Thank you
Before I speak about my dedicated prep time, I must say that during my first two years of med school I was very much dedicated to learning the material given in class, as that is the only time during which you will be able to study the subjects required for Step 1 in such breadth and detail. In addition, my school provided NBME subject exams as a final exam for each organ system module, and I was getting very high scores on those subject exams. I made it a habit starting from the 3rd month of M1 to study each organ system's chapter in First Aid alongside my coursework as a form of first exposure to the Step 1 material. As a result, my background knowledge going into my dedicated prep time was quite good.
I began studying for Step 1 alongside my coursework in M2 around December. During Christmas/New Year break (around 2 weeks) I read through High Yield Gross Anatomy as a general refresher for anatomy. My study schedule went roughly as follows:
- First pass through First Aid alongside Goljan Rapid Review Pathology, annotating relevant high yield stuff from Goljan into First Aid. During this pass through First aid I did not bother going through Biochem, Behavioral Science, or Microbiology.
- Once I finished Goljan, I started USMLE Rx. I would read the relevant chapter in First Aid, and then do all of that Organ System's questions in random timed mode (I hate tutor mode and don't find it efficient at all). This served as my "second pass" through First Aid, although at this point I still refrained from going over Behavioral Science/Microbiology and preferred to learn from solving questions. I went over Biochem once at this point as I found it beneficial to do so, using only notes from class when needed to elucidate some pathways that are not written in detail in First Aid.
- While I was doing all this, I was going through the Neurology/Neuroanatomy + Psychiatry courses in M2 which collectively were our last 4 months of M2. I finished the M2 courses and Rx around beginning of May. We had May off in between M2 and M3 which served as my true dedicated study period. It was at this point that I decided to do my first NBME, NBME 2, and scored around a 245.
- During May I decided to perform my first complete read through First Aid from cover to cover. For the Behavioral Science section I read through Kaplan's Ethics Notes, and read the chapter on Biostatistics in Crush Step 1. I also used Google to elucidate many of the Public Health concepts which were new to me (although almost none of these ended up on my real exam). I did not use any outside source for any of the other basic sciences sections other than Goljan and some class notes when needed. During this read through First Aid I made it a point to read the information very carefully, looking up ANY thing which I did not completely understand. If there was a certain manifestation associated with a disease which I did not know what it looked like or could not imagine, I would google the image. I would make sure to understand every word I read in First Aid. I also made it a point at this time to go through the First Aid Errata and make the corrections in my book.
- Once I finished with my read through of First Aid, I believe I did my second NBME exam (NBME 5) and scored around a 260. I still had not started UWorld at this point, but did so immediately after. I began UWorld doing random, timed blocks and making sure to read all the answer explanations including the wrong ones and making relevant annotations in my copy of First Aid. My Exam date was set for June 28. I had originally planned on repeating UWorld a second time during the month of June however procrastination got the best of me, plus during June I had started my M3 year and was working in the hospital. I ended up finishing UWorld around 10 days prior to my exam, and did not even have time to go over the questions I got wrong. However, since I had paid such close attention the first time going through the questions and made good notes on my copy of First Aid, I guess it didn't really matter.
- Throughout May and June I would complete the other practice exams I mentioned on the weekends. During May I was doing one every sunday, and on two of the sundays I actually did two practice tests right after each other to simulate a full length practice exam in order to build up my endurance. I did NBME 17 about 2 weeks out, and did NBME 18/UWSA 2 1 week out.
- In the final 8 days or so prior to the exam I performed my second complete read through First Aid from cover to cover. At this point I had most of the book memorized, however it was this final read through that I felt was most helpful as it helped consolidate most of the information in my mind and fill in any gaps.
- The day before the exam I was in the hospital till about 2 pm. In the afternoon I took it easy, skimmed through some last minute things I had made a list of during my prep and read the Rapid Review section in the back of the book which put my mind at ease. I was able to get a good amount of sleep (6-7 hours).
- On exam day, I remember going through my first block and thinking "well this isn't so bad". It felt exactly like I was just solving a UWorld block, except the questions themselves were somewhere in between UWorld and the NBME's. In general, I left the exam feeling okay. I thought it was a fair exam, and there was almost nothing which I hadn't seen before (there were some exceptions however). It was a very balanced exam. Probably the most annoying questions were the ethics ones (and ironically that was the only section on the exam which did not have a star on my score report). Many tables with the up/down arrows. Some gross pathology. Pharmacology was definitely not as bad as I had prepared for, most of the drugs/toxicities were your run of the mill associations with the exception of one drug that I had never even heard of.
In general, looking back I would say the most essential elements for Step 1 preparation are First Aid, UWorld, and either Goljan or even Pathoma with the videos (although I hate studying from a video, the Pathoma videos are okay. I still prefer Goljan). Basically everything else I studied I would study selectively as needed, so if I read something in First Aid that was not 100% clear to me, I would find a resource and study only about that particular thing so that I felt that I was totally comfortable with it.
I hope this helped and sorry for the long narrative
Best of luck!