UFAP + Study Method

medstudentSo you want to learn the coveted UFAP Method for studying for USMLE Step 1?
UFAP is more than just a hilarious acronym, it stands for USMLE World, First Aid and Pathoma. I would argue the importance of each resource is the order they occur in within the acronym. Even if you only have 3-4 weeks to prepare for this exam, you can incorporate all three resources into your study plan.

A lot of variations of UFAP exist including UUFAP (UWorld + UsmleRX + First Aid + Pathoma) as well as UFAPK (Uworld + First Aid + Pathoma + Kaplan Qbank). I discuss how useful these resources are within my Step 1 Medical School Resource Page. In this article I will detail the UFAP method, as well as touch on a few ways to customize it for you, I call it the UFAP+ method.

Getting Started

Before you get going, there are three action steps.

1. Identify your weaknesses: Guess what? You are different from almost every other student. You’re kindergarten teacher was right! More importantly though you have different weaknesses than other students. There is no way I can write out a study plan that’ll apply to a 100% of students without knowing more, and this is actually partly why I have so much disdain for in person USMLE classes. There is no cookie cuter easy approach, at least no one that will get you the best score possible.
[blockquote cite= type=”left, center, right”]There is no cookie cuter easy approach, at least no one that will get you the best score possible[/blockquote]

How exactly do you find your weaknesses? Well throughout basic sciences most of you already have a pretty good idea what subjects you excel at and which ones you struggle with. This is a good baseline to find out specifically what you struggle with. This brief self-assessment is not normally enough, as you may think you know a subject quite well only to realize you have forgotten major portions. I’d suggest taking one of the NBME examinations or a Uworld assessment to get your true bearings regarding your weaknesses.

Now you should have a good idea of 1-3 subjects you struggle with, before you panic and think Uworld or the NBME is saying you suck at everything – pick the 1-3 you struggle the most in. Most people will do quite poorly on their first assessment. These 1-3 subjects are the areas that are ripe for the most improvement.

7658051014_c0a8dd9c3d_o2. Identify your resources: You’ve probably realized you have a plethora of Step 1 resources to pick from. The important thing is to prevent analysis paralysis, make an informed choice and stick to it. Don’t waver, do your research now and rest assured you have made the right choice. Don’t worry I’ll break down your resources into more detail so you can make an informed decision.

3. Make a schedule: Simple enough, but you need to make a regimen you can live with mentally and emotionally as well as one you can function optimally under.  I’ll show you a few very basic examples below to help you use a schedule that works best for you.

Resource Selection

There is a metric ton of resources out there to pick from for your step 1 studying needs and frankly it can be terrifying. Some of them are fantastic, some of them not so much. The problem is you don’t have time to dip your feet into all of them and test the waters, the cost of picking poorly here is quite severe, as it’s crucial time wasted. The good news is 1000s of students have come before you, and they’ve helped sift the gold from the garbage.

I write about all of the resources available briefly here.


Uworld – Aside from the method being called UFAP, you are not serious about this exam if you are not doing Uworld. Seriously, there is nothing I can recommend more than Uworld, it is the exam, and it’ll be your best friend for Step 1. Do the questions in a method that suits you, some suggest only ever do timed question, some suggest doing tutor and then reading the answers immediately so you can correct your thought process. There is no correct method and no incorrect method, personalize it to you! Do you struggle with time on questions, than doing timed is a no brainer. Most students do best doing a mix of several methods. READ the WRONG answers as well, and understand why they are wrong. Often they contain as much if not more information than the correct answer.

First Aid – The go to resource book for Step 1. You will need to get through it multiple times to do as well as possible. Most of Step 1 information is within this review book.  It’ll cover all the fundamentals and refresh all the topics you learned over basic sciences. I also recommend heading to your local Kinkos/Staples etc. and getting your book bound and put into a binder. This lets you add pages as you need, and change the order of things as you see fit. It’ll also allow you to easily add notes from other sources.  Remember to check the errata before you begin studying! No worse feeling than memorizing a fact incorrectly.

[pullquote cite=”” type=”left, right”]Consider annotating Uworld into First Aid. Writing makes a passive process active, and adding notes either on their own or into First Aid will help you consolidate facts. Also mark questions which are High-Yield as well as ones you got incorrect. It’ll make it easier to go back and re-do just those questions if you don’t have enough time to go back and redo all of Uworld.[/pullquote]
 Consider annotating Uworld into First Aid. Writing makes a passive process active, and adding notes either on their own or into First Aid will help you consolidate facts. Also mark questions which are High-Yield as well as ones you got incorrect. It’ll make it easier to go back and re-do just those questions if you don’t have enough time to go back and redo all of Uworld. If you do chose to annotate Uworld and have separated First Aid into a binder, you can put relevant questions on some lined paper behind each relevant section. I also annotated some of the relevant sections of a few of the High Yield review books listed below. While not strictly necessary, it allows you to consolidate your resources and put all your information in one source.

Pathoma – The P of UFAP, maybe people attribute the recent rise in Step 1 ccores to Pathoma. That means people give it quite some credit. Pathoma solidifies pathology and pathophysiology concepts, which makes up the bulk of the examination. A solid foundation in Pathology and completing as many question as possible should allow you to score extremely competitively.

High Yield Resources

These are resources to supplement the mandatory resources above and address any specific weaknesses you may have. I’ll list them roughly in order of usefulness.

