Step 1 Checklist

Top 11 Things to Do Before Your Exam

Make a List and Check it Twice

Got a limited time before your Step 1 Exam? What should you do, where should you be spending your time? How much Coffee is too much coffee? (No such limit exists, trust us). We’ll run through 11 things to do before you write the exam and things to double check.

  1. Verify your Step 1 Permit is correct and has up to date information. Ensure you have ID that matches your name as it appears on the permit EXACTLY. You just spent all this time studying you better ensure you can write and kill this exam!
  2. Check out your test center! Make sure you are registered on Prometric and have received confirmation emails. I actually emailed my permit and confirmation emails to myself, another email and a family member. Paranoid? Slightly, but you never want to deal with the stress of being unable to find your permit or scheduling information. If your test center is local, drive by it the time and day you expect to go on the actual day. Scope out the area, some students eat lunch outside of the test center so find out what’s around. Figure out how long it takes you to get there and plan on leaving at least 30-40 minutes before that! Yes seriously. Test center outside your area? Double check your flight and hotel reservations. Make sure you are giving yourself enough time in case a flight is delayed (It happens often!) and print out any confirmation emails.
  3. Get a Practice Permit. If your test is more than 5 weeks away I suggest applying for a USMLE Step 1 Practice Permit at the same Prometric test center you are writing at. It takes 1-2 weeks to get the permit, and most dates are available for writing a practice test. Being in new surroundings is stressful, no need to add to the stress of Step 1. Go see the test center early, see the User Interface and the actual computers and computer terminals you’ll be using for the real test. Familiarize yourself with the bathrooms, lockers, food and resting areas. If it makes you even 5% less stressed on the actual day it’s easily worth the small fee of booking the practice test. The actual practice test isn’t extremely comparative to the actual test in terms of question quality so don’t worry about what you score or how long each question takes, just acclimatize to your surroundings. This is the battlefield where you’ll whip some poor test creators virtual behind. Learn it & Conquer it.
  4. Write an NBME. Seriously write at least one of these before you write the actual exam. There are many NBME sample exams available online, and they are by far the best predictor of the real exam. I recommend writing at least two of these before writing the actual exam. There is plenty of online debate over which ones are better, and the topics that come up on each one so give it a read, just make sure you write at least one of these. It’ll help you realize how you’ll do on the real exam in terms of how long it takes you to do a block and what topics are weak points.
  5. Make an accurate prediction on where you stand currently and what your goals are. There are plenty of score predictors and formulas online. My favorite one is here, although there a ton of others to choose from. Be aware that most people score slightly lower than predicted due to stress on the real test date etc. As I said earlier often the NBME is the best predictor of your real score.
  6. Assess your progress. How far are you in your question banks? How far do you think you will get? Ideally you want to complete at least 100% of one test bank. Some students aim to do one multiple times or do multiple banks, but if you aren’t on pace to finish one bank nearly completely it’s time to re-assess your study plan.
  7. Find your kryptonite. Figure out what 3 topics you struggle the most on, it’s easy to see what they are based off your qbank results and NBME results. Odds are you also know off hand the 3 broad topics that you struggle the most with. Write them down, it’s difficult to address a weakness often we tend to skip these questions when they come up as we’ll learn it later or it won’t come up on the real test. Knowing Murphy’s Law it’ll come up, and you are getting past the time where ignorance is a useful strategy.
  8. Make a plan! So we’ve identified 3 weaknesses. Why work on them? Simple – Diminishing returns. It make take you 10 hours to bring one topic from a 90 to 95%, or you could bring a topic from 66% to 75% in the same time. The difference on  the Step 1 exam is stark, one of the biggest mistakes average students make is that they excel in a few things, but are also very weak in a few others. This sounds normal and natural, but if you really want to score over a 240 you can’t afford to have any topic be anywhere below average. A few more questions right will make a huge difference in your final score. Check out our Step 1 Resources or our Basic Science Resources to see what we recommend for each topic. Spend a day or two or three addressing these topics, reading up on them and answering every question you can find on them. You’ll be surprised the difference it’ll make in your overall score.
  9. Now for the most difficult of all things. Make a post exam plan! This is a difficult time and if you want to keep motivated know what you’ll do once you conquer this beast. Be it drink and eat excessively, a road trip with friends, some family time or simply just watching all that missed television. It’s important to have an idea of what you’ll do once this exam is over (Yes life goes on post exam). Regardless of how the exam goes, keep in mind a plan of what you’ll do once its done for fun. I don’t suggest taking time out of studying to make this plan, but brainstorm with friends/family when you aren’t studying.
  10. Relax. Seriously relax. It’s an incredibly stressful time right now, but take some time off each day and each week. No one can go 24 hours a day 7 days a week, schedule down time and protect it. An extra few hours here won’t help you if you end up getting burnt out before the exam actually comes. Look at pictures of cats, watch your guilty pleasure tv show but do something other than study. Seriously I know it’s difficult but relax
  11. Be Realistic. What do I mean? It isn’t likely you’ll score a 295, it is important to be realistic with your goals. Know what score you must absolutely get 100%, and figure out how far you are away from that target. Sure unexpected things happen, but if you aren’t within 20 points of your target score with weeks to go, it isn’t likely you’ll meet it. I’ve seen friends write the exam hoping for a score they never got ever on any practice exam, and were crushed after they got their real scores. The Step 1 isn’t the sole determinant of getting the residency you want, but it’s a major determinant nonetheless. There is no shame in delaying your test if you aren’t reaching your goals or are afraid of failing. Short term is may suck, but you’ll thank yourself long-term.


To Recap our Step 1 Checklist:

  1. Verify your Permit and ID 
  2. Check your Travel Plans
  3. Get a Practice Permit 
  4. Write an NBME
  5. Predict your score
  6. Asses your progress
  7. Find your 3 Weaknesses
  8. Make a Plan
  9. Make a Post Exam Celebration/Relaxation Plan
  10. Relax and don’t Burnout
  11. Be Real.


Still got weeks to go? Check out our Step 1 Resources.


Want to add something or thing we missed something? Comment Below!