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USMLE Step 1

 by Junaid Nasir, MD, MBBS

 99/242 during Final Year-My Experience


Got my result ... and alhamdulillah its 99\242

My post would be a bit different in a way that it is much of guidance for those who want to take the test during their course. But it may generally be helpful for all others too.

I took the test in final year mbbs out of very odds.. cos there was not much of a trend in king edward medical university to go for the test during the course.. but owing to few of my seniors i had enough of guidance to go for this decision..

Benefits i got , to take it during the course were--- my recent knowledge of patho , pharma, immuno, micro helped me a lot a lot a lot...and due to tight schedule of final year i was much more target oriented ..benefits to get in the future may be that i may jump one year ahead of my batch mates,,and secondly ,a strong candidiate for residency as i would be much fresher than other applicants inshAllah.

i started in 4th year, gave a full 1 read to kaplan lecture notes in fourth year (and i called it a bonus read), the read was extensive, dint leave anything un understood (advice=always give an extensive first read so that in the subsequent reads u are much confident and have good prep.. also u can attach qbank with the first read)

In final year i started in march 2008.. went for the official first read in 3 months (not an ideal time span, but i had to cope with my final year studies too)
i went for the question bank of all the subjects .. All timed blocks... average/block remained above 80%


i took offline nbme form 1 after first read -- 163/200

second read went in 2.5 months (again -- i had to cope with my final year too)
i went thru usmle world (all subjects) average scores were patho 78% physio 80% anatomy 86% micro/immuno 86% biochem 80% pharma 78% beh sci 74%
i also went thru first aid ,(first read) (advice= do read first aid.. helps a lot)

third read went in 2 months.... ( again due to ;-) final year )
i dint go for q book (so i cant comment on q book)
did off line nbme form 2 --- 175/200
did kaplan simulated test cd --- got 294/350 (advice = i found the mle test level near to it ---- may be a subjective feeling but still must do it as it is a 7 block timed test, a good practice test)

4th read in 10 days ( skipped final year ths time for 15 days ;-) )
did usmle practice test + tutorial------- did first block only. 48/50

(* i had to go thru many problems regarding my step 1 application procedure... my college started participating in the usmle web portal service but the account was yet not generated to our college and i had applied for the test, ecfmg was waiting for my college to verify my student status but my college authority dint know abt this.. i had to go thru much turmoil.. but in the end thanks Allah the problem was resolved, though it wasted my 1 month rectifying this problem) also ELECTIVES stuff took much of my time.


TEST DAY:13 november

I chose for the islamabad centre and had to come from lahore to my home, could not sleep well in the night due to thunderstorm ;).. started early in the morning at 7 but due to rain and the prime time there was a huge traffic jam.. so much so that near islamabad i was literally stuck in the jam.. the time ticked passed by.. it became 8:45 (already 15 min late) but there was no scene of relief.. i jumped out of the car and got to the other road (two way highway) and requested a motorbiker to take me to the test centre , i had to convince him a lot before he accepted my request and thru unknown routes he took me.. it was chilling cold.. i was frozen.. but finally at 9:10 (40 min late) i reached the centre.. alhamdulillah.. they asked me to relax 

i relaxed for 10 min before my test was generated

TEST: (* represents difficulty level)

the first block (****)... either it was really difficult or atleast i perceived it difficult as i was much tense due to my early morning excursion...
2nd block (*) 
3rd block (**)
4th block (**)
5th block (**)
6th block (***)
7th block (***)

i took breaks after every block. 5 min for the early blocks and 10 min for the rest (got much time to offer zohar and asar prayers) 

the test was in a general sense 75% v v v easy , and 15 % ok ok and only 10% confusing (i used the word confusing-- as the material being tested is all we know abt but they present the question in a way that the person is confused among the probable choices)
i got abt an average 10 questions marked for the review but could not get time to review them . i finished each block abt 2 min still remaining to each block ( advice= do mark the questions but keep in mind , not to prefer changing the opted answer cause most of the time in my experience the first hit is the correct choice)

25% of the questions to me were 2 liners 3 liners.and easy.. 
65% of the questions to me were 4 to 6 liners and were moderately difficult
10 percent were 6 to 8 liners and still easy

got only one audio visual (many people get only one or two) and that too was not needed as the question stem was sufficient...

lots of brain cross sections and ct/mri (advice must do brain cross sections from atlas and ct/mri from jane wayne university website/webpath whatever)

patho as always was tested the most
luckily i dint get much questions (i dint remember any) from behaviour and ethics
very few but astonishingly easy from genetics.
many from biochem.
many from pharma
much more from biostatistics but easy (median, confid interval, screening tests,study designs) and physiology (endocrinology)

got many questions from anatomy which were not covered by kaplan notes (advice= do rely on ur background knowledge and must go thru an atlas like, netter)

during the test person gets very relaxed...i havent heard anyone who said that i was extremely nervous thru out the day.. u do get relaxed in the middle..

