I wanted to write a Step 1 advice post that avoided the narrative format (I know how precious

our time can be, and there are so many great write-ups out there already).

So, what is this? I wanted to give you a punch-list of items that you can take action on for Step 1
success and mental resiliency. This is a list that was created from my own experiences and from
popular advice across the r/step1 community. You can act on nothing here, you can implement
every piece of advice, or fall somewhere in between those two parameters. Regardless, I put this
together to help anyone I can!

u/Slapping_Spacebar’s 50 Tips for Step 1 Success (and shortly thereafter):

Anki is king.

“ u/Slapping_Spacebar, I don’t use Anki and I don’t like Anki.” Understood. As professional
learners during M1/M2, we should at least think about the optimal way to learn an enormous
pool of facts and recall them for application. I read A Mind for Numbers: How to Excel at Math
and Science before M1 and it helped frame my learning strategy (highly recommended!).

If you need help setting your Anki up or you’re too intimidated to start on your own, refer to
u/AnKingMed’s fantastic YouTube series.

Zanki. It’s the tried and true gold standard for pre-clinical Anki. We strive to practice evidence-
based medicine. You should practice evidence-based studying.

Do your reviews. Every. Day.

Be honest with yourself when you do your reviews. If you get a card wrong, mark it as wrong.
The algorithm will only work for you if you work for the algorithm.

Make a daily schedule. Build in some wiggle room. Even if you fall behind, it’s better to try and
keep yourself accountable to something you have down on paper.

I think the entire BG expansion/other expansions in the ever-expanding expansion catalog are
worth doing (even though they include a lot of cards). This includes lolnotacop micro.

I’m all about limiting your resources, so even with a larger Anki deck, you should strive for a
narrower, but deeper, use of a few resources. That’s how you can justify using the expansion
decks.

Make sure that you understand the card rather than just memorize the words that will pop up
when you hit the spacebar. Can you explain the card to a friend?

Supplement your Zanki cards with pictures, extra text, lecture notes, and anything else that will
function as a memory hook for you.

Put pathology pictures in your cards. I wish someone told me this before I took my Step exam. I
had some bizarre pictures of rashes, worms, autopsy specimens, brain chunks, etc. on my exam
that I wish I could have more rapidly associated with certain pathologies.

Anatomy is an important resource to supplement your Zanki with. Anettermy/Dope and the 100
Concepts decks were great. They helped me get a couple of tricky anatomy questions on step,
and they can provide another dimension of understanding in organ system learning.

If you have gotten to #14 and STILL insist on not using Anki, please utilize Pathoma and First Aid
throughout M1/M2. If you use Zanki, you don’t need to buy a physical copy of First Aid.

Find a study partner (or study group, but don’t make your study groups too large).

Sketchy Micro and Sketchy Pharm are brilliant.

No matter how you study, you can only gain so much from passively watching videos. Videos can
be an awesome way to present material, but you should supplement them with active learning.

Goljan audio is great. It’s not the same as Pathoma. Put it on when you work out, cook dinner, or
are in the car for a long drive.

Study without distractions, and block in/plan for healthy distractions to keep your daily stamina
up. Every day and every year, your studying should be for a marathon, not a sprint (unless you’re
cramming for a lecture test). I used the Pomodoro Technique.

More practice questions = a higher score.

2 passes of UWorld is not necessary. It will, of course, help, but you have to think of your time as
a commodity. Is the investment worth the return on the second run? Besides, you absolutely will
remember some questions. Use a separate secondary Q bank.

I really liked Kaplan as my second Q bank throughout the year.

Consider saving UWorld for your dedicated. UWorld is a statistical tool as much as it is an
excellent textbook, and it can help you pinpoint areas of improvement as compared to all of your
other peers after you have a full foundation of knowledge.

You don’t always have to do UWorld on timed mode. Time is sometimes not an issue on
questions. I would mix timed, random blocks with untimed tutor mode blocks throughout the
day. I found it easier to sometimes review the questions right after I completed them.

