# The Week Before Your NBME

> How to study the week before your NBME: a tab for every Step 1 form (26 to 34) with the plan for your last score, and the Step 2 CK ladder with the full notes cycle before every form.

URL: https://drmarishasudani.com/week-before-nbme
Canonical: https://drmarishasudani.com/week-before-nbme

## Questions this guide answers

- **How should I study the week before an NBME?** It depends on which form you're giving and your last score. Before NBME 27: 7 days at 10 hours a day, with Sketchy Micro, FA Foundation Anki and 2 timed blocks of NBME 26 a day. After NBME 27 on the USMLE Vault schedule: above 70% nothing changes, 65 to 70% adds a 15-day Patch, below 65% adds a Rebuild and moves the exam date. Before NBME 31 and 32: the NBME Booster Anki system by system (forms 20 to 31 before NBME 32). Before NBME 33: the Neil Randy PDF and the Mehlman HY Arrows. For Step 2 CK: a full notes cycle before every NBME.

## Page text

USMLE Vault · Step 1 & Step 2 CK
The week before your NBME
Your NBME is 7 days away. This page tells you what those 7 days are for, whether it's Step 1 or Step 2 CK.
By Dr. Marish Asudani · Published 22 October 2026
How should I study the week before an NBME?
It depends on which form you're giving and your last score. Before NBME 27: 7 days at 10 hours, Sketchy Micro, FA Foundation Anki and 2 timed blocks of NBME 26 a day. After 27: above 70% nothing changes , 65 to 70% adds a 15-day Patch, below 65% adds a Rebuild. Before 31 and 32: the NBME Booster system by system. Before 33: Neil Randy and the Mehlman HY Arrows. For Step 2 CK: a full notes cycle before every form.
Most IMGs study the week before an NBME the same way, whatever form it is. Read a bit of everything, do some questions, hope. That's why the score doesn't move.
Your week depends on 2 things: which NBME you're giving , and what you scored on the last one . NBME 27 and NBME 33 are not the same job, and a 62% and a 72% don't lead to the same next week.
So below there's a tab for every form. I won't ask you anything. You find your score, and the plan is written next to it.
Everything here comes from the USMLE Vault schedule , the same plan my students follow. If you're stuck and nothing is moving, go straight to the Road to exam day on your schedule ; it already knows your next form.
Students on the NBME Booster Anki
Real students on the deck built from every NBME form. Tap to play.
Ashna · Passed Step 1 An honest review of Vault Anki
Lakshmi · Passed Step 1 An honest review of Vault Anki
Try a free 3-day trial → usmlevault.com · no card needed
Tap your exam. Step 1 has a tab for every form; Step 2 CK has its own ladder of forms.
Step 1
Step 2 CK
0
Before any tab The 3 rules for every single form
Offline. Always. The online version gives you 50 questions in 75 minutes. It feels comfortable, and it inflates your score by 4 to 6%. You'd be training for an exam that doesn't exist.
Blocks of 20 questions, 30 minutes each. That is the real exam's rhythm, Step 1 and Step 2 CK. The whole day, hour by hour: 24 hours of an NBME day →
First pass done by 23 minutes. Keep 5 to 7 minutes for your flagged questions. If you can't, pacing is your problem, not content . Stop making silly mistakes →
Why offline, how to set it up, and every other NBME page in one place: NBMEs offline: the complete system → · The whole order, 26 to 33: the exact NBME order →
1
Step 1 Which NBME are you giving next?
Tap the tab that matches your next form. Each tab tells you what the week before looks like, and what to do with the score you got on the form before it.
26 to 29 first forms
30 / 31 Booster week
32 Mock Exam 1
33 Mock Exam 2
34 newest form
Want a day-by-day schedule that tells you exactly what to study next? The Vault builds it around your exam date.
Get my week, built from my score →
NBME 26 to 29
A
The week before NBME 27 Your first real NBME: the dedicated week
Once every system is done, you get 7 days before NBME 27. This is a 10-hour day, minimum , every day. Not 8. If you can't give it 10 hours for 1 week, your first NBME will not show what you actually know.
3 things every single day, no substitutions:
Sketchy Micro, 1 hour, first thing. Organism by organism, never jumping around. Day 1 DNA viruses, day 2 RNA viruses, day 3 fungi, day 4 parasites, day 5 gram positives, day 6 gram negatives and atypicals, day 7 a fast pass over the whole library. How to run Sketchy →
