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.
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.
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.
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 · firstImmunology
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.
Before heme-onc · secondMolecular, 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
32–43Molecular: DNA replication and repair, mutations, gene expression. The base for oncogenes and for the cancer drugs that hit DNA synthesis
44–53Cellular: the cell cycle, organelles, the cytoskeleton. The machinery cancer hijacks
79–83Amino 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.
9:30 AM–1 PMBlocks 9–10 (Qs 161–200): solve both in tutor mode, log each score, then review every bookmark in First Aid.
2–6 PMBlocks 11–12 (Qs 201–240): solve both in tutor mode, log each score, then review every bookmark in First Aid.
7–10 PMFA 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.
Before Day 1What 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 GuideFirst Aid pp. 410–448, page by page: Focus On, ELI5 and the MCQs on every page. Opens straight into heme-onc.
Day 1 → Day 2 morningActive 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)
410–411Fetal erythropoiesis, haemoglobin development, blood groups, haemolytic disease of the newborn
412–415Haematopoiesis and every blood cell
416–419Electrophoresis, Coombs test, the platelet plug, the coagulation cascade, vitamin K
420–425RBC morphology and inclusions, anaemia classification, sickle cell, iron deficiency, thalassaemias, lead
426–431Macrocytic and normocytic anaemias, haemolysis, heme synthesis, porphyrias, coagulation disorders
432–435Platelet disorders, thrombophilias, transfusion, Hodgkin vs non-Hodgkin lymphoma
Day 2 afternoon → Day 3 morningActive application: Mehlman Medical
You understand heme-onc. Now you learn how the exam asks it. Mehlman's videos take each high-yield topic and show you which clue rules an answer in, which one rules it out, and how to get from the stem to the answer.
My note: in heme-onc, Mehlman is a must. Do not trim this day.
Videos, not PDFs. The value is the reasoning, and the PDFs do not have it.
The full heme-onc playlist, in order. Not random clips. Watch the how-to video below first.
Pause before he answers, and answer it yourself. Anything that exposes a gap → open that First Aid Guide page and fix it the same day.
Short on time? Sort the playlist by date and watch the last 3 years first.
Why: active reading gave you the facts. Active application turns facts into decisions, and a decision is the only thing a UWorld question asks for. How to use Mehlman →
7
Day 3 afternoonActive recall: FA Foundation Anki
What it is: the FA Foundation Anki deck is First Aid, page by page. 1 high-yield point per card, and the First Aid page number is on every card. The Heme-Onc deck is 208 cards (as of October 2026).
How to use it: run the whole heme-onc deck in this half day. Answer before you flip. If you hesitate, open that page in the First Aid Guide, read the line plus a couple of lines above and below, then go back to the card.
Why: this is your third full pass of heme-onc First Aid, and the first one done without the page in front of you. Recognising a line and pulling it out of memory are different skills, and UWorld tests the second one.
Example card · FA Foundation Anki · Heme-OncA severely anaemic man (Hb 6, Hct 18%) has a reticulocyte count of 6% but normal haemolysis markers.
Why is the 6% reticulocyte count misleading, and what corrects it?
The percentage is falsely high because the total RBC count is so low. The reticulocyte production index corrects it: (6 × 18/45) / 2 ≈ 1.2, an inadequate marrow response.
Run the FA Foundation Anki · Heme-onc deck208 cards (as of October 2026), First Aid page by page, with the page number on every card. Opens straight into the deck.
Now you open UWorld. You are not meeting heme-onc here. You are proving you already own it.
UWorld settings
QuestionsUnused
SubjectsAll
SystemsHeme-onc only
ModeTutor, untimed
Block20 questions
Solve. Do 2 blocks of 20. Bookmark every question you got wrong and every one you got right by guessing.
Review in First Aid. For each bookmark, find the exact First Aid line it came from, highlight it, and read a couple of lines around it. 5–6 minutes a question, no more. Then the next 2 blocks.
Target:65% or above. If your last 2 blocks are under 60%, go back to the Mehlman videos for those topics, then the First Aid pages behind them.
Heme-onc has about 240 UWorld questions on the USMLE Vault schedule: 12 blocks, 4 a day on Days 4–6 (the plan above). Keep going until the 3 checks below are true.
Heme-Onc is finished when every heme-onc UWorld question is attempted, every miss is traced to its First Aid page, and your last 2 blocks held above 65%. Not when a date passes. When is a system actually finished? →
Later, for your NBMEs: NBME Booster Anki · Heme-oncThe heme-onc questions from retired NBME forms 20 to 34 and the Free 120, as cards. Not for now: open it when your NBME phase starts. What the Booster is →
Build my schedule →
