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6 mistakes to avoid on the

USMLE Step 1
While there are many ways to succeed in medical school, the students
who fail to reach their target score on the USMLE Step 1 tend to commit
the same mistakes. At Memorang we work closely with tutoring centers
from top medical schools around the country, and wanted to share solid
advice compiled from students, tutors, faculty, and our own Step 1
experiences.
What are the most common mistakes students make?
1. Adding too many resources.
2. Passive learning instead of active quizzing.
3. Not using QBanks correctly.
4. Not knowing how and when to use different
resources.
5. Study Fatigue.
6. Test-day anxiety.

Mistake #1: Adding too many resources

What is the point of wasting time with additional resources if you havent
mastered whats already in front of you? As a thought experiment,
suppose that you performed reasonably well in your coursework and
knew 100.0% of every detail from First Aid, Pathoma, and the UWorld
QBank. What score would you reasonably expect to receive? You would
be hard-pressed to find any student that would expect anything less
than 250 and many would claim 260.

These are high-yield review resources of the topics and facts most likely
to come up on your exam and are meant to be used alongside your
coursework long in advance of your Step 1.
7. First Aid for the USMLE Step 1 ($27-$45) - The bible of the
preclinical years. You should be reading and annotating this
book alongside your regular coursework from the beginning
of medical school. By the time you reach your dedicated
study period for boards, you should have completed a few
full passes through the material.
8. Pathoma ($99/year) - A popular resource created by Dr.
Hassan Sattar lauded for its clear outline format and video
lectures. Its not a replacement for First Aid, but can be a
useful complement if you have extra time and are at least 36 months out from your exam.

9. Goljan Rapid Review ($45) - Preceded Pathoma as the goto pathology resource. Many students have relied upon
Goljans audio recorded lectures, although these are
technically bootlegged and unofficial. Like Pathoma, you
want to give yourself plenty of time to get through this.

Mistake #2: Passive learning instead of active quizzing

If you dont have eidetic memory, the best way to retain the raw
information for the Step 1 is through active learning. This means that
you should be spending most of your time quizzing and testing your
knowledge instead of passively re-reading your textbooks. As you go
through your review resources (e.g. First Aid, Pathoma, course lecture,
QBanks) you should be actively quizzing yourself with flashcards (or
other similar tools) to solidify your fund of knowledge.
One of the biggest mistakes students make with flashcards is spending
more time creating them than studying them. Unless you have tons of
free time, its better to start with pre-made flashcards and then work
from there. The only dangerous part about starting with pre-made decks
is verifying their accuracy. While some students enjoy the challenge of
fact-checking decks they find on the internet, others prefer to purchase
verified decks for peace-of-mind.
10.

Memorang (free for user-generated content, $99 for

lifetime access to premium content) - A free learning

platform that offers an optional 10,000 flashcards for the
USMLE Step 1 designed to help you memorize all of the
details from First Aid (updated & fact-checked daily). Has

spaced repetition, multiple learning modes, and you can

find, create, or import flashcards from Anki, Quizlet,
StudyBlue, and others. Available on the web and on
iOS/Android.
11.

Anki (free for user-generated content, $30 for iOS

app) - A popular open-source flashcard platform (launched

in 2006) created by Damien Elmes with a searchable
database of user-generated content. Its a bit user
unfriendly, but the biggest appeal is its spaced repetition
algorithm which gives you a daily quota of which flashcards
to review. There are many flashcard decks you can
download from others and you can create your own.
Available as a desktop application and on iOS/Android.
12.

Quizlet (free for user generated content, $25/yr for no

ads) - The worlds largest flashcard website. Is much less

advanced than Anki or Memorang as its primarily intended
for K-12 language vocabulary. Not recommended for medical
students. Available on the web and iOS/Android.
13.

Picmonic ($249/yr) - A neat program that uses colorful

picture mnemonics to help you remember various Step 1

concepts in a fun way. The most common criticism we hear
is that with so many images, you can conflate them in
memory.
14.

