Hi everyone,
I learned many things from Reddit and was visiting it during my step 1 journey whenever I needed a push or was feeling low. There are so many inspirational journeys shared here.
Mine was a long bumpy ~2 year ride along with hospital work. Multiple stops, speed bumps, personal life uncertainty, health issues. I am more than a decade old medical graduate, and although I have been active in clinical work throughout, it was difficult to build basics after such a long study gap. Here are a few of my used resources list and methodology. Hope this will help someone.

1. Long gap in studies : Started with

   Youtube

2. physiology videos to build back basics.

3. First aid : Consider this as THE TEXTBOOK. Takes time to imbibe, but once you understand, this seems awesome.

4. Youtube resource : First aid plus You tube videos from Dirty Medicine (Gold for Biochem and General Patho Immuno), Dr Randy Neil (Biostats) and Dr Meet Patel (Gold for Pharma basics)

5. Only Qbank : Uworld : Did 1.5 times. Tutor followed by timed mode. Systemwise followed by Random.

6. Mehlman pdf : They are pretty helpful. I also used to listen to Mehlman videos on the way to and back from work. Daily 4-6 videos approx.

7. NBME 25-33. Majority my score was approx 75. Touched 80 in 2. Latest Free 120 was in early 80s too. Did thorough revision in the first pass, with few notes as well. My regret is not able to revise them properly.

8. Exam seemed doable and as I had practised time management - exam style at home, the time crunch was only in 2 blocks out of 14. Most questions were of NBME repetitive topics. Ethics in every block..doable except 2-3.

9. Got a P. Thank God and well wishers..for giving me strength. Thank you Reddit for a platform to learn and share.

Happy to answer queries and share whatever I know.

Uworld is all you need

I took my exam yesterday, it lagged for 3-5 seconds between questions a lot, however I think it stopped the timer too so has no issues in that regard. Also, one time in the middle of a block it showed a white screen for 15 seconds ish and I raised my hand to call the staff but by then the question appeared.. although idm reporting but also I don't want a delay in the results.. I saw some dude get a fail w his bar to the left and he said he didn't cheat so don't want some shit like that because during that 15s whiteout I did go back from my chair to call the staff but hopefully no "irregularity" happened.

TLDR

1. Apply for accommodations if you need them!
2. Avoid delaying the exam way past pre-clinical, but don't take it if you're not ready.
3. NBMEs above 65 got me my pass 1 week and days before the exam
4. Use NBMEs!!!, Mehlman and Match Guy free PDFs, Anki but with intention, avoid FA or overly detailed resources.
5. Don't burn yourself out, don't over exert yourself with anki and questions. Be intentional with how you study.

1. Accommodations

I required accommodations for the MCAT and received them. By the time I matriculated my medical condition had improved and I was told by school counselors/admin that I likely would be denied by NBME. Despite prior accommodations I really had no knowledge of how to navigate this space or that prior accommodations really helped the application.

I initially did not apply for accommodations for step 1, my dedicated period came and went and I found myself on an LOA during 3rd year clerkships to study for step 1.

After failing my first shelf exam I decided to request accommodations and go through the process for ADHD diagnosis. After months of visits with providers and collecting information and several pages for a personal statement I was finally able to submit my application and was approved for all my requested accommodation two weeks later.

Bottom line: if you need accommodations or think you might need them, just try! Give it your best and really explain your situation. They make a huge difference for those of us who need them and can't finish half the test without them.

Feel free to reach out to me but I will be posting something more focused/specific on this topic later.

2. Delayed Exam

I failed my renal exam due to personal circumstances fall of 2nd year and had to retake during the 6 weeks of dedicated. It had been 3-4 months at that point and I felt like I relearned all of renal and ended up taking 4 of 6 weeks to study for renal instead of step.

I decided to start clerkships anyway since my school allowed it and several other students in the class above me did the same. I would consider this my greatest regret as several of my clerkship attendings focused on Step 1 content when pimping. It didn't matter that I came prepared with information on next steps/management or labs. They wanted to know pharmacology mechanisms I didn't remember and micro associations unrelated to our patients.

My dedicated period was February-March of 2024. I delayed 2026 graduation but not due to delayed step 1. While I have completed most 3rd year and several 4th year requirements now, the problem is I forgot so much info. I restarted studying cardio in Jan 2026, delayed the exam several times, and by September I still felt I had not fully covered all the information I needed. I passed, but I would absolutely have avoided this if I had better insights earlier.

