Student Advice Survey

Many students ask about the best ways to prepare for Step 1. We surveyed students who took Step 1 in 2016 about their study and exam preparation strategies. Twenty-eight percent of students who took the exam responded to the survey. The most common piece of advice given by students was to create a plan that works for you. Your lead advisor or the learning specialist will be happy to assist you if you need help creating your study plan or being accountable to your plan. The following summarize our findings:

1. Please rank the question bank(s) you used (in percentages)

Highly Recommend Somewhat Recommend Do not Recommend Did not use
Becker’s Step 1 Question Bank 0 0 1.11 98.89
Kaplan Qbank 3.33 7.78 3.33 85.56
USMLE-RX Step 1 Qmax 23.91 44.57 2.17 29.35
USMLE Step 1 Qbank (Uworld) 97.83 0 1.09 1.09

Board Vitals, USMLE Easy and Firecracker were also used by students but were only indicated as “Somewhat Recommend” or “Do not Recommend.” None was rated as “Highly recommended.”

2. Please rank any additional resources you used (in percentages)

Highly Recommend Somewhat Recommend Do not recommend Did not use
Anki/Quizlet Flashcards 18.18 12.50 0 69.32
Audio Lectures – please specify 25.58 19.77 0 54.65
Goljan 18.89 14.73 0
Pathoma 2.10 0 0
First Aid 0 1.05 0
Dr. Barnes Pathology 1.05 0 0
Class Lectures 1.05 0 0
Doctors in Training (DIT) 11.49 9.20 2.30 77.01
Firecracker 3.41 7.95 3.41 85.23
First Aid 92.31 6.59 1.10 0
Pathoma 86.81 3.30 0 9.89
Picmonic 6.98 10.47 8.14 74.42
Sketchy Micro 54.44 3.33 0 42.22
Sketchy Pharm 15.73 10.11 3.37 70.79
Other – please specify 20 0 0 80
NBME Practice Exams 1.05
Study Buddy 1.05
Deja Review Plan 1.05
Kaplan Plan Flash Cards 1.05

3. When did you start answering qbank questions?


  • Used Rx throughout the year, didn’t start UWorld until January.
  • Used QMax throughout the year to study for exams. Started working on UWorld in December.
  • USMLERx while in learning blocks, started UWorld in March. Wish I had spent less time on Rx and started on UWorld in January.
  • I used Q max studying for exams during the school year. Did not start specifically using my Q banks for step 1 studying until Jan. 2016
  • Started USMLE Rx with classes and UWorld after spring break
  • June 2015

4. How many Step 1 practice questions did you complete?

More than 7,000:

10,000 X2


Kaplan, USMLE RX, Uworld 2x


5. Did you go through your qbank more than once?


If you went through your qbank more than once, how many times did you go through it?

  • I only went through it once, but I thoroughly reviewed the explanations before moving on.
  • Didn’t go through two times, but I would review questions I missed the first time
  • Did not go through more than once
  • Once spread out through classes, second fresh run thru starting a month before Step 1, third “missed/marked” only run thru a weekish before Step 1 but was running out of time on this one, so in the last day or two, I gave up on trying to finish the “third run thru” and just went back and did a fourth run thru on some of the “missed/marked” questions from the third run thru, and that’s when my score jumped the most, because it was plateauing before then.
  • One and a half times
  • I went through it once and then had 20% unfinished on my second time
  • I went back and reviewed all the questions I missed, and then reset the Qbank. I repeated about 1/4 the qbank following reset.
  • After reviewing 2 times, I went through a 3rd time on questions I did not understand fully
  • As I went through the qbank I marked the questions I wanted to see again (many questions I missed were easy – oops! – and I didn’t really want to see them again). This way, there were less questions to go through the second time around and I was only seeing questions that were difficult for me.

6. During the school year, did you organize your Step 1 review and/or practice questions to coordinate with MS2 topics?

If you answered no, how did you organize your Step 1 review and/or practice questions?

  • Random questions, all topics selected
  • Followed through the DIT program in order to get through First Aid. Used First Aid to study for MS2 copies.
  • Organized by First Aid chapter
  • I created a schedule of first year material that I wanted to get through on a weekly basis.
  • Randomly after the academic year ended
  • Rotated through the different organ systems; i.e. block of questions on cardio one day, next day is endocrine, etc.; would throw in a mixed block of questions once or twice a week.
  • mainly on my mood / the organization of FA
  • I started really focusing on Step 1 during spring semester.
  • I somewhat did that, but only for second semester.
  • Random timed questions of all topics
  • I just increased the number of daily questions as the year progressed
  • I did it completely randomly
  • I only coordinated Step 1 review in the spring when it was convenient. My primary focus was on classes.
  • I matched it up at the beginning of second semester, but then to get through Qbank twice you cannot match it up unless you want to be working on your pass through Qbank until the end of the school year. You have to just read ahead in Pathoma and First Aid to finish first passes in a timely manner.
  • I studied by section in First Aid
  • I did random q blocks since that’s how the real test is
  • Did random questions

7. How many NBME practice exams did you take? Please EXCLUDE the Comprehensive Basic Science Exam (CBSE) provided by IUSM in your total.

