USMLE Step 1: Leading up to the Dedicated Period


Depending on your medical school’s curriculum, you might be juggling courses with studying for USMLE Step 1 in the months leading up to the dedicated Step 1 study period (also known as “dedicated”).

There are different ways to approach your dedicated study period for Step 1. Traditionally, some students like to focus only on their school’s curriculum during each block, ensuring they fully understand the coursework taught in their school’s lectures. However, there are certain high-yield resources that we recommend that need to be covered before you take your exam. For this reason, students often have a 4-8 week dedicated period to focus on these high-yield resources and to learn how to ace the test.

On the other hand, some students may simultaneously review board material along with their school’s curriculum. Students sometimes prefer this method since all of the preparation leading up to dedication dampens the pressure and time-crunch felt during dedication.

Regardless of your study approach, the high-yield resources still hold true for either. Using a traditional dedicated period, at a minimum, your goal during this period is simple: complete a first pass through all your study resources (i.e., UFAPS = UWorld, First Aid, Pathoma, Sketchy).

It is imperative that you create a study schedule so that you can get through these resources methodically. This post will provide advice on how to organize your Step 1 studying in the months leading up to the dedicated period.

After this post, we recommend reading: USMLE Step 1 – Dedicated Study Period Schedule.


1 | Finish the UWorld Question Bank

UWorld is arguably your best study resource. It is highly recommended that you go through the question bank at least twice before taking Step 1. This demanding task is made easier for you if you complete the first pass before dedicated and the second pass during dedicated. Here are three suggestions for approaching this challenge:

Set and Complete a Daily Question Quota

Firstly, set and complete a daily question quota so that you complete the entire question bank before dedicated starts. Calculate your daily quota by dividing how many days you have left before dedicated starts and how many unanswered questions you have left on UWorld.

Reduce the quota on weekdays or on days leading up to your block exams or other commitments, and increase the quota on weekends or other relatively free chunks of time. If you have an organ block exam coming up (e.g., Cardiology), do all the cardio-related questions until the week before the block exam so that these will be fresh in your mind when you take the exam.

A question block a day means you’re well on your way.

Simulate Exam Conditions

Secondly, simulate exam conditions whenever you do a question block. This means on your computer, timed, no Tutor mode, and >10 questions. If you are doing UWorld questions during your first pass during your organ system blocks, you can set it up by organ system. However, once during your dedicated period, set the questions to be random (covering multiple topics). This is the most accurate representation of what to expect on the actual test.

Try not to worry if you are getting demoralizing low scores. The point of the first pass through UWorld is to get used to the demanding pace of the exam and learn from your mistakes. This is a very hard hurdle to get over mentally, but always keep in mind that your second pass will be much easier than the first.

Review Answered Questions and Keep a UWorld Journal

Thirdly, review all answered questions closely and keep a UWorld journal using your preferred medium (e.g., Anki deck, paper flashcards, Word document, notebook).

Condense the explanations into bite-sized chunks that are organized by disease, treatment, or clinical finding. If you got the question wrong, write down the information from the explanation that helps you understand what the right answer should be.

Start by rephrasing the learning point listed at the bottom of the UWorld explanation. This journal is an invaluable study resource during dedicated because it allows you to quickly review condensed concepts that are written in your own words.


2 | Get Through First Aid and Pathoma

The goal here is to get through First Aid and Pathoma at least once before dedicated. Calculate and adhere to a daily quota as best you can. If you miss a day because you are sick or too busy studying for a block exam, endeavor to find a chunk of time where you can play catch up.

Organize it so that you go through the First Aid and Pathoma blocks that correspond to each other and to your current block in school (e.g., if you are on Cardio block, skim through the relevant First Aid and Pathoma chapters).

Alternatively, students may review the same content found in First Aid and Pathoma; however, in the form of a premade Anki deck, such as the AnKing, Zanki, or Duke’s Pathoma decks. Students usually start Anki decks during their pre-dedicated period, so all the material is mostly covered by dedicated. Find the student strategy that works for you and stick with it.


3 | Watch Sketchy Medical Videos During Meals

Maximize your study time by watching Sketchy Medical videos while you are eating instead of watching TV. Consider Sketchy videos as a form of low-stress studying that you can do while taking a break from the high-stress exercise of getting through UWorld blocks or the monotony of wading through First Aid or Pathoma chapters.

Start with the Sketchy Micro videos, as they are the most high-yield and time-tested videos. If you find yourself needing help with pharmacology and have extra time, consider watching the Sketchy Pharm videos if your schedule allows.


4 | Maintain Your Performance in Your Medical School Courses

It is both natural and wise to spend the bulk of your mental energy on studying for USMLE Step 1 instead of your medical school’s block exams. This is especially true if your medical school has a pass/fail grading system for the preclinical years. However, you still have to pass your exams and complete your other commitments.

Spend about one-third of your day keeping abreast of coursework by attending or watching lectures. Spend the remaining two-thirds going through UFAPS. Switch to nearly 100% focus on coursework in the days leading up to your exam, and cram material so that you can pass the exam.


Final Remarks

The key to learning the mountain of material required to do well on Step 1 is to go through your study resources multiple times. It is thus important to complete your first pass through the material before you begin your dedicated Step 1 study period.

Your first pass will likely be mentally exhausting, and it is natural to feel demoralized by both your poor performance and the perception that you are only absorbing a fraction of the “fire hose” of information. Know that all your hard work will pay off and that the second (or even third) time you go through UFAPS, your scores will be much improved, and you will surprise yourself with how much you actually picked up the first time around.

If your USMLE Step 1 practice test scores aren’t where you want them to be, don’t leave it up to chance. Med School Insiders offers premium tutoring for Step 1 in addition to other medical school courses and exams. Our tutors excelled on the test themselves and utilized the tried and true Med School Insiders methodology. Ultimately, that means a significantly smoother study experience, reduced test anxiety, and a passing score.

Learn How USMLE Step 1 Pass/Fail is Changing Medical School. We cover Step 1 and other testing strategies on our blog, including What I Wish I Knew Before Taking USMLE Step 1 and 4 Mistakes to Avoid When Studying for Step 1.


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