 Nearly two years ago, I made this video on how step one was going to be past fail after that video. I was almost certain that people will stop asking me questions about step one because who would really want my help for a test that was past fail. But to my surprise over the last year and a half, I've had more step unrelated questions than I had prior to it when the test was actually graded. So in this video, we are going to break down exactly how to study for step one despite it being past fail and we're going to break down everything when I mean everything, I mean everything in this video. I'm going to tell you exactly the strategy, the resources, as well as the approach you should be using when you're in your dedicated studying. So if you're excited, I'm excited. Let's get into it. Hey friends, welcome back to the channel. In case you're new here, my name is Lakshman and I'm an internal medicine physician. And here on this channel, we try to make videos to help people just like you succeed on their medical journey, but doing it with less stress. Now, back when I was a medical student three years ago, it felt like the most stressful part of a medical school was taking step one. That's basically because it was the one test with the score matter the most to what specialty you'd be going into. But all of that changed in February of 2020 when they announced that step one would be officially going past fail starting in January of 2022. And so in all honesty, I thought that the new med students would enjoy the process, would remain calm, just kind of take the test and move past it. I've actually had more and more students who are more stressed out about the fear of feeling it and not so much about the score they're getting nowadays. But in this video, I'll specifically break down what strategy I would recommend or resources I would recommend, as well as some bonus and pro tips within each of those. And finally, if you're getting close to your step one prep and you're dedicated, how I would have go ahead and approach each week to week basis. So hopefully this video is a nice little walkthrough of how to prep for step one. But if you found this video and tips to be helpful, a quite easy way to say thank you is just hitting that like button and subscribe button if you haven't done so already. Now, before we get into the strategy to understand why it's effective, the one thing I have to get off my chest is step one is now past fail. OK, when I was taking it, you needed to get a 240, 250, 260 to have all of the specialties open to you. That was stressful. Now it's past fail. So if you're still stressing out, that is OK. You're not the only one, but you do need to chill out. I have way too many students who are coming to me through emails, Instagram and asking me so much about step one scheduling. Really, the goal again is to pass the test. So a P equals a P doesn't matter if you're getting a hundred and ninety seven. Right now, the pass mark is a hundred ninety six, or if you're getting a 250, a pass as a pass. So you need to have a strategy that helps you do that first and keeps it as simple as possible. And so for me, whenever I'm working with one of our coaching students, if you're interested, those programs will be down below. The three things I recommend is you need to have one practice resource, one learning resource and then one weakness recovery system. And we'll talk about each of those one by one. So first, let's get into a practice resource. Now, this is a resource that has questions of some style, typically in the format of a question bank. And there are a lot of resources out there, and I'll recommend a few that I've heard or have used personally. Those include USMARX, Uworld, Kaplan and Boss, Boards and Beyond, Physio, Picmonic and so many more. Now, whenever I recommend a practice resource, a lot of questions follow. But the one that definitely comes afterwards is, OK, which resource should I be using? And honestly, of that list that I gave you, all of them are great choices for a variety of reasons. The ones I typically enjoy using, at least closer to my dedicated include things like Uworld and USMARX, just because those are where a majority of the questions are. USMARX is made from the same creators as First Aid. So if you know anything about First Aid, it's basically the most highest yield review book in one place. But I hate using the actual book, so I enjoy using the practice questions from the same creators. And Uworld is, well, Uworld, it's one of the best companies out there to make questions to the level of difficulty similar to the actual thing. So if you just want the database of the highest quality and amount of questions, USMARX and Uworld are great options to choose from. That's typically what I recommend to most of my students. But if you're somebody who is going to want to combine their testing and learning resource, which we'll talk about in a second, together, then you may want to consider some of the other resources that we talked about, including things like Picmonic, Physio, Boards and Beyond, and Boss, as well as some others. And often after I give that answer, I find students who are like, OK, actually, you don't have to tell Joe and Sally, but what is the best resource? Like, just tell me. And this really gets to the main point of this video, which is now step one is pass-fail. OK, so it doesn't matter if you're getting a hundred and ninety-seven or a two-fifty. No one resource is going to have that big of a difference between the quality that goes to. So find some of the resources on that list. Find the ones that may resonate to your style of learning. So if you enjoy an all-in-one type of resource that has videos and the questions, try one of