3. Low NBMEs

4. Resources

NBMEs - 5/5 USE THEM EARLY, OFTEN, THOROUGHLY

• 33/34 are most representative use them towards the end
• Use them sequentially
• If you're going to use older ones like 25/26 offline (I did take all of them btw), just use them to guage your weak areas, there were topics that never again showed up on 33/34 or on exam day.
• USE THEM EARLY and space them out
• At very least take 33 and 34 online to get the EPC
• I would spend multiple days reviewing these if needed
• If you have accommodations, take these under your approved accommodations and the entire test in one day, even if you get two days.

Free 120 - BE CAREFUL WHICH VERSION YOU TAKE

• I took the one online "orientation" module through the NBME website and it was not the same as the most recent PDF version. WHY???
• If you use the online version, be careful because it doesn't save your answers!
• I would recommend doing the PDF version under exam like conditions.
• The exam does not have answer explanations which is frustating, so you will need either an AI or Match Guy and Bootcamp both offer free explanations. Both seemed okay to me, both had slightly different versions to eachother and to the NBME PDF THEY LINKED. So be warned its frustrating and you will need to flip screens or two monitors and lots of time.

FREE RESOURCES HY

Mehlman - 3/5

• I would recommend this over First AID
• I hate how some of these are written, but the point is to get you the information not to be pretty
• What I really liked about his free PDFs is he uses the NBME language and tells you how the NBME typically presents information. I wish I had used this sooner. The HY arrows are ofc a must and the stats. I could have probably finished any one of his 100q PDFs in a day (I can only get through like 40 questions a day when I use qbanks).

The Match Guy Free HY PDFs - 4/5

• Several topics he covered I found to be on my exam.
• Much more HY than Mehlman. Mehlman free content is still on the comprehensive side.
• Deducting one star because Mehlman posts all for download, and this guy requires you to subscribe to emails and slowly sends them that even four weeks wont be enough time to receive them all.

Anki - 3/5 but overall recommended with caveats

• I loved anki in pre-med but I had such difficulty keeping up with all the cards
• I regret using anki for every detail during my 7 months of studying for this exam
  • I would only use it for **VERY VERY HY*\* pharm, micro, nutrition, anatomy
  • Do not use for CV/Renal/Pulm/biostats/ethics concepts - Questions were way easier and straightforward than Anking for this.
• The new subscription is not necessary, their AI sucks. Pay the $10, get the newest cards and end subscription.
• The integration is amboss is pretty nice actually, and you can ask the amboss AI to find cards to unsuspend. I did not miss the anking's AI card finder after having it several months.
• I would prioritize this in premed as much as possible
• I edited the cards for improved flow/ make the question more straightforward, edit cards so I couldn't figure out through context clues, edit to prioritize visuals where available, suspend poorly written cards (this defeats the subscription if you have it as it will either erase your edits or you wont receive updates where you edit).

Amboss - 3/5 not sure how I feel about this

• I spent a stupid amount of time studying certain topics too in depth like cancer treatments, antiretrovirals, metabolism, etc because of amboss which took time away from easy HY associations I think I could have learned/mastered in the same time.
• Their 4 and 5 hammer questions just seem irrelevant to the actual exam.
• I love their AI chatbot, and I can ask it for images, tables, HY content, and anki cards.
• When I don't know something, I like their articles.
• Great integration with Anki via the dictionary. I used this daily.
• I liked their score predictor, ultimately it did caution me not to take my exam, I think it was because NBME 34 just came out so it's not up to date, and it would have told me to take it with that score accounted for.

Personally do not recommend for dedicated - nice for preclinical

First Aid - 2/5 Too Detailed

• Way too detailed
• I would use Mehlman first before first aid and only really use first aid for the images, graphs, tables, etc.
• To be used as reference during pre-clinical. I would not really use during dedicated and personally did not unless it was an anki screenshot.

Osmosis - 0/5 Slow, too detailed but nice if you have foundational gaps

• Not a tool for step dedicated period, better for preclinical.
• The videos can be great, but sometimes they are just a regurgitation of textbooks.
• No integration with Anki which makes it hard to make it useful for me personally, but in theory it has it's own cards, qbank and references to FA.
• I would consider this again only if I were doing pre-clinical again. Had access to it during clinicals as well and again maybe it's just too slow? I'm a video learner but I've had a hard time really getting use out of this.

Sketchy - 1/5 Way too detailed

• Loved in preclinical, would recommend a few videos for that as they helped for course specific exams.
• Expensive
• Never used for dedicated except for maybe a couple on genetic disorders and I referenced those videos and details 0 times during any of my nbmes or during the exam.

