When it comes to preparing for Step 1 of the United States Medical Licensing Examination (USMLE) few understand the process and its pressures better than medical students who have been through it.
Interviews with medical students from across the country who have recently taken Step 1 offer insight into what makes for a practical preparation plan. Here are a few key tips for medical students approaching their dedicated Step 1 study window.
Don’t put off practice questions
Bijoya Basu is an MD–PhD student in the midst of a five-year research track after her second year of medical school, and she took Step 1 before the exam transitioned to pass-fail scoring. Since then, she has spent five years tutoring fellow medical students for Step 1 and has become deeply familiar with what it takes to excel under the current exam format.
In looking at where medical students can go wrong, she said some may wait too long to make practice-exam questions part of their study process.
“A lot of students don’t want to begin practice questions until they have reviewed all the content,” said Basu, an AMA member who recently earned a place in the finals of the AMA Research Challenge. “That’s a big mistake. It could take you six weeks to review all the questions, and you might only have six to eight weeks of dedicated study time. So, it’s worth it to do those questions at the start of your review. Even if you are only getting 30% of them [right], that number will go up.”
When doing practice questions, Basu also recommended that students do them on exam mode rather than tutor mode. Exam mode is more efficient, and the pace mimics the real test.
Familiarize yourself with the test
AMA member Sneha Kapil is a fourth-year medical student in Florida. She said that in making sure to cover all the content areas, it is easy for medical students to lose focus on the exam’s structure and question formats.
If she could do it over again, “I would have spent more time learning about the test itself and how to take it,” said Kapil, who serves as an alternate delegate of the AMA Medical Student Section (AMA-MSS) Governing Council for the 2025–2026 term. “I focused heavily on the content, which is really important, but at a certain point you know the content and you have to build comfort with the test and your confidence in your test-taking skills.”
Kapil highlighted that the USMLE offers a content outline that gives students valuable direction about what is on the exam.
The AMA offers essential tools and resources to support medical students in their preparation for the USMLE series of exams. To help you with your studies, AMA members receive discounts on test prep materials for the USMLE and the Comprehensive Osteopathic Medical Licensing Exams (COMLEX-USA).
Lean on your near peers
Each medical school is going to have its own unique curriculum. Because of that, students from your own institution are going to be uniquely positioned to speak to what areas you should focus on in your Step 1 prep, according to AMA member Andrew Bell, a third-year medical student training in Massachusetts.
"Seek out advice from lots of different people, but specifically seek out advice from people at your school that have recently taken it,” said Bell, the AMA-MSS Governing Council Speaker for the 2025–2026 term. “Because anyone can Google how to study for Step 1, but not everyone will be able to tell you how to work it into the schedule that your school is going to set up for you and understand what our curricular obligations are going to be in that time frame.”
Bell added that classmates can offer valuable insight into how much you should be studying, both several months before the exam and when the exam date is weeks out.
Create a winning routine
How you study, particularly in the period set aside exclusively for Step 1 prep, is going to be as important as what you study. For the methods, Basu recommends that students start each day by doing practice questions, reviewing those questions, making Anki cards, reviewing those cards and then doing a broader content review. The pace and routine are going to matter as well.
“Make sure you're taking breaks for all your meals.” Basu said. “Put in at least 30 minutes to an hour somewhere to walk or work out or do something to move your body, because it's so easy to just sit at your computer hunched over, doing your flash cards and your questions.”
And treat yourself, she said, to keep motivated. “Have one small thing you're looking forward to at the end of every day that's not related to studying.”
She also advised that students try to study in the same time window in which they will be sitting for the exam.
“If you're going to be testing at 8 a.m., start studying at 8 a.m. every day,” she said. That can be hard if you’re not a morning person, but you have to keep in mind that is when your brain has to be alert for the exam.”
