USMLE Step 1 Resources

Books

 

First Aid:

  • The de facto reference for the exam.
  • Best for quick review and refreshment of topics learned over the first two years of medical school.
  • Nearly 100% of the material in the book is ‘high-yield’; while there are certainly topics in the book more likely to be tested than others, generally, everything in it is fair game.
  • In other words, the book contains high-, and highest-yield material only.
  • Our recommendation: Highest recommendation for including in your study plan.
 
 

Pathoma:

  • A book and video set that advertises as a ‘high yield’ review of pathology.
  • It really covers physiology, pathophysiology, and classic presentations of some very commonly tested subjects.
  • Videos and chapters are short (< 1-2 hrs each) and easy to work through.
  • Dr. Sattar’s explanations are crisp and concise, and his method of presenting information makes it easy to remember.
  • Our recommendation: High

 


 

Question Banks

UWorld:

  • ~2200 challenging, lengthy, and well-written questions that most closely resemble actual USMLE questions.
  • Each comes with a detailed answer explanation which is also part of the value.
  • UWorld should be approached as both a study reference and a readiness-assessment, with emphasis on using it as a study reference and learning tool.
  • The content is just as important as (if not more important than) the process of analyzing and answering a question.
  • We often tutor using UWorld questions as a stepping off point for discussion and learning.
  • Our recommendation: Highest
 

Kaplan:

  • ~2500 questions of mixed difficulty and length, not as similar to the real test as UWorld.
  • Our philosophy, though, is that any question is a good question, since the purpose of completing questions is to cultivate active learning and spontaneous, recall of information – just as you’ll have to do on test day.
  • Purchase for extra questions and bonus review.
  • Our recommendation: Intermediate
 

USMLE-Rx (QMax-Rx):

  • ~2500 questions of mixed difficulty and length, closely parallel content in First Aid.
  • An excellent supplement of questions while reviewing First Aid.
  • Questions are not as similar as UWorld to the actual test, but they test concepts and multi-step logic effectively.
  • Purchase for extra questions and bonus review.
  • Also very useful as a warm-up or lead-in to a formal study period.
  • Our recommendation: Intermediate

 

Sample Tests

NBME Comprehensive Basic Science Self-Assessment:

  • 4-set sample tests published and sold by the NBME.
  • Contain questions from previous board exams and are sold as a means of equating a score on these tests to a predicted score on the USMLE.
  • Our experience is that the questions are a close approximation to the actual test, and that the score prediction is reliable within a range of perhaps 10-15 points.
  • An average of several of these sample tests closely predicted our actual scores within ~5 points.
  • Time commitment: 4 hours.
  • Our recommendation: Highest

“Free 150”:

  • A 3-set bank published by the NBME, intended to be as close to the actual test as possible.
  • There is no ‘score’ correlation at the end, though internet rumors abound about how your percentage on this set does/does not correlate to the actual test.
  • Use it to become comfortable with the FRED testing interface used on test day.
  • Our recommendation: High, mostly for the experience of test-day conditions. 

USMLE World Self-Assessment:

  • 4-set sample tests, sold by UWorld, that also offer a predicted score.
  • Questions are very similar to the actual USMLE, but score prediction varies.
  • High scoring students on the NBME (>260-270) tend to score lower on these tests than on the actual USMLE.
  • Middle-range students (220-240) tend to score higher on these tests than on the actual USMLE.
  • Lower range students (<210) tend to score accurately on these as compared to the actual test. 
  • Our recommendation: Intermediate, though recognize that the scores may deviate from your actual score.

 

Flash Card Sets

Lange Pharmacology Flashcards:

  • A case-based, question-stem style set of flashcards, hitting the highest yield drugs for the exam.
  • Cards cover mechanism of action, uses, and commonly tested side effects.
  • A strong supplement to First Aid’s pharmacology chapter and pharmaceuticals sections at each organ-system chapter ending.
  • If you can easily memorize drugs and their uses, you may not need this set, but it is well-prepared and concise.
  • Our recommendation: High
 
 

Lippincott Microbiology:

  • A very dense set of flashcards that could easily take the place of a great deal of the First Aid Microbiology chapter.
  • Closer in nature to a textbook distilled onto flash cards, these are not ‘tactically’ useful – they take a long time to get through, and are not easily memorized.
  • Use if you need additional microbiology help and have exhausted First Aid/SketchyMicro, otherwise, not high-yield.
  • Our recommendation: Intermediate
 
 
 

Lange Biochemistry:

  • A large set of cards covering everything from biochemical reactions (e.g. Glycolysis) to presentations of diseases resulting from inborn errors of metabolism (e.g. Glycogen Storage Diseases).
  • Essentially a rehashing of First Aid’s Biochemistry chapter, with a few added bonuses like additional metabolic diseases not covered by First Aid (note – that means they’re probably not high-yield).
  • If you wish to quiz yourself on the pathways and their intermediates, go ahead and buy these, but they are time-consuming, and are not likely to net you more than reviewing First Aid a second time.
  • Our recommendation: Intermediate

 


 

Supplemental Materials:

SketchyMicro:

  • A pictoral mnemonic method to memorize nitty-gritty details of bugs and drugs.
  • We found this tremendously helpful as a means of creating long-lasting memory of microbiology.
  • Overall, it was very useful, especially when used in tandem with First Aid.
  • Our recommendation: High
 
 
 

Firecracker:

  • A very comprehensive resource that essentially takes the place of First Aid.
  • Firecracker would be best used while memorizing basic sciences detail, in tandem with learning it during your first two years of medical school.
  • It is very comprehensive, with thousands of built-in flashcards and its own question bank, which is very challenging.
  • Of note, it would be difficult to start Firecracker from scratch during a dedicated study block.
  • It is perhaps best used as a means of long-term retention during years 1 and 2 so that you arrive at the start of your study block with a large wealth of knowledge.
  • Our recommendation: High, if used from the start.
  • Not recommended for use solely in the study period.
 
