Run respiratory exactly like renal. Day 1: 15 organisms and the antihistamines. Day 2 to Day 3 morning: active reading of First Aid pp. 678–706 with the MCQs. Then the Mehlman pulmonary playlist, then the FA Foundation Anki respiratory deck. Days 5–6: UWorld respiratory, system-wise, every miss reviewed in First Aid.
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 →
Respiratory is the second system I'd do, right after renal, and you run it exactly the same way. If you've done renal with this method, you already know every step on this page.
Short does not mean you skip the order. 29 pages tempt people straight into UWorld. Do the steps first, and the questions feel like pages you already know.
Haven't done renal yet? Renal is free on the Vault. Do that one first, with the renal page open.
Start here · before page 1
Respiratory: micro and pharm first
Respiratory starts with its own organisms and drugs: 15 organisms and 1 drug group, the antihistamines. Day 1 below does both. These are the full guides.
Respiratory is the 2nd system, right after renal. Renal, respiratory and GI are the easy systems: do them first, and don't skip them. Cardio comes last. Tap a system to open its guide.
9:15 AM–1 PMMicro: the 15 respiratory organisms, WRWRT. Watch, recall, watch the gaps, read the Sketchy PDF.
2–4 PMTest: the First Aid Guide MCQs for all 15 organisms. Any miss → that organism again.
4–6 PMPharm: the antihistamines (Osmosis), twice. Read them in the High-Yield Pharmacology PDF, then the respiratory pharmacology MCQs. Day 1 ends here.
Day 2 · Active readingFirst Aid Guide, page by page, MCQs on every page
2–6 PMpp. 686–693 · CO2 transport, hypoxia, the haemoglobin curve, altitude, CO vs cyanide, rhinosinusitis, PE, mediastinal masses, obstructive vs restrictive, emphysema, asthma
9:30 AM–1 PMBlocks 7–8 (Qs 121–160): solve both in tutor mode, log each score, then review every bookmark in First Aid.
2–6 PMBlocks 9–10 (Qs 161–200): solve both in tutor mode, log each score, then review every bookmark in First Aid.
7–10 PMBlocks 11–12 (Qs 201–240): solve both in tutor mode, log each score, then review every bookmark in First Aid.
Same pages, 5 angles. Micro and pharm, then active reading, then active application, then active recall, then UWorld. Every step hits the same 29 First Aid pages from a different direction. 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.
Respiratory in the First Aid Guide on usmlevault.com: its First Aid pages, MCQ count, the micro and pharm pills it has, and the How to do Respiratory video.
Micro · 15 organisms · the WRWRT method.Watch the sketch at 1x with no notes → Recall the whole story in your head, in order → Watch again only the gaps at 1.5–1.75x → Read the Sketchy PDF for that organism → Test with the First Aid Guide MCQs for that organism.
Pharm · the FWRT method.Find the resource (already mapped for you, below) → Watch each video twice, back to back → Read the High-Yield Pharmacology PDF after all of them, and highlight only what did not survive → Test in the First Aid Guide → Respiratory → Pharmacology.
01 · Antihistamines (Osmosis). Sketchy has no antihistamines video, so this one switches to Osmosis.
Never done Sketchy? Do the same list from First Aid and the First Aid Guide alone. The list does not change, only the source. Every system's micro and pharm →
Why micro and pharm first: when you reach pneumonia on p. 701 and the H1 blockers on p. 704, you meet them as old friends, not new facts.
3
Before Day 2What 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 respiratory page (pp. 678–706) 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: 158 across respiratory (as of October 2026), with a Rule-out button so you practise elimination the way UWorld makes you.
Example: p. 703, Lung cancer.
Focus On tells you what matters on this page: the paraneoplastic syndromes are the highest-yield part. Small cell makes ACTH and ADH and causes Lambert-Eaton. Squamous cell makes PTHrP. Adenocarcinoma is the most common, and the one in non-smokers and women. Then Pancoast tumour and SVC syndrome.
First Aid p. 703 (Lung cancer and paraneoplastic syndromes) 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 Respiratory in the First Aid GuideFirst Aid pp. 678–706, page by page: Focus On, ELI5 and the MCQs on every page. Opens straight into respiratory.
Day 2 → Day 3 morningActive reading: First Aid pp. 678–706
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.
Day 2 · pp. 678–696 · development to pneumoconioses (19 pages)
Day 3 afternoon → Day 4 morningActive application: Mehlman Medical
You understand respiratory. 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.
Videos, not PDFs. The value is the reasoning, and the PDFs do not have it.
The full respiratory 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 →
6
Day 4 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 Respiratory deck is 121 cards (as of October 2026).
How to use it: run the whole respiratory 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 respiratory 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 · RespiratoryA heavy smoker with a central lung mass develops proximal muscle weakness that improves with repeated use. EMG shows incrementing amplitude on repetitive stimulation.
What antibody causes this paraneoplastic syndrome, and what is its target?
Anti-voltage-gated calcium channel antibodies. They block presynaptic calcium entry at the neuromuscular junction: Lambert-Eaton myasthenic syndrome.
Run the FA Foundation Anki · Respiratory deck121 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 respiratory here. You are proving you already own it.
UWorld settings
QuestionsUnused
SubjectsAll
SystemsRespiratory 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.
Respiratory has about 280 UWorld questions on the USMLE Vault schedule. That is 14 blocks. Days 5–6 take 12 of them (the plan above), and the last 2 go to the next morning, before you start GI. Keep going until the 3 checks below are true.
Respiratory is finished when every respiratory 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 · RespiratoryThe respiratory 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 →
