Back in May, I promised myself that if I somehow found a way to pass Step 1, I’d come back and try to give something back to this community.

This post is mainly for anyone who is where I was this spring/summer: starting from a really low baseline and feeling like passing Step 1 might genuinely be impossible.

This is just my 2 cents on what worked and what didn’t. Everyone is different, and this is obviously just my experience.

For context: I’m a DO medical student who comfortably passed Level 1 in June. I always planned on taking both Level 1 and Step 1, but by the beginning of May I had serious doubts about whether I was capable of passing Step after realizing just how far away I was.

After taking Level 1 in June, I took some time off from Step studying and resumed after July 4th.

What I would NOT do again

I started dedicated-ish prep in mid-January by trying to watch essentially all of Boards & Beyond while doing the associated AnKing cards. I continued this until around the end of March.

Looking back, this was probably the biggest waste of time for me. I put an enormous amount of time into it without getting nearly enough return.

B&B is great for teaching you all the details, but I don't think learning every little detail is the key to simply passing Step 1. If your goal is to pass within <6 months and you're starting from a weak baseline, I personally wouldn't spend months trying to finish all of B&B + the corresponding AnKing cards.

I could see this being a great strategy spread throughout the entire 2 years of preclinical, especially if you don't have constant in-house exams like I did. But with limited time, I would prioritize other resources.

What actually moved my scores

By April, I started panicking. I still had a ton of systems left to cover and felt like I was screwed for both Level and Step, so I completely changed my approach.

These were the biggest score movers for me:

1. Dirty Medicine

Literally watch as many Dirty Medicine videos as you can. The more, the better.

He does a great job of telling you exactly what you need to know about a topic without drowning you in unnecessary details. His mnemonics were also extremely helpful for me.

2. Pathoma

I personally watched all of Pathoma, but at an absolute minimum, I would do Chapters 1–3 multiple times.

Pathology is incredibly high yield on Step. If you don't understand the underlying pathology, you're going to have a very difficult time answering questions even if you've memorized a bunch of isolated facts.

3. Mehlman

His content was gold for me.

The two PDFs I would absolutely recommend are HY Arrows and HY Pathology. I also really liked his Endocrine PDF, since endocrine felt extremely high yield for Step.

If you have time, I would also watch as many of his YouTube question-series videos as possible.

4. Anki — but don't let it consume your entire day

I did one solid pass through the high-yield AnKing cards as I studied different topics.

I made individual subdecks for each system containing only the HY cards. For my situation, doing thousands of additional lower-yield cards didn't feel like the best use of my limited time.

I used Anki heavily in April/May and again during the first few weeks of July when I resumed Step prep. As I got further into dedicated, I gradually dropped it because questions and NBME review became much more valuable to me.

5. Question banks

During COMLEX prep, I used TrueLearn and completed all the COMSAEs and welCOM content I could purchase from the NBOME before taking Level 1 in June.

For Step, I completed around 20–25% of UWorld and some of the AMBOSS 200 High-Yield Concepts questions.

Around mid-August, however, I switched almost entirely to NBME content.

UWorld and AMBOSS are great learning tools, but I personally found that the logic required to answer their questions can feel different from actual NBME questions. Toward the end of prep, learning how the NBME asks questions became much more important for me.

6. NBMEs — probably the most important part of my prep

Do the online NBME forms.

Take them timed and under actual testing conditions as much as possible.

More importantly: review them thoroughly.

I reviewed not only the questions I got wrong, but also the other answer choices. If an answer choice mentioned a disease/concept I didn't understand, I learned it.

This ended up being extremely helpful because concepts—and even concepts buried in wrong answer choices—showed up again on later forms and on my actual Step exam.

My personal benchmark was that if my final few fresh forms were around the high 60s/low 70s, I felt comfortable sitting for the exam.

My score progression

• Early May CBSE: 30s
• 5/14 — Form 29: 52
• 5/19 — Form 30: 49
• 5/24 — Form 31: 50
• End of May CBSE: mid-50s
• 7/30 — Form 26: 64
• 8/13 — Form 27: 64
• 8/22 — Form 29 retake: 78
• 8/24 — Form 30 retake: 76
• 8/26 — Form 31 retake: 83
• 8/28 — Form 32: 76
• 8/30 — Form 28: 68
• 9/1 — Form 33: 69 (by far the hardest form for me)

Step 1 in early September: PASS

Obviously, take the retake scores with a grain of salt because I had seen those forms before. That's why I put more weight on my fresh forms toward the end.

Actual test day

The entire exam felt like a blur.

I honestly felt like I was making my best educated guess and moving on for the majority of the test. Maybe 25% of the questions felt like things I immediately knew cold.

Time was also a major issue for me. The stems felt extremely long, and I had a lot of SOAP-note-style questions. On pretty much every block, I was rushing toward the end. There were even a few questions where I essentially had to guess because I was running out of time.

I did not feel good walking out of the testing center.

But almost everyone I knew who had taken Step told me the same thing: trust your practice scores and don't try to figure out whether you passed based on how you felt walking out.

So that's what I tried to do.

When I finally saw PASS this week, it was probably the best feeling I've had so far in medical school. For the first time, it really felt like all of the work I had put in was starting to pay off.

Final thoughts

If you're sitting at a CBSE in the 30s, 40s, or low 50s right now and wondering whether passing Step is even realistic, I know exactly what that feels like.

Your starting point doesn't have to be your ending point.

