When to Start UWorld for USMLE Step 1

StartUWorld is unquestionably the best resource for the USMLE. Before Step 1 switched to pass/fail, students had been known to score 270+ on USMLE Step 1 just by using UWorld and First Aid. Yet, some students, despite multiple question bank runs, struggle to pass. This underscores the fact that UWorld is effective for Step 1 only if used properly. How and when to start using UWorld is often a matter of debate. Through our experience with high-scoring students, we have determined the most effective ways to get through this high-yield resource. 

Start Using UWorld for Step 1 in the First Year of Med School

Start utilizing UWorld as a supplement for basic science exams in your first year of medical school. It’s ideal for focusing on USMLE-relevant material and excelling in pre-clinical exams. Further, it is often on par with what is expected from each individual medical school.

The ability to select individual question topics is key to this approach. If your school starts off with biochemistry, prepare for the topical exam using the UWorld biochemistry questions prior to your exam. A great strategy that some students find helpful is to start a limited number of UWorld questions at the very beginning of the topic covered – prior to actually getting through all the material required. This can help narrow the focus of your studies as you go through the material. Then, some students will do a second pass of the topical questions prior to their topical school exam, and get through 2 or 3 blocks of 40Q in the days leading up to their pre-clinical exam.

Use UWorld as a Learning Platform – Is UWorld Enough for Step 1?

Some students get frustrated with UWorld as they realize they haven’t covered all the tested material. This frustration leads students to delay question practice, assuming they’ll learn the content later. Do not make this mistake! Medical school lectures, First Aid, and even very detailed video review platforms like Boards and Beyond will not cover all the material that is presented and tested in UWorld. UWorld is not just a reinforcement platform – it is also a learning platform . When you get a question wrong in UWorld, use that opportunity to learn the material. They should annotate their First Aid, go through the relevant lecture material, and solidify any facts using self-made flashcards. The sooner students begin this process, the better . Starting UWorld in the first year of medical school allows students to develop efficient review and annotation habits. By the dedicated study period, time management becomes easier.

Although UWorld is valuable for learning and reviewing, it’s not sufficient as the sole study tool for Step 1. We recommend utilizing UWorld in conjunction with First Aid and flashcards to get the most out of your dedicated. For more information on how to utilize these resources within a study schedule, take a look at our 10-week and 6-week Step 1 study plans.

Is UWorld Enough for Step 1?

 
UWorld has earned its reputation as one of the best Step 1 study resources because of its realistic question style and detailed explanations. Many students use it as the main component of their Step 1 prep, and for good reason. It mirrors the clinical reasoning tested on the exam and reinforces high yield concepts that strengthen confidence.
 
Is UWorld enough to pass Step 1? That depends on each student’s background and study habits. Those with strong fundamentals and practiced test-taking strategies may reach a passing score for Step 1 using UWorld and First Aid alone. Others might benefit from more extensive review and structured planning to reinforce weaker areas.
 
A complete study plan for Step 1 should combine UWorld with other trusted tools that broaden understanding. Adding NBME self-assessments, Anki decks, and review videos helps cover additional science content and improve score predictors. This approach can give students a clearer view of progress and highlight areas needing reinforcement.
 
UWorld often works best when treated as both a question bank and a learning system. Students who take the time to analyze explanations and apply time-saving study strategies typically retain information more effectively. Instead of focusing solely on finishing questions, you should approach UWorld as an opportunity to learn actively and build lasting mastery of difficult material.

A Second Pass of UWorld Should Begin No Later Than the Start of the Dedicated Study Period

Going through the question bank a second (or third) time reinforces all the material students should have already learned at some point during their medical education. During the initial periods of dedicated study, students should be taking blocks of at least 20 questions, with at least 50 questions covered per day. Prioritize a block of 40 topic-specific questions, followed by a block of at least 10 mixed questions. These mixed questions are crucial for reinforcing, recalling, and simulating real test conditions.

How to Make UWorld More Effective for Step 1 Success

To study efficiently, begin by creating a daily Step 1 study plan that balances new material with regular review. Knowing when to start UWorld for Step 1 helps prevent rushed preparation. Beginning early also encourages gradual improvement, while dedicated study periods should include mixed and timed question sets that reflect exam conditions.
 
High-performing students engage deeply with UWorld instead of using it passively. Annotate your notes or First Aid using efficient annotation methods that keep insights organized and easy to revisit. Many learners ask how to annotate First Aid with UWorld, and the best approach is to summarize key points rather than copy explanations word for word.
 
It’s also recommended to plan consistent NBME check-ins to measure progress and readiness. Understanding when to take UWorld self-assessment Step 1 allows for better tracking of improvement over time. Students who focus on identifying weak areas sooner, rather than later can begin overcoming low NBME scores through steady review and reflection.
 
Another recommendation is to focus on how to use UWorld for Step 1 by reviewing every question thoroughly, even correct ones. Apply UWorld review tips for Step 1 to strengthen reasoning and reinforce retention. Adjust your pacing to maintain focus by learning how to pace UWorld review blocks and dedicating time for reflection. Professional coaching for USMLE can also help students master recall techniques and improve how to retain Step 1 material through repetition and active learning.
 
By combining consistent review habits, deliberate reflection, and structured organization, students can approach exam day with clarity and confidence.

Starting UWorld During Your Dedicated Study Period

 
 
If a student hasn’t had the opportunity to start UWorld during their first year of medical school and is just beginning the resource during their dedicated period of study, the approach remains the same. Ideally, students will still complete 2 passes of UWorld prior to taking the exam . If the period of dedicated review is 2 months or more, this is often feasible with advanced planning. There are currently 3500+ UWorld questions and growing. If a student has 60 days of dedicated studying, the student would need to get through 2-3 blocks of 50 questions per day to get through 2 passes of UWorld. This is doable! Granted, getting through this number of questions will be challenging and time-consuming, so students in this position should limit their resource use to UWorld with First Aid annotation, and use a condensed video review platform like Osmosis when necessary.
 
If a student has not had a chance to start UWorld prior to their dedicated study period which is 6 weeks or less, this is the rare case where it is advisable to focus on getting through UWorld just once. Students should plan to get through 1 to 2 blocks of 40 questions per day. If time remains, then getting through the incorrect questions closer to exam day can be helpful (rather than doing a full UWorld reset).
 
In summary, the sooner you start UWorld, the better!

For more help studying for Step 1, creating a custom study schedule and more consider enlisting the help of a 1-on-1 tutor ! Schedule your complimentary consultation today to hear more about what we can do to help you succeed.