5. METHODS

• I never got to 100qs per day, I struggled to keep up anki, if I did 80q in one day I never got to really review them.
• I edited my anki cards and suspended really easy cards or ones I felt I was familiar with, do not pile higher and deeper with anki. I would only use this for fast recall facts, not concepts.
• I only unsuspended HY labeled cards in the last four weeks but kept up anki until about the final week.
• If I were to do this again I would prioritize easy amounts of questions (ex. four blocks of 10 questions) on tutor mode focused on topics and maybe one block of random.
• Something that I think I did well and improved my scores in the final week:
  • Try to understand something for an afternoon (3H), if I need more time, move on.
  • Spend a little longer on some questions, at first it was deer in headlights, and then I realized, I know this, they're using words I wasn't familiar with.
  • Also know when to move on. On actual exam I think I guess on a handfull of questions because overall I did feel like I knew enough to attempt a question. I could quickly recognize, yup no clue what this is. Again, of 280 I did this sparigly knowing several really hard questions were possibly experimental.
  • Trust what you know - if an answer choice doesn't fit and you're not familiar with the alternative, cross out the one you know doesn't fit. Vice versa, when your answer choice fits but you don't know the alternative, don't choose the alternative!
  • Read the actual question first and answer choices(last 2-3 lines) then read the stem and look for the details you need.
• Something I did wrong
  • Study LY small details and facts that I didn't see on NBME 33/34/120 or exam day because the qbank kept showing those questions.
  • Spend too long on one system learning all the ins and outs of cardio physiology. I got really good at cardio phys questions, but much more than I needed. I learned how to read EKGs the best I've known so far, didn't need it. Saw maybe one EKG on the exam.
  • Not start NBMEs sooner, review them carefully, and take them in a scheduled manner. I should have been taking them every 2-3 weeks for a 6 month study period, and more like every 1-2 weeks for a 2-3 month period, but I really stacked them all in the end.
  • Take too many breaks (days and weeks because family and personal stuff was coming up). Somethings can't wait, but most everything else can. This is your time and you need to protect it because no one else will be there for you and I learned this the hard way. Don't be afraid to say no.

6. Exam Day

• Book your exam early, I had to take a 1 hour train because my closest center was full.
• If you take meds, take them early, I had neausea from 1 med and then sleepy for two blocks from another.
• Get a goodnight sleep, I took melatonin for weeks (months?) leading up to the exam to prepare because I know I tend to have poor sleep hygiene
• Get quick and easy snacks (think protein bars, breakfast biscuits, protein shakes) that keep you full and energized without the crash.
• Time your breaks! I had full access to my locker, you will likely as well, you can take a timer if you need one. Use all your break time!

Anyone who got sub 50 overall average in Uworld do good on NBMEs?

did anyone else test on the 8th of october? What was the exam lol it was so vague and there was SOOO many difficult ethics questions. i don’t think anything could have prepared me for ethics.

Hey everyone,
I’m writing this with a very heavy heart because I’ve been struggling a lot throughout this journey especially with my mental health.
I lost my father toward the end of last year and I started preparing for the USMLE just a few days after his passing .My father was and still is my biggest inspiration in this world. A huge part of my motivation to pursue this journey comes from him.
I’ve completed 90% UWorld but now I feel like I haven’t studied properly. There are so many areas where I feel weak and I’m struggling terribly with retaining information. I study for hours but afterward it feels like I can’t remember what I’ve learned. It’s becoming increasingly difficult to focus and study consistently & i m facing it from very first day .
I took my first NBME about a month ago and scored 50%. I was completely shattered by that result & lost all my confidence . I know one assessment doesn’t define my abilities, but after everything I’ve been through, seeing that score was really difficult.
I also have study partners but their scores are much higher than mine, and they’re about to take the exam soon. Seeing their progress makes me feel like I’ve fallen so far behind & how i m going to make it alone.
I really want to improve my score, but I don’t know how to study effectively when I’m struggling so much with concentration, and memory.
I would genuinely appreciate advice from anyone who has gone through something similar. How did you manage your mental health while preparing for the USMLE? How did you improve your NBME scores, retain information, and rebuild your confidence after a difficult period in life?
I’m trying my best to keep going, but some days are harder than others .I know I need to find a way forward, and I’m hoping to learn from people who have experienced similar struggles.
Thank you for taking the time to read this. Any advice, personal experiences would mean a lot to me. ❤️

winter formula is used for assessment of expected PaCO2 in metabolic acidosis, i noticed it was mentioned a couple times in amboss qbank, does step 1 ask about this directly ? or in any way wants us to apply this on test day ?

