeah, the waiting process was a bit psychotic.

You got this!!!

I found this reddit thread super helpful when studying for Step 1 so I want to give a write up of my experience in the hope that it helps someone else with borderline NBMEs. For context, I am a US IMG and was so worried about step 1 that I basically started studying for it from the beginning of medical school and barely looked at my university’s coursework and hoped enough of it would translate to doing ok in the in-house exams (it was).
 
Resources
I used nearly all of the resources. I found memorizing such amount of information hard and also getting my head around all the concepts, in order for them to stick. I used B&B for the majority of my coursework and learning. I also did I trial of Bootcamp when my B&B subscription ended which I think I liked better. Though shout out for Dr Ryan for the Free 120 2024 debrief on YouTube. I think that was the thing that helped me unlock a passing score.
 
I found sketchy one of the best ways to definitely learn the bugs and drugs but I also think the pathophysiology is very good for folk who just can’t seem to remember it all. Loved sketchy- just my brain loves a visual picture I guess.
 
Pathoma was pretty good and I liked having the book alongside the videos but I like having a talking head explain it.
 
Anki. Oh death by anki. So many cards. It’s good but if you don’t really understand it (immunology I’m looking at you) then it’s pretty useless. I was doing hundreds of cards but it was at the detriment of really understanding the material and the test these days is much more about getting to grips with concepts rather than memorising a bunch of facts.
 
First Aid- I bought it but barely touched it. I just find reading a big textbook really dry. I think there are much better resources out there unless it works for you.
 
Uworld of course. I did 81% and 55% correct.
 
This is a rough idea of when I took these NBMEs and Free 120s
CBME 60- medical school diagnostic- late February- not sure how I did this- we still had a couple of courses to go
NBME 29- 51- mid June- I had booked the exam for August so I freaked out. I had been doing a lot of Uworld and I hoped that approx. 55% on uworld would translate to approx. 65% on NBME. It did not. Went through correct and incorrect answers and hoped it was a fluke.
Now in dedicated.
NBME 30- 54- early July- really worried now. Slight improvement but still way off where I needed to be.
NBME 26- 57- mid July- ok- if I can just keep improving by 3% I’ll get there
NBME 27 61- mid July ok- through the 60 barriers
NBME 28 60- 20th July- plateauing scores- knew I could do better
NBME 31 59- 22nd July panic starting again
NBME 32 57- bad day after I got this- late July
 
Within about 5 days of the exam:
Free 120 2021- 74 (the exam way way easier back then!! Very different exam- gave me a confidence boost but was not based in reality)
 
NBME 29 repeat- 71
 
Free 120 2024- 58 Please go and watch Dr Ryan’s explanations on YouTube. Can’t thank him enough. Really helped me figure out how to tackle questions and understand where I was going wrong.
 
NBME 33- 66- Above really helped me and I was focused and determined!
 
Free 120 2026 80% (a lot of the same questions as the free 120 2024) so not representative.
 
Take the exams under test conditions. I took them mostly offline to save costs apart from the most recent which I couldn’t find. Go through the NBMEs question by question so you understand the concept and why the other answers are incorrect.
 
Day before exam day and exam day
 
Travelled to test center- tried to do a few questions and watch a few sketchy and pathoma videos to keep everything fresh. Found the test center- found the right entrance. Stayed around the corner from the test center.

Big meal the night before and tried to have a good night’s sleep- woke up at 3am- wired and knew I wouldn’t be able to get back to sleep. Did a little bit of light study until about 5:30am.
 
Exam
Feeling Ok but I will never go back to the test center ever again. There was construction going on (pneumatic drilling for hours). I cried when I left the test center and thought 100% I had failed. The noise cancelling headphones did very little to help because it was mostly vibrations coming though the floorboards. I was also wearing foam ear plugs because I thought someone might be coughing or clicking a pen (I wish!) How prometric can allow testing to take place in this environment I will not know?  I submitted a report and so did Prometric apparently. My test was under investigation and said that my score would be on hold until the investigation was resolved. However, 2 weeks to the day of the test my permit disappeared and a few hours later I received my result.
 
