{Score 249} Full USMLE Step 1 Experience IMG – 15 October 2019



FINAL SCORE– 249 (disappointed, but only for a few days) 

Test date- 19 September 2019

Total Prep time– 18 months over 4 years. 

Final dedicated Prep time– 6 months


1. Kaplan 2010 videos, and 2016 notes

Download last Kaplan Videos and lecture notes

2. First aid (used the 2018 edition, added updates from 2019)

3. Uworld online (6 months subscription during final dedicated prep) and offline (2016)

4. Pathoma (videos and notes)

5. Sketchy for Micro (tried using them once, did not find it very useful for me. I could directly memorize Micro facts after a couple of reads)

All Sketchy notes, flashcards, books and videos 

6. High yield neuroanatomy (found it useful for understanding detailed structural neuroanatomy and its clinical correlates)

7. Anatomy shelf notes (some exciting topics, but the exam, in general, does not have in-depth anatomy questions)

8. Biostats review (a few outstanding questions, and has two flow charts that make study designs and tests more natural to understand and remember)

9. Conrad Fisher’s 100 cases of Ethics (useful for understanding basic ethics questions)

USMLE Medical Ethics: The 100 Cases You are Most Likely to See [Kaplan]


10. Boards and Beyond videos (watched the videos for my weak areas during the last month. Awesome videos!)

My assessment of the study tools I used-




3.PATHOMA videos and notes

Complete Pathoma Videos, PDF Books, Study Note 2018

(the only three things you need to get 240 and beyond)

4. BOARDS AND BEYOND VIDEOS- really precise and to the point. Great explanations as well.

I wish I could have used these as my primary study source instead of Kaplan, would have saved me much time. Kaplan, although good, is too extensive to be useful in the final prep phase. Lots of things you won’t ever need for the test.

Other sources are good too, but not entirely essential.

High Yield Neuroanatomy 5th Edition PDF

Anatomy Shelf Notes 100 cases anatomy for usmle step 1


2016- Started my prep in 3rd year of medical school, with the aim of taking the test the same year.

Started with Kaplan notes and videos for all subjects except Pathology.

2-3 months into my prep, I realized that Kaplan would take a lot of time, and I will not be able to take the test that year. So, I decided to finish with Kaplan at least for the year.

2017- took a break from USMLE prep to focus on Final year college exams.

2018- Had a hectic internship year, but studied as much as I could. Read Pathoma along with the videos. Read the FA 2018 once. I Did offline Uworld from 2016, annotated notes into the FA.

Had a four months break- went to the US for electives and finished Step 2 CS.


Had four months of internship left (April-July) which slowed me down, especially till June.

April– Brushed up on FA and Pathoma.

May and June– Took online Uworld subscription. I Started online Uworld, tutored mode and section-wise. Would read the section from FA first, then do the Uworld questions, annotated extra info into the FA, and then reread the FA. Helped me consolidate each section. First pass Uworld- 77%

July– Took two weeks to memorize the FA correctly. Then did Uworld 2nd pass– random timed mode. Finished with 93%. Started with mock tests by the end of the month.

August– online and offline mock tests. Used extra study resources for anatomy, neuroanatomy and Biostats. Read FA in between.

I deliberately chose to delay using extra resources until the final month, so that by that time I had a grip on FA and Uworld, so knew exactly what kind of info could be useful, and what I could ignore. When you have a look at other sources early in your prep, it’s difficult to differentiate higher yield topics from lower yield ones. So, you end up trying to memorize unnecessary facts.

September– I had marked around 1800 questions in Uworld during my second pass that I wanted to do again in the last few weeks. So did that. I Got an average of 96%.

First Aid for the USMLE Step 1 2019, 

It is THE book for Step 1. Spend a lot of your time understanding and memorizing it. I must have read it at least 7-8 times. Annotated extra info from Uworld and NBMEs into it, making it more comprehensive.

First Aid Express Step 1 2019 (USMLE-Rx) Videos + PDF Books

Uworld Qbank 2019 For USMLE Step 1

Along with the FA, it is the absolute basis of your prep. So, spending most of your time doing these two things makes sense.

Complete Uworld Qbank 2019 For USMLE Step 1

I did Uworld a total of 4 times- 1 time offline (I forgot most of the questions I did by the time of my final prep but had a lot of the notes annotated into the FA) and three times online.

The first online round was for KNOWLEDGE BUILDING– so no point in going for timed mode. I went TUTORED and SECTION WISE, consolidating each section by reading the FA before and after the Uworld round. I have annotated extra notes into the FA. Finished with 77% correct answers, but that is irrelevant.

The second online round was after I read the FA properly and had a grip of the Uworld questions. So, it was about TESTING MY KNOWLEDGE. I Reset the Uworld. Then I went RANDOM and TIMED. I finished with 93%. This round gives you a good idea of where you stand. This round I finished a month before my exam, and I wanted to do most of the essential questions again in the last fortnight. So, during every test, I would mark all questions except those that I knew I would not get wrong ever. I Marked a total of 1800 out of 2800 questions.

The third online round was doing the 1800 questions. Again, it was RANDOM and TIMED. Finished with 96% and a confidence of understanding and remembering most questions.


