USMLE Step 1 Experience – 256 – Dr. Ahmad Ramahi

256 USMLE Step 1 Experience

My (256) USMLE Step 1 Experience

Ahmad B. Ramahi, MD

Graduate of 2015, Al-Quds Faculty of Medicine

East Jerusalem – Palestine.


My Exam was on Aug 10 2016

Exam Score: ((256))

NBME 15 (3 weeks before the exam): 245

Preparation Time: Around 5 months (Early March to Early August). I was working during the first 2 months, but the last 2 months were at home, and I was giving my full power during day and night. I didn’t save any effort as I was convincing myself that I was approaching the finish line.

After I finished my USMLE Step 2 CK with score of (257) and passed the USMLE Step 2 CS, I moved on to study for Step 1. I started with First Aid (FA) 2016, usually my first read is my most important one so I was reading with full concentration. FA was depressing at the beginning, too many things to memorize, many things that I didn’t get, and I have no time to study from other resources, so Google was my great friend, I used to Google everything that I don’t understand, on few occasions, I read from BRS physiology with a total duration of less than one day. For I biochemistry I looked at few charts from Lippincott. Otherwise nothing else. After I finished my first read of FA, I registered for Online UW. I started doing the questions by systems, it was sad at the beginning that I couldn’t recall much of the FA. But I continued, I used to take notes from UW into my FA, and I read the topic quickly from the book so as to revise the FA while doing the UW, and this was of great benefit.

I was too slow, at the beginning I couldn’t do more than 30 questions per day at my best, then a max of 1 block per day. 1 month before the exam, I found myself stuck with no hope to finish the UW. I decided to stop doing by system and to do the UW by topics. I started with anatomy as it was my biggest fear, I did it all then the same thing with embryology, genetics, pharmacology, physiology. After all of that I had around 600 questions left from Pathology and Microbiology. I tried to do as much as I can from them, as my plan was to stop doing UW 20 days before the exam so I can revise the book, because many friends told me that the FA is more important than UW.

3 weeks before the exam, I did NBME 15 online and I got 245, I felt hopeless that I wanted to postpone the exam. But with the great support of my family and friends I continued.

After that, I was revising the FA during the day, and doing UW questions in one to two hours at night, reading just the educational objectives without the other explanations, that was too risky and Frustrating but I had no other choice. I revised all the FA except the Neurology chapter and the biostatistics as I ran out of time.

2 days before the exam, I revised the Neuropharmacology, and embryology, then I skipped the rest, I revised the biostatistics equations, and all the equations at the end of the FA. I revised my notes that I felt they are important. And I went to the exam with 200 questions from UW not done.

On the exam day: Despite all that I was relaxed and happy that am going to do the final step and in few hours I will be free. The exam went smoothly, I took a break after each block. Time wasn’t a problem at all, I used to have 10 mins left from each block. Most of the questions were short, many of them were direct from the FA and many tricks were mentioned in the UW. I found Biostatistics and ethics to be the worst part and that was reflected on my performance sheet as they were my lowest.

In Summary: My journey in Step 1 wasn’t the optimum and I don’t really encourage anyone to follow the exact way I did. My main and almost exclusive resources were UW and FA. They are more than enough if you master them and I found it impossible to do so. Believe in yourself, stay near the positive people and go for your dream.

Difficult roads often lead to beautiful destinations.

Nothing worth having comes easy.

Best wishes,


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

261 in Step 1 – Argentinian IMG

250 – USMLE Step 1 Experience

USMLE Step 1 Experience of an IMG – Hard Work

December 4, 2017
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