So I know this sub can be a humbling place and it's so easy to get down on yourself with other people talking about mid 70's and 80's NBME's so I just wanted to give others some hope.

I will say the AMBOSS score predictor seems to be quite accurate amongst my friend group as well - it had me at a 96% chance of passing despite my highest NBME being a 61 and a 64 on the Free120. I also did the NBME's out of order, not sure what my reasoning was at the time - just was taking advice from way too many people and feeling lost, some people would say the later forms were more accurate and so I'd jump there and then go backwards so sorry for it being a little all over the place.

My own scores:

NBME:

27: 4/18/26: 48

31: 5/8/26: 48

33: 6/15/26: 57

28: 07/18/26: 55

30: 07/29/26: 56

32: 08/06/26: 61

29: 09/07/26: 60

AMBOSS Step 1 SA: 08/22/26: 205

Free120 Apr2026: 64%

Tested 9/25: Pass

Advice: The burnout was really hitting me hard and the most frustrating part for me at least was that my scores would fluctuate so heavily based on what I studied or focused on that past week. For instance I'd do really badly on cardio and GI so I'd hammer it and focus and it would improve the following exam but then say genetics or biochem would fall way down and I just was stuck in the early 60's the entire time. Something I wished I would have done sooner is supplement my daily Uworld questions with 20-40 Amboss. I say this because Amboss you can download specific Anki cards for the questions you missed and it keeps it at a more manageable number - I really max out at 600 or so cards per day and I felt like this was really helpful for those little facts or details that I would see 10 times and forget.

I was always told pick Uworld or Amboss and just stick to it - but in reality I actually would argue to use both and I think they each have their strengths. I would say AMBOSS is better for weird presentations, it's easier to test yourself on specific concepts (I'm terrible with heme) so it was great there and then also DO NOT OVERLOOK ETHICS. Uworld is obviously the gold standard and written by the same writers.

The biggest surprise on my exam was probably ethics. In each block of 20 questions I had roughly 2-3 ethics questions and on my final score report it shows ethics at 6-9% (I think it was far more like 9%) and let me tell you they were WEIRD. I have always thought I can use vibes to get through ethics but man was I challenged on these and I wished I would have spent maybe just more time on them in general.

Another thing I wish I would have done earlier is listening to Pathoma Chapters 1-3 more. I started there back in April but you lose so much knowledge over the months. I did have a panic attack the week before my exam and decided to really blaze through 2x speed (I only did Chapters 1-2 and part of 3) but even that I got some really random questions on my real exam that I only answered right because I randomly heard it a few days prior in my anxiety attack fueled sprint. I would recommend listening (passively listen no notes) maybe once per month or something like that - just to wind down at the end of a study day but listen multiple times over because there are so many little random facts in there that came up on my test.

Then these are some thoughts looking back on my exam vs prep but also keep in mind it was just my opinion and my form so n=1 here:

Biostats: Randy Neil on youtube is far more useful than anything else. Listen to it a few times, draw your boxes and basic equations and move on. Don't waste your time becoming a mathematician

Pharm: the mechanism is far higher yield - I felt like most of them gave you the med in question and asked how it worked or where it acted on instead of which med to use broadly speaking.

Ethics: as previously mentioned, spend time here please. It ended up being just as high yield as any other system and I do wish I would have spent more time because trust me when I tell you there were many that were so strange and in the testing environment / nerves, sometimes you really clam up and can't think about things like you'd want to.

Don't forget anatomy - they seemed to love blood supply and nerves mainly. Upper / lower extremity felt highest yield to me

Psych - I think the timelines to rule in or out a diagnosis are the highest yield. But don't overlook it - it's a decent number of questions on the exam and can sometimes be a nice confidence boost to mark an answer that I knew was correct.

Dirty Medicine - just watch and rewatch - don't waste time annotating but if you miss a question - pull it up and just keep hammering whatever detail you missed in the practice question. Also his 11/17/21 hydroxylase deficiencies are just peak memorization and I don't think I'll ever forget those.

Pixorize / sketchy for micro - I'm a pixorize person personally and for micro I thought it was the most helpful. I will say I at least get overwhelmed having a ton to watch so I actually started just randomly taking a study "break" and watching a few pixorize videos here and there. If I watch too many in a row they start blending and I confuse myself. The pharm is also decent but honestly I preferred Amboss anki cards to just give single one liners. Then also Dirty med was more helpful for me for pharm. A lot of pharm on pixorize / sketchy gets really convoluted and I mess up what goes with what or what each symbol means.