Treat yourself like a professional athlete. Your brain is your asset. You need to value wellness.
And I’m not referring to the wellness from your school wellness lectures.
Meditate.

Get enough sleep. Tired studying is like drunk studying. You’re not helping yourself and your
recall will be diminished. If you’re doubting whether to push on for another hour, just hit the hay
and get up 30 min earlier tomorrow (or today, realistically).

Eat/drink intelligently. You don’t need to eat like a monk, but avoid heavy meals, excessive
caffeine, and overly-processed foods.

Lean on your family and friends for emotional support. It can be all too easy to experience
burnout during this period in your life.

If you’re taking a dedicated study period, you want to peak at the right time. Block out enough
time to get through your material, but don’t delay your test for too long. Try scaling up the
amount of practice questions you are completing daily until close to the test (it will get you used
to sitting in a chair for hours and staying in the zone).

Finish Zanki before dedicated.

I found that doing a practice test a week during dedicated was sufficient. I did a test every week
on the same day of the week that I was going to take the exam.

Don’t get too high with the highs and low with the lows on discrete practice tests. There is a
confidence interval for everything we do, so a practice test could include 3-4 questions in a
content area that particularly focuses on your strengths/weaknesses. Default to trusting your
averages and trends over time.

Make sure you review your practice test incorrects/flagged questions.

Utilize the USMLE content outline! They have produced a document that literally tells you the
spectrum of what can be asked on Step 1. I went through and made an outline during dedicated.
I got some questions right only because I did that and identified some gaps in my knowledge. At
least look it over.

Supplement your Anki with additional biostats and ethics reviews. YouTube was fine for this.

A few weeks before the exam, adjust your sleep schedule so that you are waking up at the same
time every day, the same time you will be waking up on test day (if you need to taper down to
this point, that’s ok).

DirtyUSMLE videos are great review tools in dedicated. I would do one a day during lunch.

Do the Free 120. And then do it again in the days leading up to the test.

Drive to the testing center in the days before your exam. Eliminate that variable of stress for the
morning of your test.

Be CONFIDENT on your Step 1 exam. You have worked harder than you ever have worked
towards an academic goal. You have an incredible bank of knowledge to tap into. Attack the
blocks, don’t let them attack you.

Bring your ID and permit to the testing center. Bring a sweatshirt if you’re prone to being cold.
Dress comfortably. Bring water, caffeine, and light meals/snacks for your breaks.

Your step 1 exam is designed to be challenging. They pay people to write these questions. Don’t
let that throw you off. Expect that and prepare for it. They aren’t going to give you 7 blocks of
verbatim UWorld (they did, however, repeat 1-2 Free 120 questions on my exam).

If you encounter a unique clinical situation on the exam that you have never seen before, fall
back on your general principles. You can often reason your way to some semblance of an answer
if you can take a few steps back after a complex passage.

Your questions on test day will take longer to complete than your UWorld blocks (so budget for
that). I was regularly finishing UWorld blocks with 15 min left. Test day blocks were done with 5
min remaining and ~3-4 min of last-minute question-checking.

Take a break after each section.

When the test is over, the test is over. Don’t look up questions. You aren’t going to change your
score.

At the end of the day, your score is a number. It won’t define you as a provider. It’s a number
that most people don’t know or care about (try to explain Step 1 scoring to your grandmother!).
That being said, of course it’s important to pass and important to you. That’s why you’ve read up
to this point in the first place! Just don’t let this test get the better of you.

Take any and all advice with a grain of salt. You should look at multiple opinions and make your
own judgements. You are the only person taking your Step exam!

My friends...why are you asking about MCAT scores? We are all in medical school. The MCAT is a
different exam that relies on a different skill set. Had to save this one for last.

I am happy to elaborate on any of the above in the comments (for anyone who is interested).
Never hesitate to PM me. Thanks for reading, and good luck!