In the last 3-4 months of dedicated full time prep, I had an 8-8-8 FORMULA: 8 hours of study, 8 hours of sleep and 8 hours of other activities. I found that I functioned most efficiently when I followed this schedule. I worked out 4-5 times/week, watched football matches on weekends. It is extremely important not to get burnt out, and knowing your most efficient schedule and having other things to do apart from studying is extremely important.

In the last two weeks, I started adjusting my clock to match the exam timings. Went to bed around 10-10:30 and got up around 6-6:30. I found it extremely useful- I felt alert and energetic throughout my exam.

I had a couple of days of mental fatigue around 10-12 days before the test. Had to take a day off to recover. Otherwise smooth sailing throughout.


People usually start giving NBMEs around 3 months before the exam. I started 2 months before my test, as I wanted to be confident of having memorized First Aid and Uworld to an extent before going for mock tests.

End of July– NBME 13- 24 mistakes

NBME 16- 23 mistakes


NBME 22- 232 (46 mistakes)

5 weeks out- UWSA 1- 262(27 mistakes)

NBME 23- 244 (30 mistakes)

NBME 15- 16 mistakes

NBME 24- 242 (32 mistakes)

NBME 17- 14 mistakes

3 weeks out- NBME 21- 261(17 mistakes)


2 weeks out- NBME 18- 255(16 mistakes)

NBME 20- 250 (27 mistakes). I Was going through a couple of days of mental fatigue. That may have had a role here.

1 week out- UWSA2- 269 (13 mistakes)

+ Free 120- 88% (Tried to simulate the 7-hour exam feel- 4 + 3 blocks)

The NBMEs have a different question style compared to Uworld. It’s more specific, information-based. However, it more or less gives you a good idea of where you stand.

The UWSAs were well designed. It had a lot of intellectually stimulating questions that I loved. It may overpredict your score a little, especially the SA1 (although it also depends on when you give these tests)

By the last week of my prep, I was feeling really confident of achieving my target score. I had memorized most of the FA, done a lot of practice questions and was peaking at the right time..

Download All (NBMEs) With Answers For USMLE Step 1


I reached the night before the test in Mumbai, where I was taking the test. I Was calm and relaxed. I Slept well, around 7-8 hours. Woke up at 6, reached the exam centre by 7:15. I was checked in early, and my exam started a few minutes before 8.

I Took a few snacks with me, as well as glucose water & Took a break after every block, around 10 minutes per break. Had the glucose water in every break, it really helped me concentrate better. Ate less to avoid feeling heavy and lazy.

The sign in and sign out process was very smooth at my center, taking around 30 seconds each time.

I was expecting a lot of tough/weird questions as well as intellectually challenging ones like in the UWSAs. To my surprise, there were very few of them per block (maybe 3-4/ block max).

Question pattern was midway between NBME and Uworld, and question stems almost like Uworld in length.

I knew that easier questions meant the possibility of making more silly errors if I was not careful. Tried my best in concentrating in each question.

I finished with around 3-4 minutes left out of the 8 hours. I had almost perfect concentration throughout.

I felt satisfied with my performance. Thought I could get 255 at least, if not more.


Chilled for three weeks. Caught up on movies, talking to friends and stuff. I Was not nervous at all.

Felt quietly confident of getting 260.


I Got my result on the 3rd Wednesday at 6 PM IST.

As soon as I got the email on my phone that my result was available, I went into my room, closed my eyes, and told myself- This is a very important result. I have worked really hard for this. BUT whether I get more or less than I deserve, I will not let it get to me.

Logged into my account- saw the result:


I was a little taken aback. Did not think that my prep, mock results or exam day performance merited this. I Was expecting more.

It took a few days to accept my score, although I know it’s a very decent score and probably enough to get into a good residency program. I just felt a little sad I could not reach my expectations.


There are 3 things in our control that help us reach our goals-

1. INTELLECT- There is little you can do to modify it.

2. HARD WORK- This is probably the most important exam you will ever take. So not working hard enough is just criminal. Do what you have to do, irrespective of whether you like it or not.

3. PLANNING- This is where you can make a difference. Proper planning not only helps you be efficient and reach your short-term and long-term targets, but it also helps you avoid frustration and anxiety, which in turn affects your productivity. Have a daily, weekly, monthly plan during your prep. And try to reach all those targets. Also keep a little buffer, in case something unexpected occurs and disrupts your plans.

Another thing that is notorious for affecting your end result is LUCK.

It is funny how we blame bad luck when we do not reach our desired results, but when things go our way and we have a stroke of luck in our favor, we tend to ignore it and feel we deserve it all.

I felt the same way, that my test being slightly easier had a steeper scoring curve which affected my result. But after a few days of introspection, I realized that it was probably the fact that I inadvertently made more mistakes than I normally do that allowed the steeper scoring curve (if that was actually even a factor) to affect my score.


This is probably the most important test you’ll take in your life, having a big say in if/where you get your residency.

But eventually, that is all it is — a TEST.

It does not define you.

It does not dictate who you are, and what you can become in life.

It does not define all the amazing things you’ll do and all the success you’ll achieve.

If you achieve your goals for the test,then BRAVO!

If you don’t, take it to the chin and move on.


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