Tips From a Physician: Getting Into the Step 1 Mindset

Sean Robert Huff, MD - Feb 18, 2021

No matter how much research and preparation you’ve completed, the USMLE® Step 1 exam is a big undertaking for any medical student. Whether taken in the pre-clinical years or at a later stage of your medical education, the undeniable fact is that Step 1 poses challenges unlike those of other exams.

For starters, the medical content featured on Step 1 is not only broad but deep. In other words, those preparing for Step 1 will have to master both a wide range of topics and a large amount of information about each potential topic. This cognitively difficult task is further complicated by the sheer amount of time needed to complete it; a successful Step 1 study process takes place over many months, not weeks.

Despite these challenges, the Step 1 exam presents all medical students with the opportunity to polish previously studied material, expand their knowledge of undiscovered medical content, and take a big step (no pun intended) toward medical licensure.

Whether you are just starting to think about it or are ready to take the dive into studying for Step 1, keep these tips in mind:

1. Reflect on your medical school experiences

As a general rule, it’s good to reflect on how far you’ve come before deciding in which direction to go next. This is especially important for Step 1 given the years-long learning that leads up to the exam.

Start by first reflecting on your curriculum. Are there core Step 1 topics you haven’t covered yet, partially or in full? As the majority of Step 1 studying should actually be content review rather than first-time learning, it may be best to save this content for later on during your study period. This should increase the efficiency of your Step 1-specific study activities and also reduce frustration.

Next, consider your own personal learning style or the type of curriculum at your school. Perhaps your school places special emphasis on problem-based learning? If so, you may have already developed the critical eye needed to parse a Step 1 question stem, and a high-yield lecture series or factful review book may provide more value to you than other students. 

Alternatively, lecture-heavy curricula can have the unintended consequence of causing students’ critical thinking to rust somewhat; pairing your lecture review with question-based practice is essential to remaining a nimble thinker. This you can achieve by diving into the AMBOSS Qbank, and answering questions. The detailed answer explanations will show you why you got something right, or why you go it wrong, so you can learn it for next time. 

2. Research with a critical eye

When plotting your approach to the Step 1 exam, you should keep an open mind and be receptive to different opinions. One unfortunate consequence of Step 1’s significance is that it can be easy for an echo chamber to form regarding a particular study technique or set of research choices.

To find the Step 1 approach that works for you, it is important to collect information from a variety of resources and think critically about each of them. Consider, for example, that students from different schools take Step 1 at different times; failure to place their insights within the timeline of your curriculum could leave you feeling overwhelmed or out of time. 

That’s why it’s better to also consult the students and faculty in your own environment, as they are more aware of contextual nuances relevant to you. 

Likewise, not all resources that work for others will help you achieve your best score. Of course, certain study principles are firmly established and well-suited to most students. For example, it is very efficient to review video- or text-based resources before consolidating that information with practice questions. Furthermore, research indicates that the best predictor of your Step 1 performance is the amount of unique (i.e., not repeat) Step 1-style questions you complete before test day.

Nevertheless, something that should work in practice may not be a great match for your particular style or needs. That’s why it’s important not to use the opinions of others as a stand-in for your own experience and insights.

3. Make a plan

Given the size and scope of the challenge that Step 1 poses, it’s best to decide on a plan of action. Not all plans are created equal, however. Whether in your medical education or another area of your life, successful plans share common characteristics.

One such characteristic is setting a measurable goal. This goal may pertain to your performance on the exam or the amount of study resources you complete before test day. Either way, first decide on a goal, and let all matters of timing and effort follow from that.

Another characteristic of successful plans is the ability to track progress and maintain accountability. If your goal is performance-based, it’s best to distribute self-assessments throughout your study plan that may act as checkpoints. One such self-assessment is the annual AMBOSS Step 1 Self-Assessment Week. More than 75% of all students studying for Step 1 signed up to take it in 2021, making it the biggest and most representative assessment ever!

For tracking the day-to-day grind of studying, nothing beats a task manager, calendar, or study planner. 

One golden rule that’s easy to forget: people often underestimate the amount of time it takes to complete long term projects by 30% or more!

4. Remain kind to yourself

No matter how well researched or thought out, no plan should be set in stone. After all, a study plan is merely a guide intended to make it easier for you to manage your time and simplify decision-making.

Flexibility during the execution stage is critical as life is not only unpredictable, but also challenging; studying for Step 1 will likely cause moments of stress, uncertainty, and frustration. Therefore, it is critical to make peace with these aspects of your own humanity and adopt a study approach or plan suitable to all aspects of your life. Believe in yourself and trust the process!


To get more detailed insights into taking the Step 1 exam, check out the webinar with AMBOSS Chief Editor and physician, Zebulon Tolman.