Step 1

The United States Medical Licensing Exam (USMLE) Step 1 is a difficult exam that consists of 7 blocks of 48 questions in one day. It is a challenge in many aspects, but with the right strategy it can be easily conquered. The following are some recommendations for a successful exam.

Positive Thoughts

Set some time aside to recall some difficult situations and how you dealt with them. You can ask yourself questions such as: How did I feel? How did I overcome this situation? You can also write down some inspiring things loved ones have said about you. Another important task is to set your goal for the USMLE Step 1 exam, do you want to just pass or do you want to ace the exam? Once you have this, keep this close. At times studying will be harder than others, do not despair, breathe and go and read what you wrote.

Diagnostic Tests

National Board of Medical Examiner (NBME) exams can be purchased from the NBME website. Do not study for the diagnostic exam; this is just a starting point where you can build up from here. See your results which will be given to you immediately and draw your study plan from there, start your review from your weakest to your strongest subjects. It will seem harder, but it is the best way to increase your knowledge.


There are many to choose from, review the back of the book First Aid, which grades books based on peer reviews. Go to a book store and pick a couple, review a topic of your choice in all the books you have chosen. See which one explains things better or which one you feel more comfortable with. Pick just one source as you will not have enough time to review 2-3 sources.

  • FIRST AID: It’s a very good book; my suggestion would be to use it near the end of your journey. It’s more of a review or outline of what you should have dominated before taking your exam. Do not just memorize this book, USMLE exams are a measure of your ability to understand and apply concepts not if you can memorize. The name of the game on the USMLE is the why of the diseases, not the what.
  • KAPLAN: It’s great, but quite time consuming. If you have the time and the money then definitely see the videos, take notes and get the most out of this information, go to the live lectures, then do a question bank, in that order.

Question Banks

Currently there are many options concerning question banks. Kaplan Question bank and Usmleworld in my opinion are the best. If you want to do both, then we suggest you begin with Kaplan and finish with Usmleworld. If you are short on time or money then go directly to Usmleworld, some people subscribe for 2-3 months. There are several ways you can use this tool, create your practice exams and then review the questions and answers. Always go back and review what you are getting wrong.

When to Take It

My best advice here would be, take it when you are ready, not when people tell you to take it. Another clue as to when you should take it is when you have taken NBME exams consecutively and you are getting 500 or above.

Final Thoughts

Yes the USMLE Step 1 is hard, but let your desire to pass and be a physician in this country be stronger. Surround yourself with positive thoughts, positive people, eat right, rest, exercise and focus on your goal. What we think about today will create our tomorrow, so set your goal and work hard every day to go get it!

For more information about USMLE Step 1, please visit the official website.

Updated October 2010