I took Step I last June and did pretty well (265+ / 99). I didn't crack a single book until around March, and then I started studying sporadically, probably around 2-4 hours a day while I tried balancing classes with ongoing lab work and a week-long trip to Europe to help present at a conference. As soon as school ended, I kicked it into high gear and probably studied 12-16 hours a day for about 3 weeks. The key for me was to save almost all of my practice questions until this final 3 week period, during which I did all of Q-Bank (2000 questions), all of WebPath (1000+ questions) and all of the free released USMLE items (which I found to be the most representative of the actual exam, albeit slightly easier). Here is some general study tips for the Step I exam that I prepared for a panel we gave for the second year class (book recommendations are at the end):/ q( d0 E+ L* r0 D8 A# I

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7 T7 S" k/ |" [ ]6 r+ s; {$ gWhen to take it:
5 }* O) P% e* a- X( |4 a1) Be sure not to schedule the exam for late June, as you really need at least a week or two (at least!) to decompress after the Boards before starting rotations. Taking the exam in May could be too early, as it allows little dedicated study time after school ends. Scheduling the exam for early to mid-June is ideal.
6 ]. C/ q6 j R% n6 e: V8 `2) You can always change your test to a later date, if you are truly desperate. Don?t worry about running out of study time.# x& |- u' {- B. b5 f. P4 C

3 N$ n" I+ H. V: M7 A" e( g7 CWhere to take it:
@ }; W2 Z& N# P: t1) Consider taking the exam at home rather than in the city of your med school. You can study in a supportive atmosphere (and enjoy decent food!), while also escaping the inevitable tension that envelops the med school area as the Boards approach. However, if you are someone who is easily distracted at home, or if you don?t have a good Internet connection at home (for the Kaplan Q-Bank questions), then this may not be a wise option for you. 2 q: R/ X! ~0 R S3 u* ~
2) Be sure to register for the USMLE early so that you get the location you want! Also, be sure to visit the site a couple of days before the exam so that you know the area well and there are no surprises.9 Y; K" k1 ~1 C' J$ o4 s; S

% Q" D |1 k% V0 uWhen to start studying: ( y7 u) n# y8 F+ o+ {$ {; I
1) DON?T start studying too early! Starting around March is perfect.
, \: Y, ~4 z q' j8 g. U3 J% S& x2) There are some things you can do right now, though, that will aid you in studying down the road. The organ-system pathology you learn this year lies at the heart of the USMLE Step I, so while you are learning the material for the first time, you can read some of the appropriate sections in the review books you will use later on, which should help you remember it better. As I was learning each block of pathophysiology in class, I read the corresponding sections in BRS Pathology and BRS Physiology, and I answered the appropriate questions in the Robbins? Pathology question book.
- `# e+ o6 c: U, ^9 ^) w4 L3) Remember, all of the material this year will return on the Boards and throughout your 3rd year clerkships, so be sure to learn it well the first time, not just well enough to pass the block exams! i6 i# o5 D: G7 m/ L% P: \

