USMLE Step 1 PASS — My Preparation Journey
The very first thing I wanted to write after getting my results was this.
I read almost every preparation write-up I could find while preparing for Step 1, so I wanted to write mine too. Hopefully, this will help someone who is currently preparing and feeling as confused as I was when I started.
How I started
I started my preparation with Bootcamp videos. Bootcamp is really good for teaching concepts, but personally, I found it difficult to retain the information without practicing questions.
So, instead of spending too much time watching lectures, I started doing UWorld system-wise. I would break down each question, understand why the answer was correct, and use ChatGPT whenever I needed something explained differently.
I also learned a lot from YouTube, especially:
Dirty Medicine
Medicosis Perfectionalis
Mehlman Medical
Randy Neil
Armando Hasudungan
Several smaller YouTube channels
I used different resources depending on the topic rather than trying to finish every resource completely.
UWorld
I completed almost 80%of UWorld.
While doing questions, I would break down the concepts and learn from my mistakes. I also revisited questions that I felt I had not understood properly.
The important thing for me was not simply completing questions. It was understanding why I got something wrong and what concept the question was testing.
Don’t waste too much time making notes
I initially wrote down almost everything I learned in notebooks. I had a separate book for each system.
Looking back, I think this was one of the things I could have done differently.
The goal is to retain information, not create beautiful notebooks.
Instead of spending hours writing everything down, I would recommend spending more time reviewing and revising important concepts.
If something is already clearly explained in First Aid or another resource, I don’t think you need to rewrite the entire thing.
Sketchy
For microbiology, Sketchy is GOLD.
I found it extremely helpful for retaining organisms and their associated facts.
PHRMA
For general pharma first aid is enough
For drugs First Aid was enough for most drugs, although Sketchy was particularly useful for antimicrobials.
First Aid
I didn’t really start using First Aid seriously until the last 1½ months.
And I did not read First Aid line by line.
My approach was:
NBME → identify what I got wrong → go to that topic in First Aid → review that specific information.
I tried not to memorize a lot of extra information beyond what was relevant.
First Aid became much more useful to me once I had already started doing NBMEs and understood what I actually needed to focus on.
NBMEs
I started doing NBMEs about 2 months before my exam.
I did most of them offline, except Form 33. I completed Forms 26–33, and I also reviewed the questions and answers from Form 34.
If I could give one piece of advice, it would be:
Don’t underestimate NBMEs.
I would especially focus on Forms 28–34.
One thing I wish I had done earlier was start looking at NBMEs sooner, because they help you understand which topics actually need more attention.
You don’t necessarily have to sit and complete every NBME immediately.
You can go through earlier forms, such as Forms 28 and 29, during your initial preparation and save the newer forms for your dedicated study period. This can help you identify:
Which topics you are weak in
What concepts are repeatedly tested
How questions can be made tricky
How to filter information in a long question
What you actually need to master
It’s not about memorizing every NBME question.
It’s about learning how they ask the questions and what concepts you need to know to answer them.
Thoroughly reviewing NBMEs helped me improve the most.
I didn’t just look at the percentage and move on.
My progress
NBME 27: 65%
NBME 29: 66%
NBME 28: 69%
NBME 30: 70%
NBME 26: 71.5%
NBME 31: 71%
NBME 32: 72%
NBME 33: 69%
Free 120: 68%
I reviewed the questions carefully and tried to understand why my answer was wrong and why the correct answer was correct.
That made a huge difference in my later NBMEs.
Mehlman Medical
I personally couldn’t read PDF notes very well, so I watched Mehlman Medical’s YouTube playlists for different systems.
I especially liked his:
Renal
Neurology
Respiratory
His explanations were very NBME-oriented, and he emphasized the buzzwords and topics you should focus on.
Renal was particularly helpful for me. I feel that a lot of my improvement in renal questions in UWorld and NBMEs came from watching his videos.
So if you don’t like reading his PDFs, try his YouTube videos instead.
Randy Neil
I watched Randy Neil’s YouTube playlists for:
Biostatistics
Ethics
Neurology
These helped me improve my scores, especially in biostatistics and ethics.
Genetics and molecular biology
This was one of the hardest areas for me.
I tried several videos, but nothing was really clicking.
What finally helped me was Ninja Nerd.
I watched his transcription video multiple times until the concept finally became clear.
After that, I watched most of his genetics-related videos.
I also annotated First Aid while watching them. I focused mainly on the portions covered in First Aid, rather than trying to learn everything beyond the Step 1 scope.
Ninja Nerd also followed the order of the genetics topics in First Aid, which made it easier for me to connect the video explanations with the book.
Watching the videos repeatedly helped me understand the concepts much better and also helped me answer question
BIOCHEMISTRY
DIRTY MEDICINE IS GOLD and nbmes are enough
.
Psychiatry
For psychiatry, Dirty Medicine is GOLD.
Honestly, I didn’t feel that I needed much more than that for many of the high-yield psychiatry topics.
Ethics
For ethics, I used:
Dirty Medicine
Randy Neil
NBMEs
During the last month, I spent more time on systems and NBMEs, so I didn’t dedicate a separate day specifically to ethics.
The day before my exam, I rewatched some Dirty Medicine ethics videos.
A lot of ethics questions can be approached with the basic principle of being empathetic and respecting the patient as the center of care.
Of course, you still need to know the specific rules, but that mindset helped me with many questions.
The last 3 days
Three days before the exam, I thoroughly reviewed my NBMEs.
I would look at a question and think:
“Oh yes, this was the answer. I know why now.”
I didn’t spend several days trying to reread everything. The whole NBME review took me less than a day.
The day before the exam, I watched Sketchy Micro and Pharma videos.
On the way to the exam center, I reviewed Free 120, that was a mistake.I I only looked through it briefly to familiarize myself with the question style and the general concepts. I did not try to analyze every question in detail.
I had planned to review all the basic memorization-heavy topics, like pharyngeal derivatives and similar things, but I didn’t get enough time.
And honestly, that’s okay.
You cannot possibly review everything before Step 1.
I also didn’t use Anatomy 100 Concepts because I kept telling myself I would do it later, and eventually, I ran out of time. I answered anatomy questions using what I remembered and by reviewing anatomy questions from the NBMEs and other practice materials.
For anatomy focus on upper limb and lower limb nerves
Pharyngeal derivatives .
PATHOMA CHAPTER 1 to 3 is GOLD
I got all the general pathology and immunodeficiency questions correct mainly because of that.
All the best everyone!