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For IMGs with 7 days left who have been putting it off. By the end of this page you will know exactly what is enough, and nothing more.
By Dr. Marish Asudani · Published
First check the gate: you only give Step 1 if you are above 68% on all 3 of NBME 31, 32 and 33. If you are, the week is recall, not new content: the Neil Randy PDF, the Mehlman High-Yield Arrows at 40 a day, the NBME Booster Anki with the NBME images, the FA Foundation Anki and Rapid Review. Bookmark every card you don't remember. On the day before, you study only those bookmarks.
Read this firstIf you've been putting this week off, it's not because you're lazy. Procrastination 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 exactly what is enough for this week. Checklists work: knowing exactly what to do. No new content, no new resources. Just the list my students run in their final week, in order.
1 rule before you start: you check the gate first. Then you open the list.
You should not be attempting your Step 1 if you haven't scored above 68% on NBME 31, 32 and 33. All 3. Not your best of 3. And you should be finishing your blocks with time left on the clock.
If you've got those, this week is yours, and the rest of this page is your checklist.
If you haven't, this isn't your exam week, and that's fine. Fix the plateau first with Stuck at 62–65%, and if your date is already booked, use Reset in the Vault schedule. It tells you honestly whether your date fits. How Reset checks your date →
Not above 68% yet? Let the Vault re-check your dateSet your exam date and hours in the Vault schedule. Reset tells you honestly whether the date still fits, and what to do each day until it does.
Open my schedule →Those scores only count if you took them offline. NBMEs are always taken offline, timed, 20 questions in 30 minutes a block. The online version gives you 50 questions in 75 minutes, which feels comfortable and inflates your score by about 4 to 6%. An online 70% is not a 70%. Why NBMEs are always offline →
In this order. Anything new or anything you don't know while you do them, you bookmark it. That rule is further down, and it's the most important line on this page.
This is the biggest cheat code for the last week. People think Neil Randy is only biostats. He isn't. The PDF is his high-yield playlists in 1 place: every high-yield system, with the questions that go with it.
It takes 2 to 3 days at most. If you haven't done it yet, do it this week. No exceptions.
PDFOpen the Neil Randy PDF in the Vault Universityusmlevault.com/university, with the Mehlman High-Yield Arrows.160 up-and-down arrow concepts. Do 40 a day and you're finished in 4 days. The exam loves arrows: what goes up, what goes down, and why.
PDFOpen the Mehlman High-Yield Arrows in the Vault UniversityArrows 1–40, 41–80, 81–120, 121–160. Same place as the Neil Randy PDF. ▶Mehlman on how to use the HY Arrows PDFWatch once before arrow 1.What it is: every NBME form, gone through topic by topic, with every topic written as a 1-line card, explained underneath, and sorted into the system it belongs to. It now covers forms 20 to 34, and the Free 120 has been added too. The line on the card is the line that comes back at you in a vignette.
Why this week: the real exam asks what the NBMEs ask. The NBME retires forms, not logic. So in the final week, you do the NBMEs again, as recall.
How: do it system by system, never form by form. For every system you feel weak in, run that system's Booster deck to the end.
Open the NBME Images AnkiEvery image asked in NBME 20 to 34, as flashcards. Do it this week: the NBME repeats its images a lot in Step 1.
Open the images deck →
It just simply wraps up the entire First Aid. Every high-yield line of every page, asked actively, with the First Aid page number on every card. And that is basically what the questions in the exam ask.
2,499 cards in 17 system decks. At 400 to 500 a day, a full First Aid pass takes 5 to 6 days. Go system by system, with First Aid open beside you. If a card makes you hesitate, open that page and read a couple of lines above and below it.
Open the FA Foundation Anki, all 17 systemsEvery high-yield line of First Aid as a card, with the First Aid page number on every card. Start with your weakest system.
Open the deck →For every system you feel weak in, if you're frustrated reading the same First Aid pages again, stop reading and do that system's FA Foundation Anki instead. It's lines of the First Aid, recalled as Anki. Same content, but your brain has to pull it out, which is what the exam asks it to do.
The Rapid Review section at the back of First Aid is a definite must this week. You've read First Aid already. This is the fast pass at the back of it.
Sketchy Micro gets revised every single day this week, alongside the 6. In the last-month plan, days 30–31 add the 90-minute antimicrobials video, and day 32 adds the High-Yield Biostats PDF.
▶Antimicrobials in under 90 minutesThe single most important video on antimicrobials. PDFThe High-Yield Biostats PDFEvery formula in 1 place.Saved on this phone, so you can come back to it every day. Tick it only when it's finished.
Be honest. If the week is full, you don't skip the list. You cut it down to the highest-yield things.
Tap the tab that matches your week
Why the NBME decks first? Because in the final week, the real exam just asks the NBME. So that's what you recall.
While you do the NBME Booster Anki and the FA Foundation Anki, anything you don't remember, you bookmark. Anything new, or anything you don't know from the PDFs, you make a note of it.
That list becomes your final day, the day before. On the last day, you just do the bookmarks. Nothing else.
On the Vault's last-month plan, the final week is days 28 to 32, and nothing new goes in. This is how it's laid out:
The full 33 days, from NBME 27 to the exam: The last month, day by day →
▶How to Pass USMLE Step 1 in 2027, Part 6: the last monthChapter at 12:29. The bar, and what the last month looks like.For Step 1, "last minute" means your final week and your final day. You don't learn anything new now. You recall. If you only do 4 things, do these, in this order:
Your day before → The Final Day Protocol: your bookmarks only, books shut at 5 PM.
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 →
The Final Day Protocol — the day before, hour by hour.
Exam day — 20 questions, 3 deep breaths, 20 questions, a glucose break.
The final 14 days — the 5 resources, with links.
The month before Step 1 — for procrastinators, by your score.
The last month, day by day — all 33 days from NBME 27.
The NBME Booster — what it is, and why system-wise.
The NBME Images Anki — every NBME image, as flashcards.
How to know you're actually ready — the trend, not the score.