USMLE Step 1 Experience – 257 – Dr. Akram

257 USMLE Step 1 Experience


257 USMLE Step 1 Experience

257 USMLE Step 1 Experience


Year of Graduation : 2015

Study Duration : 3 Months during House job (March-May) + 6 months of Dedicated Study (June-Nov)

Date of exam : Nov, 2016

Resources Used

  1. Physio : Kaplan with Kaplan Videos + FA + uworld
  2. Pharma : Kaplan with Kaplan Videos + FA + uworld
  3. Biochem & Genetics : Kaplan with Kaplan Videos + FA + uworld (Revised Genetics during last months of prep)
  4. Pahtology :

Pathoma e pathoma Videos + FA + Uworld (Nothing else, Quickly reviewed pathoma for histo pics in last days)

  1. Anatomy :

Gross : Kaplan esp CT scans of thorax and abdomen ( used it in last days as well) + Muscles of upper and lower limb , origin insertions from KLM + FA + Uworld [will not recommend HY anatomy, all necessary info is covered in uworld and FA]

Neuro : HY Neuro ( Must b done from kaplan, i personally believe that HY is LY for Neuro :p

Embryo : HY embryo (Best book)

  1. Micro : FA and uworld r MORE THAN ENOUGH
  2. Immuno : Kaplan(recommended) + FA + Uworld
  3. BS & Ethics : Kaplan Books with Kaplan Videos + FA + Uworld

100 cases of Conrad Fischer [N.B :DONT FOLLOW ANY OTHER BOOK FOR ETHICAL PRINCIPLES, as there is a lot of stuff that creates confusion]

For Ethics : Uwrold and Conrad’s 100 cases are the best sources

  1. Biostats : Kaplan e videos + FA + uworld + uworld subject review

Qbanks : Uworld + Did kaplan Qbank for Genetics section.

Time Line

1st Phase

Kaplan, Pathoma, HY & all stuff other than uworld and FA (3 Months of housejob + 1 month)

Assembled the stuff, started with Kaplan books and videos, like most peolple didnt realise that kaplan must b done as fast as possible 😛 wasted a lot of tym , obviously it wasnt easy with housejob. Pathoma is an excellent book to cover patholgy, rest is covered in FA and uworld. Did Physio, pharma, biochem, immuno, BS & biostats and Antomy from kaplans.

Advice for starters :

  • Have a STUDY PARTNER. A DEDICATED ONE. 2 heads are better than one 😉
  • Try to complete Kaplans e videos asap. This part of prep is just for concept building, dont cram anything, just try to build a strong base. Repeat Kaplan only if you think you lack concepts even after doing uworld.



Pathoma histologies ,

Neuro cross sections ie Brainstem, brain.

Gross anatomy CT scans ie Abdomen , Thorax.

Muscles, origin insertions, nerve supply (only the ones that are mentioned in uworld)

2nd Phase

FA (1 month)

The First step towards the exam & very important one as well. Did it in a month.

Advice : Most of the people start uworld immediately after finishing kaplans, i ll highly recommend to give FA a read BEFORE starting e uworld qbank. It ll help u not only with uworld questions but also with annotations as well.

UWORLD QBANK ( 2.5 Months )

The most imp part of this journey to succuss is UWORLD.

Target : 50-60 questions per day with explanations.

Advice :

  • Subscribe it for 6 months ( will keep u tension free 😛 )
  • It’s a learning tool , so do it System wise in sequence of FA , it ll help e annotations and save ur time. AIM : CONCEPT BUILDING & PROPER UNDERSTANDING.
  • Regarding annotations : Try to annotate most of the uworld stuff on FA , so that u ve all the important info on a single book. Do keep a register for extra information. It was the first time ever in my life i used sticky notes :p
  • During First go MARK the wrong as well as imp questions & only use these questions for the 2nd round. DONT waste unnecessary tym by doing uworld twice.2nd tym Just do marked Qs .

3rd Phase

ANNOTATED FA (1 month):

This period is all about efficacy. Try to revise Annotated FA properly and effectively. Forget about uworld during this time. If u can manage tym, try to do marked uworld questions.

NBME , ANNOTATED FA e Marked Uworld (1.5 Month)

REVISON REVISION REVISION. Make your plan to take NBME after first revision of annotated FA. (i took NBME 7, 11, 15 after first revision)

EXTRAS: UW biostats review. It is a good resource, mark the important questions for revision in last days of exam. 100 cases of Conrad, i ll recommend to give this book a quick read in addition to the questions if you score less than 60% in uworld ethics. Neuro Brainstem sections, Gross anatomy CTs, Heart sounds, Pathoma histo pics etc.

