When Should You Start Studying for USMLE Step 1? A Longitudinal Approach That Works

Preparing for the USMLE Step 1 can feel like an enormous task. With so much content to cover and the stakes so high, it’s no wonder students are constantly asking:

• How early should I start studying for Step 1?
• What’s the ideal Step 1 study timeline?
• What month do most medical students take Step 1?

Let’s dive into these questions and explore a study philosophy that doesn’t just prepare you for the exam but helps you truly master the material. Afterall, your future patients are going go expect you to know all this stuff, right?! Spoiler: It’s all about studying longitudinally for Step 1, and using spaced repetition.

How Early Should You Start Studying for Step 1?

Here’s the truth: You should start studying for Step 1 on the first day of medical school. But before you panic, hear me out! I’m not suggesting you dive into full-blown Step 1 prep as a first-year. Instead, adopt a longitudinal study approach by integrating spaced repetition into your daily routine.

The idea is to gradually build and reinforce your knowledge throughout medical school, so by the time you reach your dedicated study period (about 6-10 weeks before the exam), you’ve already seen most of the material multiple times. This makes the final push so much easier.

I know what you’re thinking: “I’m a good student so if I study hard for each class, I’ll remember the important points when I’m getting ready for Step 1, right?” Unfortunately, the truth is that there is just so much material to cover in medical school that even if you learn something thoroughly the first time, it is so easy to forget if you don’t keep reinforcing it. 

Why Longitudinal Learning Works

Cramming doesn’t work for Step 1—there’s simply too much information to integrate and apply. Longitudinal learning, on the other hand, leverages the power of spaced repetition, ensuring you don’t forget what you’ve already learned as you continue adding new material.

What’s the best tool for this? Anki. Specifically, the AnKing Master Deck for Step 1. Here’s how to make it work for you:

• Download the AnKing Master Deck early. Start as soon as you begin medical school.
• Unsuspend cards as your curriculum approaches relevant USMLE material. This way, you’re always studying what you’re currently learning, plus reviewing older material.
• Do your cards every day. Consistency is key. By reviewing every day, you’re constantly reinforcing older information while adding new knowledge. And this makes learning even easier overtime because you practice forming connections and integrating material as you go, which is what you will have to do as a doctor anyway. 
• Keep adding as you learn. As you progress through your curriculum, continue unsuspending cards relevant to your classes. This keeps your knowledge base growing without losing what you’ve already learned. It also helps you differentiate what is truly high-yield for the Step 1 exam. If you search for a topic in the anki deck that you’re covering in class and there are many cards about it, you can assume that this is a pretty important topic to know well for the exam, and by doing those cards consistently you can prepare yourself for that! 

This approach builds a solid foundation that makes your dedicated study period more about application and fine-tuning and less about relearning.

How Long Do I Need to Get Ready for Step 1?

As I mentioned before, practicing spaced repetition is a great idea from the very beginning of medical school. However, I do acknowledge that during the first semester of most medical school curriculums, you will be learning preliminary information that is not yet the advanced knowledge you will be tested on for Step 1. The best time to start Step 1 prep is typically in the second semester of your first year, when more exam-relevant material is introduced. This is a great time to increase your Anki use and focus on active recall strategies.

Need a Personalized Step 1 Study Plan?

Starting Step 1 prep early is key, but figuring out the best strategy can be overwhelming. Our expert Step 1 tutors can help you build an efficient study plan, master high-yield concepts, and stay on track. Schedule a free consultation to see how we can support your success!

When Do Most Medical Students Take Step 1?

Most medical students take Step 1 at the end of their second year, typically between February and April. The more prepared you are through spaced repetition early, the earlier you may be able to take the exam and then enjoy a well-deserved break before moving into third year clerkships!

Knowing this timeline helps you plan your study schedule. Ideally, you should begin your dedicated study period about 6-10 weeks before your exam date. If you’re looking for a study schedule for your dedicated study period, the Elite Medical Prep Step 1 study schedule is a fantastic place to start! Use it as-is or adapt it to your dedicated study timeline. 

Essential Study Resources for Step 1

While Anki is crucial for spaced repetition, question banks are essential for application and practice. My favorite? UWorld. Here’s how to incorporate it:

• Start UWorld 4-5 months before your exam. This gives you enough time to go through all the questions. Starting UWorld any earlier than this is not useful in my experience, as you really don’t start to build all the knowledge needed to answer many of the questions until you’re well into your second year of medical school. 
• Do questions daily. Aim for at least 40 questions a day to build stamina and get used to the test format.
• Review thoroughly. Don’t just focus on what you got wrong—understand why every answer choice is correct or incorrect.
• Repeat incorrect questions close to your exam date. I am not a fan of repeating entire question banks 2-3 times. You’ll be surprised at how many questions you remember and it’s not the best use of your time. Instead, focus on only repeating questions you got incorrect, as these were the questions that you didn’t think about the right way the first time so you need to approach them again to see if your studying is paying off and helping you to think about them the right way. 

Additional Step 1 Study Tips

1. First Aid for the USMLE Step 1 – This is your go-to reference book. Use it to reinforce concepts you learn through Anki and UWorld. I recommend saving this for the very end of your dedicated study period. Start reading through about 2 weeks before your exam as a general refresher of key concepts. Using it to guide your studying early on is not as useful because the book typically does not quite provide the level of detail the exam requires you to know for each topic, but rather gives a great overview of high-yield Step 1 concepts. 
2. Pathoma, Sketchy, Boards & Beyond – These resources are great for understanding pathology and microbiology, respectively. Use them alongside your daily Anki cards if you find this helpful. The anki Step 1 deck has cards that go with each video, so if you find watching the videos helpful, you can do the cards after you watch and use this method to supplement your studying for courses. 
3. Practice Exams – Incorporate NBME practice exams every few weeks during your dedicated period to gauge your progress and adjust your study strategy. At 200 questions per exam, collectively, you should treat these practice exams as another question bank, and this is the highest-yield question bank because these questions are written by NBME test question writers themselves. 

Final Thoughts: Study Smarter, Not Harder for Step 1

The key to acing Step 1 isn’t just about how long you study but how you study. By starting early, using spaced repetition with Anki, and gradually building your knowledge base, you’ll set yourself up for success.

This longitudinal approach not only makes Step 1 prep more manageable but also enhances your overall medical education. You’ll retain more information and be better prepared for clinical rotations and beyond.

So, if you’re just starting medical school or already deep into it, don’t wait! Make spaced repetition a daily habit and be intentional with your study schedule when your dedicated study period begins. Ideally, your dedicated study period will be for questions, practice exams, and filling in small knowledge gaps as opposed to re-learning old material. With this approach to Step 1 studying (and all exam preparation in medical school), your future self (and future patients!) will thank you.

Good luck, and remember—consistency is the key to mastery!