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How to Best Use First Aid USMLE Step 1 to Study

A medical school student using a First Aid study book to study for the USMLE Step 1.


How to Use First Aid USMLE Step 1 to Study for Your Exam


First Aid USMLE Step 1 is arguably the most important study resource for the USMLE Step 1 exam (alongside your favorite qbank, of course!). Together, First Aid and a well established qbank like UWorld can help both struggling students pass Step 1, and high-achievers score 260+. 

First Aid is a publication put out by McGraw-Hill Publishers (the ubiquitous textbook company of all educational resources in the Unites States), and is written by students who excelled on the exam. Importantly to know, it is NOT written by the National Board of Medical Examiners, who create and administer the USMLE Step 1 exam. A new edition is released yearly to account for changes in the USMLE exam, updated with useful diagrams and charts, and mnemonics are added as students contribute what worked for them. These changes are reviewed by faculty and subsequently published.

While using First Aid, follow this formula to get that score you’ve been dreaming of: 


Get the Newest Edition

Getting the newest edition of First Aid ensures that you are up-to-date with the most recent versions and changes to the USMLE exam, as high-performing students from the previous years’ cohort contribute suggestions and edits to First Aid. The newest edition is often the best edition, simply because there have been several years of comments, suggestions, and corrections which are (often) for the best. At the very least, the newest edition will be most reflective of recent exam content, as it has been most recently updated.

*Beware of fake copies being sold online! This has reportedly been a problem especially for IMGs. Be extremely weary of any website claiming to have an “early release” version of the newest First Aid edition. Always buy from credible distributors!


Correct the Errata as Soon as Possible

Before you begin your intensive study, spend the couple of hours making sure that any and all errata are corrected in your edition. Simply google “First Aid 20XX Errata” and that should get you what you need, often through a forum such as Reddit. Doing this as soon as possible ensures that you won’t accidentally memorize something that is actually a mistake.


Don’t Make Flashcards (Wait, What?!)

Memorizing First Aid word-for-word is not a helpful study strategy, neither for the USMLE exam nor for life as a doctor. Making flashcards of every single detail you encounter in First Aid is also not the best use of most student’s time. Instead, students should make flashcards when they are reviewing their UWorld questions. Reviewing UWorld should involve going to the corresponding page in First Aid, adding any information from UWorld that is not present in First Aid, and then making ONE flashcard (but only if necessary) containing any relevant facts (not concepts) that the student has a hard time recalling. Incorrect questions in UWorld should trigger the creation of flashcards because this is a situation where the student is clearly missing some key piece of information which prevented them from answering the question correctly. Flashcards shouldn’t be used to memorize First Aid, because this will 1) rapidly lead to an overwhelming number of flashcards which the student will then struggle to keep up with; and 2) consume inordinate amounts of time which would be better spent actively learning through UWorld questions.


Annotate with a Video Review Platform

Instead of memorizing First Aid, treat First Aid like your one and only medical school textbook. Pretty much everything you need to know is in there, but it’s just way too dense to make sense of it if you just try to sit down and read it without a backup. Your backup should be a video review platform – we recommend Osmosis (for intensive review periods) or Boards & Beyond (during coursework, or if you have loads of time). Use these lecture platforms as a way to walk through First Aid, and make sure that when you watch a video, you are looking at your First Aid, and taking notes. 


Keep Everything in First Aid

This means that all of your notes & annotations should be in ONE place, and that place should be First Aid. Often, this means the best way to annotate First Aid is through a pdf version. A pdf is easily searchable, allowing you to “control+F” phrases like “paroxysmal nocturnal hemoglobinuria” and get right to the page you need, rather than by flipping through endless pages in Renal? Heme? You get the picture. Furthermore, in a pdf copy, you can add nearly unlimited notes and content by adding “sticky notes” to appropriate locations. Some students, who perhaps may be a bit old-fashioned, resist the pdf copy and prefer annotating a hard copy of First Aid. This is fine, though just be aware that this strategy may be a bit more clunky and time-consuming. Even if you do choose to annotate a hard-copy, all of your notes should still be in that one hard copy (don’t have a separate notebook! Things will just get lost and confused). Many students find that adding extra space into their First Aid becomes necessary, either through filling it to the brim with sticky notes (the cheap option) or by taking it to a book binder and having extra pages inserted (the expensive option).


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About the Author

Karolina Woroniecka, MD/PhD

As a former Howard Hughes Medical Institute Student Fellow, Karolina Woroniecka graduated Phi Beta Kappa from Brown University with a B.S. in Biology and Hispanic…

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