those first. And if it works for you, it doesn't really matter if it's going to give you a two-ten or two-forty. You're going to pass, nonetheless. So find a resource that works for you and then go with it. We'll talk about that a little bit later when we talk about learning resources. But again, there is no one best resource if the goal is simply to pass the test. All of them will help you do it as long as you stay consistent with one resource. And once you commit to a resource that helps you do the practice questions, the next question that I often get is, OK, how often should I be doing the question? Typically, I recommend that students do anywhere from twenty to forty plus questions a week and basically deciding if you're studying with other classes of where on that spectrum you may be. If you have a lighter schedule or if you're during a break, you may be able to do forty or eighty questions. If you are really busy or if you have things like labs, because you are a first or second year medical student, then you may choose to do twenty. The next part of that is, OK, when do I actually find time to do those respective questions? And typically what I'll recommend is either two things. One, find a time in your weekend and just schedule that on a Google Calendar or your iCal and say these two hours or this hour and a half is going to be when I'm going to be doing my forty questions on USMLRX, on Kaplan, on U-World, whatever it may be. Or you can say, OK, I may not have the time commitment to do one hour and a half session, but maybe I have a lighter time on Wednesdays because I typically don't have labs there, for example. So I may choose to do twenty questions on a Wednesday and twenty questions on a Saturday and just block those off on my calendar. So I feel like my step one prep is being done. But honestly, twenty questions isn't too overwhelming. So it feels like it's doable. A nice little bonus tip or exercise I make students go through is if they ask me, OK, how many questions should I do? I flip it back and ask them saying, OK, what is something or what is an amount of questions that feels silly saying no to? Like if I told you, could you do five questions a week? Most students would say, yeah, I could do five questions. OK, what about ten? Sure, twenty. Sure, eighty. OK, once you find that little uncomfortable zone, then I usually I recommend students start a half that. So they find themselves saying, maybe I could do eighty questions. I say, OK, fine, do forty questions in a week. And if you really find that forty questions is so easy, two to three weeks in a row of you remaining consistent, then bump it up to sixty and then eighty. But the last thing that you want as a student is to be stressing out about step one, simply because you can't come into a schedule that was too hard in the first place. So typically it's not really about how many questions can you do over the span of two to three weeks, but really how many questions can you do over the span until you're dedicated? So if you're early on a medical school or even if you just have months and months left until you're dedicated prep, doesn't really matter if you're going to do twenty or forty questions. The matter of the fact is that you do questions where it's easy to do twenty questions consistently week and in a week out. And one of the common traps that I find students do a lot is they say, I can do more. I'm going to do more. And remember, it's not really about doing more right now to do more questions in two weeks. It's more so about finding something that's so simple that you can be affected over the span of several months, two years in medical school. By the time you're dedicated comes around. So if you haven't started doing practice questions, just do twenty questions a week. And if you can do twenty, bump it up to thirty. If twenty is difficult for you to say consistent, do ten. Doesn't matter. Doing some questions consistently is so much more valuable. The next we want to talk about are one learning resource. Now, a few recommendations that I have include resources like Boards and Beyond, Ambos, Physio, Sketchy, Patoma, as well as Picmonic, who is the sponsor of today's video. Now, in case you're not familiar with Picmonic or if you haven't given it a shot before, it's literally a database of hundreds and hundreds of videos on every topic in medical school and combines really interesting videos, quizzes, and so much more, which we'll go into in a second. But one of my favorite reasons of recommending for Step One is that they do a great job of colliding their databases of videos to the specific pages and sections of our favorite texts for Step One. So for example, whether you're using First Aid or Patoma, you can go into the specific edition that you're learning about and then go to the specific page. So I can say, well, I read page 36 of Biochem because I'm a boss. And I can actually see, okay, well, I can never actually remember anything about Azothiopram or Imuran, which is a very important medication that we use. Maybe I can actually just go ahead and make sure I remember that part from First Aid that I read. And the nice thing about Picmonic is that they're experts in one of the first companies to really combine really interesting videos and storytelling together to help your long-term retention. So if you're struggling, remember difficult medications like Imuran or Azothiopram, you can watch this video, which is not very long, two minutes, 44 seconds. You can also read it down below. But my favorite part is then you can review the aspects of the story and actually ask yourself, okay, what did that represent? What did that image tell me about Azothiopram? And then you can use their quiz