# 4 Step 1 Hacks > 4 Step 1 hacks from Dr. Marish Asudani: never start with cardio or biochem, finish every UWorld question of a system in system mode, finish each system in 6 to 7 days, and watch Mehlman's videos instead of his PDFs. URL: https://drmarishasudani.com/step-1-hacks Canonical: https://drmarishasudani.com/step-1-hacks ## Questions this guide answers - **What are the best Step 1 hacks?** 4 of them, and all 4 are about order. 1: never start with cardiovascular or biochemistry; start with micro and pharm, then renal. 2: do UWorld system-wise, never on random mode, and finish every question of that system. 3: stop worrying that you're forgetting, and finish each system in 6 to 7 days with the same loop: First Aid with the First Aid Guide, Mehlman, FA Foundation Anki, then UWorld. 4: watch Mehlman's videos, not his PDFs. ## Page text USMLE Vault · Step 1 4 Step 1 hacks For IMGs who have started Step 1 prep more than once and stalled. No shortcuts, no tricks with the exam software. By Dr. Marish Asudani · Published 22 October 2026 What are the best Step 1 hacks? 4 of them, and all 4 are about order. 1: never start with cardiovascular or biochemistry; start with micro and pharm, then renal. 2: do UWorld system-wise, never on random mode, and finish every question of that system. 3: stop worrying that you're forgetting, and finish each system in 6 to 7 days with the same loop: First Aid with the First Aid Guide, Mehlman, FA Foundation Anki , then UWorld. 4: watch Mehlman's videos, not his PDFs . Read this first Most IMGs who quit Step 1 quit because they begin in the wrong order . Not because the content is too hard. They open the biggest, scariest system first. They open UWorld before they've read anything. They save questions for "later". They read Mehlman's PDFs and wonder why nothing sticks. Then they decide Step 1 isn't for them, and they quit. None of those are discipline problems. They are order problems , and order can be fixed in an afternoon. Here are the 4 fixes I'd give you on day 1. 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 Assessment Roshni · Passed Step 1 An honest review of Vault Mentorship Try a free 3-day trial → usmlevault.com · no card needed 1 Day 1 Never start with cardiovascular or biochemistry 99% of IMGs begin with biochemistry, and then they quit, because biochemistry is just that difficult. Don't make that mistake. The ones who skip biochem usually start with cardio, because it feels like the most important system. It isn't. Open your First Aid and it tells you itself: cardiovascular is not one of the most important systems. Pharmacology and microbiology are roughly 20 to 30% of all questions on Step 1 on any given day. So that's where you start: micro and pharm first, then renal . Why it works: once micro and pharm are done, every system you study after that is a revision of them. The organism shows up in a UWorld question weeks later and the whole story comes back to you. That forced repetition is what makes it stay. Free micro and pharm PDFs, in the Vault University Sketchy and the High-Yield Pharm PDF, free, in 1 place. This is where your day 1 starts, not cardio, not biochem. Open the free PDFs → Renal first , because it's the easy one and it builds momentum. Cardio last , because it's genuinely hard and not that high-yield. Biochem is a prerequisite, not an opener. It's split into 7 small pieces, and each one lands right before the system that needs it. So you never spend 2 weeks on biochem at the start. The full system order Micro and pharm (your first 9 to 10 days) → Renal → Respiratory → GI → Reproductive → Endocrine → Immunology → Heme-Onc → MSK → Derm → Psychiatry → ANS → Neuro → Cardio, then biostats and ethics. The biochem pieces slot in on the way: nutrition before GI, carbohydrate and fat metabolism before endocrine, cellular, molecular and amino acids before immunology, genetics before ANS and neuro. Easy systems first, so you build momentum. Cardio last. Tap a system for its own guide, in this order → What Step 1 actually tests (official USMLE content outline) ▶ Antimicrobials in under 90 minutes Watch this once, at the end of microbiology. Then your micro is finished. Read next: Sketchy Micro in 6 days · Pharmacology in 48 hours · where the 7 biochem pieces go · the full timeline 2 Every system Finish every question of a system. UWorld system-wise, never random ⭐ MOST IMPORTANT UWorld is a learning resource. It is not a resource you do once at the end, and it is not a first-pass or second-pass thing. You do it once, and you do it in system mode , because you're learning and assessing how much of that system you understand and retain. Random mode feels productive, but every block jumps from 1 system to another, and nothing