# Heme-Onc, Start to Finish, in 6 Days

> How to study heme-onc for Step 1 in 6 days: immunology and the molecular, cellular and amino acid biochem first, then active reading of First Aid pp. 410–448 on the First Aid Guide, 1 day of Mehlman, FA Foundation Anki, and UWorld with the RPSR method.

URL: https://drmarishasudani.com/heme-onc-6-days
Canonical: https://drmarishasudani.com/heme-onc-6-days

## Questions this guide answers

- **How do I study heme-onc for Step 1?** Do immunology first, then the biochem of molecular, cellular and amino acid metabolism in the First Aid Guide, because they cross-connect with almost every heme-onc page. Then heme-onc in 6 days if you have 10–12 hours a day: Day 1 to Day 2 morning, active reading of First Aid pp. 410–448 with the MCQs. Day 2 afternoon to Day 3 morning, the Mehlman heme-onc playlist (in heme-onc, Mehlman is a must). Day 3 afternoon, the FA Foundation Anki heme-onc deck. Days 4–6, UWorld heme-onc with the RPSR method.

## Page text

USMLE Vault · Step 1 · Heme-Onc
Heme-onc, start to finish, in 6 days
System 7 of 11, and the one that punishes skipped biochem hardest.
39 First Aid pages 235 MCQs 6 days + immunology and 3 biochem pieces first
By Dr. Marish Asudani · Published 22 October 2026
How do I study heme-onc for Step 1?
Do immunology first, then the molecular, cellular and amino acid biochem in the First Aid Guide . Then 6 days: 1.5 days of active reading of First Aid pp. 410–448, 1 day of Mehlman ( in heme-onc, Mehlman is a must ), half a day of FA Foundation Anki , then UWorld on Days 4–6.
Read this first
This is only for you if you have roughly 10–12 hours a day for studying, and you're an intern or a graduate.
Working, or studying 5–8 hours a day? Keep the same order and stretch the days. Step 1 while working →
Heme-onc is where biochem comes back to bite you. Sickle cell is 1 amino acid swap: glutamic acid to valine at position 6 of the β-chain. Learn amino acids in isolation and it's a fact you lose. Learn them right before heme-onc and it's obvious.
The immunology and the 3 biochem pieces you finish first cross-connect with almost every page you're about to read. That's why they come first.
And the 1 step you can't trim here: in heme-onc, Mehlman is a must.
Students who did this
Real students, in their own words, on the exact tools in this guide. Tap to play.
Karthik · Passed Step 1 An honest review of Vault Anki
Dr. K · Passed Step 1 An honest review of Vault Anki
Try a free 3-day trial → usmlevault.com · no card needed
Start here · before page 1
Heme-onc: micro and pharm first
Heme-onc has no Micro or Pharm pill: no organism list, and no group on the drug map. So its micro and pharm are 2 checks on the morning of Day 1, and its drugs are pp. 440–448 on Day 2: the anticoagulants, antiplatelets, thrombolytics and the cancer drugs. These are the full guides.
Microbiology
SystemWise Micro → The chart every micro list is cut from. The Vault schedule has you check it before every clinical system
Microbiology by system → Why micro is 9 short lists, 1 per system, and how to run each one
Pharmacology
The High-Yield Pharmacology PDF → Look for any heme-onc drugs before you read. Free
Pharmacology in 48 hours → The FWRT method and the whole drug map, system by system
The NBME Booster pharmacology deck → Every NBME pharmacology question as flashcards, for your final week
Open Heme-Onc in the First Aid Guide → The Micro and Pharm pills are at the top of the system in the First Aid Guide. Free for your first 3 days.
Where this system sits
The order: easy systems first, cardio last
Heme-onc is the 7th system: immunology first, then the cellular, molecular and amino acid biochem, then heme-onc. Cardio comes last. Tap a system to open its guide.
1 Renal 6 days · the easy one, start here Open →
2 Respiratory 6 days · same method as renal Open →
Before it: Biochem nutrition, 1 day, right before GI · where it sits
3 GI 7 days Open →
4 Reproductive 7 days Open →
Before it: Biochem carb and lipid metabolism, 1 day, right before endo · where it sits
5 Endocrine 6 days Open →
6 Immunology 5 days Open →
Before it: Biochem cellular, molecular and amino acids, right before heme-onc · where it sits
7 Heme-onc You are here 6 days Open →
8 MSK 6 days, no derm Open →
Before it: Dermatology, 3 days, after MSK · the derm block
9 Psychiatry 5 days Open →
