One thing I found when studying for Step was there was a lot of advice for

dedicated studying but not a significant clear guideline of how to prepare you before
dedicated during classes. Each studying plan is unique and there is no one right way
to study for Step (there are a few wrong ways though), so I’m writing this as an
explanation of what resources I used, and how I found them to be useful or not as
useful in terms of the real deal. I began prepping for step longitudinally about a year
before taking it, and then ramped it up the last semester.

Outline of pre-dedicated:
Starting the beginning of Organ Blocks, I began using the Bros anki deck (this
was pre-Zanki), and I would set it up so I would complete the corresponding anki
cards a few days before the test. I then carried over the old review cards at
minimum 6 months, and the decks I was weak on all the way through till Step. I used
pathoma the week leading up to an exam as a one time watch through to focus on
the high yield details of what seemed important. I also found qbanks very important,
before I started dedicated I had seen close to 4000 unique questions. I used
USMLERx during classes and tried to finish the 200 or so corresponding questions
the last week before a test to hammer in the fine details. I then purchased Kaplan
about half way through the curriculum, I wanted to use these in random mode to
make it more similar to step, so I waited till I had covered enough topics to make
that possible. I continued all the way through our last class with this.
In terms of time spent doing this, Id estimate that in a week I spent 7 hours
doing anki, 3 hours doing practice questions and 1-2 hours of various other step
stuff the 2nd semester (MSK-Cardio). My time break down of class to step studying
was about 2/3 spent towards class, 1/3 spent towards step, but ultimately there is
some overlap of the two. I wanted to do well in a class, but I was not looking to ace
it, I had a score I was happy with, and that was it, if I missed a question about a
random fact on a test that was 1 sentence from the syllabus, so be it.
Over the summer during my research time, I made it my goal to study 2
hours a day for step. For this I’d watch 2-3 sketchy videos a day, finish my anki, and
with the remaining time complete as many qbank questions I could. I also found
boards and beyond at this time, so each weekend I’d spend an additional hour a day
watching biochem/genetics topics from B&B to shore those topics up.
The final semester before step, I added boards and beyond as part of class, I
would watch 20-30 minutes immediately after lecture that day on topics
corresponding with our lecture, and follow that up with the bros anki related to
those videos. This didn’t seem to add anymore time to my studying as overall I felt
this actually meant I had to study less for class as I understood the topics better.
In the month before dedicated I made it my goal to make 1 complete pass
through FA, this was to get comfortable with the topics, this ended up meaning
during the weekdays Id spend an hour on biochem and an hour on micro/immune,
followed by 4 hours each weekend day on an organ block chapter. Before this first
pass I started at 240 on my first NBME. This was surprising to me, when all of this
started this was my goal score, so to be there already I realized that maybe I should
aim higher.
Resource summary:
Boards and Beyond:
- I believe this to be the best overall video resource out there, as it is the
only resource that covers everything we need to know for step. I wish I
had found it earlier. It taught me biochem, helped understand the
physiology for many blocks, and gave me the context to read FA and
actually understand it. It is very affordable, and I would highly
recommend it. That being said there is ~100 hours of video, therefore
this is NOT for dedicated. It can be used as part of dedicated to watch any
week topics, but there is no way it can be completed in that amount of
time. If you want a resource to help you in class and long term for step,
this is it.
Sketchy Pharm and Sketchy Micro:
- Another resource that I thought was absolutely worth using. It is another
time investment, but if started early enough, 2 videos a day isn’t so bad.
The challenge is reviewing the videos. I put each picture in anki and used
anki as a way to schedule when to review the pictures. I only watched
each video once, and by the time I completed step I had seen each picture
10 times. This was more than enough. As for the utility of it. I found that
actual step asked more detailed questions in terms of the micro than
sketchy provided, BUT sketchy provided the backbone that I could read
FA and pick up those details and just add them on to my memory cue that
sketchy provided, in that sense Micro questions felt like freebies. As for
pharm, these are hard to get through, but they work! They teach the
physiology behind the drugs and almost every drug worth knowing is in
sketchy. USMLE loves testing whether you know how the drugs work and
the mechanism behind them, sketchy makes it stick.
USMLERx
- I have mixed feelings about Rx, I ultimately think its value stems from
how you plan on using it. If you are looking for a resource that will help
you for the types of questions you’ll see on step, this is probably NOT it. If
you are looking for a good first pass qBank to go along with classes, to
hammer home the NEED TO KNOW information, this is perfect. The price
is fair, and also they actually have really good explanations even if the
questions are more first order. If you are a year out of step this is
probably a wise pick up, as you get closer to step this loses its utility. If
you have time to do both Rx and Kaplan that is great, if not and I was
forced to tell you to pick one I’d say Kaplan.
Kaplan QBank
- The price of Kaplan is a bit steeper than Rx, so this may be a deterrent to
some, but they occasionally have some pretty good discounts. I picked
this up about 6 months out of step, and did all blocks on random, this was
very helpful. This question bank is a step up from Rx in difficulty but a
step below uWorld. It does make you think and asks some good
questions, for this I found it was the second best qBank. The issue I found
 was it was pretty heavy on minutiae. ‘Oh really? I need to know the
protein structure of that cytokine?? Sureeee….’. That being said there
were similar questions on step that came out of the blue where it felt like
one of those questions from Kaplan, those questions you cant be prepared
for the content but there are work-arounds to get them right which you’ll
learn from Kaplan (ergo I know the A-D are certainly NOT correct
because I know how they work, it must be D)
Uworld
- Need I say more, it is a must. But to give a heads up, don’t read too much
into the scores you get on uWorld, it is a learning tool. I personally
thought it was best to save it to close to dedicated, it is such a valuable
resource that starting it too early you may forget some of it before your
test. The questions are great, but they can be frustrating. For example,
you may know the exact answer to a question, and then read the answer
choices and they use words you’ve never heard, or each choice sounds
exactly alike and it’s a subtle difference between the right and wrong
ones. So don’t let it freak you out, I actually found Step to be very similar
in terms of the questions asked but LESS ambiguous than uWorld making
it easier to answer. Use it, embrace it, if you have time at minimum redo
your wrong questions, just think hard about it and how you study before
starting it well before dedicated.
Pathoma
- This is another must, and honestly will help very much during classes.
The fact of the matter is he has things FA has, and FA has things Pathoma
has, so ultimately to be the best prepared you have to see both. I watched
it once during classes, once before dedicated, and then only read it during
dedicated. As a video source it can take a lot of time to try to watch it all
during dedicated so keep that in mind, but it is short enough it can be
done. There were test questions on step where I could hear Dr. Sattar’s
voice answering it for me.
Bros and Zanki
- Last but certainly not least, the two best resources I found in terms of
getting down the pesky details that will undoubtedly come up on your
exam. About half of step was pure buzz word -> answer. This resource
was just that. I personally used Bros for all of the path/FA stuff, and Zanki
pharm as it covered sketchy. It was a challenge, I did 150,000 flash cards
over a year, 380 hours worth. You don’t have to do that much to get use
out of it, but keeping up with old stuff did help a lot, its amazing how
much you can learn, and subsequently forget as if you’ve never seen it
before. My two cents on the Bros v Zanki debate. Zanki is 2 years newer,
so it will undoubtedly have a few things bros doesn’t, that random drug
you’ve never heard of? It has it. BUT it is 10k cards more than Bros, to get
the full utility out of it, I would have had to have done 250k cards over a
year, that means 500 hours worth of studying, that was impossible for
me. Bros does misses maybe 1% of info that is in FA, but you can easily go
through new FA, pick out those deets and make a flash card on it.
 Lange Flash Cards for Pharm
- I got these for dedicated and did 30 a day so that I could see all of them each
week before step. This was helpful, it solidified my pharm, there were questions on
uWorld and Step that I only found from here. That being said, its another thing to
add to your study schedule so they are helpful but not essential.