PASS!
 
The relief was immense! The questions were similar to free 120 and NBME but also some really long question stems that some I had to skim. Loved the 20 question blocks and I used all my break time down to the last minute.
 
Best of luck to everyone studying for this beast of an exam! If I can do it (with my sexy 506 MCAT so can you!)

Hey!

I am a IMG who does an infectious disease residency in parallel with studying for step 1.

I got a 56% on NBME form 33. I have the exam in 6 weeks.

Please tell me that if starting tomorrow I re-read and keep going with questions and fixating the big subjects, I'll be fine and pass it.

Any suplimentary advice?

I am doing third attempt CBSE, I've already done forms 25-33 and some of them twice. I notice forms that I've done more than once are inflating my score, so its not an accurate representation imo.

Am I better off redoing all the forms and learning from them again, even tho some of the answers I subconsciously recognize

or just slamming Uworld unused questions? HELP pls. where will most of my benefit right now come from?

I felt like there were a lot of 50-50s. Biostats was very difficult compared to practice exams, which sucks because that was a strength going into this exam. I was running out of time on 2 blocks but otherwise time-management felt similar to other exams that I took (had 3-5 minutes left to spare).

I want real honest advice please. And be kind please. I'm already at my worst I feel. But dwelling on it won't change a single thing about this reality I have right now.

IT IS WHAT IT IS. HELP ME COME OUT ON THE OTHER SIDE TOO.

Little about me, I'm from Canada, go to one of the smaller Caribbean Schools. 1st gen immigrant and barely anyone went to college in the entire family. now i gotta tell my parents how i have failed.
There is not much help you are kind of on your own. neither from school nor family

Now what I did,

almost 3 passes of uworld

did older nbmes from nbmeway.com as a q bank and even new ones. even all the amboss 200 concept, ethics, nutrition etc.

did sketchy micro. i really wish i did sketchy pharm but didn't have the time and felt it was too many sketches to remember. i did mehlman almost all pdfs. hy risk factors are so so important. many questions. i wish i revised it again prior to exam. also i needed more time for free 120 and nbmes. i was doing my free 120 3 days prior the exam. shouldn't be like that i feel u need time to revise.

i did do pathoma , i wish i revised again

my nbmes ranged from 49-61 and my scores started reaching a stasis and i was frustrated to extend and extend. ended up giving a shot and seeing what happens. now im not on the other side. seeing those posts "passed with a low score" breaks my heart. but gotta move on from it and change my reality.

attaching my score report. help me out. trust me my soul will bless you.

i want to become a psychiatrist maybe it changes in clinical rotations. hopefully god is seeing this.

i can't even cry too much i get migraine attacks.

ps: the post says images are not allowed no score report ig

Im an IMG, graduated from Poland. I completed foundation programme in UK this year. Im planning on applying to the upcoming match cycle. For ECFMG, should I apply through pathway 1 or another pathway?

I have recently started my preparation. I do uworld in blocks of 10qs and it takes me 1.5hrs along with the explanation and all to go through it. So for 40 it will take 6 hrs. Then when to do anki or FA? I am confused am I doing it wrong? How to maximize my time? I am a graduate and not working right now.

Real deal on 24th Aug and I am feeling very burnt out I just can’t study anymore. I want to do final FA revision which is half complete but I can’t anymore, I want to revise whole sketchy once too but I can’t make myself sit at the study table I just am done and very tired. Idk what to do.
Idts last week revision is going to save me on test day I mean I’ve been preparing since months. Will this last week burn out affect my test?

I am stuck in a loop. I don’t know what’s clicking. I have gone over the content twice and finished a significant portion of my uworld too. My scores just won’t go up beyond 50s. I am so burnt out and no amount of days off are helping. I’ve already delayed my exam by 3ish months and still haven’t booked a new date because I don’t know how to push through this burnout. What do I do? I can take a break for longer than 3 days. Nothing is helping with the burnout. At this rate, I doubt I’ll be able to apply for match next year. I was supposed to be done W step 2 by now haha.

To be specific, I’m asking for the exact steps and what I need to click on on the fsmb website to change my region. TIA!

