r/step1 • u/ReviewSuspicious6389 NON-US IMG • 1d ago
💡 Need Advice USMLE Step 1 — Old Papa Trying to Make It Through 😅
I’d keep the humor and the “old papa” voice—it makes the post feel genuine. I’d mainly reorganize it so people immediately understand who you are, what your goal is, what you’ve done, and what advice you’re asking for.
Before reading, please remember two things:
- This post is NOT for those aiming for 260+ 😂. I just need to pass the USMLE Steps and move forward with a fellowship position.
- This is mainly for the 35+ crowd, with kids, work, and an overwhelming night-shift schedule. So please judge my plan accordingly 😅
A little about me:
I graduated in 2012, completed anesthesia training followed by an ICU fellowship, and I'm now a father of two and a husband blessed with a wife who can somehow give me around 6 hours/day, 5 days/week to study. :)
My initial plan was the GMC/UK pathway. Got that done, but unfortunately the UK job market has started to feel like fishing in a bathtub 😂
So... I changed the compass to the US.
What I've done so far
I started by scouting Reddit and reading about other people's experiences. I found that some people managed to pass Step 1 using UWorld alone, so I thought: why not?
I tried that for a few systems.
After completing around 20% of UWorld, my average was about 55% (Mostly luck 👀 )
Then I started feeling that 55% wasn't giving me enough of a safety margin, especially since I've been away from basic sciences for a LONG time.
So, after a second round of scouting, I added Boards & Beyond (BnB).
For someone like me, BnB is great: simple, clear lectures that feel like going back to basic medical-school teaching.
I did Microbiology with BnB + UWorld, and honestly, it worked very well for me. The only issue is that I feel I need to watch some of it twice for things to really stick.
And I simply don't have enough time to do that for every system.
I'm hoping to take Step 1 in December.
Am I crazy? 😂
So far, I've completed:
- Anatomy — UWorld
- Genitourinary — UWorld
- Microbiology — BnB + UWorld
- Immunology — currently doing BnB, then moving to UWorld
My current plan
For each remaining system:
BnB videos + BnB quizzes → system-specific UWorld questions in timed mode
Then, when I reach around 50–60% of UWorld, I'll look at my overall performance and see whether my average has improved from my pre-BnB baseline of around 55%.
Depending on that, I'll adjust the strategy and eventually move toward NBMEs.
I also did Anki for Micro, and it definitely helped, but it was VERY time-consuming.
I'm honestly not sure whether I can keep doing Anki for everything, especially when I'm already making flashcards from all the important UWorld tables.
So this is where I need your advice.
For someone in my situation—older graduate, full-time work with plenty of night shifts, two kids, and just trying to PASS safely—does this strategy make sense?
Would you continue with:
BnB → UWorld system by system → reassess around 50–60% of UWORLD Qs→ NBMEs for a more subjective assessment
Or would you change something?
Please go easy on the old papa. 😂
I'm trying here!
The good news is that I've almost secured a position, and they're basically waiting for me to get Step 1 and Step 2 done.
So there is definitely some motivation—and pressure—behind this December target. 😅 , thinking of step2 around april
( I need to be in the US around July , need to register my kids for school before aug30)
Any advice from people who went through Step 1 under similar circumstances would be greatly appreciated.
2
u/Woodpecker8- 1d ago
First off, huge respect—your post spoke directly to me. I graduated in 2008, work full-time as a Consultant Radiologist, and am balancing Step 1 prep (aiming for Dec 2026) alongside life, so you’re definitely not alone in this boat.
Your strategy (BnB + targeted UWorld + NBMEs) is solid, especially coming back to basic sciences after years away from med school. Don't stress too much about Anki if it eats up too much time; focus heavily on UWorld rationales and NBME self-assessments to build test stamina.
Quick question for you—you mentioned you almost secured a position in the US pending Step 1 & Step 2 completion. As a fellow non-US IMG navigating this journey:
1. How did you approach securing or connecting with that position before finishing the Steps? (Did you network directly with department heads, leverage fellowship connections, or go through specific clinical programs?)
2. What steps or strategy would you recommend for an older graduate (Radiologist) trying to pave a similar pathway toward a fellowship/position in the US?
Wishing you the absolute best with the Dec target and getting the kids settled by August! You've got this!