Dedicated:
- I found real Step to be very heavy on the general principals topics from
FA disproportionately to any specific organ block, even the organ block
questions sometimes turned into a way to test general principals. By
those I am referring to Pharm, Pathology, Biochem/Genetics, Immuno,
Public health, and Micro. The thing about these questions, they were
pretty straightforward if you knew those topics well, however if you
didn’t there were not many ways to reason around them. If you can start
dedicated with just one of Biochem, Micro, or Pharm down as a strength,
you will be in good shape as they each will take up a large chunk of time
so the time saved from those blocks can go a long way towards saving
time for the other organ blocks. I wont go into full details as to my actual
dedicated schedule as I essentially followed the Phil Tolley method, but
I’ll mention what I did different.
- I did a pass through micro, pharm, biochem, pathology, and public health
every week so 5x total for step. For the organ blocks, I did one pass pre-
dedicated and 2 passes during dedicated over the course of 4 weeks, I
then used the last week to do a rapid review pass of my weaknesses. I
spent the morning doing biochem/Immuno/micro for 2-3 hours, and then
the afternoon solely dedicated to one organ block. I also did 2 blocks of 80
uWorld questions a day. This was very similar to the Tolley plan so I’ll let
you check that out. The 6th day of the week Id do the FA Path section,
Public health, and Pharm section and some uWorld, the 7th I’d take an
NBME and then the afternoon off. As for pathoma I did two passes of most
chapters and 4 of chapters 1-3 (these were the most high yield). I just
spaced out the pages by day to complete that in 2 weeks, as I had already
watched the videos before dedicated and annotated my book.
- For the NBMEs I found 18 and 16 to be most representative of what the
real test felt like, 13 (I didn’t do 15), 17, and 19 were a lot of short
question fact recall with some tricky ones sprinkled in. They were still
useful, and the scaling still gives you similar scores for all, just may be
better served taking 16 and 18 closer to the end.
- UWSA’s were useful in terms of the types of questions youd see on step,
but I felt the 1st one vastly overpredicted your score, I took the 1st one day
1 of dedicated and my best NBME at the end was nearly identical score
wise. The 2nd one had a more realistic scale.
- Step is about 50-70% know it or you don’t buzz word heavy questions,
20-30% make you work for it kind of questions, and 5% questions you’ve
never heard of or expected to see which you can’t really prepare for, the
good thing is (NO ONE HAS SEEN THOSE). If you’ve done uWorld and a
fair amount of NBMEs, you are more than ready for what you’ll face test
day.