8. How many Uworld practice exams did you take?

42% took no Uworld practice exams
18% took one Uworld practice exam
40% took two Uworld practice exams

9. Did you take additional practice exams from a source other than NBME or Uworld?

94% did not
6% took practice exams from another source:

  • DIT two exams
  • USMLE Rx Q-bank
  • USMLE “Free 120” on the Step 1 website
  • One Kaplan

10. During winter break, how much time per week did you devote to preparing for Step 1?

11. During spring break, how much time per week did you devote to preparing for Step 1?

12. How much time did you allow between the time classes ended and Step 1?

13. Did you feel this amount of time was adequate to help you prepare?

14. Do you have any general study or test-taking tips or advice you would like to share with rising second year students?

  • Do what feels right for you and don’t worry about not doing something someone else is doing. Don’t get caught up in how other people are doing.
  • Know how you learn, and don’t worry about what your classmates are doing. Do questions, but if you learn some other way, don’t try to rely on questions.
  • Use a few resources but no more than 3 or 4, stick to a schedule that includes time for relaxing. Don’t compare yourself to your classmates.
  • STEP is all mental. You have to think about it as a measure of dedication versus sheer intelligence. Being mentally and physically prepared will serve you so much more than spending 12 hours a day killing yourself studying. Meditation and a study plan were my biggest advantages.
  • Everyone studies differently so set your own plan based off your own needs. Use UWorld and annotate first aid with questions. Pathoma, first aid, and UWorld are must haves.
  • Actually learn the material while being covered in the courses–there were some things that I had to re-learn during Step 1 studying that I really should have spent more time learning the first time around.
  • The “blank paper test” was very useful for me to learn well. That is, where you pick a topic (like all of the leukemias/lymphomas), and draw out a chart organizing your thoughts from memory. Whatever you can’t fill out, you look up. Then you draw it again, until you can do it from memory. This is particularly useful before class exams because you can draw out your diagram on test day and organize your thoughts.
  • Make goals for # of questions/week, when to finish Qbanks, and use Qbanks to study for class
  • Get used to questions and build up your stamina.
  • STUDY FOR SCHOOL! Studying for school IS studying for Step 1 and you end up with good grades and a good step one score. Don’t blow off school to “study for step” because it will only end up hurting you.
  • Make a detailed, realistic study schedule and stick to it!
  • Start early, budget time. Correlate it with classes
  • Don’t forget that you have been studying for a long time and you know what study methods work best for you! Everyone I talked to and everything I read said questions were key, so I focused on questions. However, I have never liked doing questions because it is too sporadic of a way to study for me and I don’t retain the information. When I wasn’t improving, I started putting less emphasis on questions and more emphasis on the ways I normally study and I immediately started doing better on my practice exams. Don’t get me wrong, questions are important as they show you what you don’t know and get you problem solving. Just don’t get too attached to a study method if it isn’t working! I wished I had changed my plan sooner. 2) Some of the questions on Step 1 can be strange (similar to NBME questions) so just be prepared for that! They won’t all be perfect questions like the UWorld questions. 3) Don’t worry too much about getting tired on test day. You study a ton in the weeks beforehand so you build up your stamina and test day doesn’t feel too different from a normal day of applying your brain all day long.

15. Looking back on your own Step 1 studies what would you do the same?

  • Start doing questions early, do plenty of practice exams, use RX Qbank to hone in on my weaknesses.
  • Going to class and studying lecture material to build a knowledge base. Working on questions relevant to the subjects covered in class.
  • Questions, practice exams, and develop a detail study schedule
  • I would focus on questions and read the explanations carefully, taking notes on anything I was unfamiliar with. I would also continue to study hard for classes because they do help.
  • Drawing out concepts and what I don’t know. Making my hand notes.
  • I wrote out weekly goals that were extremely reasonable and achievable. And then I was EXTREMELY strict in achieving those reasonable goals. I would absolutely do this again.
  • I would be confident with what has worked with me and stick with it.
  • Lots of time management second semester of second year. Taking the time to understand and learn why you missed questions. Really focusing on my classes.

16. Looking back on your Step 1 studies what would you do differently?

  • Take more NMBE practice exams. I wouldn’t have spent the money on DIT.
  • Started questions earlier in order to have time to more thoroughly read explanations.
  • Spent more time studying EBM.
  • Stick to my schedule better.
  • More practice tests
  • Don’t listen to other people
  • Not stress out as much if I wasn’t meeting my daily goals. Because I started so early, it didn’t really matter if I didn’t finish certain goals within that week because I was still ahead overall. Further, I should have taking more dedicated time to relax.
  • Freak out less.

