Should You Prepare for Step 1 Before the Dedicated Study Period?

Bliss Chang

Bio: Bliss is a fourth-year medical student at Harvard. He applied into Internal Medicine with hopes of pursuing a Cardiology fellowship. He is an avid mentor and passionate medical educator currently working on two books for medical students. In his spare time, he travels the world with the hopes of visiting every country.

March 28, 2020 |

In this article, we’ll explore whether preparing prior to the dedicated study period is beneficial and whether this is a potential path for you.

The Value of Prepping for Step 1 Before Dedicated

The Key Ingredient to a High Step 1 Score

As a senior medical student who scored in the top percentile for Step 1, and having helped many students with their Step 1 studies, I can say with confidence that the secret to a stellar Step 1 score is simply hard work. The exact amount of work varies between students, but ultimately this is derived from time invested and efficiency of studying. Most students will have similar efficiencies of studying (for strategies on maximizing your Step 1 study time, look out for a post next month!), so this really leaves us with time invested as the key variable for Step 1 success. Let me say that again – if you want to score better, you need to first and foremost devote more time to studying for USMLE© Step 1.

Limited Time

There is only a finite amount of time during a dedicated study period, which usually ranges between 4 and 8 weeks. This time is plenty to score well on the Step 1 exam, but that doesn’t necessarily mean it is enough time to achieve your personal Step 1 goals under your own circumstances. Everyone is different – there will be someone who can study nothing before dedicated and obtain a very high score; on the other hand, there are people who can study a lot before dedicated and obtain an average score. The best rule here is simply to be honest with yourself: Are you historically a good test-taker? Are you on course for a strong mastery of preclinical content?

If you answered yes to both questions, you’re probably okay to study only during dedicated. If you answered no to both, you should probably plan on studying a little more before dedicated. If your answer is in between, it really depends on your goals and what you want out of your Step 1 score.

Career Goals

It’s never too early to start thinking about your career goals. Even as a first-year medical student, there is probably some aspects or fields of medicine that spark more interest than others. You should use your time outside of lectures in part to explore your interests – knowing what you want to do after you graduate is very beneficial as you can begin tailoring what you do to help you get there. As an undifferentiated medical student, however, it is best to keep your options open.

Based on your goals, the importance of Step 1 may change and the extent to which you will need to do well on the exam as well. There are numerous reasons why you may want to do very well or not on the exam. First and foremost, you should consider which specialties you are currently interested in. Are any of them highly competitive specialties (e.g. neurosurgery, orthopedics, plastics) that place high value on Step 1 scores? A good place to get a sense for the average Step 1 score per specialty is on the NRMP website. Next, consider what type of residency program you’re interested in – programs that are academic and/or in big cities likely have more competitive applicants and as a result a higher Step 1 average. If you aren’t sure of your goals, just keep your doors as wide open as possible, meaning shoot for somewhere around 240-250.

That being said, there are only a few benefits to truly acing the exam (>250) since programs will typically not provide significant boosts in their evaluation of you based on a score greater than 250. One benefit is being able to command credibility and tutor underclassmen, often at a lucrative rate. If side hustling is your thing, you may want to consider your Step 1 score as an investment on your future earning potential. Next, students that do very well will almost always have a superior command of the basic science knowledge compared to the average medical student, and this can really come in handy during clinical rotations when your teams who are often far removed from the basic sciences become curious about the pathophysiology or mechanisms of a disease. This is an opportunity to actually contribute (a lot) to your team! If these are things that you seek, you will need to invest more time to studying for Step 1 than other students.

To recap, you should study before dedicated if you:

  • Want to really ace the exam
  • Are a poor test-taker
  • Have been performing below average in your preclinical courses
  • Want more assurance that you will reach your goals

Dedicated Before Dedicated?

So, if you’ve decided to prepare for Step 1 prior to dedicated, I think you’ve made the right decision. To me, I think our first and foremost duty is to care for patients, and the more we know, the better care we can deliver. Sure, Google is convenient and accessible, but there are many situations where having an understanding of the basic sciences can really enhance your ability to think through unfamiliar cases fluidly and quickly. I also think Step 1 is a great way to prepare for during the preclinical years as opposed to all the nitty-gritty of your professor’s lectures, because Step 1 emphasizes the content that is most high-yield for your future practice, believe it or not.

How to Study Prior to Dedicated

My recommendation for preparing for Step 1 prior to dedicated is to start with the areas in which you are weak. Seeing something more than once can do wonders for wrapping your head around the concept – sometimes, more than efficiency, you just need repetitions.

Be sure to prep the way you will be tested. This means avoid passive studying such as reading, and practice active recall such as using flashcards (Anki is great!) and question banks. For Anki decks, the Broscephalon Decks have everything you need to know from First Aid in there – I actually didn’t ever read the First Aid book. For question banks, I recommend saving UWorld for later, and avoiding Amboss as the questions are too esoteric. Pick a qbank that will encourage you to keep studying ahead of time – all you’re really trying to get out of it is encouragement and forced active recall in the form of question-answer as on the real exam.

Lastly, how much should you study? Ideally, you will cover all the Step 1 content once (a first pass) prior to dedicated. Remember, however, to start with your weakest areas. You should create a schedule that will allow you to get through what you deem necessary prior to dedicated. And remember, ideally this is no more than an hour or two each day – you want to use your free time for other things too!

That’s a wrap! Best of luck on studying before dedicated, you’ll be happy you did it!

Get in contact with us

Are you a medical student and want to write about your USMLE Step 1 experiences or a product review?