Surviving Step 1: Creating a Study Schedule

study tipsBy Walter Wiggins

Everyone should have a study schedule when preparing for any of the USMLE Step exams, particularly Step 1. No matter when you’re planning to take the actual exam, you should set aside time to organize your thoughts about how you want to proceed with studying. In general, you should plan to dedicate some amount of time to each of the subjects tested on the exam. However, there are a few things that are helpful to consider when generating a schedule.

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First, you should consider starting with the topics that fall under “general principles” component of Step 1, comprising approximately 13-17% of the test (which is changing slightly to 12-16% after May 4, 2020). Most medical schools cover these topics earlier in the preclinical years, as they form the foundation for the systems pathophysiology that comprises the “organ systems” component of Step 1, comprising ~80% of the test. Communication and interpersonal skills take up the remaining 3-5%.  Given these percentages, you might think about dedicating similar proportions of your study schedule to these blocks.

Next, you should consider your strengths and weaknesses. You’ve been tested on most, if not all, of this material at some point during the first two years of medical school. Therefore, you should remember what you crushed and what you bombed. Not only should you spend a little more time on the subjects you didn’t learn as well on the first pass, but you should also consider reviewing those subjects earlier in the process as that will afford you more flexibility if you don’t feel like you’re making progress as quickly as you’d like. You may find a topic or two on which you really need to spend an extra day or so reviewing. Saving the topics you know better for the end will allow you to take care of these problem spots earlier.

There’s a fine line on which to balance rigidity and flexibility with respect to study schedules. On one side, it’s a waste of time to generate a schedule you don’t plan to adhere to. But on the other side, you may find that your review of some subjects goes more smoothly than others. You may have a day where you get through as much material as you had planned to cover in two days. If that’s the case, don’t force yourself to review the same material for the second day in a row. You’d be better served to move on to something else, in the event you hit a rough patch later in your schedule and need to take an extra day.

Within each block (general principles vs. organ systems), my suggestion is that you dedicate approximately as much of your study period, proportionally, as your medical school dedicated to your preclinical curriculum. The only exception would be anatomy, which I would spend a little less time on as it tends to be integrated into the organ systems questions, for the most part.

Each day, spend some time reviewing high-yield topics for each subject. First Aid for the USMLE Step 1 is a great guide. However, you should dedicate a little time to lower yield topics, as these will be covered on the exam. Also, you’ll want to make sure to spend some time doing practice questions. Make sure you allow yourself breaks every hour or two. Also, be sure to eat well, get plenty of sleep, and try to get some exercise most days. It’s very easy to burn out when you’re trying to study 12-14 hours per day.

Finally, and perhaps most importantly, don’t be too aggressive with your schedule. Make sure you take at least one afternoon a week off from studying. I recommend a full day, but this doesn’t work for everyone. Also, schedule days (or half-days) for more general review, such as taking a practice exam or reviewing flashcards. Practice exams are a great indicator of your progress. However, you should be careful not to put too much stock in the predictive value of the scores they give you as they often have a very wide margin of error.

If you want your own study schedule based on First Aid, take a look at the new Rx Study Planner.  Along with it being free(!), there are videos that are designed to walk you through the process of setting it up.

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