5 Strategies to Acing the USMLE Step 1 and COMLEX-USA Level 1

Jan 10, 2019 by Osmosis Team

As you probably know, USMLE®️ Step 1 and COMLEX-USA®️ Level 1 assesses whether you can apply scientific basics to the practice of medicine. Osmosis is here to help you prepare for and ace the Step 1 and Level 1.

Strategy 1: Plan Ahead

6 months to 24 months before test day

So, you know Step 1 or Level 1 will be in your future as a medical student. Let’s consider your mindset in that first year of medical school, planning very early on before you’re near taking this test. The tip is simple: be a good medical student. Enjoy your classes, enjoy your life, and try not to stress too much. No need to rush into USMLE®️ or COMLEX®️-mode immediately after that white coat ceremony.

You may hear from mentors or professors about taking apart the First Aid and Pathoma books and filling the margins with annotations and study notes. Generally, it’s easier (and more practical) to keep everything electronic so you’re able to quickly search for keywords in your notes. Start this process early on in medical school. It may seem trivial at first, but later on when you’re looking for a particular topic, it can save you a lot of time.

Osmosis has a built-in feature that helps you automatically search your notes by tagging your personal notes to your coursework. Another thing to integrate early on is spaced repetition, as it helps with long term retention. Osmosis does all that planning so you don’t have to—read about it here. Try it with our two week free trial.

Strategy 2: Start to Study

3 months to 5 months before test day

At this point, you’re starting to figure out which question banks you should use. Osmosis Chief Medical Officer, Dr. Rishi Desai, recommends resources like UWorld and NBME®️, which together have about 4,000 questions. Also, take a look at the Osmosis question bank of over 3,300 USMLE®️ Step 1 questions with over 330 OMM questions, or Qmax, Combank, and Kaplan which have another 2,000 questions each. What’s unique about Osmosis’s question bank is that it tests your confidence level before you answer the question; this helps you focus on the topics you’re not confident about, as well as the questions you get wrong.

From there, you can seek out resources, some of which you might already be familiar with, including: Costanzo, Pathoma, DIT, High-yield and Lange. You can also watch Osmosis videos for free to review topics you’re struggling with.


Watch Osmosis's Chief Medical Officer, Dr. Rishi Desai, talk about these 5 strategies for how to ace the USMLE® Step 1 or COMLEX-USA®️ Level 1.


Strategy 3: Ramp Up

1 month to 2 months before test day

Think about your goals for the test first. The average Step 1 score in 2018 was 233; if you’re looking for a competitive score, you should set a goal for around 265. If you’re looking for something less competitive, like pediatrics or family medicine, aiming for 235 is a good benchmark. Consider your goals in regards to that scoring scale.

Setting a deadline for the exact day you’re planning to take the Step 1 or Level 1 is the best strategy. It’s easy to say, “I’ll take it when I’m ready,” but you need to narrow in and focus on that date. It’s tough, but you really need to put a lot of hours into studying for this exam: 10–12 hours per day. This requires being disciplined with your social life, and you need to make sure you’re also maintaining healthy habits like eating well and exercising. Everything in your life should be geared towards preparing for that test.

Leading up to the test, consider what resources you want to use, and create a daily schedule to keep track of everything. Osmosis will generate a schedule for you based on the resources you want to use, what your test date is, how long you want to study, and so on.

Spend a good amount of time going over questions and reviewing your answers to get a good sense of what you’re doing right or wrong. By doing this, you’re building endurance to answer all the questions on test day. Prepare by covering the answers to the questions to test your own knowledge first; verbalize why you think that answer is correct, and if you’re incorrect, look into the reasons why.

Strategy 4: Crunch Time

One week before test day

At this point, you’re still doing a lot of the same tactics we’ve already mentioned to prepare for your exam. However, this week it’s important to shift your focus onto memorization and study less on the concepts, preparing for topics such as biochemistry, microbiology, pharmacology, and genetics. There is a lot of information to keep straight and little details to remember that require more memorization.

Be sure to finish taking your NBME®️ exams, which can help predict where your real score is going to end up on test day. This is a good assessment to evaluate your readiness for the real thing. While we stress earlier how important it is to stick to a test day, it’s also important to pass your Step 1 or Level 1 exam. So, if your practice score is significantly lower than your goal score, you may want to consider pushing back your test day.

Strategy 5: Final Day

24 hours before test day

On test day, you aren't going to have anything with you: no flashcards, no textbooks, and no notes. Apply the same rule to the day before testing and use this time to relax. Try to get yourself into a good frame of mind for the test day. You can work through logistics of where you’re going and how to get there, preparing snacks, bringing light layers in case the testing room is cold, and getting a good night’s sleep. Try not to drink too much coffee the day of the test. You’ll likely already have lots of adrenaline flowing, so you don't want to be shaking from a caffeine overload.

Pump yourself up, though, and build your confidence! Scientifically proven ways to do this include:1) power posing with your arms in the air and exclaiming YES! or 2) forcing yourself to laugh to put yourself in a good mood.

Bonus Tips from Osmosis

Studying is hard. Capitalize on the tips we’ve provided here, but as a bonus we suggest: 1. Removing distractions, whether that be social media or TV. 2. Power through 25 minutes of studying with two minute breaks in between. 3. Wash your hands and avoid anyone that’s sick leading up to your test. 4. Do what makes you happy!

Alright, as a quick recap…

There are 5 strategies leading up to your USMLE®️ Step 1 or COMLEX-USA®️ Level 1 test day. Throughout your months of studying, it is important to utilize all of the resources available to you, complete a large variety of test questions to best prepare, and take care of yourself throughout this very stressful time.

Good luck! Osmosis believes in you!