How I Scored a 266 on the USMLE Step 1 in 6 Weeks


The most important piece of advice I can offer is to take your pre-clinical coursework seriously and to try to learn and integrate as much as possible during this time. Believe it or not, much of what we learn in the pre-clinical coursework–particularly physiology, pathophysiology, and microbiology–is extremely relevant for questions you will be asked on the wards, on shelf exams, and ultimately on the board exams. I cannot stress this enough: having a solid foundation going into my dedicated study time made this SO much easier.

Everyone has different study techniques, but this is what worked for me. In six weeks, I wanted to make sure I got through every page of First Aid, every section in Pathoma, and every question in the UWorld Qbank. I created the schedule below that allowed me to do all of this and finish by the beginning of week six so that I would have some time to review and relax:



The Resources I Used

First Aid: A great resource to learn a little bit about everything. Often not enough to really understand a topic and to fully integrate to get a complicated question right, but a great starting point. Also really helps with association and recall, and has some excellent images/diagrams that are really helpful. ($20-$50 on Amazon depending on how new of a version you use, I used one that was 2 years old).

Pathoma: Dr. Sattar’s lectures are amazing. He’s clear, concise, and teaches really high-yield topics. Plus his voice is really soothing! This type of passive learning was exactly what I wanted/needed to break up some of my long study days. ($85 for 3 months, $99 for 12 months https://www.pathoma.com)

UWorld Qbank: If you can only choose one resource to study for Step 1 – CHOOSE THIS ONE. This Qbank is extraordinarily helpful for integration and even learning new material. You can do up to 40 questions as a time, either on particular topics or random questions, timed or untimed, and with feedback after each question or at the end. I highly recommend making sure you do each question in this Qbank at least once! ($279 for 60 days https://www.uworld.com/purchase.aspx?cid=1)

Practice Exams: I did both Uworld Self Assessments ($70 for both), and two practice NBME exams ($40 apiece). I think that the NBME exams mirror the actual test slightly better than the Self Assessments, but overall both are fairly good approximations. Unfortunately, the NBME exams only give you a score but do not give you answers to the questions you get wrong.

My Approach

I started with a 40-question random Qbank (each blue Qbank block above is 40 questions in 3 hours – 1 hour to take the exam, and 2 hours to correct, review, and take notes). From there I went to page 1 of First Aid and starting reading and taking notes on anything I wasn’t comfortable with.

My days were all fairly similar. I did at least one 40-question Qbank per day, but often one in the morning and one in the afternoon. I started off doing questions that were related to the topics I had been studying, but after a couple of weeks mostly transitioned to doing entirely random Qbanks. I also spent 3 hours daily reviewing a particular topic in First Aid (orange sections above). Longer sections took me more time – for example I spent 3+ days reviewing the microbiology chapter. I took notes on these chapters, and then supplemented my notes with new information from both Pathoma and relevant Qbank questions. I had a built-in hour each day to review topics I had covered previously that were challenging, and an additional hour for a break. This is important! Do something fun – go outside, meet someone for lunch, exercise, etc. I studied 6 days a week and then on the seventh day I tried my hardest to not even think about medical school or the upcoming test. 6 weeks is a long time – prioritize your time off and do something for you!

At the end of week 3 I did my first practice test. I tried to simulate the actual test day – find a quiet place, use earplugs, have scrap paper ready, etc. These practice exams are half the length of the real deal – they take about 4 hours. I did an additional practice test once per week after that, with my final practice test at the beginning of my final week. By my final week, I had finished reviewing topics in First Aid and had finished Pathoma, but had several hundred Qbank questions left so I spent most of my week completing these and reviewing the Qbank questions I had gotten wrong earlier. The day before my test I did NOTHING. On the morning of my exam, I had a nice breakfast, drove to my test center while listening to inspiring tunes (“The Greatest” by Sia, “Fight Song” by Rachel Platten), and went into the exam room feeling nervous but confident.

By the way – this dedicated study time doesn’t have to be miserable! I adopted a kitten at the beginning of the 6 weeks (had been wanting one for years) and we had tons of time to snuggle and study together:


Jessica Mueller is a fourth-year Harvard medical student and Step 1, Step 2 CK, shelf exam, and medical coursework tutor for USMLE Pro.

#USMLE #Step1 #250 #260

68 Harrison Avenue, 6th Floor

Boston, MA 02111

USMLEPro.com is not endorsed by or affiliated with the National Board of Medical Examiners (NBME) or Federal State Medical Boards. "USMLE" is a trademark of the NBME and is used pursuant to the Fair Use Doctrine.

  • White Twitter Icon

© 2020 USMLE Pro Tutors, LLC