FA Foundation Anki , in the order you studied the systems. 2 rounds, one before your blocks and one after. First Aid open beside you; every card maps to a page. Open FA Foundation Anki: all 17 systems in 1 deck Run it in the order you studied the systems. Every card maps to its First Aid page.
Open FA Foundation Anki →
2 timed blocks of 20 from NBME 26, offline, days 2 to 6. Offline because the online version (50 questions in 75 minutes) inflates your score by 4 to 6%; why offline → 5 days × 40 questions is the whole of NBME 26, done in blocks. That's what 26 is for: confidence and rhythm, not a score.
Whatever is left of the 10 hours goes back into First Aid, on exactly what you missed that day. Day 8 is NBME 27: 200 questions, exam conditions.
▶ Before giving your first NBME, watch this video Watch it 5 to 6 days before your NBME.
▶ How to solve NBME blocks My video. The 2-pass method inside every block of 20. It's on your Vault schedule before NBME 27.
If you study 15+ hours a day, the schedule gives you 6 days instead of 7. Full protocol: Taking your first NBME →
Road to exam day: the 7-day run-up to your first NBME.
B
After NBME 27 Your NBME 27 score writes your next weeks
On the schedule, NBME 27 is your NBME 1. Your score picks 1 of 3 roads, and all 3 are planned before you give it . Find your score:
Above 70% Nothing changes. You go on to the full ladder, and the next 10 days are 1 system a day:
Mornings: micro guides for 2 hours, then the pharm guide for 1 hour.
Then that system's whole First Aid Guide in the Vault, or just its FA Foundation Anki . Pick one, or both if it worries you.
2 blocks of NBME 28 or 29 a day. All 20 blocks of NBME 28 and 29 are spread across these 10 days.
65 to 70% A 15-day Patch for your weak systems is added, then the plan resumes.
Days 1 to 15: Amboss for your weak systems (up to 5 fit), or a broad pass: morning micro, pharm and biochem, Mehlman for the system, and FA Foundation Anki , all 17 decks across the 15 days (about 152 cards a day).
Days 11 to 15: 2 blocks of NBME 28 a day, alongside everything else.
Day 15: NBME 29, all 200 questions, exam conditions.
Day 16: every question you missed on NBME 29, back through First Aid. No new material.
Then the plan branches again, from your NBME 29 score.
Below 65% A Rebuild block is added and your exam date moves. The plan is re-cut, not abandoned.
Every system again, in the order you first learned it: a First Aid rapid pass at 8 pages an hour, that system's FA Foundation Anki with First Aid open, then Amboss untimed in tutor mode, 100 to 200 questions a system.
It takes about 5 weeks, and your exam date moves by the same. Then you join the full ladder.
Consistently under 65% on 27 or 28? Stop. Don't book a date, don't grind another form, don't add a fifth resource. Read Stuck at 62–65% , the page the Rebuild is built from.
Road to exam day on the Vault schedule: the NBME 1 checkpoint, and what changes below 65% or at 65–70%.
The whole road, start to finish: Week 1 to exam day → Had a bad one? The 24 hours after a bad NBME →
C
The week before NBME 28 and 29 Study what the last form exposed
27 and 28 are your baseline. Whatever 27 and 28 expose is the syllabus for 29 and 30. That is their job: not to score you, but to tell you what to fix.
Before 27 and 28: FA Foundation Anki for every system, First Aid read and understood for every system, and the Amboss 200 high-yield concepts.
Before 29 and 30: Mehlman videos for every system, with First Aid open alongside, not afterwards. Fix exactly what 27 and 28 exposed. Nothing else. How to do Mehlman →
The NBME Booster , the week before. Took NBME 28 last week and you're taking NBME 29 next week? Run the NBME Booster Anki across forms 20 to 28, every system, to completion. Open the NBME Booster Anki: every system, every form In Pick & Mix, filter to forms 20 to 28, then go system by system.
Open NBME Booster Anki →
Why it works: the NBME retires forms, not logic. The concepts tested on 29 have already appeared on the forms before it. What the Booster is →
Road to exam day: the 10-day rebuild, 1 organ system a day, with all 20 blocks of NBME 28 and 29.
Students on the Vault Assessment
Dr. K · Passed Step 1 An honest review of Vault Assessment