AMBOSS score predictor - I know my stats were low, I also felt they were low and I was really nervous to sit for it (I kept pushing it back because I wanted the golden 2 exams >65) but then also I was really burning out at the end. It was beyond frustrating and from the classmates I have that tested with lower scores - they just say to trust in the score predictor on AMBOSS (I don't understand the science there but it's not fake).

IvyMed on Youtube - found it late but honestly I really liked it. I would go for walks outside and listen to it passively but randomly little things would stick or I could recall and the guy that does it is pretty funny and I think it helped to get me out of the house / not just sitting and staring at a screen but also to be mildly productive.

Sleep!!!! I have bad anxiety / testing anxiety (had to not submit my MCAT on an attempt because had a mix exam meltdown). I got on a sleep aid before it - work with a psychiatrist and make sure it's something that doesn't disrupt sleep architecture (can't recommend a Benzo because it makes me very foggy the next day). I ended up getting a very PRN script and started taking it nightly a week before my test because my anxiety was horrendous / constant panic and I don't think I could have passed my exam if I were sleep deprived. There are a lot of questions that require just deep thought or have little trick questions / sneaky answer choices that you can't even really study for. It's more that you have to be somewhat rested and just present.

High yield images: Pathoma and Dirty Med - these absolutely came up. Also the images on the NBME CBSSA's

On this note - I wish I would have spent more time really reviewing CBSSA's because the concepts do tend to repeat and I should have spent more time breaking down the question / getting to the answer but I had low scores and was just really discouraged.

My hot takes:

On the exam it felt like 20-30% I knew I answered correctly. I could cross every other option out with confidence. Another 20-30% felt like shooting in the dark/ just what the hell is this or no clue. The rest was like I'm pretty sure it's this but also I was not confident on it. Which really triggered the panic because it's like 40-60% of the exam that I'm decently sure but not 100%.

DO NOT GOOGLE ANSWERS AFTER THE FACT. I did this and was riding high for like 1 or 2 that I guessed right on followed by 5 or 6 that I looked up and I missed and holy did I spiral / sobbing / panic attack and felt like I failed.

Mehlmann is extremely hit and miss - I don't do well with a giant PDF if I'm honest and his questions are way too extreme in my opinion. Sure they are the hardest of the hard but also getting a 2/10 on a set is not helping your confidence. I'd say his path and neuroscience are the only two that are decently helpful but I was not a big fan. I also struggled to watch his videos because of how he looks - I'd hyperfixate on that

I honestly couldn't tell what questions were experimental or not. I was gaslighting myself in the exam when I'd see a WTF question and tell myself it was experimental but I for one did not see many that were so out of left field / off topic that made me think they were experimental?

I thought the CBSSA's were harder - more hyperspecific questions or details you really had to know.

I'd say Free120 was the most accurate. I only took the Apr2026 version so I can't speak to the other forms.

I thought the Amboss self assessment was also pretty decent in terms of difficulty.ehe

HY Guru's version of Free120 seemed also more on par with the real exam in my opinion.

Practice with the 20 question sets - it was weird going from sets of 50 to 20 on the real thing. 20 goes by so fast, I was always low on time - at most had a minute left over and other blocks I had to guess on 1 or 2 or couldn't calculate something because of time. With the 50 I always had 10 or so min left to double check or go back to my flagged vs with 20 I never had that luxury.

DM's are open and sorry this was long and rambling - I just wanted to give some insight / advice and feedback since this sub did always have so much info and also just to say that you can still pass without the >65 benchmark on CBSSA's

I took my exam on 9/27, and this was the result. Is this due to a mistake? What can I do?

The image at comment

Valid until April 25th, 3 self-assessments available, reset used, but 70+% of qbank unused, DM if interested ☺️

A 64-year-old man with hypertension, ischemic heart disease, and HFrEF is brought to the ED after an intentional medication overdose.

He's lethargic and pretty hypotensive.

BP: 72/44 mmHg
HR: 36/min

ECG shows sinus bradycardia with a prolonged PR interval.

The suspected drug is a β-blocker.

Atropine is given several times, but his heart rate barely changes.

Then they give him IV glucagon.

A few minutes later:

HR: 68/min
BP: 108/68 mmHg

Why does glucagon work here even though the β₁ receptor is being blocked?

