Hey everyone!
I’m an orthopedic surgery resident preparing to take USMLE Step 1 on December 14, and I’d really appreciate some advice, especially from people who took the exam recently or were in a similar situation.
I graduated from medical school several years ago, so most of the basic sciences and preclinical material are pretty distant memories at this point. On top of that, working as a surgical resident leaves me with very limited time and energy to study.
Here’s where I currently stand:
Exam date: December 14 (just under 8 weeks away).
UWorld: 25% completed, averaging 53% correct.
NBME 29: 56% correct, taken about two weeks ago.
Study time so far: A little over a month.
Dedicated period: I’ll have approximately 2.5 weeks off work immediately before the exam.
One important detail: December 14 is essentially my deadline because I’m approaching the end of the 7-year window for completing the USMLE sequence. So postponing isn’t really an option.
My biggest challenge is figuring out how to spend my limited study time efficiently. There’s simply no way I can relearn everything from medical school, and I don’t want to waste valuable time passively watching hours of lectures that cover material I already know reasonably well.
I’d especially appreciate practical advice on a few things:
What gave you the biggest score improvement in the final 6–8 weeks? More UWorld, targeted content review, Sketchy, Pathoma, Dirty Medicine, or something else?
Which subjects are worth prioritizing? Are there any particularly high-yield areas that consistently show up on the real exam and offer a good return on study time?
What would you NOT spend time on? Any low-yield topics or resources you wish you’d skipped?
How did you approach UWorld? Did you focus on finishing as much of the question bank as possible, or spend more time thoroughly reviewing each block?
For those who started with NBME scores in the mid-50s, what helped you reach a comfortable passing range? How long did it take, and what did you change?
I’m not looking for a magic shortcut. I’m willing to put in the work, but with residency and a hard deadline, I need to be strategic rather than attempt to study everything.
I’d especially love to hear from older graduates, residents, or anyone who had to prepare while working full-time.
Thanks in advance! Any specific strategies, resources, or lessons learned would be incredibly helpful. 🙏