functions and actually answer specific questions related to the story and the video itself. So if I haven't had a chance of fully revealing all of these medications on page 36 of First Aid, I could just go ahead and add the ones that I had a chance to actually read about a little bit more and then make sure I watch those videos and do those quizzes to make sure I nailed that specific page. And as we talked about in our simple step-on strategy, you wanna make sure you have one learning resource, maximum of two, and ideally, if you can find one resource that can help you do the learning and the quizzing and testing all in one place, a resource like Picmonic, then you have a true winner. So if you're interested, you haven't checked out Picmonic Bifolo, there'll be a link down below. They'll also be able to give you 20% off if you use the code, the MD journey at checkout. So thanks again to our friends Picmonic for the discount code, as well as being the sponsor of today's video. Now the most important thing that reminds students about first step one nowadays that is past fail is that you don't need to use multiple resources. Back when I was studying, it made sense if I really wanted a 256 or 259 that I needed to combine multiple resources to cover for the weaknesses that our other resource didn't fill for me. So if a certain resource couldn't teach me cardiology, well, maybe I'd have to go elsewhere. But if you just have to pass, stick to one resource. A really easy analogy is imagine you're standing in a garage and all you have to do is drive five miles to your destination. If you have several cars to your disposal, you're not gonna spend way too much time asking, okay, which one is gonna be the best one? You just wanna get in the one that fits for you that you like decently enough and this will just take you there. Sure, another one may have gotten you there a little bit faster. Another one may have taken you there a little bit slower, but as long as you get to the finish line or your destination, that all that matters. The same thing goes for step one when it's past fail. So it's not about out of those resources, how many should you be using? Really, it's about finding the least amount. So finding ideally one resource that'll cover as much things as possible, which is why I love resources like Picmonic, physio, and boards and beyond and emboss because they tend to combine multiple different pathologies and topics into one place. But if you're using a specific resource, let's say you're using boards and beyond and saying, overall it's great, I love it, but it's not doing a good job of making my long-term retention for microbiology. I'm gonna find a resource like Sketchy to fill in that gap. That is a very nice way of using it, but trying to jam too many resources at once is a recipe for disaster. I know I had a coaching student who sent me their study schedule and saying, here are the seven resources that I plan on using to study for step one, which is a past fail. The schedule seems a little bit overwhelming. What would you recommend that I change? And I told them, take out five of those resources. Like all that student really needed is a resource they could learn from and a resource that they could go ahead and quiz themselves. And as soon as they did that, they felt the monkey off their back and still they're doing really well on their prep. So out of the resources that I recommend, I'll add a link to them down below and some of them, including physio and Picmonic, we have a discount through from the MD journey. So if you guys are interested, you guys can check those out down below. If you guys are interested in saving a few bucks while using a high old resource, I'll add the links down below for the companies that do offer a discount if you use the code, the MD journey at the checkout. Now, once you get past the question of what's the best resource, which we just said, find the one that feels good enough and just go with it. The next question I typically get is, okay, how often should I be using this, especially if I'm studying with my classes during the semesters, during the break. And typically what I would recommend is you can either use a two pronged approach depending on the kind of student you are. One is learn by fire, which is typically I recommend the students do the practice questions method that we talked about earlier. And then if they miss something, they create a list of all of those things and then use their resources to go ahead and learn those. So for example, if I was doing a question on USMLRX and I missed the question about is a diaphragm, then I may go back to my resource of choice. Let's say I was using pickmonic, I may go back to that individual video and then watch it to make sure that I avoid missing a similar question about is a diaphragm in the future. This is arguably one of my favorite ways of prepping for step one because all I have to do is do questions, identify what I miss, move it to a list and then add another scheduled time on the weekends. I may say on a Sunday between one and two 30, you're gonna look up videos related to the missed topics and just go down the list. I may say, oh, I missed a question this week about is a diaphragm. Let me just watch a video really quick about it. So make sure I don't miss it in the future. So that's approach number one, but it does take a certain type of student who's confident and okay with having really low marks on our practice questions because again, it doesn't really matter what you get on your U-World averages. It's more so about making those mistakes and learning from them than it is about avoiding getting a low score on U-World tutor mode. Like that doesn't matter. But if you are a student who