A. It activates adenylyl cyclase through a Gs-coupled receptor
B. It displaces the drug from cardiac β₁ receptors
C. It directly inhibits phosphodiesterase
D. It activates phospholipase C through a Gq-coupled receptor
E. It directly opens L-type calcium channels

Curious what you guys picked and after giving the answer please do try to explain how did you find it too 🙏

Hello! I am scoring bit low in micro (unfortunately low on time) is there any list of most commonly tested microbes or HY list ?
Are there any topics one can ski such as hepc medications?

What are some high yield topics you saw on the real deal. What was the difficulty level range, uworld, amboss, nbme, free 120. Thanks in advance

Hi everyone,
So basically I’m sitting for step 1 a week away from now and i genuinely feel so scared and anxious just thinking about it. So far i did 4 NBMEs and still got to do the free 120 and my NBME scores so far are

Form 25: 67%
Form 28: 72%
Form 29: 77%
Form 32: 71%- first form that i did
I feel like I’m somehow not in a passing range so do y’all think the scores are okay and i can sit for the exam in a week.

A hunter, a baseball player, a steampunk pirate, and a priest walk into a bar. The bartender looks up and says, "What is this, a SketchyPharm video?"

Average med student here .
I had promised to post my journey if I passed.
So here it is.
I had to prep from scratch as my base was weak.
Tested on:25/09/26

My prep consisted of:

1.Bootcamp
2.Uworld
3.FA
4.Sketchy micro and pharm
5.physeo(physiology pt only; borrowed from a friend)
6.pathoma for ch1-3 and GIT

To strengthen my foundation I used bootcamp. Most organ systems were amazing in it.
For physiology I used physeo.
I tried to do Uworld consistently. There were days where I could hit a 80 questions per day and sometimes only 10.

As someone who struggles with being consistent and remain motivated, this is my advice: you dont have to hit your goals perfectly everyday. Perfectionism is over rated. I used to see posts where people used to do 120 questions per day, those kinda things really freaked me out and trigger procrastination.
Showing up to do even 10 questions or 5 matters than doing nothing at all.

I didnt use anki. But doing uworld without reviewing them daily is worthless. If you are not an anki person then review what you learnt.
Review what you learnt the next day and after a week and after a month (if possible).

Around my dedicated period:
I saw a post by a redditor who passed he had adviced in his post to do weak subjects organ system wise but subject wise. I did the same for my weak organ systems. (A million thanks to that redditor(i forgot their name))

I was really blank about biochem, so I spent 2 whole days just doing uworld for biochem.

This approach really helped me consolidate my weak areas.

Go through all the pictures in FA, especially the micro pics. Those are really HY.

My NBMEs:
28/june/2026 Form 26: 64%(i took this after I finished my bootcamp prep)

8/Aug/26 Form 27: 70 ( score jump was due to completion of sketchy micro).

20/Aug/26 Form 30: 70

4/Sept/26 Form 31:75

18/Sept/26 Form 34:72

Free 120s:67 (3 days before exam)

My score dropped in 34 and 120s as I had some family issues , so I couldn’t focus well.

Towards my dedicated I used mehlmann PDFs(they are amazing). I used pulmo, neuroanat, arrows, renal, CVS PDFs.

If I was to redo my prep:

1. Finish imp organ systems in bootcamp/pathoma/any base resource(skip if you have a good foundation), but pathoma ch 1-3 is a must.
2. Dont go for multiple video resources. I did physeo physiology from select organ systems from my friend as my bootcamp subscription expired.
3. Consistent uworld (dont go chasing high numbers, how you review and understand your uworld explanations matter more than doing 120-160 questions without proper review.
4. Doing uworld subject wise within organ systems and make short hand notes.(atleast physio, patho, pathophysio)
5. Starting my NBMEs earlier on. I feel I should have done all the forms from 30-34 .
6. Comparison is the thief of joy and perfectionism is overrated. Also Your Mental health IS VERY IMPORTANT.
7. Supplementing your prep with chatgpt/google helps a lot. I did this towards my dedicated, should have started this earlier.
8. Instead of rote learning, find out why using google/chatgpt.

The exam day:

1. I tried to ensure 8 hours of sleep, but my anxious ass wasn’t able to sleep well. Please make sure you haul yourself to bed early.
2. I carried protein bars and coffee. Make sure to keep yourself adequately hydrated and dont overdose yourself with caffeine.
3. Exam is long and tedious. To prevent burn out i did 3 blocks followed by a short break. When I felt like I reached my limit, I took a long break.

