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For IMGs with about a month to go and a habit of putting things off. Tap your last NBME scores and get your last month, not a generic one.
By Dr. Marish Asudani · Published
It depends on your scores. Consistent at 65 to 68%? The last month is a push, in order: the NBME Booster Anki, the FA Foundation Anki, Mehlman videos for the systems you feel are weak, the Neil Randy PDF, and the Mehlman High-Yield Arrows. Already above 68% on NBME 31, 32 and 33? Follow the day-by-day plan. Below 65%? Fix the plateau first. Either way, the exam only stands when you are above 68% on all 3 of NBME 31, 32 and 33.
Read this firstProcrastination only happens when you don't have a vision, or when you don't know what to do and what is enough.
So I'm going to tell you, based on your situation, what to do and what is enough for you. Not a generic plan. Your plan, from your last NBME scores.
The best way to make sure you don't procrastinate is to know exactly what you're supposed to do. That's the exact reason I already built a full schedule of what to do, based on your score: a day-by-day task list. If you just want to read, tap your score below. If you want that exact schedule built for you, it's on usmlevault.com/schedule.
The procrastination goes away when you have a checklist.
Your road to exam day begins from your scores, not from the calendar.
Tap the tab which matches your last forms.
This is who the last month is for. It should only be 1 month before if you've been getting consistent scores in the 65 to 68% range, so that in the last month you can push it.
The push is 5 things, done sequentially, so that you keep getting good scores in the NBME. They're in section 2. Your schedule tells you how to take every next NBME from your last score: section 3.
The bar doesn't move: you give the exam when NBME 31, 32 and 33 come back above 68%. All 3, taken offline and timed. The push is how you get them there.
You're past the bar. Here is every day. The last-month plan is the 33 days after your first NBME, in order: a repair round, the NBME Booster system by system, the Neil Randy PDF and the Arrows, 3 full 14-block days, then a final week with nothing new.
On the Vault schedule, your exam date falls 35 days after your first NBME.
The last month, day by day → And if you're scoring 75% or more on your last forms, book it soon. Waiting longer only adds fatigue. How to know you're actually ready →
This isn't your final month yet, and that's fine. Stuck at 63–65% with 1 form at 71%? That's not ready. That 1 form is noise, and it's the most common reason people book too early.
Sequentially, so that you keep getting good scores in the NBME. Tick each one when it's done. It saves on this phone.
Every NBME form from 20 onwards, written as 1-line cards, explained, sorted by system. Forms 20 to 34 now, plus the Free 120. Run it system by system, never form by form, finish every system, then take your next form.
Students who ran it system-wise, to completion, have moved from 49% to 75% on their NBMEs in 15 to 20 days.
Open the NBME Booster Anki, every systemForms 20 to 34 and the Free 120 as 1-line cards, sorted by system. Pick your weakest system and run it to the end.
Open the Booster →How it's built, and why system-wise: The NBME Booster →
2,499 cards, a First Aid page on every card. At 400 to 500 a day, the whole book in 5 to 6 days. First Aid recalled, not re-read.
Open the FA Foundation Anki17 system decks in First Aid order, with the First Aid page on every card. 400 to 500 a day, the whole book in 5 to 6 days.
Open the deck →Whichever system still feels weak to you gets its Mehlman playlist now: the videos, not the PDFs. He teaches you how the exam thinks: how the stem is built, and how to rule out every option.
How to watch them: the Mehlman guide →
His high-yield playlists for every system, in 1 PDF, with the questions that go with them. 2 to 3 days, maximum.
PDFOpen the Neil Randy PDF in the Vault Universityusmlevault.com/university160 up-and-down arrow concepts. 40 a day, done in 4 days.
PDFOpen the Mehlman High-Yield Arrows in the Vault UniversityArrows 1–40, 41–80, 81–120, 121–160. ▶Mehlman on how to use the HY Arrows PDF4 minutes. Watch it before arrow 1.The 5 things above are what you study. The 6th is knowing what to do between 2 NBMEs, every day, based on your last score. That's the next section.
Your next NBME isn't a guess either. The scheduling engine decides it from your last score. On the Vault schedule, your first NBME (NBME 27) picks 1 of 3 roads, and all 3 are planned before you give it:
The order after NBME 27: 28, then 29, then the NBME Booster Anki, then NBME 31, 32 and 33. On the schedule, 32 and 33 are inside your 2 full 280-question mock days: NBME 32 with 4 blocks of 31, then the rest of NBME 33 with the Free 120. Only the NBME 31, 32 and 33 trend carries the verdict. On the Step 1 side, the Free 120 is realistic practice, not a predictor. The exact NBME order →
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 in the Vault →
Every NBME, offline. You always take your NBMEs offline, timed, 20 questions in 30 minutes a block. The online version gives you 50 questions in 75 minutes and inflates your score by about 4 to 6%, so it can't tell you whether you're past 68%. Why NBMEs are always offline →
Just had a bad one? The NBME review protocol → the same day, every form. 24 hours after a bad NBME →
Every stage of the month has its own page. Open the one you're in.
This is what is enough. When every line is ticked, you're ready to give it. Each line has its how-to in brackets: tap it.
Give your 280-question day: the Vault Assessment14 blocks of 20, 280 questions, at the real exam's stem length, with a system-by-system report and an honest pass verdict. Assessment 2 is free for every signed-in student.
Start the assessment →How both assessments work: the Step 1 assessments →
The week before Step 1 — the 6 things, and the bookmark rule.
The Final Day Protocol — 24 hours before Step 1.
Exam day — breaks, glucose and the 20-question rhythm.
The last month, day by day — if you're already past 68%.
Stuck at 62–65% — if this isn't your month yet.
3 tips to avoid failing Step 1 — the bar, the last 14 days, the 280-question day.