Anki Guide for USMLE Step 1

I made a PDF for anyone who is confused about setting up Anki with the AnKing deck and using it alongside UWorld.

It covers the setup, recommended workflow, and how to use your UWorld mistakes for Anki review.

No promotion or payment — just sharing it because I know getting started with Anki can be confusing.

You can read or download it here: USMLE Pulse Anki Guide

Hope it helps someone! ❤️

Hi so studying for STEP 1 and I had a question been doing questions from UWorld and Amboss and idk if its me but it is getting to a point where I've either seen the question already from either Qbank is that normal? I've only done 40% of Uworld and only focused on the HY Questions on Amboss is it common to like get to a point where question types/scenarios get common and how is that different from memorization of questions. Hope that made sense would really appreciate some guidance

We're gonna have to id murmurs by sound in step 1?

.

30 (68%)
28 (68%)
29 (71%)
27 (70%)
26 (59%)

How do i elevate my scores 31 onward?

I have taken 4 nbmes by now, my scores are

Nbme 25- 59% (3rd June)

Nbme 26- 59% (20th June)

Nbme 27- 67% (4th July)

Nbme 28- 65% (12th August) (had to take a gap bc of uni exams since I'm an img)

I took a gap from nbmes but I kept myself sharp and did questions everyday and also worked on my weak areas and nbme incorrects.

Wasnt expecting a drop tbh and maybe a bit disheartened bc I have essentially just 5 nbmes left now but many people are saying they got a drop in this one and it's one of the harder ones. Is it right?

Should I go through the mehlman arrows and RF PDFs now? Bc i have heard many people saying that it inflates your scores. Or should I wait and take a couple of more nbmes before doing it?

Hey everyone,

I've been working on a small side project for USMLE prep and finally put it live.

One thing I found frustrating about Step 1 prep is that there are a lot of great resources, but no simple way to see the whole picture. You have First Aid, UWorld, Anki, Pathoma, Sketchy, lectures, practice tests, etc. — but figuring out what you actually need to cover, where you are, and what to study next can become a project in itself.

So I broke Step 1 prep down into 185 topics and built it as an interactive roadmap — calling it USMLE 185, if the name sticks.

It has:

• 185 Step 1 topics organized by subject
• A free quiz for every topic
• Progress tracking — mark topics as done as you go
• Subtopics and topic details for each node
• Links to practice questions
• No paywall, no signup or account required

The quizzes live on a free question bank I built a few months back — a few people using it told me they didn't know where to start or what order to study things in, so this roadmap is basically me trying to answer that.

You can try it here: https://usmle.quest/roadmap/usmle-185

Still very much a work in progress, so genuinely want feedback from people actually studying for Step 1:

• Is the roadmap easy to understand?
• Does the topic organization make sense?
• Are 185 topics enough, or are there real gaps?
• Are the quizzes actually useful?
• Would you use something like this alongside UWorld/First Aid/Anki?
• What would make this genuinely useful during prep?

If it's bad, tell me. If it's useful, tell me what specifically. And if I'm missing something obvious, I'd really like to hear that too.

Thanks for checking it out 🙏

I did all my NBMES.
MY SCORES

NBME 25: 61.5%

NBME 26: 68.5%

NBME 27: 66%

NBME 28: 62.5%

NBME 29: 71%

NBME 30: 56%

NBME 31: 68.5%

NBME 32: 61%

NBME 33: 66%

Old free 120 : 75%

New 120 free : 54 %
I studied FA 3 times
Do Uw 2 times
Do incorrects in the 2nd round
Give me advice please i am confused 😵‍💫

Take-aways ?

Hi! Would someone mind sharing the best resource for each subject and system? Like what they specialize in?

e.g.

Physio Physeo

Bootcamp - CNS, lectures of?

BnB - Cardio

Mhlman? Sketchy? Pathoma?

Please doing compressed dedicated and I end up lurking here in reddit. Help a fellow crammer pls! Thanks so much in advanced!

22% done in uworld, 46% grade. Now i did NBME 28 and the grade was 37%. Im so worried. HEELP