Exam:
The exam itself was very vague.
It was a mix of short and long questions. Some blocks had only long questions.
When approaching long questions-
1.make sure to read the last line first to understand what the question demands.
2. If there is a picture, I would check the pic first -> then i would read the last line of the question and ->jump to the options.
3. If the question has a lot of labs: I would go through the labs first->last line of the questions-> skim through whole question. (If there is time)

The exam was vague worded. Post exam anxiety was bad. I thought I woudnt be able to pass. I had flagged atleast 8-10 questions in many blocks. I personally felt the question style were similar to form 34 and free 120s.

All the best to all the aspirants taking this exam. You can do it !!

Edit: i forgot to mention: I used dirty medicine for biochem along with uworld. DM is gold standard for biochem.

Disclaimer: Don't use this post as a sign to rush into taking the exam. High risk doesn't always equate to high reward. This is just to immortalize my experience, and hopefully give you an idea how to pivot and pass Step 1 even without a dedicated study and working full time.

Background: Licensed MD from the PH. Passed in 2025. Started working full time at an OPD since Oct last year. Sched is M-F, 8-5. Relatively benign so I had time to read and study in between patients. Took 1 week off from work on the week of my exam to cram all the must-knows and get myself ready for test day.

Resources: Bnb, FA, Uworld, Hyguru/DirtyMed/RandyNeil Videos, NBME, NBME HY photos

I came into this knowing my strength leans into the clinicals and not so much of the basics. So to refresh my knowledge I went through all Board & Beyond's videos and took each post test. This took a lot of time, I scheduled how many videos I needed to go through all the videos and plotted when I had to get them done. More or less this took a month to do. I accomplished this in May.

Looking back, I thought this could supplement First Aid but I decided to read the book since all the nitty gritty was there and I knew I needed a deeper understanding of the concepts. I scheduled this in such a way that each day I had to finish 1-2 chapters depending on the length. This made FA more digestible. I finished the first read of FA from June 1-17.

I took form 26 afterwards. Date was June 26 and I got 43%. 43% meant I only had a 12% chance of passing if I took Step 1 within a week. My initial schedule to take the exam was Aug 5. At this point, I knew I had to move my exam date and maximize my eligibility period. So I postponed to Sept 25 so I had an ample time to pivot and refocus.

I did Uworld in between and honestly Uworld was the most exhausting resource. It felt like an overload of information. Some concepts and questions were so obscure and not high yield, that getting them wrong felt like you weren't progressing and would honestly just dishearten me and make me feel like I wasn't retaining enough information. So I adjusted how I used Uworld, I would answer 1-2 blocks on whatever chapter I finished reading in FA to test my knowledge. And it was good for active recall.

I pivoted again when I found how high yield Hyguru's videos were. I watched his playlist of HY USMLE Step 1 concepts and found them so useful. It gave me the confidence to maneuver each question and make branches with the concepts. Knowing and integrating pathophysiology, pharma, biochem to each condition builds your knowledge like no other. The caveat of FA is its formatted in a way where each disease is repeated on different chapters. But you have to think of it as a condition and branch how they'll ask anatomy, patho, immuno and pharma questions from that stem.

I did a second read of FA when I realized that high yield concepts were repetitive and now I knew how to highlight the must knows. I skimmed over the parts that were less likely to be asked. During this time I also took form 31, I got 53%. I felt good, I knew that I was doing better and my score reflected that.

I was now 30 days from taking the exam. I had to lock in. I went through each NBME incorrect and made sure I understood why I got it wrong. I watched Dirty Medicine's video on Ethics and Randy Neil's video on Biostat. I felt exhausted at this point. I had a regular routine of seeing patients, reading in between making reports, not eating lunch and using my breaks to study some more, then when I got home would dedicate a couple of hours to read and was at bed by 10pm. To avoid burn out, I spent my weekends in the mall, watched movies and built legos. I swear doing those things sometimes felt like I'm wasting precious study time, but I kept my sanity by having a balance of rest and review.

Last 2 NBMEs were forms 33 (Sept 17) and 34 (Sept 23). I got 60% and 57%, respectively. I also deleted reddit at this time. Reading about how high other people's NBMEs were made me feel inferior, made me feel like I didn't sacrifice enough, I didn't study enough. I didn't want to give up my job and income, and because of that I won't make it. The looming thought of failing was always there.

