USMLE Step 1 – 269 Experience – IMG

First of all…I´m an OLD IMG (I finished med school > 10 year ago)… 

I started studying last week of March 2011 (I took May off….bad idea…) and I took the exam today … 

– Kaplan videos (all except for pathology and cardiovascular / respiratory physiology) = I watched them twice
– Microbiology = I read CMMRS once
– Pathology = Goljan audio x 1 time + first 12 chapters of RR Pathology
– Physiology = Costanzo (loved it!)
– Pharmacology = couple of chapter from Lippincott’s Illustrated Reviews

DIT: only the first & second day videos…that guy is so boring!
FA 2011…just read Embryology, Neurology and Psychiatry twice

I finished UW (timed unused random) with 70% 
Kaplan Step 1 Qbank (completed less than 40%) 76%

USWA 1 = 680/252
USWA 2 = 800/265
NBME 12 = 600/245
NBME 7 = 580/240
Kaplan Diagnostic Test = 84%
150 free questions = 94%

Test: the question stems were pretty long!…more like kaplan Qbank. 

Anatomy I had like 10 questions…KAPLAN videos is not enough!
Embryology FA is enough.
Neuroanatomy FA is enough.
Behavioral Science was so weird! I had like 7 questions…I think kaplan is really good but not enough
Biostatistics I had like 15 question…I didn’t use kaplan/FA for this, so I cant help here…a little bit of everything I guess
Immunology like 12 questions…Kaplan OK
Biochemistry Kaplan and UW more than enough
Pathology …don’t read RRPathology!…goljan audio + UW are enough.
Physiology a lot of up/down questions…check kaplan Qbank!!!
Pharmacology…you must listen to Lionel Raymond (kaplan videos)

A lot of CT-MRI, plus microbiology/hematology pictures…(I used google images)

the bottom line is…the test is really doable…don’t be afraid and good luck to all!….

Took Step 1 about a month and a half ago, got my score back about a month ago. Followed this forum sometimes so figured I would contribute. These are basically my posts from SDN, but figure I would post them on here as well for the people who don’t follow the SDN forum. Feel free to message me if you have any questions. 

Overal-not bad at all. Thought it was actually WAY easier than any of the NBME exams as well as usmleworld. Maybe 2-3 questions each block I was unsure about-the rest I felt were gimme’s. Had plenty of time each block-usually finished with about 5 minutes to spare. I’d say maybe 2 of the blocks I continued to check over my answers until the last second. My advice: just know first aid. There were only 1-2 questions total that were on step that could be found in Goljan and not in first aid. Just know first aid and DO QUESTION BANKS. I ended up doing usmleworld, all 7 NBME’s, Kaplan, usmlerx, and robbins rapid review questions. Here are my stats: 

NBME 1 7 weeks out: 260
NBME 2 6 weeks out 260
NBME 3 5 weeks out 260
NBME 4 1 month out 271
NBME 5 3 weeks out 260
NBME 6/7 same day 2 weeks out 264/266 2 weeks out
USMLE WORLD self assessments 2 weeks out 265

USMLEWORLD stats 100% completed random, timed 85%
Kaplan random timed (did this one first)-~78%
UsmleRx and robbins rapid review were around 83%

My goal for what I would be okay with is 250. But my hope is to get above a 260. 

Again-focus on first aid. Goljan for me was incredibly low yield. You are better knowing every single detail in first aid instead of learning things in Goljan. Do questions banks!!! And having a year of clinical rotations helps too =)


Ok so here is my advice for step: My usmle score was 269/99. Main advice is DO MASSIVE AMOUNTS OF QUESTIONS!! Not once did I read/study Goljan rapid review, Goljan audio or BRS physiology. I spent the vast majority of my time doing questions. I know its hard to tell on forums which people are just geniuses but let me tell you I am NOT one of those people. In terms of intrinsic IQ/memorization skills I am very average for a medical student. I have to study much harder to get the same grades as those “genius” people in my med school class.’


Refer to my previous posts for what I was scoring on NBME’s, uworld percentage etc.

More Hx-I have had about a year of clinical experience before taking the step.Yes it helped a little bit. When I first started clinics I studied my ass off
but still performed very average on shelf exams (70’s range). But my last clinic (medicine) I switched to a new system where I only did questions to study and I did NO reading whatsoever-only questions. My shelf score for medicine=99. So, I continued this method for step and as you can see it paid off immensely.

No only do questions, but whenever you miss a question or learn something from a question write it down on a separate sheet of paper. This is SO important and valuable and high yield-because later on you can read over these notes (write maybe a sentence max for each question short notes-they add up quickly) and remember what you learned from a question a month or two ago.

Now yes you should still go through first aid because this is the most high yield of any source. But go through it fast-limit yourself to ONE WEEK going through first aid. No you are not going to learn even 50% of it in that week but you will learn a little bit and reinforce and learn more by doing questions. I used goljan/brs only to look up things I was unsure about from questions I did-I repeat-use these only as a reference! Question banks (except for uworld) are notorious for having errors so if you aren’t sure about something yes look it up in goljan/first aid/brs or Wikipedia (my personal favorite). 
After the first week of going through first aid my advice is the following: do 200 questions a day. This is very doable and you will still have time to write
short notes for the questions you do. I would do the following question banks in this order

1st: UsmleRx-an easier question bank, has some errors but relatively fewish compared to other qbanks. In the explanation for the question it has the first aid page image to view. Good for learning more from first aid

2nd: Kaplan. Also fewish errors compared to other banks. Questions more picky but overall a good qbank. 

3rd: robbins rapid review qbank. Would recommend purchasing online subscription so you can go back and do the questions you missed. DON’T purchase subscription to usmleconsult. This qbank is SO INCREDIBLY ERROR FILLED. I started doing this qbank and got frustrated after 1 day because of the incorrect questions and massive amounts of errors. I don’t care that goljan approved it, he has obviously never done a single question from this bank. It is a horrible question bank I repeat don’t waste your money. If anything your score will decrease by doing these questions because the answers are incorrect and the explanations are WRONG.

4th: Uworld. Do this one last so it is fresh. MARK the questions you got right but only because you guessed or weren’t really sure about the answer. Go back and do these in addition to the ones you missed. 

While doing qbanks do ALL of the nbme’s, the free 150 as well as the two uworld assessments. In the beginning I did these tests every two weeks. Towards the end I did a couple of week including two full length test simulations

Ok that is my advice. Not saying this will work for everyone, but for me as a student who has a hard time memorizing information this is finally the system that worked for me. As you can tell I’m not one of those superstars that has always done amazing on shelf exams etc that test knowledge. (if anyone wants to know my MCAT score was 34). After doing average on shelf exams I took a risk and changed the way I study and it has paid off. Please let me know if you have any questions about this method-but I think many people would benefit from studying this way.

Seriously almost every question I had on my actual exam I felt like I had encountered a question testing similar concepts before. I had very few WTF questions but had I not done so many questions I would have had many many more WTF questions. A theme I saw on usmle forums is people who were scoring around 270ish all did at least 3 or 4 question banks-not just
uworld. Good luck to everyone!

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

Journey to 250+ USMLE Step 1 – Dr. Donmez

Dr. Nikki – 2017 Experience – USMLE Step 1 – 244

Dr. Adil Cheema – USMLE Step 1 Experience

December 26, 2017
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