How I scored a 268

USMLE Step 1 Experience

99th Percentile


I’ll give a quick rundown on here. In total, I had about 10 weeks of dedicated study time. I had some school commitments for about half of this time, but honestly a lot of that was essentially board prep that our school puts on under the guise of clinical year prep. For the first 5 weeks I focused on meticulously getting through FA/Pathoma and doing the Rx questions that corresponded with that.

Five weeks out from the test I started UWorld on timed/random. This was truly a first pass through UWorld. I spent about 2 hours reviewing each question block and aimed to do/review 3 blocks per day. IMPORTANT – really take the time to review each question, including your correct ones. I have a lot of friends that flew through UWorld just because they wanted to do 2-3 passes of the entire qbank and neglected dedicating the appropriate time in the review stage.

On top of this, I went on faster passes through FA, focusing specifically on the areas that gave me problems. I flagged any UWorld questions where I felt I wasn’t 100% sure on the answer. After I finished UWorld, I had about 1.5 weeks left and redid all of my misses and flagged answers. I tried doing another pass of my correct answers, but I was consistently remembering all of the questions/answers and didn’t find it helpful, so I stopped after a few blocks.

I ended up doing two NBMEs: 13 & 17. I did NBME 13 about three weeks before my exam date and got a 256. NBME 17 was 10 days out and I ended up with a 264. Even with such a high avg I was still nervous as hell going into the exam and was positive they would test me on all the things I had trouble with.

Exam day: get good sleep! Easier said than done, but I luckily didn’t have too much anxiety the day before – I watched movies/tv the entire day. During the test I took a mini-break after each block. I felt like I needed to do this to keep my energy level high, but others prefer to steamroll blocks at a time. Do whatever you did for the NBMEs. You will absolutely feel like shit right after the exam, but just try to trust the work you put into this beast of an exam. Good luck!


This study method will not yield the same results for everybody. The very best way to prep for Step 1 is to really, REALLY learn the material in years 1-2. My school does a very good job teaching to the boards and I very rarely felt like I was learning anything new during my dedicated study period – it was more like I was dusting some cobwebs off of things in my mind that I at one point understood pretty well.

Practice Details

NBME Average: 260

USMLE World Percent: 83% on first pass (timed, random)

UWSA Exams Taken; Scores: N/A

USMLE-Rx Percent: Generally in the 80-90% range right after I finished a FA chapter

Free USMLE Step 1 Questions

Preparation Time

  • 10 weeks

Books Used

  • First Aid for the USMLE Step 1 2015 (about 2.5 times)
  • Pathoma (2 times)

Question Banks Used

  • UWorld (one full pass plus misses/flagged questions)
  • USMLE-Rx (finished about 80% of it)

NBMEs Used

  • NBME 13:  256
  • NBME 17:  264 (most indicative)

*This post has been used with permission.