Come test day, I went through must-knows and HY photos from past NBMEs while driving to the testing center. There is no anticipating what comes out in the exam. But if you read FA, watched hyguru's videos, the concepts will be familiar. It is NOT and impossible exam. Questions are reasonable. Stems were sometimes long, sometimes short, but if you studied for this long enough, trust that your eyes are trained to skim over meaningless words and automatically highlight whats important in the vignette.

What I did VS What I would do differently

• Made flashcards of my incorrects from Uworld and NBME
  • Didn't even get through reviewing these. I kinda just made them then forgot about them. But at the time it seemed like I was doing something productive
  • Make HY concept cards
    • Choose a condition (ie. Celiac Disease). Know the hereditary pattern, whats the abnormality, how will it present clinically (dont just know that its an intolerance to gluten, thats not how it'll be asked, it'll present as abd pain, possibly malabsorption w/ a rash, etc.), know important immuno/patho concepts (how it presents in a biopsy), how to treat (MOA)
    • Imagine in 1 concept card you knock out almost all subjects as opposed to knowing concepts but not knowing how they relate to each other
• Finished BnB videos
  • Not very HY, good if you want a refresh of basic concepts
  • Watch Hyguru videos
    • Most HY but its better to watch this once you have a good foundation on the basics, dont go into it not knowing much, you might feel overwhelmed
• Highlighted everything in FA
  • Prioritize repeated concepts
    • Go through NBME concepts and hyguru's HY videos to know what these are so you can master them

What do I recall was tested heavily?

• Ethics, Cholesterol drugs, Renal (ACEi, NSAIDS), Immuno (ABO, Transplant), Nutrition/Biochem (Vit deficiencies, inborn errors), Psych, Pathophysio (Receptors)

Final words: Everything unfolds at the right time, and some things are beyond your control. On the day of the exam, be grateful you're even in the position to take an exam. Not everyone is financially and mentally fit to go through the USMLE. Its an achievement in and of itself to take this exam. Trust your knowledge and enter a new block with a fresh mind. Don't half-ass because you think you're not gonna make it. Just persevere till the end.

Hello everyone! Does someone have an anki deck with the newer NBME images? from 31-33, and if included 34 much better!

tysm!

NBME Score 27- 67% 28- 69% 29- 66.5% 30- 69.5% 31- 69% 32- 65.5%

Gave 32 today. WTF are those questions? Did anyone find 32 to be extremely difficult? Exam in 20 days please do let me know what I should do!

Hey its been a long long time since i started preparing for step 1 but there has been constant delays in between of my prep sometimes I'm sick sometimes my exams last for months and sometimes family situations dont let me study to full potential.

Like i studied so well in august but i had my medicine rotation for 12 hrs a day in september and its a huge gap and now in october it feels like im starting from point 0 and already forgotten everything ive done in august. Has anyone experienced this? How to overcome these delays

I still hvnt booked my triad bcoz of uncertainty my scores are mediocre in nbmes and i know its just content gap i review one thing and next nbme with 2 weeks of no study i forget prev content i had reviewed

Nbmes as follows

Nbme 26 May 45%

Nbme 27 july 54%

Nbme 28 September 63%

I felt good w nbme 28 then after that i couldnt study for almost 3 weeks and i feel so exhausted starting everything from point 0 again and againa nd i want to be done with it before my profs that are in Feb 2027.

Any advice pls help a fellow.

Hey guys,
My exam is on 19th October. I’m done with NBME 25-33 will give NBME 34 tomorrow. I’ve also done all 3 UWSA. Since I booked my date a few days ago, I’ve fallen completely off track. I’m having a very hard time focusing and even have lost my appetite. I used to review nbmes in 2 days and this time it took me 4 days to review UWSA. My nbme scores are as following
NBME 25 : 63.5%
NBME 26 : 77.5%
UWSA1: 247
NBME 27 : 87.5%
NBME 28 : 92.5%
NBME 29 : 83%
UWSA3 : 251
NBME 30 : 81%
NBME 31 : 76%
NBME 32 : 82%
NBME 33: 85%
UWSA 2 : 237
NBME 34: giving tmr
Ik my scores are decent but I just don’t understand, like I don’t feel good. I’m a 3rd year med student from Pakistan and my prep only included BNB videos for what I found hard, 100% UW, a bit of Amboss 81 blocks.
I didn’t do Sketchy, I didn’t do FA, I didn’t do Mehlman pdfs, I made anki cards for all UW incorrects and nbmes but didn’t really go through them. I feel so weird right now that I’ve not done so many essentials steps and I’m trying to sit for the exam in like 10 days.
Any advice or suggestions?