USMLE STEP 1 – 253 Experience – Indian IMG (Malak Modi)

USMLE Step 1 253 Experience

Name: Malak Modi

Medical college: B.J.Medical College, Ahmedabad.

Exam date: July 4, 2017.

Preparation time: 12-15 months

Study materials used:

  1. During my 3rd 1 st year of MBBS I had watched Kaplan videos of all the subjects and annotated some extra points from videos in my Kaplan lecture notes.
  2. Kaplan lecture notes in all the subjects except pathology
  3. Fundamentals of Pathology – Pathoma
  4. Uworld
  5. First Aid USMLE

In addition to these, I used some extra sources for my weak chapters like:

  • BRS Physiology – CVS
  • BRS Behaviour Science- ethics and patient-doctor relationship chapter
  • Rapid Review Pathology by Goljan book pictures.
  • Kaplan Medical Ethics – 100 cases for ethics.
  • Uworld biostats review
  • Anatomy shelf notes

Online Assessment exam scores:

  • 10/5/17: NBME 17- 248 (satisfied)
  • 17/5/17: UWSA 1- 269 ( I was on cloud nine.)
  • 27/5/17:NBME 16 – 248 (was hoping to reach 250 in NBMEs but couldn’t)
  • 3/6/17: NBME 18 – 240 (I freaked out)
  • 18/6/17: NBME 19 – 252 (Finally reached 250)
  • 22/6/17: UWSA 2 – 260 (Really needed that confidence boost)
  • 28/6/17: 120 USMLE Practice questions – 90%


  • NBME 1 TO 4 : Don’t remember the scores.
  • NBME 7: 180/200
  • NBME 11: 182/200
  • NBME 12: 181/200
  • NBME 15: 188/200
  • NBME 13: 182/200


Kaplan Videos:

It was after 2nd year exams of MBBS, that I was in dilemma about whether to go on USMLE path or Indian residency path. Finally, I decided to take Usmle path. One of the reasons for my decision was that I got my US immigration visa. I started gathering information about USMLE process from seniors and internet and found that with US green-card in hand, I would have a good shot at US Residency. I met my college seniors who matched that year and got insight about whole this process works. Both the seniors advised me to finish Kaplan videos in 3rd 1 st. I did that and annotated the extra points from videos into my Kaplan lecture notes so that during my final preparation in internship I won’t have to watch videos again.

Kaplan notes , FA and UW offline:

During Final year of MBBS I didn’t even prepare for step 1. I just read all the final year books and concentrated more on Medicine. As it turns out, my strong final year concepts and differential diagnosis basics helped me a lot in step-1 cases. It was after the Final year that I again opened Step 1 books. I started with Kaplan lecture books (with videos annotations) and Fundamentals of Pathology – pathoma. I used to take Kaplan books with me to college and would read them whenever I got a chance during my internship. After I was done with Kaplan in all subjects, I bought FIRST AID USMLE Step 1. I put 15 blank pages after each section of FA. I would read a system from FA first and then do UWorld offline for that system writing important points from the explanations of UW into those blank pages of FA. This process of making Uworld notes was long but in the end it was worth it. There were some bad postings throughout my internship when I didn’t get the time to study but there were some good terms too which would allow me to finally catch up. The beauty of this exam is you can give it whenever you feel ready.

FA read with UW notes and old NBMEs:

After finishing offline uworld systemwise, it was time for a thorough first read of FIRST AID with Uworld notes. Whenever I got bored, I would start doing 20-30 questions from the old NBMEs (NBME 1-7). This way alongwith FA I completed 1-4 NBMEs.

Online Uworld:

Then, in January end I took an online UWorld subscription for 6 months. I would read FA for a particular system along with offline UW notes and then on the next day would do 3 blocks of online Uworld for that system and review those blocks with explanations. This habit of doing Uworld blocks back-to-back and in the morning really helped me to keep my mind focused in exam.

Thorough reading of FA with NBMEs:

After about 2 months, I was done with online Uworld. Then I read FA for 1 month concentrating on little details and gave my first NBME 17. After that I took various NBMEs and UWSAs as stated above and focused on my weak areas. I gave a week to offline NBMEs in which I did all the remaining NBMEs (7,11,12,13,15). But the real shock for me was my performance in NBME 18. It was not that I scored less compared to other nbmes, but the kind of mistakes I did that freaked me out. I was getting the tough questions correct, but did many silly mistakes. Lack of concentration, perhaps. I talked to my friends and seniors who took their step 1 and that really cheered me up and made me believe in myself. Took a break of 2 days and cleared my head. But I couldn’t risk making silly mistakes in real exam so thought that I need to improve my concentration. I started doing 7-8 uworld blocks a day back-to-back from 8am to 4/5pm daily for a week and simulated exam like conditions. This time I wasn’t using uworld for knowledge, but to improve my concentration skills. And this, really helped me in real exam to prevent mental fatigue in those last 2 blocks. After doing this for a week, I took NBME 19 and was satisfied to see my NBME score above 250 for the first time. Took UWSA2 and got 260. Booked the date and started my final First Aid revision of 10 days. A week before exam I took the practice test 120 questions and got a good percentage and I knew I was good to go.


Even Zolpidem didn’t help on the night before exam, but still I was fresh in the morning. Reached exam venue at 7am. And exam began at 7:30. Skipped the tutorial and started block 1. I was going at a good pace from the very beginning and that helped me a lot. I was finishing about every block within 40 minutes. And in the remaining 20 minutes I would review marked questions and unanswered questions. There were about 4-5 questions in each block I had no idea about but don’t freak out. Its USMLE and it is not a piece of cake. It happens to everyone. Instead focus on those 35 questions which you should get correct. Because, if you keep worrying about tough questions, you might end up making silly mistakes in the easy ones. I took a 5 min.break after every block in which I would eat chocolate, got to washroom and drink water. I found that in my test, micro and immune both were heavily tested. There were some weird questions from immunology but I don’t even remember them as I hadn’t even heard about those things. Don’t panic. Be calm and confident. Don’t let a block of tough questions ruin your whole exam performance. You will have a block or two which would drain your mind but keep believing in yourself. Because, after 1 or 2 tough blocks you will surely get some easy questions. Now about the questions, they were of mixed length. Some were lengthy and some were very short. But pretty balanced overall. I felt that exam was exactly like doing Uworld or UWSAs. The format, the length, the pattern all resembled Uworld.


Uworld and FA are the most important resources. 80% of exam was based on these two things. Dont underestimate the Final year subjects especially Medicine. I don’t know if old NBMEs helped me or not but I sure as hell know that those NBMEs gave me new questions and new concepts. And at the end it doesn’t matter how much you read, but what matters the most is how you think after reading a question and the only solution to improve your way of thinking, is doing more and more questions and old NBMEs provided me that.


  • Malak Modi


If this experience helped you, we recommend you check out the following experiences:

USMLE Step 1 Experience – 259

USMLE Step 1 – 240 Experience – US AMG

US MS2 scores 253 on USMLE Step 1 – Experience of 253

November 11, 2017
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