SketchyMedical ($120/yr) - Similar to picmonic in

spirit but covers less topics (only microbiology and some

pharm), has no advanced features other than watching
videos, and is technically the most expensive resource on
this list considering the limited scope it covers. Even so,
many students swear by it and point out how easy it makes
remembering difficult micro and pharm concepts.
Developed by students from UCI.
15.

Firecracker ($399/yr) - A standalone medical

curriculum that divides what would otherwise be an e-book

into Q&A subchapters. If you opt to use Firecracker, they
insist that its best used 1-2 years out from your exam as
its designed to replace your medical school lectures due to

its massive and comprehensive scope. Its not, however,

intended to be high-yield or to provide rapid-fire flashcards.
The most important thing with flashcards is that you have to pick a tool
that works for you and be diligent about quizzing yourself regularly.

Mistake #3: Not using QBanks correctly

QBanks are the most essential component of your Step 1 studying and
serve two main purposes: simulating the exam through higher-order
reasoning and providing assessment of your current fund of knowledge.
Since QBanks help polish your knowledge, starting them too early can
be a frustrating waste of time unless you have already reached subject
mastery. Towards the end of your Step 1 preparation, making additional
passes through your existing QBanks (or picking up new ones) is the
best investment of your time and money.
1. UWorld ($399/yr) - The gold standard of Step 1 QBanks. This
resource is best kept until the final stages of your Step 1
preparation (e.g. final 3-6 months), as you work to integrate
your knowledge and hone your test-taking skills. You get

one full reset and should aim to complete two full passes
through the material.
2. USMLE-RX ($249) - Made by the creators of First Aid (i.e. Tao
Le and Vikas Bhushan), this resource is great to start using
one-year out from your exam alongside your coursework
and First Aid. Otherwise, if you have extra time after going
through UWorld this should be the next QBank you pick up
for solid practice.

Mistake #4: Not knowing how and when to use different

resources
3. 1-2 years left - Use First Aid +/- Pathoma alongside your
coursework. Quiz yourself daily with flashcards (ideally at
least one hour per day, broken up into smaller segments),
and create your own notes for concepts you have trouble
remembering.
4. 3-12 months left - If your schedule allows, add in a QBank
like UWorld for at least 30 minutes per day. You still should

be reviewing flashcards every day and reading along in your

high-yield resources (e.g. First Aid +/- Pathoma).
5. 6-12 weeks left (dedicated study time) - Continue using
the same resources as before, but plan on studying a
minimum of 8 hours per day, 6 days per week. You should
be doing an absolute minimum of 88 UWorld QBank
questions per day in timed blocks.
6. < 6 weeks left - At this stage you should only be using
review books for reference rather than part of your daily
routine. The focus should be on answering 3-4 timed QBank
blocks per day and active quizzing with your flashcards.
Remember that QBanks are best served to connect the dots,
but you still need to learn them in the first place.

What about NBMEs and practice tests?

Remember that these are expensive and should be thought of as
primarily for diagnostic purposes to adjust your study plan. The best
times to use NBMEs are at the beginning of your dedicated study period,

sometime in the middle (optional), and then again 2-3 weeks before your
exam.

Mistake #5: Study fatigue

Take small breaks every hour and longer 1-2 hour breaks in the middle of
the day. Alternate between review books, QBanks, and flashcards to
keep things fresh. You can also opt for one complete day off per week (or
a half-day off for the gunners).

Mistake #6: Test-day anxiety

About 6 weeks out from your exam you should get on a rigorous
schedule of when you go to bed, wake up, study, and eat meals such
that it lines up exactly with your test day. For example, if your exam
starts at 8am, then you should wake up early, eat breakfast, and then
start answering QBank questions at exactly 8:00. One very useful
strategy is to start every day with two back-to-back timed, random
QBank blocks to simulate the first two hours.
If you keep this routine up for a few weeks, the day of your exam will
feel like any other and you can better avoid test-day anxiety that would
otherwise negatively impact your performance.
Summary: Stick to high-yield resources and know them cold.
Use review books, flashcards, and QBanks strategically
throughout your test preparation, and remember to take
frequent study breaks.

Happy studying!
Best,