 

 

Shelf Exam Resource Guide

Question Banks:

USMLE World for Step 2 CK:

  • Invaluable.
  • The content and style of questions is challenging, requiring multiple logic steps. This question bank should be a part of every third-year student’s study plan. There are few, if any, errors or misguiding questions. The answer explanations are packed with valuable content.
  • The downside is that outside of internal medicine, the question bank has relatively few questions covering the other topics; the upside is that the third year material is all cumulative, so you should expect to see questions that seem like internal medicine on your psychiatry exam (example: a hypothyroid patient presenting with symptoms of depression).
  • Our recommendation: Highest

The “Pretest” series:

  • These are books of additional questions, typically 500, categorized by clinical topic.
  • The questions are sometimes outdated, so be sure to buy the latest edition to avoid this. The books provide a solid supplementary amount of questions when you feel that UWorld might be a little light (example: psychiatry).
  • The questions do not always follow the format of the NBME though, so don’t be surprised if you find subjectivity in them, statements involving true/false analysis, or questions that seem incorrect (they may be – these books are not perfect and they are not the equivalent of UWorld).
  • Regardless of these flaws, the more questions you do, the more prepared you’ll be for the actual test at the end, so if you run out of questions early, which can, and does happen, these are an affordable source of additional ones.
  • Our recommendation: Moderate, if needed.

ExamGuru:

  • This boutique question-bank is specifically focused on shelf exam and Step 2 CK content, unlike UWorld, Qmax-Rx, and Kaplan, which are more geared to Step 2 CK in isolation.
  • The content of this question bank is extremely challenging, and will help you develop a masterful knowledge when it comes to differentiating subtle presentations on Step exam questions.
  • Even though your score will likely be low on these questions, the point is not to get 90% and above per set. The point is to use the questions as an opportunity to learn, and to hone your ability to distinguish subtlety.
  • We would not recommend using this question bank prior to completing UWorld and some primary resources, but this bank can certainly be the difference between a high pass and an honors.
  • Our recommendation: High, for the right student

NBME subject tests:

  • The NBME offers short subject tests, called the ‘Clinical Science Mastery Series’ that simulate the shelf exams, much in the same way that they offer similar tests for Step 1 and Step 2.
  • These tests are aligned to the length, content, and style of the shelf exams, and are available for purchase on the NBME Self-Assessment Services website.
  • They generally offer two-to-four tests per subject area, all of which tend to be accurate predictors of the scores on the shelf examinations when taken under realistic exam conditions (timed mode, quiet room, no interruptions or researching answers).
  • Our recommendation: Highest.

Content and Review Books:

The “Step Up” book series:

  • Detailed, dense. Very useful for the medicine clerkship (and therefore, covering much of Step 2 CK).
  • Some students may find it difficult to read the entire volume, and may be better suited to using it as a reference. This varies dependent on learning style.
  • The content, though, is spot-on, and is organized in a logical fashion, progressing from risk factors to classic presentation to diagnosis to treatment, in order of ‘next steps’.
  • Our recommendation: High

The “Case Files” series:

  • These books walk the line between high-yield test questions and high-yield clinical presentations.
  • Each book contains about 60 clinical vignettes spanning about 3-8 pages each, with plenty of high-yield images and content called out in the sections.
  • The information can be higher level than that presented in the ‘Step Up’ series, so these books are often best for people who consider their medical knowledge to need a ‘tune up’ prior to diving into a more deep resource.
  • They are terrific for a quick review of a topic, and fit easily into the pocket of a white coat. In our opinion, they are an excellent ‘tactical’ review of a topic, say, during your lunch break in anticipation of the afternoon’s cholecystectomy.
  • Our recommendation: High, for the right student

Kaplan Master the Boards for USMLE Step 2 CK:

  • Unlike for Step 1 and COMLEX Level 1, there is no de-facto book like First Aid to guide you.
  • The quality of First Aid for Step 2 CK is generally lower than that of its Step 1 counterpart, as the Step 2 version is less scannable, contains mostly bulleted points, and lacks a lot of high-yield content by comparison.
  • The Master the Boards book presents information in a logical manner, moving from risk factors and epidemiology to classic presentation, diagnosis, and treatment, pointing out the ‘best next action’ at each step along the way, so that students learn to distinguish a test offering definitive diagnosis from one that offers an increased likelihood of diagnosis (example: echo for right heart failure vs. cardiac catheterization), and so that students learn empiric treatments from definitive treatments (example: vanco and ceftriaxone for meningitis vs narrowed therapy once culture or gram stain results confirm the pathogen).
  • The book won’t necessarily replace Step Up to Medicine or its counterparts in terms of content, as those tend to dive deeper into subjects, though its tactical and readable approach make it very useful.
  • Our recommendation: Highest.