Dr. Rana · Passed Step 1 An honest review of Vault Assessment
Try a free 3-day trial → usmlevault.com · no card needed
NBME 30 / 31
A
The week before NBME 31 The NBME Booster, system by system
NBME 30 goes with 29 in the repair round: Mehlman on what 27 and 28 exposed, then both forms in blocks.
Before NBME 31, you run the NBME Booster Anki , system by system, never form by form . 3,219 cards carry an NBME 20 to 30 tag, about 460 a day across 7 days. These counts are a recommendation, not a quota. If a day is short, take your weakest systems first and leave the rest.
The 7 days, as the schedule lays them out
Day 1 · Renal 194 · Respiratory 177 · General Pharm 24 395
Day 2 · GI & Liver 239 · Biochem 264 503
Day 3 · Repro 189 · Endocrine 201 · General Path 26 416
Day 4 · Immuno 199 · Heme/Onc 183 · Ethics 72 454
Day 5 · MSK 208 · Micro 272 480
Day 6 · Psych 140 · CNS 273 413
Day 7 · Cardio 183 · Pharm 249 · Biostats 126 558
NBME 31 runs inside the same week. 2 offline blocks of NBME 31 a day on the last 3 Booster days, so 6 blocks. The other 4 are held back for Mock Exam 1 with NBME 32.
A real NBME Booster Anki card: the form it came from, the one-liner, and the First Aid page under it.
Start the Booster week in the Vault →
Road to exam day: the NBME Anki week, every card tagged NBME 20–30 plus 6 blocks of NBME 31.
B
Your score, from here on From NBME 31, only the trend predicts
31, 32 and 33 are the 3 forms that predict. Not 1 of them. The trend across all 3. You want 68% or more on all 3 , consecutively and progressively. 67, 70, 73 is readiness. 68, 67, 68 is a plateau.
68% and above On track. Carry on to NBME 32. One good form is not the trend yet, so don't book a date on it alone.
65 to 67% Close, not there. The 3 moves that push a 65 above 70: Mehlman and Amboss for the systems you keep missing, the 2 high-yield PDFs , and the Booster . Stuck at 62–65% →
Below 65% Stop and diagnose. Something in the method is broken, and another form will only confirm it. Fix the review first: the review protocol → If it still won't move, book a 30-minute call with me .
How to know you're actually ready: Ready or not →
NBME 32
A
The week before NBME 32 NBME Booster, forms 20 to 31
This one is non-negotiable. Right before you give NBME 32, you do the NBME Booster Anki from NBME 20 till NBME 31 , every system. That is every topic the last 12 forms have tested, as one-liners, explained underneath.
How to fit all of it into the days you have: All the NBMEs in 6 days →
Open NBME Booster Anki, forms 20 to 31 →
B
The day itself NBME 32 is Mock Exam 1, a full exam day
On the schedule, NBME 32 is not a normal form day. It's Mock Exam 1: NBME 32 plus the 4 held-back blocks of NBME 31, 280 questions, 14 blocks of 20. That is the exact shape of Step 1.
Offline, like every form. Same wake time as your real exam, same breakfast, same break strategy. On a 10-block NBME you use 40 to 45 minutes of breaks; the real exam is 14 blocks, so on a 14-block day the rest of the break time is still there. This is a dress rehearsal, not a quiz. The point is the 8 hours, not the score.
Hour by hour, with the break and glucose plan: 24 hours of an NBME day → · Want to rehearse a full 14-block day on questions written at real-exam length? Attempt the free Vault assessment →
Road to exam day: NBME 32 + 31, a full-length 280-question simulation.
C
Your score Read it as part of the trend
68% and above On track, if 31 was 68%+ too. Go on to the Mehlman days and NBME 33.
65 to 67% Not there yet. Mehlman and Amboss for the systems that keep showing up, the 2 PDFs, and the Booster on those systems. The 3 moves →
Below 65% Don't book a date. Review this form properly, then book a call and we'll look at your date honestly.
Students on the mentorship
Ananya · Passed Step 1 An honest review of Vault Mentorship
Dr. N · Passed Step 1 An honest review of Vault Mentorship
Try a free 3-day trial → usmlevault.com · no card needed
NBME 33
A
The 4 days before NBME 33 Neil Randy and the HY Arrows
After Mock Exam 1, you get 4 Mehlman days. Every day has the same 3 tasks:
Neil Randy , 1 section of 4 a day. Not just biostats: high-yield MCQs across every system. Work them like questions, not like notes. Commit to an answer before you look.
…

## Source

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

Updated: 2026-10-22