tends to build anxiety because you're getting 50s and 60s on U-World, then maybe you're gonna be somebody who needs to look at all the videos you need to watch. So if you're using boards and beyond, you may say have X amount of videos that I need to watch before am I dedicated, which is going to be in let's just say eight months. So this is how many videos I need to watch on a weekly basis. And then similarly to how many practice questions you do a week, you wanna also keep this stupid simple and easy to say. So if I said, could you watch four videos a week? You said, sure. Could you watch 10 videos a week? Okay, back it down to five and then do that for a week, two to three weeks consistently. If you're struggling, back up even more. If you feel like you're doing great because the videos are entertaining, actually learning the stuff, then increase it to six or seven until you get to that goal where you weren't sure about. And that's an easy way to do this. You can do this on a daily basis. You can do this on that Wednesday and then Saturday, whatever schedule works for you, just keep it consistent. The easier it is to say yes, the easier it is for you to stay consistent. And that's the most important part about studying for step one. Now that you've picked a resource to help do your practice questions as well as learn from, let's finally get into your mistake system. This one sounds the most mysterious but probably is the most effective and the reason that most of my students that I worked with from coaching will improve their grades if they do this consistently. That's the biggest part. So really what your mistake system is and I love using this analogy. If you imagine this cup right, for example, the best thing you can do for yourself when you're taking step one is to have this cup as full as possible with as much knowledge. And ideally, if this is how much is needed for you to pass exam, then you have knowledge getting close to the brim. But unfortunately over time, as we learn more information, more things tend to leak out of this cup, which is completely normal. The best thing you can do for yourself is one, give yourself a steady flow of new information coming in by not overwhelming yourself. That's where the consistency comes in. But then two, avoiding having too many holes in the cup itself. The best way to do this is as you're missing more questions on your practice questions, that's why I recommend doing more and more of those. You try to plug in those holes by having a system that avoids you making those same mistakes in the future. But the same way that you have a system on how many practice questions you do as well as what days you do them, as well as how many videos you may cover in a week or a daily basis, the same thing goes for how you do your weakness system. So typically I recommend that a student either has something in their weekly basis or a daily basis that they focus on plugging in those holes. Now you may ask Lux, like how do I actually focus on plugging in those holes? Lots of different techniques that we can talk about. A few things that I love having students do is typically when they miss questions, I'll have them create a flashcard deck. So Anki is a great resource. If you guys are interested on how to make Anki even more effective for you, I'll go ahead and link below a video right here, which I'll put here and below in the description. But essentially you can look at the explanations from your practice questions and simply ask like, why did I miss this question? And then put that in a quick question answer form. It doesn't have to be super elaborate. No one else else to understand the flashcard. You just have to say, oh, I missed a question about cardiac output because I totally forgot the formula that went through it. Here it is, here's the answer, move on. And then you're just quickly making questions and answers about those and then moving forward. And then you wanna have a scheduled system where you can cover those flashcards. If your flashcards aren't your thing, you can do the same thing in Excel sheet where one column can be the question, the other column can be the answers, or you can have a simple word doc of all the questions in a bullet form, and then another bullet right next to it, all the answers. Other things that I recommend sometimes students do is if you really enjoy writing things, you can have a big notebook of all the things that you've missed, and then simply be able to cover those pages because if I can say, I know everything in this notebook now, that means you know a lot of mistakes you made before, that's a lot of darn holes that you've since plugged. And just like everything else in this video, it doesn't really matter what technique to use, more so that you actually use one to keep track of the things you miss and then getting into the next part of this video, which is, okay, how often should I be doing this? Typically I love my students doing this on a daily basis and how often or how long you do this really depends on your schedule. You can do this five minutes a day. For example, if I had an onky deck of everything that I missed on step one related stuff, I spent five minutes a day at the start and into my sessions or study sessions and said, that's not really hard, but one flashcard may take me a few seconds. So I'm in five minutes, I may be able to cover 10, 20 flashcards and that's 10, 20 pieces of the facts that I can avoid missing in the future. That's a lot of learning, that's a lot of holes. Now you may have hundreds of holes in this proverbial cup of knowledge of step one, but filling in 10 to 20 of them on a five minute basis is the start of your day at the end of your day, that's a big win. And if you