consolidates. When you do 1 system at a time, the reps stack on top of each other and the patterns lock in. And finish every question of that system. The 30% you "save for random" was never saved. It was never opened. Those are the topics that show up brand new during revision, when there's no time left to learn them. The settings, every time: Unused questions · your system only · tutor mode · untimed · 20 questions. How you know a system is done Every UWorld question of that system is done. Check the completion %, not the score. Anything under 100% means it isn't finished. Every bookmark is traced back to its First Aid page. Your last 2 blocks are above 65 to 70%. That system's FA Foundation Anki is cleared. The last block felt boring. Halfway through the system's questions and not consistently at 65 to 70%? Stop. Go back to that system's Mehlman and FA Foundation Anki , then carry on. ▶ What to do before UWorld of each system 15 minutes. Watch it if your scores lag after half the questions. ▶ How to solve UWorld 20 minutes. Watch it before your first UWorld block. Read next: the RPSR method · when is a system actually finished? · the study methods I would never use 3 Every system Stop worrying that you're forgetting. Finish each system in 6 to 7 days Every IMG worries that by the time they finish neuro, they've forgotten renal. So they slow down, re-read, and finish nothing. Stop. Try to complete each system within 6 to 7 days , using the same loop every time. Forgetting isn't the problem you think it is. In 2 to 3 days of this loop, you attack the same First Aid pages 4 to 5 different ways: you read them, apply them, recall them, and then test them. And every new system revises the micro and pharm you already did. Here is the exact breakdown, using renal: Day 1 Renal micro and pharm, from the Micro and Pharm pills in the First Aid Guide . Renal is free. Day 2–3 Active reading of First Aid pp. 596–628 with the First Aid Guide: Focus On, Concept Walkthrough, ELI5, the page, then that page's MCQs. Day 4 Active application: the Mehlman renal playlist . Day 5 Active recall: the FA Foundation Anki renal deck (about 140 cards). Day 6 UWorld renal, 20-question tutor blocks, at least 2 a day, reviewed with RPSR . Aim for 65%+. About 6 to 7 days a system, 10 systems: roughly 70 to 80 days for First Aid and UWorld of every system. Start where nobody quits: renal is free Open the renal First Aid Guide with its micro and pharm pills, page by page. Day 1 of the loop above, at no cost. Open renal free → Dr. S always struggled with renal. After this method he sent me 2 UWorld renal blocks: 85% (block average 64%) and 95% (block average 62%). "I've always struggled with renal, so I'm really happy that it's becoming much clearer and easier for me to recall, and I'm seeing better scores." Every system, day by day 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 on usmlevault.com/schedule → Read next: Renal, start to finish, in 6 days · the First Aid method · every system guide 4 Day 4 of every system Watch Mehlman's videos, not his PDFs The PDFs are chunky, and there's no repetition in them. You read a fact once and it's gone. In the videos, he repeats the high-yield concepts again and again until they stick. And he doesn't just teach you the answer. He teaches you how the NBME thinks, how the stem is built, how the options are built, and how to rule out every single option . That elimination skill is what moves your score. The full system playlist, in order. Not random clips. Watch at 1x with no notes. Pause every 2 to 3 minutes and ask yourself what you just learned. Close the video. Spend 5 to 10 minutes recalling the main concepts on blank paper. Rewatch only the parts you forgot. Then go to that system's Anki and UWorld. ▶ How to watch Mehlman Medical videos 10 minutes. Watch it once, before your first playlist. ▶ Mehlman · Renal playlist Start here. Same method for every system below. Every Mehlman system playlist Pulmonary · GI · OBGYN / Repro Endocrine · Immuno · Hematology Anatomy / MSK · Psych · Neuro Cardio · Microbiology · Pharmacology Biochemistry / Genetics · Pathology Read next: how to use Mehlman Every one of these is already built into the plan. Micro and pharm first, renal next, every system day by day, from your exam date and your hours. Open usmlevault.com/schedule → usmlevault.com · free for your first 3 days Read next 10 IMG mistakes — and the fix for each one. Canon events — the 10 things almost every IMG does. 10 tricks to pass Step 1 How to actually stay consistent USMLE Vault · 4 Step 1 Hacks · Created 2026-10-22 USMLE Vault Try the Vault free for 3 days Start free trial ## Source USMLE Vault — https://usmlevault.com Author: Dr. Marish Asudani Updated: 2026-10-22