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2 lists. The first 10 stop a fail. The second 10 make your prep faster. Pick the one you need today.
By Dr. Marish Asudani · Published
Pick a hard date from your hours, and know your plan day by day, not week by week. Have a structure that shows you progress, with First Aid and your Anki deck on your phone. Do UWorld system-wise, every question, and put every miss back into its First Aid page. Take your first NBME only after every system, offline, and review it the same day. Don't attempt the exam until you're above 68% on NBME 31, 32 and 33. Do 1 full 14-block assessment. And the day before, close your books by 5 or 6 pm.
Read this firstThese are not ways to cheat the exam. They are the things I watched work, again and again, for IMGs who passed, and the things that were missing for the ones who didn't.
Step 1 is pass or fail. So the first list is about not failing. The second list is about getting there in fewer weeks.
Tap the list you need today.
A few tricks are on both lists, because they help with both.
Tricks 2 to 5 are borrowed from my 10 habits to stay consistent. The rest are my own.
A hard date in your mind keeps you studying hard. Pick it from the hours you can really study, not the hours you wish you had.
Then get your scheduling permit for that window, and build every day backwards from it.
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 on usmlevault.com/schedule →
"Finish cardio this week" is not a plan. "Today: pp. 596–611, then that page's MCQs" is. A weekly target lets you push everything to Friday. A daily list doesn't. And the night before, you already know tomorrow's tasks, so you wake up and start.
Every system the same way: micro and pharm → First Aid with the First Aid Guide → Mehlman's videos → FA Foundation Anki → UWorld. The structure gets you scores, and seeing 70s and 80s is what makes you study the next day. Dr. S got 85% and 95% on 2 renal UWorld blocks this way.
Try it today on renal, free → · how to actually stay consistent →
First Aid, UWorld and the Sketchy PDFs all live on your phone, so every gap in your day becomes study time. If it's not on your phone, it doesn't get done on a busy day. That's how I did Step 1 in 14 weeks during internship.
Open the First Aid Guide on your phoneRenal is free: every page, its explanation and its MCQs, in your phone's browser.
Tap to begin today →The FA Foundation Anki (First Aid line by line) and the NBME Booster Anki (NBME forms 20 to 34 and the Free 120). Keep both on your phone, so your reviews happen in the gaps of your day and never pile up.
UWorld is a learning resource. You do it once, in system mode, in blocks of 20, at least 2 blocks a day. Questions you save for random were never saved. They were never opened.
60 to 70% of UWorld questions are direct lines from First Aid. For every bookmark, find the line that would have given you the answer, and highlight it. If it isn't in First Aid, write 1 line per topic in the margin, maximum. Never a second set of notes.
Tap to begin today: review your misses inside the First Aid Guide → · the RPSR method → · the First Aid method →
You get 8 to 9 NBME forms. Never burn one on a baseline. A first NBME in week 3 gives you a number you can't do anything with, and 2 weeks of doubting yourself.
Always offline. The online version gives you 50 questions in 75 minutes and inflates your score by about 4 to 6%. Offline: 10 blocks of 20, 30 minutes each, the real exam's pace, so the score is one you can trust. Then the same day, you review it, because a form you don't review is a diagnosis you've paid for twice.
▶Before giving your first NBME, watch thisThe block method and the days before a form.Try today: revise every form you've given with the NBME Booster Anki →
The NBME order → · NBMEs offline → · the NBME Review Protocol →
Only those 3 forms carry a verdict, and the trend beats the number. Stuck at 63, 64, 65 and 1 form spikes to 71? That spike is noise. The bar: above 68% on all 3, and finishing your blocks with time left over.
Tap to begin today: get every form placed on your plan → · how to know you're actually ready →
The real exam is a full day. Give yourself a full 14-block day in your last month, so the real one feels short.
Take the Vault assessment14 blocks, 280 questions. Assessment 2 is free.
Try it today →The day before: a little tired on purpose, books shut by 5 or 6 pm. Say your exam is on the 10th. On the 9th, you wake at 6 or 7 am after sleeping at 2 or 3 am. I don't want you well rested on the day before, or you might lie awake that night. Study the rapid review and your weak systems until 5 or 6 pm at the latest, then close your books and don't open them again. Dinner, a 45-minute to 1-hour walk, back by 8 or 8:30, lights out by 9. That's 8 hours of sleep before the exam. This is for the real Step 1 only, not for your NBMEs.
Exam day: breathe every 20, break every 40, sugar every break. 14 blocks of 20. After the first 20 questions, 3 deep breaths. After the next 20, go out for a 5 to 7 minute break: restroom, water, half a bottle of Gatorade, Tang or Glucon-D, or half a chocolate bar. Your brain only uses glucose. 20 questions, breathe. 20 questions, break. Repeat.
▶How to pass USMLE Step 1 in 2027Part 7 is the day before and exam day.The day before Step 1 → · exam day → · Tap to begin today, free for your first 3 days →
They're roughly 20 to 30% of your exam. Do them once, up front, and every system after that revises them for free.
▶Antimicrobials in under 90 minutesThe last step of microbiology.Try today: the micro pills in the First Aid Guide → · Sketchy Micro in 6 days → · Pharmacology in 48 hours → · the free Sketchy and HY Pharm PDFs →
Renal first, because it's easy and builds momentum. Cardio last, because it's hard and not that high-yield. Biochem is a prerequisite, not an opener: 7 small pieces, each one before the system that needs it.
Begin today with renal, free → · 4 Step 1 hacks → · where the biochem pieces go →
Micro and pharm of the system → First Aid with the First Aid Guide → Mehlman → FA Foundation Anki → UWorld. The same loop every time, so you never waste a morning deciding how to start.
Every system, the same loop, on its own daysThe schedule lays out each system step by step from your exam date. Free for your first 3 days.
Tap to begin today →System by system, the reps stack and the patterns lock in. Random mode jumps around and nothing consolidates.
When a system is finished → · never save questions for random mode →
The videos repeat the high-yield points and teach you how to rule out every option. The PDFs don't.
▶How to watch Mehlman Medical videos10 minutes, before your first playlist. ▶Mehlman · Renal playlistFull playlist, in order, 1x, no notes.You review inside First Aid, never by redoing the question. By exam day, your highlights are your revision list. Try today in the First Aid Guide →
Every extra point goes into the First Aid page. 2 sets of notes means you study once and revise twice.
A baseline in week 3 costs you a form and 2 weeks of doubt. Save every form for when it can tell you something. Revise the forms you've given with the NBME Booster Anki →
The hour you spend deciding what to study is an hour you didn't study. Decide the night before. Tap to get tomorrow's list →
Unnecessary breaks break the cadence. MrBeast works 30 days nonstop, then takes 2 days off when he's burnt out. Rest when you need it, without guilt.