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Step 1- 255



Hello everyone, I didn’t get an extraordinary score or break any records, but I did relatively well in very little time. So, I am doing this write up because most people spend 9+ months prepping getting their 260+, have fully matured Anki decks or have a high baseline. To most of you out there without a year of planning ahead, trust me, it can be done. 70% of STEP1 is properly reading and reasoning with a few basic points of HIGH YIELD™ knowledge. It’s all about mindset.
I used a minimalistic and barebones approach and basically crammed for my step 1 exam in 4 weeks. I DID “0”, ZERO memorizing. Use this guide as an idea of what can be done in very little time, if you have more time to play with then all the more power to you!
Firstly, I’m an average to below average student. Crammed couple days before 90% of my school exams. Never used First Aid.
My Pre-dedicated Baseline: Our school makes us take a CBSE, my correlated step 1 score was 200ish. Like 100 questions MAX completed in uWorld. Like I said **First Aid untouched**.
Our school gives us 6+ weeks of prep, I wasn’t motivated to study till I had 4 weeks left, watched One Punch Man and Full Metal Alchemist, I strongly recommend them. Tried reading Some First Aid in the meantime, book is useless, just a random list of facts without any teaching value to me. However, If you have time to properly use it or a great memory, it is a powerful tool.
THE APPROACH:
With 4 weeks to go your approach is all about covering weak points, you DO NOT HAVE TIME TO REVIEW EVERYTHING. Here’s all you need and what I personally did, UFAPS is out UBoPS is in:
- Boards and Beyond subscription
- Pathoma Subscription
- Sketchy Micro and Pharm Subscription, and OPTIONAL Pepper Micro and Pharm Anki decks
- uWorld Step 1 Qbank and 2 Assessments.
- NBME exams self-assessments.
Reddit.com/r/step1 for moral support, questions and the BEST score predictor.
1. Grab any assessment you have (I used my CBSE score breakdown) or take an NBME self-assessment or self-diagnose your weaknesses (i.e. make a list of topics you struggle with).
2. Watch Pathoma, boards and Beyond at 2x speed covering your weak points. Dr. Ryan and Dr. Sattar beautiful voices are meant to be in high speed. NO NEED TO WRITE ANYTHING, just listen and learn.
3. If your weak points include Microbiology pure/rote memory facts (e.g. list of diseases Staph Aureus can cause) or Pharmacology (e.g. Antibiotic names and Bacteria they cover) then Sketchy at 2x speed is very VERY useful. It is much easier to remember an image than to memorize some random words like Cefepime or Abciximab (your brain has no hook to use for recall).
3a. If you have trouble retaining some of the Sketchy videos, load up Pepper Anki and use the flash cards as a rapid-fire review to quickly review all the important points of the video you have just watched.
4. Anytime you are learning from B&B or Pathoma focus on LEARNING concepts, it is pointless to memorize factoids because your brain will not retain it, I repeat, UNDERSTANDING CONCEPTS and PRINCIPALS is primordial to your success.
4a. Those pointless facts that NBME loves to test can be learned passively and from doing questions and getting them wrong, there’s no better way to learn things than by getting them wrong first.
5. Every day you should be cranking out uWorld blocks of 40 questions in timed and random. Day in day out. Read the answer explanations ONLY on questions you guessed and the ones you got wrong. The goal is to move quickly and only read what you don’t know. No point in reading questions you already understand. I did a minimum of 120 questions a day, this will GREATLY improve your reading speed and time management skills.
6. Whenever you feel like your weak points have been addressed, Do a Self-Assessment/Exam Day Simulation. This involves doing a uWorld Assessment or an NBME followed by 2-3 uWorld Blocks. Take the same break schedule as you would on exam day. I’d do this every couple of days.
7. After your Exam Day, review the questions you got wrong and try to understand why you got it wrong (was it knowledge, reading or uncertainty). Reviewing with a Tutor or a study buddy is an excellent approach.
8. Now that you have another self-assessment under your belt. Use your score breakdown to make a new list of weaknesses and repeat the same process to learn.
9. Rinse-repeat, eventually your scores will increase as you repeat the cycle of Assessment/exam days and Material review with UBoPS.
10. Once your scores are where you want them to be (Using the score predictor) then you are ready to sit your exam.
ADDITIONAL COMMENTS:
My Assessments were:
NBME 13: 236
NBME Free 120: 83% (felt like the Step 1 exam)
NBME 15: 257
NBME 19: 255
NBME 16, 17: 248 each (taken back to back)
UWSA1: 271
NBME 18: 252 (felt like the Step 1 exam)
UWSA2: 269 (felt like the Step 1 exam)
Actual Exam: 255
Post exam feels: I definitely underperformed, missed multiple easy questions due to overthinking but was able to nail very difficult questions because my time management and Stamina were excellent. The exam most closely resembles NBME FREE 120. The 8 hours flew by. The 3 week wait was a minor hassle but my Beaauuutiful girlfriend was there to make it go by quick.
I’m sure I’ve forgotten some point and if I remember I’ll edit them into the main post.
THE MAIN POINT of all of this is that you shouldn’t underestimate yourself, you’ve made it this far and you know a lot more than you think you do. There were multiple times where I didn’t feel ready but the rule of step 1 is TRUST YOUR ASSESSMENTS.
What I would do differently:
- Do the Free 120 a day or 2 before my exam (it is the most similar to the actual Step 1)
- Occam’s razor. Stop OVERTHINKING on exam day, simplify my approach. Most times the “good enough” answer is correct, if you have to do any complex mental gymnastics to find an answer then rethink your approach.
- Given More time I’d use the Lightyear Anki deck as a rapid review of difficult to memorize facts.
Don’t hesitate to direct message me if you have any questions or if you need affordable tutoring (mahdi.katz@gmail.com), I’m happy to help. Godspeed my fellow astronauts

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