I started in May, full of doubts about whether I was going to stay on this road at all. I gave biochemistry a full month and microbiology a full month after it. By July I opened my ECFMG account, and that is when the whole thing started feeling real. More commitment, and a bit of fear along with it. That is when I actually pushed, and I built a schedule to finish First Aid in four months.

The first read

Every time I finished a system I did the UWorld questions for it. My day looked like this:

  • Anki first thing after waking up.
  • Review the First Aid I had read the day before.
  • One UWorld block.
  • Review the block.
  • Watch lectures offline and read First Aid.

I ran that for about three months. Then I noticed Anki was not really paying me back and was scattering the information instead of holding it together, so I dropped it and replaced it with light reading of the Mehlman files.

A while later First Aid got deleted off my iPad, and every note, diagram and mind map I had written went with it. That one hurt. I decided to keep going with the same system anyway.

The first NBME

By October I had finished First Aid and UWorld completely and decided to take my first NBME, form 26. Before it I felt my recall was slipping, so I gave myself two weeks of pure First Aid review, and that helped a lot.

I sat NBME 26 on 31 October and got 78.2 percent. I was genuinely happy. It was the first proof that the work had gone somewhere.

Dedicated

Then the dedicated period started, and the day changed:

  • Three UWorld blocks first thing: incorrect, timed, untutored.
  • Review the blocks.
  • Start reading First Aid again from the beginning.
  • Go through the Mehlman files and write notes on my repeated mistakes.
  • Review the topics I was weak in.

I tried pushing to four blocks a day and could not find time for anything else, so I went back to three.

Every Thursday I did an NBME. On 10 November I did UWSA2 and got 76 percent, and I booked the exam off the back of it. On 11 November I paid, the eligibility period started, and I scheduled for 28 December.

I kept the same routine for three weeks. After that I decided to finish every NBME from 20 to 31 in two weeks, so two a week, every Monday and Thursday. Once I was done with incorrects and marked in UWorld, my days became First Aid and Mehlman.

The last week before the exam was Mehlman files and the highest-yield points only, plus the Old and New Free 120.

Exam day

I woke up at 5:30, had a light breakfast and a cup of coffee, got dressed and left, and reached the Prometric centre at 7:30. The waiting room was tense. People there for different exams, everyone holding a book or a stack of paper, revising.

When they called my name they took my fingerprint and signature, searched me, and I left my things in the locker. I got into the room around 9:20. I tested the headphones, skipped the tutorial, took a breath, and started the first block.

The first question was long and strange and I could not work out what it wanted from me. I told myself it might be experimental and moved on. The problem was that nearly the whole block was like that. Long, loaded with detail, and unfamiliar. I would read a question, forget what it was asking, read it again, and get nowhere. I finished on the last minute, took a short break in my seat, and tried to convince myself that block was an outlier.

The second block was almost identical to the first. I was properly discouraged while solving, because I could not feel any connection between what I had studied and what was in front of me. I finished it, went out for a slightly longer break, washed my face, and came back. The staff member asked me to start block three immediately, so I did not really get to catch my breath.

The rest of it went the same way. It felt strange the whole time, like I was seeing this material for the first time. Stay confident that your work does not evaporate. What you feel during the exam is a feeling, not a measurement. Keep solving.

I walked out at 5:20 with my head completely scrambled. I opened my phone and the messages started coming in and I did not know what to say to anyone. Then: pass.

All my scores

  • NBME 26: 77.8 percent
  • NBME 25: 82 percent
  • UWSA2: 76 percent
  • NBME 28: 74 percent (this is where I went back and reread First Aid)
  • NBME 30: 85.5 percent
  • NBME 20: 86.5 percent
  • NBME 27: 86.2 percent
  • NBME 21: 87 percent
  • NBME 29: 86 percent
  • NBME 22: 87.5 percent
  • NBME 31: 80.5 percent
  • NBME 24: 87 percent
  • Old Free 120: 95 percent
  • New Free 120: 88.2 percent

What I would tell you

  1. Step 1 rests heavily on the content itself. Master that and you have got this. Go over First Aid once, twice, three times. I think of it as a treasure for medicine generally, not just for Step 1. Watch a proper explanation and actually understand it, and by the end of your preparation you will feel the topics clearing up and connecting to each other.
  2. Trust your scores no matter what you feel inside the exam room. Do not panic.
  3. Relax.
  4. Plan your breaks before the day and stick to them.
  5. Do not stretch your Step 1 preparation out. It leans hard on memorisation, and the longer you take, the more you get stuck in a forget-and-review loop that never ends.

Good luck. You have got this.

Want this as a plan instead of a story? If you want a day-by-day schedule built around your own exam date and your own weak systems, that is what Dumirieh mentorship does. You can read my full story on the about page.