8 hours in an exam room… Yet somehow the exam feels like it’s over the minute you sit down to take it. Sound familiar? Yeah, sorry for bringing back any negative memories of the MCAT you may still be holding onto… But good news! The length of the two exams is really where the similarities start and end. And while STEP 1 might technically be a more difficult exam, your preparation will start Day 1 of medical school. You got this!

So how does one prepare for such a daunting exam? As I said above, your preparation truly does start your first day of medical school. This is not to say that you should have already purchased UWorld, the main question bank used by medical students, before your first day of class. However, you should make sure to keep up with the material being taught in class. It is very easy to get behind in medical school, and a few months in it might feel impossible to catch up!

If your medical school is anything like mine, after each block/module you will have a final exam. This exam will likely be made courtesy of the NBME (i.e. National Board of Medical Examiners). In theory, the questions you will see on these exams will be similar to the questions you ultimately see on test day when you sit for STEP 1. Many of the questions on NBME exams are in fact recycled questions from old STEP 1 exams. Therefore it is in your best interest to do well on these exams, as they can be predictive of your future performance on STEP 1.

You might be asking yourself, “what resources should I be using to prepare for STEP 1?” This is a great question, one that I was consistently going back and forth on throughout the first two years of medical school. From my experience, I would say that First Aid is a definite must. No matter what other resources you decide to use (e.g. Boards and Beyond, Pathoma, Anki, UWorld, etc.) always make sure to go back to First Aid. This will help you frame the information you have just learned, and there is space in the margins for annotation. If your First Aid book is not worn out and full of notes by the end of your first two years of medical school, then you probably aren’t studying right!

Now it is important to note that there have been recent changes to STEP 1 that will likely affect the person reading this blog post. While I was studying for my STEP 1 exam during my M2 year, I received an email from my school that the NBME was in the process of making STEP 1 pass/fail. However, this change would be made effective the following year (i.e. the first class that would be affected by this change was the M1 class in the year below me).

When I received this email, I had a mixture of emotions. On one hand, I was studying so hard for an exam that would determine my future in medicine. The score I would receive on STEP 1 would go a long way in determining which specialties I could or could not potentially go into. With this in mind, it did not seem fair that the M1 class would essentially be given an easier path through the first STEP exam. But then I realized that more pressure and emphasis would be placed on STEP 2. In my opinion, it is too early to know the downstream effects of this change to STEP 1. However, from anecdotal accounts in the class below me, I have heard that there has been an increase in failure rate. I am not saying this to scare you, but it is human nature to relax a little when you know that “the exam is just pass/fail.” My advice would be to study as if you were going to receive a score to make sure you do not fall into this trap!

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