7 W$ c8 E3 ]/ wGeneral Studying Strategies: , R6 N; T) f. L4 i" D3 j$ q
1) The one aspect of studying that I think is crucial for everyone is to develop a REGIMENTED schedule! Set concrete goals for yourself with a definite schedule, and then meet them. For example, I allotted 3 days to review BRS pathology, 2 days to review BRS physiology, a week to review First-Aid, etc. I also chose to save all the Q-Bank questions to do at once soon before the exam rather than spread out over months, so I made a goal of completing 300 Q-Bank questions a day for a week.
* g% D3 K. a; ^. k2 n6 a k! x3 R2) When making your study schedule, be sure to give yourself at least 1 ? 2 weeks of ?safety-cushion? time at the very end, as you will invariably run over your schedule at some point.
2 ^# A2 D0 h6 S1 {2 s3) Consider having a ?master source? where you transcribe all of your study notes. For example, many people my year annotated any new facts that they learned in their First-Aid books, so that near the end of their studying, they only had to consult this one source.
6 a2 Y/ h1 `# a4 H4) Do not use too many review questions too early. The practice questions are most useful after you have already studied some, so don?t feel as if you must start practice questions before the last month of your studying. The one exception, I would say, is for the Robbins Pathology questions, which are especially helpful if you start them now during your classes." W' s; c: O/ H; B4 `
5) Finally, a word about study groups. If you are someone who benefits from study groups, then definitely consider joining one, but DO NOT use study groups as a time to learn or review material. There is simply too much material to learn unless you spend 8+ hours a day with your study group. Study groups are best used to discuss questions that you encountered that you don?t understand the answers to.6 }0 u& |8 z3 O
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What to Study: The following are resources that I used, with an asterix to indicate the relative value& X# F" J* R0 v6 g5 P& e u4 j; }
****First-Aid for the USMLE Step I: This book is simply exceptional! Although its format is off-putting to some, it is an amazing compilation of info you need to know, and you should really strive to memorize almost the whole book. Its Anatomy, Pharmacology and Behavioral Sciences sections are especially useful, encompassing almost all of what you need to know of these subjects (especially for Pharm).
8 F) f2 w1 {9 F5 T1 \" ^****BRS Pathology: Another heaven-sent tool for med students. An imposing book, but again try to memorize all of it, as almost all will be fair game on the USMLE. Best to use early during the year.! G" p+ L. m- t! ?. |, w: S
****BRS Physiology: A terrific synopsis of all the physiology you need?a big topic on the USMLE.' G$ E3 \1 K3 `; N, x
***Kaplan Q-Bank: A great practice tool, as it uses the real USMLE computer-interface. Wait until they offer the group discount before buying it. Make sure you do every question (2000+), and read all the answers (even for the questions you got right!). I personally like doing the questions in large batches towards the end of studying, rather than spreading them out over several months (you forget too much that way). Also, it is very important that you have a pen and paper with you always when you are answering these questions?write down every fact that you didn?t know (even if you think you will learn it later on). I have close to 20 pages of legal paper inscribed with facts from Q-bank, and this is what I studied the night before the USMLE. Don?t panic?the Q-Bank questions are usually much harder than the real exam, and the real exam isn?t quite as fact-specific as the Q-Bank questions.- e' `8 g6 O8 w3 g
***Released USMLE items: These can be downloaded at (http://www.usmle.org/step1/default.htm). Even though only ~250 items are released, these were probably the questions most representative of what I had on the actual test day. Yes, these questions are a bit easier than the real thing, but not by much.7 O/ J1 Q- [6 g3 g3 U! g
***Robbin?s Pathological Basis of Disease- Self-Assessment and Review: This book is a great deal, especially if you can buy it off of a 3rd or 4th year. The questions and especially explanations are fantastic (the questions are much more difficult than the actual exam, though, so don?t panic). This resource is especially valuable to use starting in your actual second year classes.
/ N1 n' a. `4 f' S***WebPath questions: a free set of over a thousand questions, often with path pictures. Found at (http://medlib.med.utah.edu/WebPath/EXAM/EXAMIDX.html). These questions go quickly, and they are very similar to USMLE questions. Again, write down any facts that you didn?t know that you encounter in these questions.2 v4 D& }/ \, p1 X; M. k, R$ [* d
***High-Yield Microbiology: This book was fantastic! A really great synopsis of micro, covering all you need.
+ v; e& S; P; Q8 y @, x***High-Yield Neuroanatomy: Even though only a few questions on the exam will concern neuroanatomy or neuroscience, spending a day or two with this book is a worthwhile investment. Be sure to learn about the different types of headaches?I had about 5 questions on this subject on my actual exam!
2 a4 {6 O* i, L, `8 a# z***BRS or High-Yield Behavioral Sciences: Truthfully, I didn?t use either of these (I had the Kaplan Behavioral Sciences notes from my job), but these are great resources for a field that is often overlooked, but comprises a surprising proportion of questions on the USMLE. About 10% of the exam is Behavioral Sciences!
; M/ B% W7 P" ~) h/ @! K v" Y***Micro Cards or Pharm Cards: I didn?t use these, but people who had them seemed to like them. They seemed to spend a bit too much time on these subjects, though?neither of these subjects is covered as much as Path or Physiology.3 _3 e; e6 N, J
**Lippincott?s Illustrated Biochemistry: One of the first books I read when I started studying was to quickly review all of this book. It is easy to bog down in this book, though. Biochemistry isn?t a huge topic on the Boards, so the Biochem reviewed in First-Aid is in many cases enough. Be sure to know all the diseases that occur when various lipid products accumulate (Hurler?s, Hunter?s, Tay-Sachs, etc.).9 s: {$ V# Z% O( i$ w/ }6 g# ]
**High-Yield Anatomy: Useful if you have the time, but anatomy questions make up a small portion of the exam (be sure you know the innervation of the hand, though!). Perhaps a better resource would be to just read the Blue boxes throughout Big Moore Clinical Anatomy.
5 P# n( K( `+ ]3 f9 V+ `**Step-Up for the USMLE I: This is an organ-system based book, and if you learn better that way, you may like this format more than First-Aid. I found, though, that this book didn?t quite have the same depth of coverage as First-Aid.6 M$ J* Z" j2 {! R
*High-Yield Embryology: Devote at most a day to this topic, as it is barely covered on the exam.4 A0 F; g- t* e" v: [9 C/ Q
*Pathophysiology for the Boards & Wards: A good book, but covers a lot of clinical information that won?t be tested on the Boards.