increase that to 10 minutes, if you increase that to 10 minutes in the start and end of your day, that's 20 minutes of reviewing and that's more and more topics that you can cover. This is really the simple yet key structure of how I can see a student who truly progresses versus a student who keeps coming to me saying, should I use this resource now or what about this one? I'm struggling here or my year well percentages aren't high enough. Again, it doesn't matter, you're trying to pass a freaking exam. The best thing for you to do to pass exams is do as many questions, make as many mistakes, remember those mistakes, have a system on how you collect them and then have a daily ideally, if not a weekly system on how you come back to them. If you're a student who says, that sounds good, but you can't say consistent to your review, then that's the biggest downfall of your step one prep. So out of all the things of doing the practice questions of doing the learning resource, of doing the weakness system, the weakness system is going to be the biggest impact for you and over time, you're gonna start to see your scores go up because you're gonna notice the patterns from your prior misquashions. So far on this episode, we've covered a lot. We talked about our simple strategy of having that one practice question resource and that simple strategy of collecting that into a weakness system. And then typically my recommendation is just if you use those two, you're solid. But obviously there are going to be students who are going to need to go to a ladder resource to understand things a little bit better. Maybe you miss a question and you're not really sure why, that's where your learning resource really comes in. And if you can find a learning resource that teaches you something, quizzes you something, and then you can have a system with Anki combined to it. So a combination of Picmonic with Anki or Boards and Beyond with Anki or Amboss with Anki, that is like enough for you to have a golden strategy to prep for step one. And that's just two resources while your classmates are suddenly trying to figure out how to use seven resources at once, you don't need to. So so far we've talked about how to prep for step one when you are several weeks months away from dedicated. But now let's talk about how to actually prep during the dedicated. And again, if you guys are enjoying this video, if you're like, there's some good content coming here and I'm actually learning something, hit that like button down below, hit that subscribe button, really helps me get more views to this YouTube video, helps the channel grow, helps me want to make more videos like this because you think it's helpful. Comment down below the questions you have, maybe I can either answer it down below in the comment section, make another related video, but let's get into the dedicated prep part of the video. Personally, I'll recommend to students is that if you're using a resource that has videos or if you're using Patoma or sketchy or Boards and Beyond, typically I would recommend finishing those within the first two to three weeks of your dedicated. So if you're studying for six weeks or eight weeks, try to create a schedule where your main priority is getting through those videos because as soon as you do, you free up so much time to do more questions and typically you have to taper up how many questions you do anyways. And so if you're just starting your dedicated, maybe you're doing 40 questions a day or 80 questions a day and you wanna eventually be able to taper to 120 questions or three blocks. So that way you build a stamina and confidence when you get closer to the actual several hour exam and so wanting to finish those videos within the first two to three weeks is gonna be super crucial. So that's principle number one. Principle number two is to focus on doing an NBME practice exam every single week. Now if your question is which exam should I take and what order, honestly, I don't care because you need to pass the exam. So it doesn't matter if NBME 65 is more related to the exam today, just take an exam. Yeah, certain exams may be more predictive in terms of their style of questions or difficulty or grading curve, just take the exams. You just need to get a pass. You just need to get above a 197 as a mahi of this video. So it doesn't really matter like how far you are. Don't really freak out about the scale. Do more questions, schedule them, commit to a schedule. Don't spend too much time of asking which one's more predictive and just take them. And if you're asking, okay, when should I be doing U-World or if I'm using Kaplan or USM-LiRX, when should I be doing those self-assessments? Typically I leave those for later and where I can then stack them. So when I'm getting to my last few weeks of dedicated prep, so I may do one U-World standard exam and then do an NBME on the same day back to back that way I can kind of try to replicate a real test day. Now common question during dedicated is how many questions you should be doing. Now to avoid this video being dated, all you have to really do is ask yourself how many U-World questions are there? If that's typically going to be the question bank that most people use and divide them among the days you're going to be studying. So if you're gonna be studying for eight weeks, typically I'll say, let's try to finish all the U-World questions within five to six weeks. This way it gives me enough time to review my mistakes and ideally do my marked questions or the questions that I miss wrong one more time. So if you can get through U-World one and a half times during your dedicated, that'd be awesome. So to find the amount of questions that you need to do per day, look at the