USMLE Step 1 was the hardest part of medical school for me. I wasted weeks studying, only to see my NBME practice scores barely increase. I was grinding for 12+ hours a day with no breaks, considered watching Sketchy a “study break,” and completely neglected exercise and proper nutrition. Despite getting eight hours of sleep every night, I felt constantly fatigued, and my brain was in a fog. Thankfully, I still did well—but at a huge cost. By the end, I was completely burned out.
Looking back, I now realize I struggled because I didn’t know effective study methods or test-taking strategies. I followed a lot of bad advice, relied on passive study techniques (like re-reading First Aid cover to cover, and taking endless notes on incorrect questions), and had no real direction.
One of the biggest reasons I started sharing USMLE study advice on Instagram—and now through this newsletter—is to help students avoid the mistakes I made. After tutoring hundreds of students for Step 1, I’ve refined the most effective study techniques and test-taking strategies. If I could go back and give my younger self advice, here’s EXACTLY how I would study differently:
How I Would Approach Step 1 If I Had to Do It Again:
✅ Start studying early.
As a U.S. medical student, I would study consistently from week 1 of med school, then take 6–8 weeks of dedicated study time.
If you are an IMG who is currently in medical school, I’d recommend studying alongside classes for ~2 years, then take dedicated study time for at least 8 weeks. This means starting about two years before taking Step 1, but if that’s not possible, the best time to start is now—just be consistent.
If you are an IMG who has graduated, I recommend 3–9 months of dedicated study time.
Dedicated study time means focusing entirely on Step 1, without school or work commitments.
✅ Create a detailed, flexible study schedule.
Plan every day down to the hour, but adjust as needed. This is called time blocking – an incredibly effective technique for productivity.
Make sure to include time for practice questions, spaced repetition, and some content review. And just as important – schedule time off from studying to prevent burnout.
✅ Use only 2–4 high-yield resources.
Learning one or two resources deeply is far more effective than knowing a little bit from ten different ones. One of these should always be a question bank, with the others focused on content review.
Every Step 1 resource contains the same core information, so the key is finding what works best for you and sticking with it. Studying from too many sources shifts your focus to quantity over quality studying.
It’s also important to note that Anki or other flashcard tools aren’t separate resources but rather learning tools to reinforce information.
✅ Prioritize practice questions over passive review.
Research shows that a higher amount of unique practice questions completed strongly correlates with higher USMLE scores. The majority of your study hours should be spent on active learning – practice questions, Anki cards, and teaching the material.
✅ Do 80–120 UWorld questions daily during dedicated.
Start smaller (even 40 per day) and gradually increase. During your dedicated study time, you should be doing 80-120 questions daily. This will build the endurance needed for the 280-question Step 1 exam.
✅ Stop panicking over low UWorld scores.
It’s completely normal to start with very low scores (such as 30s and 40s). Other students may not admit this to you – but everyone starts with scores like this. Instead of being discouraged, focus on learning from the questions, and use them as a learning tool.
✅ Make my own effective Anki cards for incorrects.
Making your own Anki cards helps you remember information better because you need to think critically about the topics to generate good, clear questions from them. Additionally, creating your own cards helps you focus on the areas that are weaknesses uniquely for you– something pre-made decks can’t do.
✅ Study 10–12 hours daily, but take one day off per week.
This will help ensure you stay on track with your study schedule and also build endurance to take an 8 hour long exam. Take one day off every week to prevent burn out and make sure you plan something fun for days off!
✅ Take one practice exam per week during dedicated.
Make sure to review EVERY practice exam thoroughly and adjust the study plan accordingly, incorporating more study time for the areas with lower scores.
If you are an IMG, I recommend spreading out your practice exams more and not doing the first one until you have done at least one full pass of the material.
✅ Learn USMLE-specific test-taking strategies.
I’ve helped students significantly improve their scores just by teaching them how to approach questions strategically. Strong test-taking skills alone can boost Step 1 scores by 5 to 10%—possibly even more—without any additional content review.
Looking back, I would absolutely invest in working with an experienced tutor, which would have saved me time and taught me essential test-taking techniques that aren’t covered in medical school.
✅ Exercise regularly.
There is a lot of research that shows exercise boosts energy, memory, and productivity. At minimum, I would at least take a 30 minute – 1 hour walk every day.
✅ Research & use productivity and focus hacks.
Techniques like time blocking, establishing routines, and timing caffeine properly can make studying significantly more efficient.
I didn’t learn about these productivity strategies until I was studying for Step 2, but they made a huge difference. I’ll be sharing more of these techniques in future newsletters—so stay tuned!
✅ Adopt a growth mindset.
Studying for Step 1 isn’t easy. There will be days when the material feels overwhelming, or life gets in the way. But, real growth happens when you push through discomfort and keep going, especially when it’s hard. Struggles and setbacks are just part of the process.
“Success is not built on success. It’s built on failure. It’s built on frustration. Sometimes it’s built on catastrophe.” — Sumner Redstone
✅ Remind myself why I’m doing this.
Studying for Step 1 is temporary, but the knowledge you will gain will help you be a better physician for your future patients.
My own difficult Step 1 journey led me to develop better study techniques—ones I’ve refined even further as a tutor. I’ve been sharing these strategies on Instagram, and now I’ll be sharing even more through this newsletter.
Want a Step-by-Step Plan?
If you found this advice helpful and want a detailed, step-by-step guide to creating your own study plan, check out my 100+ page Step 1 Strategies eBook here. It’s currently on a discount for a limited time and packed with everything I wish I had known from the start.
Thanks for reading,
Dr. Alina