Okay here is mine. Keep in mind I'm a dumbass, who forgets where I park my car twice a day, once in the morning, and again after school. I'm always walking around the parking lot trying to remember where I parked my car and what level. So I need massive amounts of repetition and questions to retain anything. Also that I've read all these books once already while following along these subjects in class. So hopefully when I get out of school these books won't be to hard to review.
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1. Anatomy-HY anat, HY neuro, HY embryo, HY histo
, u8 e) E$ D6 y. P2. Behavioral Sci-HY Beh Sci8 @' T- S- A- z% {3 f( B
3. Bio chem-HY bio chem, HY molecular bio
J4 ]& K- `5 E/ t6 k3 m4. Micro/Immuno-Micro made ridiculously simple, Medical micro & immuno exam and board review by levinson and Jawetz (just the immuno section)' d* P! p* i! e# i+ J
5. Path-Stars Pathology Review by goljan, robbins review of path done first time during christmas vacation (~70%) did it again 4 weeks b4 exam, goljan audio (listen to while working out, gone threw them 5 times from Aug-Dec of 2nd year).
: g* ^. | f$ z0 N- d4 r9 k6. Pharm-Kaplan lecture notes
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8. Question books- Kaplan Q book, Appleton & Lange question book, did subjects will following along with class. k! F# W: J4 l' m T, B( _
9. Comprehensive sources-Web prep listen to while working out (tryin to learn via osmosis) started in Jan almost finished second time threw except for path and micro. FA 2005 started in Jan.* C/ s0 `& }) @( R$ P/ i+ G
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Things finished after last final exam.
( B/ [: @1 \. ]-CBSE 88~245 (10 weeks b4 exam).
2 B) w9 {' f6 C-BSS ~72%, started in jan doing 50 Qs/day/5 days a week (finished 9 weeks b4 exam).- N" H0 s1 l6 ?
-Qbank 78%, all random, all timed (finished 5 weeks b4 exam).9 U! R/ N) d1 b9 E0 k
-Step 1 released items (41,43,44)=85% (4 weeks b4 exam).1 z) o' ^' b# {
-NMS 78% (3 weeks b4 exam). k! H/ M7 p) Q5 y& t8 \
-Kaplan full length simulated 77% (3 weeks b4 exam).
* g& ?2 m+ X P* H-Blueprints 85% (2 1/2 weeks b4 exam).: h# g* ^& Z& k% b4 E) x
-Pretest vignettes 76% (2 1/2 weeks b4 exam).
% C$ f2 Y# ?9 h! H-Rapid review usmle step 1 qbook 80% (2 weeks b4 exam).6 {! X0 w' s0 R* x+ \6 r
-Blackwell free online exam 80% (2 weeks b4 exam).
. x1 y7 o* V! v" R- b4 p d; l6 q-NBME form 1 670~252 (10 days b4 exam).8 v# W3 x3 w9 \& \- x
-NBME form 2 710~257 (5 days b4 D-day).
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, a8 L. S) Z) y3 B$ o6 oOkay to answer some questions about which question resources are better, if I had to rank which question sources in order of importance. It would be:, t) D8 C+ H3 ^& P( O
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1. Robins review of path, idiopathic got me hooked on this one, after doing this twice all other path questions seem easy by comparsion.
+ p7 D2 j9 s/ s( V/ {9 ]; J8 k/ I2. Board Simulator Series a guy named Dr. Cuts (carribean grad who matched rads) told me about this. This series doesn't represent the current testing format but I've seem to learn the bread and butter from this comprehensive source. One poster once said it is like training with heavy weights, other questions after are just light reps. Requires some time to get threw them all. The body systems books are pretty good, lots of thinking and questions with arrows going up and down. The basic concepts and normal/abnormal books not as good, more like factoid memorization.
$ K1 A- g: { H( w+ h3. Qbook and Appleton & Lange (big frank and omarsaleh introduced me to this one) rank about the same good basics to practice after having reviewed the subject.
# p% u, f! o& v* R% ^# X/ u, L" x4. Qbank I didn't like it to much, I didn't think I learned to much from it except for how to pace myself under timed conditions, deal with doing random blocks and guessing when you get 5-10 question in a row that make you say WTF. But you just have to do it cause you're just afraid that you'll be missing out on what others have learned.2 ?; F Y' r( {/ X; S3 J& ^
5. Pre test clinical vingettes for the usmle step 1, big frank recommended, good thinking questions.
. G |2 _" g4 L6. Blueprints Q&A, Rapid Review for the usmle step 1, and Blackwells online exam are like icing on the cake, mostly vingettes. The only reason they rank so low is because I've already seen most of what they are testing from other sources, but are good if you don't have the time to get threw BSS. 6 n/ k W$ V5 k7 B8 f) {
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The one I thought sucked a$$ was NMS alot of nit picky detail (eg SH2 second messenger after Tyrosine kinase, and TF2D binds tata box)." |- P9 T B, c' \6 N4 W R2 t
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As for how did I have time to do all these question I learned from Big frank and idio that those guys started like nov and dec of second year. These guys are also top ranked in their class, so an average guy like me would have to put in at least as much effort to get any where near them. I couldn't get myself to start that early but I did start after partying my a$$ off on new years. BF went ocd with the FA on the toilet thing, Jalby read big robbins cover to cover, idio did ~11,000 questions. I liked idios idea and did questions. I would do them during my lunch, and by the time school got out I had finished robbins review, BSS, Kaplan Qbook and A&L. I also tend to get sleepy after staring at a reveiw book for more then 3 hours so I did questions for the rest of the day during the 8 weeks that I've been out of school studying for boards.1 Y( p4 |; k# E
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I've gotten several PMs for my study schedule to I've added it to this post.
9 |; M) y+ ^$ A$ s' ]So here it goes, started the day after new years:
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-Jan first 2 weeks was still out of school so spent it on my weakest subject pharm (poorly taught as an after thought at my organ/systems school). ~10 hours a day/6 days a week X 2 weeks. First reading kaplan pharm notes, then memorizing FA pharm, then doing pharm questions from BRS pharm, Qbook, A&L. Next 2 weeks in Jan physio BRS, FA physio, physio Q's from brs, Qboook, A&L. School started so studied for class first then would spend about 2 hours a day/ 5 days a week board studying. Also started doing BSS ~50 Qs a day/5 days a week during my lunch break at school.
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$ j+ ~! A8 y8 M/ V-Feb first 2 weeks Bio chem HY,FA Bio chem, Qs from BRS bio chem,Qbook and A&L. Again 2 hours/day/5day/week while still studying for class and ~50 Qs/day/5 day/week from BSS keeping this pattern threw out 6 month of studying. Next 2 weeks micro/immuno MMMRS, the lange book for immuno and FA micro. Micro/immuno Qs from brs,qbook, a&L.
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8 j) u0 N% x* `1 i1 }-March first 3 weeks anatomy hy, neuro hy, histo hy, FA anatomy, Qs from brs, qbook, a&l. 1 week of behavioral sci HY and FA and Qs from that subject." [. K) J6 S+ l4 D' O

