USMLE Step 1 Experience - 245

USMLE Step 1 Experience – 245

USMLE Step 1 Experience - 245

USMLE Step 1 Experience – 245


Hey all, got my scores yesterday, figured I’d add my bit! First of all, thanks so much to all of you who helped make this past few months bearable, your shared experiences really do help!


Score: 245. Very pleased! Doesn’t close any doors I was hoping to keep open (looking at EM mostly).


Background: Allopathic student at a 1.5 year pre-clerkship institution, upper 33%ish of class, varied from block to block. 


Prep Strategy

-Used pathoma and FA as in-class resources to target studying to more board-oriented topics, as well as FA-Rx Qbank to test knowledge

-6 weeks of dedicated studying, but started pretty much full time during our last instructional 3 weeks (~9 weeks total study time)

-Studied from about 8am-6pm everyday. I found 10 hour days with no days off to be more manageable than 12-14 hour days with a day off a week, but this is totally up to the individual



-FA-Rx Qbank (during pre-clerkship courses. This Qbank tests very basic knowledge, relatively speaking, so it is excellent for when you are first learning material. If you use it as your only Qbank, however, the style and difficulty of the actual board exam is going to blow you away)

-UWorld (Once through, 74%, also did incorrects)

-Kaplan Qbank

-First Aid


-First-Aid Rx Flashcards- I really think these are a hidden gem. 11,000 well-curated cards that you can go through very quickly. The mobile app is a bit iffy, but functional. I would highly recommend this resource

*I found videos to be too inefficient during dedicated prep, but opinions on that vary. I would personally suggest watching Pathoma throughout pre-clerkships and possibly Sketchy micro during your Microbes section, if your school organizes in such a way.



UWorld 2- 247 (1.5 weeks out)

NBME 18- 244 (1 week out)

*I did UWorld 1 as well, but not under conditions that make it worth reporting. These are the only self assessments I did, so take the results with a grain of salt, but they were very predictive


Test Day Experience

Ah yes, the bit everyone wants to hear. I scoured the forums for the three weeks after my test reading all the testimonials of those who felt terrible and did well. The truth of the matter seems to be that pretty much everyone feels like complete crap during and after the exam, from those who scored 191 to those who scored 260. So basically, how you feel means pretty much nothing, not that that helps you feel any better about it.


I had no trouble with time on the exam, but I’m fortunate to be a very fast reader. I had ~15-20 minutes at the end of each block. The question length and style was similar to UWorld in my opinion but every test is different. I took a break after blocks 1, 3, 4, and 6, but again, feel out what is best for you come exam day. And yes, I left feeling like I had blown it big time. Ignore that crap as much as you can. Have fun with your friends and family! You finished!



-Classes are important (duh)! But seriously, I only got some of the more obscure questions on my exam correct because of some random throwaway line in some lecture. Note also that I didn’t exactly have a great lecture attendance ethic, so I probably missed some that I wouldn’t have had I been a little less lazy the first 1.5 years of med school.

-If you take only one thing away from this wall of text, let it be this: keep your threshold for changing answers on your exam insanely high! I basically did not change an answer unless I realized I had read a question wrong, and the one time I did not follow that rule I ended up getting the question incorrect. It feels bad to pick an answer and not be entirely sure why or how you know it is correct, but trust your gut! Second guesses can kill.

-You are going to have study days where you feel like you are retaining nothing/just don’t want to do it anymore. Push through those days. They separate the men from the boys.

-How do you push through those days? Find a reason why you have to do well on the test aside from the obvious. For me that was ensuring that I kept possibility open to match to my hometown EM residency (which is pretty competitive) so that I can stay near my family and friends.

-Do a billion practice questions and read the explanations thoroughly. That said, I’m not much of a believer in taking four hours for one 40q UWorld block. I typically did 120-140 questions a day (in addition to doing other things to study), and found the volume to be more helpful than annotating and analyzing every detail of an explanation, but hey, different things for different people!


If I had to do it again

-I’d jump off a bridge


-Ok, I’d do a few more self assessments, if only because there was one or two questions from NBME 18 that showed up in bastardized form on the actual thing, so it stands to reason I might have been able to snipe a few more from 16 and 17. Hard to know though


Best of luck to you all! Work hard, get it done, and then you get to be on the wards doing what we’ve all been dreaming of doing since entering medical school. It really is worth it in the end, I promise!

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

My USMLE step 1 Experience : 248

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USMLE Step 1 Experience of IMG graduate

December 8, 2017
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