USMLE Step 1 Study Principles

 

Phases of STEP Preparation

1. Didactic Phase – Longest phase, focused on foundational knowledge and includes M1 and M2 curriculum.

2. Content Phase – Intensive and focused content review, typically the first 2-4 weeks of dedicated study.

3. Test Prep Phase (Last 1-2 weeks before the exam) – Focus on testing skills, test-taking strategy, simulated question blocks in a test-like environment, self-assessments, and final content reinforcement.

 

Understanding the Exam

• USMLE Step 1 = A Basic Science Exam

  • Prioritizes application of physiology, anatomy, and microbiology.

  • Emphasizes mechanisms over rote memorization.

 

Core Resources for Content Review (Resources and Links Listed Below) 

• UWorld – The cornerstone of Step 1 prep

  • Approach questions systematically.

  • Identify key phrases and concepts.

  • Differentiate critical information from distractors.

  • Analyze all answer choices (why they’re right or wrong).

  • Hypothesize how changes in the vignette could alter correct answers.

 

Maximizing UWorld Effectiveness

• Active Learning: UWorld Notebook

  • Write down one or more key takeaways per question (new fact, forgotten detail, high-yield point).

    • Option: Convert notes into Anki flashcards for spaced repetition.

  • UWorld is for learning, NOT assessment – Read explanations in detail, even for correct answers.

• Question Block Strategies

  • Random Question, Timed Blocks = Best for self-assessment and tracking progress.

  • Subject-Specific, Tutor Mode Blocks = Useful for targeted content mastery.

  • Quality > Quantity – Thoughtful review of a few questions beats rushing through many.

 

Dedicated Study Recommendation - A Two Phase Approach

• Content Phase

  • Master your medical school curriculum – it's designed for long-term retention.

  • Integrate physiology, anatomy, and microbiology with every system.

  • Few, high-yield UWorld questions > Volume-based approach.

  • Example study day with a system-based approach 

    • 1. Targeted Review of Prior Days Material (ex. Anki Card/Uworld Notes) ​

    • 2. Pre-Test on the Days System (20-40 question Uworld, untimed, tutor mode, system specific) 

    • 3. Content Review (Majority of day) - Primary materials focused on the targeted body system with focuses on the integration of physiology and basic sciences in the setting of pathologic disease (First Aid, Pathoma, etc.) 

    • 4. Post-Test on System (40 question Uworld, untimed, tutor mode, system specific) 

    • 5. Make notes/Write Anki cards to review the following morning on missed questions 

    • 6. Optional: Brief Test Prep - 20 question block, timed, random systems

• Testing Phase​

  • Strong test-taking skills help, but content mastery is essential. It is impossible to completely mask content deficiencies with strong test-taking skills. Therefore it is vital you have mastered the content phase before moving to this phase.  

  • The focus of the phase is the application of learned content in a simulated testing environment 

  • The goal - see as many questions and vignettes as possible while applying your knowledge

  • Example study day 

    • 1. Targeted review of prior material ​

    • 2. Test Block (40 Questions, random, timed) 

    • 3. Review missed questions 

    • 4. Return to primary resources as needed to fill content gaps 

    • 5. Repeat steps 2-4 as many times as possible