i was not exhausted thruout (subjective feeling.. people do get exhausted in the end)---- (advice= dont think that u are exhausted, cause if u think this u will get exhausted soon)

get along with u some energy drinks but remain judicious in their use..

all went well cause i perceived that it ended well for me...alhamdulillah

ADVICE:-better take the test during ur mbbs course
-better take it in 4th year 
-give first read extensively and join questions with it for good judgement of the subject
-manage ur time accordingly
-do go thru mri ct scan, first aid
- do take kaplan simulated test
-do give ur last read in at the most 15 days
- must have a good back ground knowledge to help u sail thru
-dont skip any imp topic if u dont understand it.. strive hard to comprehend it
-do read posts at this community ;-)
-do select the centre which is good and in easy approach (not like in my case)
-reach well in time
-take drinks and sandwitches
-take break after each block
-do offer prayers even during the test (dont skip it cause on that day u need Allah's help the most)
-do remember me in prayers
- feel free to ask anything , would love to reply

well there is a general rule, the more u practice the more u learn.... i have learnt that in anatomy kaplan is not gonna be a full help .. cause it is very gross.. and it just go thru superficiall thru all the imp topics.... but in practice all the tests do have many questions which ask abt more detailed knowledge.. like they may ask abt imp relations of any organ, arrangement of fibro vascular bundle and tendons in a specific plane, detailed action of a muscle, important tests to demonstrate any defect in the anatomy...

develop a visual impression of the anatomy.. do kaplan extensively, but must watch the atlas for it in a quick glance, u will retain much more of the visual impression than merely cramming the anatomy... for upper and lower limb and git , must watch the atlas... brain cross sections for neuroanatomy is must.. these are essentials. cause kaplan may not help u imagine the relations so u must have to actually see the pics.... secondly... go thru as much practice test as u can do cause with it u will know that which type and pattern of questions are asked more .(like u will know that in upper limb nerve lesions are asked the most) secondly u will get a fair deal of knowledge from there too... and also in the end i must say, give anatomy its due time but dont compromise other imp subjects.... i gave my third read in d months but in the last month i would study for 12 hours and would try to read each book for its one quarter atleast.. in the last 10 days i gave my 4th read, almost one book daily,,

gave full and completer read to all books and in the last 2 to 3 days, went for first aid and ct scan, etc, murmurs 

do listen to murmurs along with its text knowledge but mostly u would rely on ur theoretical knowledge not on ur hearing skills ..
in step exam visual knowledge is much more helpful then auditory ;)

i hope it helped
wish u good luck


where to look for ct/mri and brain cross sections?

hi Junaid ji this is Sandhya from India.I am planning to take step 1 sometime soon.can u suggest me a website where i could get a good knowledge of ct/ mri and cross sections of brain?....i dont even know the basics regarding these.


Salam Ayaz bhai.....

I'm dr.mansoor from Larkana, Sindh. I have been preparing for step1 since august 2010, and i am still through my first read, my pace being 15 days maximum for each subject, few days gone waste in the mid at eve of Eid. Well, bhai I've gone thru Biochem&genetics of kaplan, genetics is what i think poorly explained, i didn't know where the author was taking us to.....nowadays i'm going thru Immuno from Kap..... Any advices fo me brO???I've taken triplet for July-August-Sept 2011.....thanks. Wassalm!!

Dear Dr. Mansoor, I apologize

ayaz's picture

Dear Dr. Mansoor, I apologize for my very late response as you inadvertently posted it in the wrong article to catch my attention. Since you are still on track for your exam, my only advice for you would be to not delay your exam without any strong reasons. This strong reason involves getting a lower than expected score in online NBME examination. If you have not yet given an exam online, I suggest you do it as soon as possible before entering your triad of months so you can better guage an idea how your preparation has come along over the time course.

If you have not yet started the USMLE World Qbank online, I suggest you start it now and purchase about a 2 month subscription. Do all your questions in timed and mixed mode because the practice that these modes can give you, cannot be matched by attempting this question bank untimed.

Other than that, don't forget to rapidly skim through your Kaplan textbooks in the last month.

Best of luck and wishes for your exam. Regards.

assalam aile kum umar bhaijaan...

hey...congrats ..... u dint tell what happend in step 2 and step 3...... I am in final year and have only studied indian authors...... can u help me ffor how to proceeeddd..from now???/

can i opt for working outside after pg from india?

can i get into some other country with usmle score ?

i am from skims srinagar.... please i want to go abroad and im not that good in intelligent but not hardworking.....

m not sure abt ur queries...

umar's picture

m not sure abt ur queries... wud ask junaid to reply to it sometime... he is quite busy these days as he is applying for match right now...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

USMLE step 2 CK Qbank

Thankyou all for all this useful information. Can some one please let me know the name /address of the place where I can get UW Qbank CD/DVD in Lahore.. I have to request my cousin who is not a doctor  to get it for me..