amount of U-World questions that are available when you're watching this video and you're preparing for dedicated. Ask yourself, okay, if I take away these many days for practice exams, these for many days for days off or things that I need to do aside from step one, this is how many questions I need to do per day. And let's say you come up with the answer of 60 questions per day. Well, 60 questions initially may be a little bit too much where you can say, okay, cool, I'm gonna do 40 questions for the first week. Then I'm gonna bump it to 60 questions starting week two. That means eventually by week four or five I need to do 80 questions to catch up for that first week where I wasn't able to stay on goal. But the very least I do recommend that towards the end of your prep that you start to actually build to that 80 to 120 questions a day, really builds that stamina and helps you get through more and more questions to be able to add to your weakness system. Now, speaking of the weakness system, during your dedicated, I do recommend that when you wake up you do a certain amount of time of your weakness system, whether it's at WordDoc or the AnkiDoc or the Excel sheet. Typically I'll have my students do this for about 15 minutes in the morning, 15 minutes when they're ending their day and that way they start into their day with again, plugging more holes. And finally, if you made it this far in the video it's one of my favorite tips to give on how to improve your overall grade. Usually when you get to about two to three weeks into your dedicated prep, you're going to find certain topics that you're truly struggling with and you're gonna start to plateau in the scores you're getting on your world as well as your NVMe. And the real fear question is, how do I make some improvement? So typically what I'll have students do is start to stratify where they're doing the worst. So let's just say there are 20 topics that NVMe grades you on. You may say, okay, what are the worst six topics in terms of percentage? You may be doing poor on all of them, that's fine. You wanna say, okay, if my average is a 60 on all of these then out of the UOL topics that I'm getting graded on the worst ones that I'm doing is micro, biochem, immunology, genetics, bio stats. Let's just say that's your list, cool. If you're doing two sets of questions a day, 40 and 40 and the start and 40 and the end try to make one of those just randomized to the weakest topics that way you have one dedicated deck or one dedicated practice question session specifically on your weakness every single day. This is a very simple and effective way of actively making yourself do those weak topics. And let's just say as you're going to your week to week prep maybe bio stats was a terrible topic for you but now it's a strength of yours. You can take it out of that 40 questions that you're doing and instead add the next thing. So if the next thing I'm struggling with is cardiology I'm gonna start doing cardiology with my immunology, biochem, et cetera. And then I'll be using that other set of 40 questions or 80 questions depending on how many I'm doing every day to be just doing on random. Again, this is a very simple way of doing practice questions every single day and then being able to evaluate out of all these topics. This is where I struggle with the most. Let's give some dedicated time and questions specifically to these topics. Now guys, so far we've covered a lot about how to prep for step one. If you did enjoy this step by step approach and you want more help on how to make the process even easier, less stressful, make sure you get that P and pass with kind of ease. And one of the programs I do recommend checking out is our step one Academy. This was a program that we created when step one was graded to help you get a 250 or above. So you can see the strategies and techniques that a lot of top students, including myself were able to use and kind of the planning system that goes behind getting an effective and high score. Now, it's not really so much about the high score but you can still use the program to be able to get that high pass while not having to spend as much time. So if you guys are interested in making that step one prep a lot less stressful, definitely consider checking out the step one Academy down below. If you guys have any questions about how to manage step one being pass fail, still getting a good grade or at least getting that pass that you need, comment them down below. If you did enjoy this video, all I really ask is a quick favor. Thank you in the form of a like or a subscribe if you're not already. If you haven't done so already, that's subscribe and notification bell to get more videos like this. If you're listening to this on a podcast form on the TMJ show, then definitely just consider going to iTunes, even if you're not listening on Apple products or an Apple podcast and consider leaving an honors five star reviews on your experience with podcasts and the video. But again, hopefully the system helps at least one of you guys watching this video saying I feel pretty good about prepping for step one. If you do, just let me know in the comment section down below. I'd really appreciate the love and support. As always, my friends, thank you so much for being a part of my journey. Hopefully I was a little helped to you guys on yours. If you did enjoy this video, you can check out this video right here that I made way back when step one was still graded but still are really important tips so how you can really get a high step one score here as well as how to use Anki step by step like a pro in medical school. Hopefully you guys enjoy these. I'll see you guys in the next one. Take care, my friends. Peace.