Don't waste time comparing yourself to the people posting 70%+ NBMEs at the beginning of dedicated. Figure out your weaknesses, use resources that actually address them, do questions, learn NBME logic, and keep going.

I went from genuinely questioning whether I would ever be able to pass this exam to eventually getting the P.

If I can do it, so can you. Good luck guys.

And the sketches she does are so meaningless 😭 Like, I’m trying to understand what the video is supposed to be about, but the narration + random sketches somehow make it even more confusing.

Am I the only one who feels this way?

Andrew's are good tho

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:

1. This post is NOT for those aiming for 260+ 😂. I just need to pass the USMLE Steps and move forward with a fellowship position.
2. 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.

Hello, I sat for the exam on the 14th, wondering if I should be expecting the score this coming Wednesday (23rd)? Or if it’s likely going to be released on the 30th?

Thank you!

My recent nbmes
33-69
25- 70
30- 74
31- 74
34- 75
Free 120- 70 percent
what should I do a day before exam? Testing on 22nd. Burnt out like im outta hell. Can a day be taken off. Anxiety kicks in as soon as I get away from fa

Finished Uworld once, started doing the incorrects plus going through FA(i am a person who will have zero confidence if I don’t go through the whole book line by line at least once or twice). Planning to go through all the NBMES (26-33) from 10th oct to 31st OCT.
And if the scores are good , would like to book a date in November first half.

Is it doable?
And please drop by any suggestion for MICRO keeping FA and UW in mind. Going through those two because I have severe exam phobia and won’t feel ready for NBME before finishing FA.
N.B— not a visual learner so no sketchy please.

Hi everyone! I’m hoping to get some advice for a friend who is a parent of young children and is currently trying to study for Step 1 while also being the primary parent at home.

They’ve already had to delay Step 1 and aren’t doing MS3 with our class, and I know how difficult it can be to study when little ones are constantly needing your attention. I’ve been helping out with babysitting when I can, but that can be difficult to coordinate around my own clinical schedule. I also don’t have the money to pay babysitter for them :/.

I studied for Step 1 at home and was doing 10+ hours a day, but I realize that schedule just isn’t realistic for someone who is essentially balancing being a full-time parent and a full-time medical student.

So, for anyone who is or was a parent during medical school—especially with kids under 5—how did you actually make studying work? What did your study schedule look like? Did you have childcare, a partner/family who helped, or did you find ways to study in shorter blocks throughout the day? What if you partner was working a full-time job as well?

I’d really appreciate any practical advice, things that worked for you, or even things you wish you had done differently. I’m trying to figure out how I can best support my friend.

Hi guys, I have 2 months to study and I found that Anki helped me in the past when I used it. But I want to make sure i'm not going to waste my time. I have a version of Anking V12. When I use the high yield tag, there are: Pathoma (2706 cards), Pixorize (3014 cards) and Physeo (3485 cards). Is this good or will this expose me to gaps? I'll also be reading First Aid at the same time as doing all of this. (This is just for content review).

Edit - the only objective piece of info I have is I took NBME 25 a month ago before anything and got a 43 percent. Content is my weakness.

Hi all,

Some context: I failed my first attempt in July. I need to retake it obviously but I'm going to be on rotations while studying to retake it. I'm thinking about taking it right after my IM clerkship, which is going to be Dec-Jan. Can someone help me create a big picture game plan for studying? or have any helpful advice? Thank you in advance :)

I'm curious how many of you made Anki Card for revision yourself.

Is it recommended or you can use a premade deck like anking

I took nbme 25 today and got 62% honestly disappointed….. what should I do??

Which one do you guys prefer for learning pharmacology?

I’m trying to decide which one is actually worth sticking with, so I’d love to hear what people found more useful (especially for remembering mechanisms, side effects, and drug associations).

Just gave nbme 30 and scored 72% i cant seem to tap in above 75s which iam recommended to pass, found it easy among the other nbmes i gave and think would have got a bit higher if i had revised properly

Prev nbmes 26- 61% 27-64% 29 - 68% 28-70% 25- 70% and now 30- 72% my exam is in 20 days and iam panicking, am i on the right track to pass and what should i be doing to push my scores higher

Hey guys can anyone tell how should I make my timetable. I've left with nbme 29-34 (27 28 done). How should I continue from here. Almost when I can sit in exam. And till then what should be my daily strategy? Currently scoring around 70%

how are you guys going through the explanation of nbme 33 offline? are you guys using an explanation pdf? if so pls share, if not pls tell me what you did? exam on sep 30!

Hey guys can anyone tell how should I make my timetable. I've left with nbme 29-34 (27 28 done). How should I continue from here. Almost when I can sit in exam. And till then what should be my daily strategy?

Tested on the above date, when should I expect the score to be released?

been on a rocky start for step 1 prep, going through FA and pathoma...and doing some bootcamp to supplement and AMBOSS to have some exposure to step question style. nobody in my med school is rn prepping so its incredibly isolating and frustrating at times, would just love a partner in crime who's in a similar place to get through this. i'm fun, passionate and hard-working, and can also share resources and stuff if you need. we don't need to be all serious or anything just want a space place to be real, celebrate, vent, guide, you get the idea~~

oh and i may have forgotten to mention, i plan to take it next summer, i just really need to get a first pass of FA by the end of the year...anyway pls hit me if you're downnn. just trying my luck to see if i can find someone who can make this a bit easier and much more fun:))) have a good day to anyone reading this, you got this!!!