$ |- K4 J% V4 k-April first 2 week path goljans review, FA path, and path Qs from above subject books, and was finishing up on BSS by now. Last 2 weeks in april out of school and began dedicated board studying$ H& a v. v# A' G$ U. S

! U- A# V, b4 R i) r-I had 8 weeks of dedicated board studying. Day began with 100 Qbank Qs done random and timed (finished q bank in 3 weeks, and a 4th week to do Qs that I got wrong over again). Then studied a subject for about 6-8 hours and then did more qestions at night 50-100 from other sources on that subject that I studied during the day. Did 3 day cycle of subject, example 3 days pharm, 3 days physio, 3 days BC, 3 days micro/immun, 4 days anatomy/histo/neuro, 2 days BS. Repeated cycle again but this time 2 day, then cylced again 1 day. When I finished q bank I did other sources instead.2 i, Q( S; K/ Q- |- D/ g
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-One week before the exam just went over FA over and over again. Day before exam chilled out, did my laundry and packed my bags for my trip to Hawaii. Day of exam took exam first 2 blocks without a brake, each block after 5 minute bathroom brake in between each block and one peanut butter power bar brake. I think I was done a little after 4, and by 7:30 was on a plan to Hawaii with my GF. Good luck all and hope this long post helps.

Posted by HMS '05.