Before it: Genetics and ANS, right before neuro · genetics
10 Neurology 7 days Open →
11 Cardiovascular 7 days · always last Open →
Biochem is never a block of its own: each piece sits right before the system that needs it. The whole method, once: how to study any system →
1
Before heme-onc · first Immunology
Finish immunology first. It sets up the cell biology heme-onc then applies: the lymphocytes, plasma cells and antibodies you meet again in the lymphomas, the leukaemias and the plasma cell disorders. Split them and heme-onc gets harder for no reason.
Immunology in 5 days →
2
Before heme-onc · second Molecular, cellular and amino acid biochem
Then the biochem pieces, by active reading in the First Aid Guide : Focus On, the explanation, then the MCQs on each page. They help you cross-connect, page after page.
Biochem · 1 day each on the schedule
32–43 Molecular: DNA replication and repair, mutations, gene expression. The base for oncogenes and for the cancer drugs that hit DNA synthesis
44–53 Cellular: the cell cycle, organelles, the cytoskeleton. The machinery cancer hijacks
79–83 Amino acids: haemoglobin is amino acid chains and antibodies are proteins
Why it works: the sickle cell page (p. 423) is 1 line of amino acid biochem , and the cancer drug pages (pp. 443–445) are the cell cycle and DNA synthesis. Read those first and heme-onc reads like a review.
Where every biochem piece sits →
3
The plan Heme-onc in 6 days, hour by hour
Immunology and the biochem pieces first. Then heme-onc in the same shape as endo. Here is every day, block by block.
Clock times assume an 11-hour day: 9 AM–1 PM, 2–6 PM and 7–10 PM, with lunch and dinner in the gaps. Shift the clock to your day. Keep the order.
Day 1 · The checks, then active reading First Aid Guide , page by page, MCQs on every page
9–9:15 AM Watch How to do the Hemonc system , the University walkthrough.
9:15–9:45 AM Micro and pharm checks: find heme-onc on the SystemWise Micro chart , and find any heme-onc drugs in the High-Yield Pharmacology PDF . Do those drug notes next to pp. 440–448 tomorrow.
9:45 AM–1 PM pp. 410–419 · fetal erythropoiesis, haemoglobin, blood groups, haematopoiesis, every blood cell, the platelet plug, the coagulation cascade
2–6 PM pp. 420–431 · RBC morphology, the anaemias, sickle cell, thalassaemias, lead, haemolysis, heme synthesis, porphyrias, coagulation disorders
7–10 PM pp. 432–439 · platelet disorders, thrombophilias, transfusion, lymphomas, plasma cell disorders, leukaemias, myeloproliferative neoplasms
Day 2 · Reading, then Mehlman
9 AM–1 PM pp. 440–448 · heparin, warfarin, the direct factor inhibitors, antiplatelets, thrombolytics, the cell cycle and every cancer drug group
2–6 PM Watch How to watch Mehlman Medical videos (10 minutes), then the Mehlman hematology playlist from the top, in order. In heme-onc, Mehlman is a must.
7–10 PM Mehlman, continued. Pause before he answers and answer it yourself.
Day 3 · Mehlman, then Anki
9 AM–1 PM Finish the Mehlman playlist. Any gap → that First Aid Guide page, the same day.
2–6 PM FA Foundation Anki · Heme / Onc , 208 cards. Answer before you flip.
7–9 PM Finish the deck. Then open the First Aid page of every card you hesitated on.
Day 4 · UWorld heme-onc Unused · heme-onc only · tutor mode · 20 questions a block
9–9:30 AM Clear today's due FA Foundation Anki cards first.
9:30 AM–1 PM Blocks 1–2 (Qs 1–40): solve both in tutor mode, log each score, then review every bookmark in First Aid.
2–6 PM Blocks 3–4 (Qs 41–80): solve both in tutor mode, log each score, then review every bookmark in First Aid.
7–10 PM Re-read every First Aid line you highlighted today.
Day 5 · UWorld heme-onc
9–9:30 AM Clear today's due FA Foundation Anki cards first.
9:30 AM–1 PM Blocks 5–6 (Qs 81–120): solve both in tutor mode, log each score, then review every bookmark in First Aid.
2–6 PM Blocks 7–8 (Qs 121–160): solve both in tutor mode, log each score, then review every bookmark in First Aid.
7–10 PM Re-read every First Aid line you highlighted today.
Day 6 · UWorld heme-onc + Anki revision
9–9:30 AM Clear today's due FA Foundation Anki cards first.
9:30 AM–1 PM Blocks 9–10 (Qs 161–200): solve both in tutor mode, log each score, then review every bookmark in First Aid.
2–6 PM Blocks 11–12 (Qs 201–240): solve both in tutor mode, log each score, then review every bookmark in First Aid.