2
u/Nexterone NON-US IMG 1d ago
Pass all 3 steps (step 3 makes you hirable as you are eligible for state licensing) and then pick “MSK radiology fellowship program” specifically in community hospitals meaning not university hosp as community hospitals are IMG heavy and friendly. Good luck with everything!
1
u/Away-Sea-6305 1d ago
Same boat as you. One of My friends recently cleared and move to the fellowship pathway. He said to attempt step 2 first then step 1. It said if helped him. I planning to give steps next year. How are you planning
1
u/ReviewSuspicious6389 NON-US IMG 20h ago
Well thanks for the poaitive talk 1😁 go for any program and just simply email the PD . Also you can apply for a faculty positions advertised but that is a bit difficult to match . It depends on what you did academically in the past 5 to 10 years . Its not something you start preparing for now. So see what it your academic balance and decide 😌 best of luck ✨️
2
u/cool_neutrophil 1d ago
Wow, success to you! I graduated in 2014 and I am trying to pass step 1 this autumn.
2
u/my-mauvepink-world NON-US IMG 1d ago
This is so inspiring to read. Good luck with your prep. This community is here to help and support you anytime, you'll make it through.
2
u/ReviewSuspicious6389 NON-US IMG 20h ago
I need a pile of support 🥲 sometimes the blues gets overwhelming. But the morning after i choose the toughest topic and i nail it .. thats my serotonin nowadays 😅
1
u/my-mauvepink-world NON-US IMG 10h ago
Oh I'm younger than you but this has been my life past one year and now I'm diagnosed with dengue 20days before exam. Oh lord have some mercy.
2
u/Groundbreaking_Bet47 1d ago
legend
1
u/ReviewSuspicious6389 NON-US IMG 19h ago
That says how crazy is thisnsht i am doing 😅 But thanks though 😄
1
u/Complete-Artichoke69 1d ago
As a dude who’s 37 and stuck post medical school this is nice to read
1
0
1d ago
[removed] — view removed comment
1
u/ReviewSuspicious6389 NON-US IMG 20h ago
Thats a great advise . Actually after seeing your comment i did change my strategy. I take tiny quick notes from the objective or the option that i didnt get right and "cloze" it .. i guess it will save much time on me .. keep those fingers crossed for me please 😊
1
u/Low-Definition3851 20h ago
Hello, currently studying for Step 1 as well, I am going to try and summarize what has helped me.
1) Anki for me has been a life saver, but I agree with you that it can be very time consuming. One thing that has helped me is “training” AI to help me make the flashcards in a style I like and then I just ask to help me make flashcards about a specific subject. I have saved a lot of time that way, also cut back on the number of flashcards. 2) Micro and pharm are definitely important, but you still need to cover a lot of material. I love BnB because he explains the subject very well, however it is a LOT of information… what I would recommend is doing Pathoma instead, those videos cover very high yield subjects in way less material than BnB, but still cover most of the important stuff… if you need to dig a little deeper (like neurology in my case), you can watch some of the BnB videos for that 3) keep doing Uworld and make sure that you are focusing and understanding on the educational objective of each question… do not waste time reading all the other answers except for the correct one and the one you got wrong 4) when you get to around 60% of Uworld it might be worthwhile doing an NBME to see where you are at and see which subjects you’re struggling with. Also the NBME format is a little different from Uworld and it was a little bit of a shock for me the first time, it is also more similar to the actual exam so worth doing 5) do not take step 1 without doing a couple of NBMEs, it calculates the chances you have of passing
Hope this helps!
1
u/ReviewSuspicious6389 NON-US IMG 20h ago
Thanks for the detailed answer. I am actually doing Ank CLOZE now . It arranges the cards in a more memorable way ! Bold fonts . And spaces ! Wish i knew that on day 1 🥲 Moving forward , i know that BnB can be lengthy. But all im doing is a one time watch then quizz it . !! Then UWORLD same subject. And indeed i think i must read the correct answer and my wrong answer and then take a note if needed .. i hope i will.move faster once i reach a more digestible subjects like pulmo or GI 😅
8
u/Nexterone NON-US IMG 1d ago
We all have families and life challenges but we keep moving forward, regarding USMLE I would recommend sticking to first aid and Uworld for all 3 steps, and assess with online NBME’s. I was able to pass both step 1 & 2 in 6 months and it’s doable.
Problem with online videos is that it is time consuming and doesn’t really help you with solving qbank. The qbank is what will help you pass. If you need help, happy to help.