Try Union or Allama Iqbal

umar's picture

Try Union or Allama Iqbal Medical College Bookshop, there are some good bookshops in Hafeez Center and Gulberg, Liberty...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

step 2 CK

Please also write about how and where from to study for step2 CK? It will be of immense help if somebody could kindly share their step2 CK experiences as well.

I wud share my experience

umar's picture

I wud share my experience whenever I give step 2 ck... I encourage everyone who has given the exam to share their experiences...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

Letter as to when planning to take the USMLE step1

Hi before i place my doubt i would like to thank you for providing such a wonderful site with everything so nicely arranged.It has really helped me a lot recently regarding electives.
I was asked by two universities to submit a letter along with my application form as to when i plan to give my USMLE step 1. I was planning to go for electives before i give the step 1 exam. Could you guide me as to what should i state in my letter. I am in my internship of graduation, it being very hectic i am not finding time to study for the step 1.

Thanks a lot for your kind

umar's picture

Thanks a lot for your kind words kuntal!

Can you please mention me the names of those universities as I am not aware of any university that has any such requirement. Anyhow, the only advice I would give you is don't lie for any reason... just state whatever your plans are....

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

hellowe umar bhai this

hellowe umar bhai this abhiram from india. even im in a plan of doin residency in usa.i jus completed my final yr. can i give both the steps durin my internship,i mean is the time of 12 to 14 months sufficient for bot steps and that too wid internship by de side. wat do u say. thanks umar bhai for such a goos website giving all the information

varies from person to person

umar's picture

varies from person to person but it is certainly doable...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

u said doable so it gives

u said doable so it gives confidence to me tanq umar bhai

step2CK before step1

 Umar Bhai,

First of all i would like to thank you for providing such a wonderful site with everything so nicely arranged.It has really helped me a lot recently regarding electives.

I am in final year of MBBS in Maulana Azad Medical College,new delhi,india.I have not given any steps.I intend to give step 2 ck first during my internship coz i will b fresh with the clinical subjects then and after thati will give step 1,

1.Is it a wise decision to give step 2ck earlier than step 1?

2.however if i give step1 during internship,how much time it would take on an average to prepare for step2ck?

Thanks al lot

Hi Kshitij Thanks a lot for

umar's picture

Hi Kshitij

Thanks a lot for your kind words...

1. m not sure if its a wise decision or not... but while writing this reply... m sitting with my cousin who gave step 2 ck before step 1 and she did pretty well... now she is a hospitalist.

2. well it varies from person to person.... no specific answer... some people do pretty well after studying for 3 months... and some have to study for 3 years...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

regarding ck before step1

 Thanks a lot bhai.

1.many people say that some questions of ck are strictly based on step1 so without giving step1 u cannot do gud in ck,is it true? i have been studying well for past 3 years and have good basics,i have confidence that i can understand medcine n surgery bcoz i hav basics and if any problem occurs then i can always refer back to the preclinical books,so do u think i should go along with this idea?


2.also pls help me with a doubt i have that is it true that step1 score is more imp than step 2?i have heard many mle takers and even haerd the same thing in a falcon seminar.

Thanks a lot.


1. m not sure as i have not

umar's picture

1. m not sure as i have not given either of them yet... but I dont THINK it would be like that... you can stick with your step 2 prep...

2. it depends upon the specialty u r applying in... for IM, Surgery, Gynae etc... step 2 is more important.... for Radiology, Pathology Step 1 is more important.

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

hi am a 4rth year student

hi am a 4rth year student from india i would like to prepare 4 usmle pls help  i dont hav a green card .. i heard that without that itz quite difficult since there r only 2000 brother will bcme a GC holder this april do i hav any advantage pls advice

That cannot be of any

umar's picture

That cannot be of any advantage to you atleast for next 8-10 years...

Well nothing is easy... my dear...  u wud hear so many stories discouraging u but the fact is if u work hard... nothing is difficult...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

aslamoalaikkom how are you

aslamoalaikkom how are you ...?i want you from where you prepare.and total marks of this usmle test and how many we have to get.your is 99/236.

for preparation visit USMLE

umar's picture

for preparation visit USMLE Step 1 section, it is a percentile result... the two digit result is percentile while the 3 digit somewhat represent the original score...

I am very busy these days and won't be replying to anymore queries. Apologies for any inconvenience and thank you for your understanding. All the best.

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