Another Qbank – Kaplan or USMLERx are the most popular behind Uworld. Both are comprehensive question banks, however Kaplan is often accused of being far too detailed and pedantic. The secret to scoring well on any standardized exam is questions, and if you have enough time to do more than Uworld, I’d recommend looking into one of the these banks. I don’t believe it’s necessary for everyone as Uworld provides a wealth of information in every question, but if time permits the more questions you do the better.

Microbiology Made Ridiculously Simple – This is specifically if you struggle at Microbiology, if so it’s a fantastic resource. I forgot a large part of the Microbio I learned during basic sciences, and know many students have the same problem. Microbiology is a topic that is mostly memorization on the real exam, and knowing the answer outright allows you to spend more time on more challenging questions. Far from mandatory, it’s still a great resource for those who need an extra boost in the subject.

Firecracker Flash Card System – I’m a huge fan of the spaced memorization system. Nothing comes close in terms at improving long-term memory. Firecracker allows you to master topics individually and do relevant flash cards, days, weeks and months later. The problem is unless you have several months to space them out over it’s overwhelming. I’d strongly recommend using them before you start your dedicated studying, ideally sometime in 2nd year of basic sciences.

Memorang – The new kid on the block, Memorang costs ~$30 and is a flashcard system based off all the high yield facts in FA. Keep an eye on it going forward as it’s still in beta but improving quickly.

BRS Physiology – A great quick review for some of the more difficult concepts in Physiology. Again if you struggle with kidney, cardiac of pulmonary physiology this provides a great quick review. It’s not dense enough that it’s draining, and it’s concise enough to reinforce any weaknesses you may have in a particular area.

Doctors in Training Course – While I’ve mentioned I’m not a fan of online classes, DIT offers online videos with their own workbook as well. If you feel your school prepared you poorly for the USMLE during basic sciences or are several months/years removed from basic sciences, this is a fantastic review tool. It’ll basically teach you everything in First Aid again, and do it in a more enjoyable way. The workbook and daily questions are also a great way to keep you on task.

Picnomic – A relatively new resource, and an entertaining one. While it may not suit every single student’s learning style, if you are visual learner with a penchant for mnemonics this is your nirvana. It’s incredibly well constructed and an up and coming favorite of many test takers.

Dr. Najeeb – Great review for any specific topics you either don’t completely understand or need a refresher in. I’m not a fan of just watching videos, but if you have identified specific areas you can use help with, Dr. Najeeb is a great educator.

Goljan Rapid Review Pathology – Before Pathoma this was a go to notebook for studying Pathology. While no longer as popular or prominent, it is still a fantastic supplementary book. Make sure to check the errata as well before you begin studying. Rapid Review shines in pointing out a few facts First Aid may have missed.

HY Neuroanatomy – Another common weakness of medical students is Neuroanatomy. I’d recommend quickly going through HY Neuroanatomy if you struggle with Neuroanatomy and cramming what you can.

Kaplan videos – Incredibly through and detailed, but also often incredibly dull. They are so detailed I’d argue they essentially reteach everything you learned over 2 years of basic sciences. Much like DIT if you feel you are not well prepared after basic sciences or are years away from when you did basic sciences, Kaplan is an excellent resource.

USMLE Secrets – Essentially a cram book full of high yield facts. Great to review in the last few days/weeks before the exam without being too draining.

Sample Schedules

Quick Hit 4-6 Weeks to Study – The original UFAP
  • USMLE World – Complete entire bank, and try to repeat any flagged or incorrect questions
  • First Aid – Get through First Aid at least once, and repeat sections as necessary
  • Pathoma – Complete Pathoma at least once
  • 1-2 NBME examinations
  • If time permits consider doing an additional Question Bank
Moderate 6-10 Weeks to Study
  • USMLE World – Complete the entire bank at least once, and complete any flagged or incorrect questions. If time permits do entire sections of the bank again
  • First Aid – Annotate First Aid and attempt to get through First Aid 2-3 times
  • Pathoma
  • 1-2 NBME Examinations
  • If you wish consider doing an additional question bank
  • Consider incorporating a High Yield Resource such as Picnomic, DIT, BRS Physio or Microbiology MRS.
Long Hauler 10 weeks +
  • USMLE World – Complete the entire bank at least once, and complete any flagged or incorrect questions. If time permits do entire sections of the bank again
  • First Aid – Annotate First Aid and attempt to get through First Aid 3 times
  • Pathoma
  • 1-2 NBME Examinations
  • Do a second question bank, consider doing it first before Uworld but ensure you have enough time to complete Uworld.
  • Consider Firecracker, Picnomic, DIT and/or BRS Physio or Microbiology MRS. You have enough time to excel, ensure you don’t burn out.


Make sure you take care of yourself physically, or mentally you will see the effects. Ensure you exercise; if that’s running, weight lifting or even those quick 7 minute exercises a day, do whatever it takes to get some exercise daily. Find a great study spot. Take a few practice test as close to a test like environment, and build up that endurance. This examination like all Steps is a marathon not a sprint, and most often scores suffer in the latter blocks due to mental fatigue. Ensure you sleep enough, and are on a regular sleeping schedule to give yourself the best opportunity to combine all these facts. Include downtime, I recommend taking at least 1 full day off for every 6-8 study days to support some level of sanity.

Take some time to make your schedule, and learn how to stick to it. I recommend chrome nanny (chrome), leechblock (firefox) and rescue time as great addons to limit distractions. Also learn how to become a better student and test taker. I recommend checking out spreeder and readline (currently my favorite extension) to boost your reading comprehension and speed. I’ve seen students go up 100-200 wpm in just a few weeks. I talk more on these tips on another article here.

Good luck, and get ready to destroy the USMLE Step 1!

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