7–10 PM FA Foundation Anki revision: the heme-onc cards you missed on Day 3. Then check the 3 finish rules below.
Same pages, 4 angles. Active reading, then active application, then active recall, then UWorld. Every step hits the same 39 First Aid pages from a different direction, and the biochem before it means you meet those pages already half-known. The method behind every system →
Want a day-by-day schedule that tells you exactly what to study next? The Vault builds it around your exam date.
Build my schedule →
4
Before Day 1 What the First Aid Guide is, and why you read it
First Aid was written to remind you, not to teach you. Every line assumes you already understand it. That is why IMGs spend 3 hours on 1 page, Google half of it, and still remember nothing a week later.
The First Aid Guide on usmlevault.com puts the teaching back into the page. Every heme-onc page (pp. 410–448) has the same 5 parts:
Focus On: what on this page is high-yield, and what to skip.
Concept Walkthrough: the page in the order you should think about it.
ELI5: each heading in plain English, with the trap the exam sets. What ELI5 is →
How is this tested?: Common Confusion → Core Concept → The Trap → Your Approach. See a real page →
Test Yourself MCQs on that exact page: 235 across heme-onc (as of October 2026), with a Rule-out button so you practise elimination the way UWorld makes you.
Example: p. 423, Sickle cell disease. Focus On tells you what matters on this page: HbS is glutamic acid → valine at position 6 of the β-chain, deoxygenated HbS polymerises and sickles, the 4 crises (vaso-occlusive, aplastic with parvovirus B19, sequestration, haemolytic), and Howell-Jolly bodies from functional asplenia by age 5.
First Aid p. 423 (Sickle cell disease) in the First Aid Guide: Focus On, the ELI5s, the video guide, Concept walkthrough, Key takeaways, How is this tested? and Test yourself.
Why it works: you understand the page, then prove it with MCQs in the same minute. 60–70% of UWorld traces straight back to First Aid lines , so a page you truly understood is a UWorld question you already own.
Open Heme-onc in the First Aid Guide First Aid pp. 410–448, page by page: Focus On, ELI5 and the MCQs on every page. Opens straight into heme-onc.
Open Heme-onc →
▶ How to use the First Aid Guide Watch once, before your first page.
5
Day 1 → Day 2 morning Active reading: First Aid pp. 410–448
Active reading means that for every page you explain it, understand it, and do it. The MCQs are part of the reading. That is what makes it active. You do not move to the next page until all 3 are done.
Read Focus On for the page. Now you know what matters.
Run the Concept Walkthrough and the ELI5s. Explain each heading back in your own words, out loud. If you cannot say it, you have not understood it.
Read the actual First Aid page. It should now read like a summary of something you already know.
Solve the Test Yourself MCQs. Any miss → back to that heading before you turn the page.
Pace: 10–12 minutes a page, 4–6 pages an hour. Do not memorise. Understanding is the only job on these pages. Memory is the Anki step's job.
No Micro or Pharm pill here. The anticoagulants and the cancer drugs are on pp. 440–448, and you read them with the rest. Before you start, open the High-Yield Pharmacology PDF and look for any heme-onc drugs. If there are notes, do them next to those pages.
Day 1 · pp. 410–435 · development to lymphoma (26 pages)
410–411 Fetal erythropoiesis, haemoglobin development, blood groups, haemolytic disease of the newborn
412–415 Haematopoiesis and every blood cell
416–419 Electrophoresis, Coombs test, the platelet plug, the coagulation cascade, vitamin K
420–425 RBC morphology and inclusions, anaemia classification, sickle cell, iron deficiency, thalassaemias, lead
426–431 Macrocytic and normocytic anaemias, haemolysis, heme synthesis, porphyrias, coagulation disorders
432–435 Platelet disorders, thrombophilias, transfusion, Hodgkin vs non-Hodgkin lymphoma
Day 2 morning · pp. 436–448 (13 pages)
436–439 Plasma cell disorders, MDS, leukaemias, myeloproliferative neoplasms, translocations
440–442 Heparin, warfarin, direct factor inhibitors, reversal, antiplatelets, thrombolytics
…

## Source

USMLE Vault — https://usmlevault.com
Author: Dr. Marish Asudani

Updated: 2026-10-22