Step 1 Study Guide - Score 259


  • Non-US IMG
  • Medical school: In Pakistan
  • Exam taken during final year of MBBS
  • Prep time: Approximately 10 months with breaks in between
  • Step 1 Score: 259
  • Current Status: Matched into Internal Medicine Residency 2020
  • Study materials used: First Aid, Uworld, 100 cases of ethics by Conrad Fischer, biostatistics uworld, Kaplan video lectures and books, sketchy micro, pathoma, DIT lectures.
  • UWORLD first pass: 83%
  • NBMEs/UWSAs range 230s to 260s

Phase 1:

The first phase is to understand all the concepts thoroughly. You need to start with the basics and you need to make sure you understand each and everything. Don’t get discouraged if your concepts are not concrete during this phase and you keep forgetting things as this happens to everyone. You just need to try your best.
Start with Kaplan video lectures for all the subjects and make notes on your Kaplan books. For micro, you must study Sketchy Micro. It is the best resource out there for microbiology and for pathology there are no better lectures than Pathoma.
Once you have listened to all the lectures and made your notes, this concludes the first phase.

Phase 2:

Now you start First Aid complimented by Pathoma for pathology. I would suggest studying it system-wise as that makes it easier. Say you start with cardiology, the key is to make sure you understand everything that is written in FA as anything can be asked. FA is the holy grail of step 1. Additionally, study Pathoma for pathology but do not skip FA pathology instead add to it from Pathoma. Pathoma is very good for histology too so make sure you pay attention to the images in it. Once you are done with the systems, study the basics and your first strong read of FA + Pathoma would be complete. In case you need additional help understanding some difficult concepts in FA, try listening to explanations on youtube. 

You might think you are forgetting stuff but that’s normal. You remember more than you give yourself credit for. So once you’re done with that good first read, start FA (complemented by Pathoma) system-wise again. This time when you finish a system, listen to its corresponding DIT lectures and then do that particular system’s UWORLD. The key here is to learn. You will find many new things in uworld and you might not score that well in the beginning but don’t worry, it will get better. More importantly, uworld is a learning tool, use it as such. Make sure to read the explanations after every test you take. Make notes on your FA of high yield points from uworld. By now you will know yourself what is important and what is too much information for you to remember.

Phase 4:

Once you’re done with all of DIT and UWORLD, the next step is to revise as much as you can. Now that you have customized your FA with notes from pathoma and uworld, it should become the most precious thing you own. Here the key is to learn and understand everything there is in your FA and not get caught up in the number of reads. The number of reads doesn’t matter, what matters is how you read it. It’s different for everyone. You can also do your marked and wrong questions of uworld during this phase.

Phase 5:

After you have revised FA at least once, take your first NBME preferably online. This would help you assess your preparation. After the NBME get back to your FA, strengthen your weak areas and then take another NBME/UWSA. Repeat this a few times and when you get closer to your desired score you are ready to take your step 1 exam.

First Aid, DIT and Uworld for all subjects.

Additional resources for all subjects are given below: 

Kaplan lectures for Gross Anatomy and Neuroanatomy, Anatomy shelf notes, Kaplan lecture notes for upper limb and lower limb.

Sketchy Micro lectures and PDF. No need for DIT.

Kaplan Lectures by Dr. Turco

Pathoma Lectures and Notes.

Kaplan lectures

Kaplan Lectures

Kaplan lectures

Kaplan Lectures and Uworld Biostatistics

100 cases by Conrad Fischer

Good luck. 


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