17. Can you summarize your study schedule in a few sentences?

  • I did uworld questions as I went along in second year, which helped me do well on the class exams and I didn’t have to review as much at the end. I also did DIT which was helpful, but I feel I would have gotten the same score without it.
  • Used Rx in tutor mode throughout the fall semester and stopped using it by spring break. Went through UWorld once, all timed and random. Took practice tests every 2 weeks or so after spring break. Only used UWorld and FA after finals before my test.
  • I read first aid and pathoma sections correlating with whatever we were learning in Path/ICM throughout the year. Beginning in Jan, I reviewed old topics (biochem) and would read some FA everyday and then do about 20-30 UWorld questions per day. Stay on top of your classes they help for Step 1!
  • I started truly studying in January – I did a mixture of videos (sketchy, pathoma), First Aid and UWorld. Because I started so early I was able to take extra time to read up on things I didn’t or couldn’t remember and find or make up mnemonics and memory devices. I was really grateful for this extra time.
  • About 20-30 questions every day, 150-200 questions on the weekend, goal of reviewing a chapter of first aid each week unrelated to class material, in depth Step study correlated to class material
  • I typically did 40 or so qbank questions per day and read FirstAid or watched Pathoma depending on how much time I had. I also made sure to study and do well for my exams, since a lot of that material overlapped. I read through FirstAid and watched Pathoma as they lined up with my class subjects. I did USMLE-Rx qbank during the Fall semester and saved Uworld for closer to test date. As I read explanations for Uworld questions I would annotate my FirstAid, making it a much more valuable study resource.
  • My courses were priority all year and making sure I understood the material the first time made it very easy to quickly review the material at the end of the year
  • I studied for about 2 hours every morning before lecture and 1-2 hrs at the end of the day. I still went to every class until the end of the year …so it is possible. I matched my studying with class topics. I tried to do about 10 40 questions blocks again. Don’t beat yourself up if goals aren’t met from day to day …it will all work out. During winter break, I did not study at all, but I got organized. I made a really thorough but flexible colorful calendar the coincided with the second semester classes. So if people need to take the break, encourage to take the break but maybe encourage them to schedule out their questions and pathmoma watching goals and such so they can hit the ground running
  • Study for class and if I felt like I had my classes under control, then study for step 1. Most of my studying for step 1 was answering questions. I never actually devoted time to reading chapters in First Aid or going back and reviewing old slides/notes.
  • Do UWorld questions on tutor mode the first time through- read ALL the explanations- there’s great info in explanations for wrong choices, and annotate in first aid after getting UWorld questions wrong. My goal was to complete all of UWorld by spring break (except topics not yet covered in ICM II) and begin doing tests with multiple topics in preparation for NBME finals. All study time after finals was spent doing questions or practice exams.
  • I did 140 questions a day. During the school year mostly with what we were studying but some were not. When we got vouchers I would take them on a Saturday at about the same time my test would be. In the two weeks before my exam, I did over 300 questions a day, 1-2 first aid chapters a day, and 1-2 practice exams a week.
  • Focus on understanding everything in MS2 classes with some qbank over MS1 topics during winter and spring break. After classes ended, 6-8 hard study hours a day, maybe 10 if I was feeling it, but no more than that. I’d go golf, or run or read or relax with friends. When I was on, I was 100% focused.
  • 40 Uworld questions a day and 10 first aid pages a day with a break day every 6th-7th day.
  • I did about 1000 questions throughout first semester, but I didn’t really start studying until second semester. 2nd semester I did questions daily and read from First Aid as much as I could (which wasn’t as much as I would have liked). In the last two weeks, I read a section of First Aid each day (or 2 days for the longer sections). I also did a 2nd run through UWorld.
  • I spent winter break doing questions over first year material, then slowly eased into 2nd year topics (path and pharm). I started by answering and annotating 25 questions/day in January and increased that amount to 80/day in May. In May I took 2 weeks to go over first year class notes. I also started making flashcards of First Aid in April, I didn’t get through all of them but I made them which helped.
  • Once I started dedicated study I would study from about 8:30 AM – 7 PM. During this time I would do about 2.5 uworld blocks, read a chapter in FA and do a chapter out of Pathoma. I feel like I was personally able to fit this much information into a study day so it may vary for others.

Questions may be directed to:

Kristin Lively
Learning Specialist
Medical Student Education
Indiana University School of Medicine
975 West Walnut Street
IB 202
Indianapolis, IN 46202
Skype: kristinlively

Abigail F. Klemsz, MD, PhD
Assistant Dean, Academic Advising
Associate Professor of Clinical Pediatrics
Office of Medical Student Education
Indiana University School of Medicine
635 Barnhill Drive
Room 164
Indianapolis, IN 46202