2nd revision of annotated FA must take not more than 15-20 days. took NBME 13

3rd revison 15 days. NBME 16

4th revison 15 days. NBME 18, 120 Usmle practice questions.


  • Keep 1 NBME eg NBME 17 for last 4 days before exam date. Do a block daily in night. It ll boost up your confidence and will orient u towards the exam.
  • MARK the most difficult pages of the book. and try to revise them daily eg immunodeficiency diseases and drugs, Cancer Chemotherapy, Biostats formulas, Patho genes, Developmental milestones, First few pages of reproductive system etc.


  • Uworld First Go = 82 % [ REMEMBER !!! UWORLD NEVER PREDICTS YOUR SCORE, The MAIN focus must be on improving ur concetps rather than ur percentage. Every thing above 70% is good enough for getting 250+ ]
  • NBME 7 : 185 / 200 offline (2months out)
  • NBME 11 : 191 / 200 offline (2months out)
  • NBME 13 : 184 / 200 offline (2months out)
  • NBME 15 : 189 / 200 offline (1month out)
  • NBME 16 : 258 online (20days out)
  • NBME 18 : 256 online (10 days out) i ll recommend to take it at least 15 days before exam.

Kept Free usmle questions and nbme 17 for 1 block daily in night a week before exam, as i mentioned above. I ll highly recommend this strategy. It really boosts ur confidence when u r down 😛

Note :

  • A strong base, better concepts definitely improve your uworld & nbme scores.
  • Set ur target for 180+/200 in offline nbmes.
  • In most of the cases online NBMES are predictive of you real exam scores, so u can rely that.
  • Of all the NBMES i took, 11 was the easiest one. and 18 was the toughest most.I usually dont have time management issue, but nbme 18 really tested my nerves.
  • DONT LOSE HOPE IF U SCORE LESS IN NBMES. Its all about struggle. I ve seen many examples in which people have challenged the predictability of NBMES.


  • In my opinion THE REAL EXAM IS MUCH MORE STRAIGHTFORWARD THAN ANY NBME (15-18). After taking the exam this is what i feel : 80% of the exam questions are easy. It’s the remaining 20% for which we are actually struggling for 😛
  • Anxiety was gone after first 2-3 questions. Took break after every Block. Came back and started the next block with the fresh mind. Thats the best strategy i ll advise, it ll keep u fresh till the last block and will not exhaust your mind. I think time for block is enough in exam, and uworld and NBMEs prepare u well regarding tym management.
  • Pathophysio was highly tested. MAKE STRONG CORE CONCEPTS. ITS ALL ABOUT UNDERSTANDING IMP CONCEPTS & definitely uworld was more than enough for that. U ll get a lot of ARROWS up and down etc. ALWAYS TRUST YOUR FIRST INSTINCT. Marked 7-8 Qs per block, left biostats calculations & experimental Qs for the end in each block.
  • Exam interface is similar to uworld, the questions are more like uworld in length and style. The exam was definitley easier than NBME 18. BUT still NBME 18 is the best predictor of ur score. U can definitiley score higher than 18.
  • U get 1-2 Calculations per block that are mostly doable.
  • 1-2 experimental questions per block, dont worry much about them.
  • DONT forget to have a look at tutorial and lab values from usmle website a day before exam.
  • Pharma was the easiest subject!! :p Biochem nothing out of FA and uworld!! Biostats all from FA and uworld. Micro FA uworld was more than enough!!


  • I will advise to get through the registration process as soon as possible during the start of ur prep.
  • Take the Traid when u r done with FA first read.
  • Take the exam date once u ve taken online NBME and u get a score,that u r aiming for.


  • Make a plan and stick to it.
  • If someone can do it , you can do it. its all about confidence and ur belief in urself.
  • DONT waste tym on low yield resources.
  • Do as much NBMES as you can. The more u practice the more u score.
  • Dont get frustrated if u arent able to cram FA. In the exam Concepts matter.
  • Set goals and keep em up with tym table. Dont take longer breaks during last months of study.
  • Keep atleast 1 hour of refreshment tym daily till exam date.
  • Everyone’s experience is different, what worked for me may or may not help you, so do follow your own pattern of study. Dont overwhelm urself with unnecessary info.
  • Do FA uworld properly and u can easily cross 250 iA

Best of luck, Remember me in your prayers

MUHAMMMAD OMAR AKRAM Services Institute of Medical Sciences, LAHORE, Pakistan.

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

USMLE Step 1 – 269 Experience – IMG

USMLE Step 1 Experience – 273 – Must Read 🙂

USMLE Step 1 Experience – 253

December 5, 2017
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