Your call with Dr. Marish is booked. Before you speak, here's how students who had already sat a Step, and not passed, went on to pass with him, and what changed the second time.
5 of 6students with a previous attempt passed with Dr. Marish
+20 pointsDr. Esra's Step 3 retake score: 219
8 weeksDr. Trishtha, from joining to passing Step 1
No one checking what you did today, or telling you what to fix tomorrow.
A plan that ignored your weak topics
Hours went into what you already knew, and the gaps stayed gaps.
Questions done, but not reviewed
Finishing a Q-bank isn't the same as learning from every mistake in it.
Exam-day anxiety
Dr. Esra's self-assessments looked good. On exam day, anxiety took over.
What changes the second time
The program, step by step
An audit of your last attempt
Before any plan, Dr. Marish goes through what you did, what you scored and where it broke down.
A plan built on your weak topics and your real hours
Working full time? The plan fits around it. Every hour goes to what will actually move your score.
Daily follow-up
What did you do today, and what's next. Every single day, until the exam.
Assessments until the mistakes stop repeating
NBMEs and Vault Assessments, reviewed question by question, until the same mistakes stop showing up.
The exam date is set by your scores
Dr. Grace booked her exam only after scoring 76% on her final self-assessment.
Student examples
They had a previous attempt. They passed.
Step 31 previous attemptScore 219
Dr. Esra: passed Step 3 with 20+ more points, as a PGY-2
The first time, she was an intern planning her wedding and studying completely alone. Her self-assessments looked good, but anxiety took over on exam day. Afterwards she spoke to 10 to 15 mentors. None of them had a real plan. Then her brother sent her one of Dr. Marish's posts.
219Step 3, 20+ points higher
16 weeksfrom joining to passing
569NBME 7, after 9 weeks
8 monthspregnant when the result came
A PGY-2 internal medicine resident, studying around residency
Her exam was cancelled 3 times, and a storm pushed her Day 2 back
She opened her result in a rheumatology clinic: PASS
"It never happened to me, even in CK or Step 1."Dr. Esra, on no longer repeating the same mistakes on her NBMEs
She had a previous attempt on Step 3, as a PGY-2 IM resident.
In just 16 weeks, even with a tight schedule, we didn't just pass Step 3. We scored 219, more than 20 points higher.
March 4, 2026
Step 11 previous attempt12 to 14 weeks
Dr. Lakshmi: 70%+ on her NBMEs, and still didn't pass. Then she did.
Her NBME scores were above 70% before her first attempt. She still didn't pass. The problem wasn't her knowledge: her preparation had gaps, and she had no strategy for her NBMEs. She joined this year, and 12 to 14 weeks later she passed her second attempt.
70%+on her NBMEs, before attempt 1
12–14 weeksfrom joining to passing
PASSOctober 8, 2026
Good NBME scores alone didn't get her through the first time
This time, her preparation and her NBMEs were planned, not left to chance
Passed Step 1 on her second attempt
An honest review of Vault AssessmentAn honest review of Vault MentorshipAn honest review of Vault AnkiAn honest review of The FA GuideAn honest review of USMLE Vault
Step 1 score report: PASS, October 8, 2026
Step 12 previous attemptsPassed on her 3rd
Dr. Grace: from 55% on UWorld to a Step 1 pass
She had found Dr. Marish a year earlier but held off, thinking she could do it alone. She joined on May 4 for her 3rd attempt. It started with a detailed audit of everything she'd done so far, and a plan built from it.
55% → 85%UWorld, by her 2nd week
60% → 75%Vault Assessment 1 → 2
76%final self-assessment
PASSSeptember 7, 2026
System by system: First Aid with the Vault FA Guide, Anki, Mehlman videos and UWorld
All systems done by early August, then 1 week of full Anki revision
She'd already used every NBME, so the Vault Assessments showed her exact gaps
Final week: the NBME Anki deck and the Randy Neil PDF
"Dr. Marish conducted a detailed audit of my progress up to that point. Based on that, he curated a customized study plan for me."Dr. Grace
Dr. Grace's story, told by Dr. Marish
Step 1 score report: PASS
Dr. Grace in her words
"By the second week, I started to see my UWorld scores jump from the 55–58% range up to the 75–85% range. My confidence grew steadily as I began to truly understand the material."
Her written review
Step 11 previous attempt8 weeks
Dr. Trishtha: passed 8 weeks after joining
She had a previous attempt behind her, and had done UWorld in bits and pieces during her 2023–24 internship. She joined on September 2, 2024.
8 weeksfrom joining to passing
NBME 30 + 31held back until she was ready
PASSNovember 5, 2024
First: Mehlman videos, the Randy Neil PDF and a full revision of her old NBMEs
Then NBME 30 and 31, and she smashed them
Passed Step 1, and is now onto Step 2 CK
Step 1 score report: PASSStill in touch, a year later
Dr. Marish Asudani on X
This is the 2nd student, Trishtha. She joined my program on 2nd September, having completed her UWorld in a fragmented way throughout her internship in 2023–24.
Gave her test just 8 weeks after joining, and passed.
November 20, 2024
Step 11 previous attemptNBME 70% → 75%
Dr. Thamiris: built up 1 NBME at a time, then passed
She came to Dr. Marish after a previous attempt on Step 1, and she was struggling. In May 2025 she restarted her preparation, and instead of rushing to the exam, we built her NBME scores up 1 by 1.
70% → 73% → 75%her NBMEs, 1 after another
May 2025restarted with Dr. Marish
PASSJune 23, 2025
Rebuilt her base with the First Aid Foundation
The NBME Series Anki deck, with its flashcard guide, after every NBME
Kept pushing, NBME by NBME: 70%, then 73%, then 75%
At 75%, we booked her exam, and she passed smoothly
Step 1 score report: PASS
Dr. Marish Asudani on X
Dr T had an attempt on Step 1.
She started her intense prep in May again with me, and finally passed smoothly.
The mentorship works!
July 16, 2025
FAQs
What students with a previous attempt ask first
Will my previous attempt show on my transcript?
Yes. Every attempt stays on your USMLE transcript. That's why the next one needs to be a pass, and why your exam date is set only when your scores say you're ready.
How many attempts do I get?
4 per Step, in total. After 4 attempts at a Step without passing, you can't sit it again, so each remaining attempt counts.
How soon can I retake?
You can take the same Step at most 3 times in 12 months. A 4th attempt has to be at least 12 months after your 1st and at least 6 months after your most recent one. Incomplete attempts count too.
Do I have to start from scratch?
No. The audit shows what you already know, so your plan starts with your weak topics instead of re-reading everything.
Can I do this while working full time?
Yes. Dr. Esra passed Step 3 as a PGY-2 resident. Your plan is built around the hours you actually have.
Will a previous attempt hurt my Match?
Programs will see it. What helps most is a strong pass on the next attempt, and being able to explain clearly what you changed. That's what we build with you.
How is this different from what I did last time?
You won't be studying alone. You get a plan built on your weak topics, someone checking your work every day, and an exam date set by your scores.
USMLE Vault
Dr. Marish Asudani on X
