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3 USMLE Step 1 First Aid Mistakes You Don’t Know You Are Making

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USMLE Step 1 First Aid Mistakes

There isn’t one right way to study for the USMLE Step 1, but there are plenty of ways to go wrong when you are preparing for this important test, especially with a review book like First Aid.

First Aid, often referred to as the Step 1 “bible” is well accepted, not only nationally but worldwide. Even though every student appearing for USMLE Step 1 uses First Aid, the results vary. Let’s identify the 3 biggest First Aid mistakes medical students make with First Aid for USMLE Step 1.

  1. Saving First Aid for dedicated study time

First Aid is a high-yield review book for USMLE Step 1. First Aid for USMLE Step 1 is a compilation of all raw information, put together by people who have taken the exam.

It’s pretty dense and it’s nearly impossible to learn the entire content few weeks before your exam. That’s why it’s recommend that your start First Aid as early as possible.  

  • Learn First Aid along with your classes during your pre-clinical years.
  • Review First Aid even after the classes end. This will help you remember and relate to what you learned in class.  
  1. Cluttering your First Aid with class notes that are low-yield

If you have to take class notes, do it in a separate notebook.

Reason: Although much of what you learn in your class is important, it’s definitely not Step 1. First Aid authors put in a lot of time to filter the massive amount of high-yield medical information into something that is manageable and can be tested.

How to identify what’s high-yield information?

It’s easy! While testing using a Qbank, have a look at the percentage of students who got that question right.

  • If the percentage is more than 50%, then you MUST know that material.
  • If the percentage is lower than 30%, then it’s probably too low-yield. So, don’t worry about it.  
  • If the percentage is in the grey zone (between 30-50%), then it comes down to what USMLE Step 1 score you are aiming for. If your goal is to just pass, then there’s no need to know the material. But if you want a high score, you certainly need to concentrate on the grey area as well.
  1. Focusing on shallow breadth over learning depth

Every student preparing for USMLE Step 1 studies First Aid. Even though students study the same book, the amount of content they retain differs vastly.

Reason: Different students use First Aid differently. Some may just read through the content page-to-page like a storybook, while others may lay emphasis on in-depth learning.

Remember that USMLE Step 1 is evolving. Having the knowledge isn’t enough unless you know how to apply it. Let’s understand this better with a story.

The story of the hare and the tortoise

A student, we’ll call her “The Hare” is overwhelmed about how much material she has to cover. She feels that she doesn’t have the time to devote to learning in-depth.

Another student, we’ll call him “The Tortoise,” took a different approach. He focused for several days or more on each block, taking the time to understand the topic well.  

When they both were tested, the tortoise scored better than the hare, even though he had several blocks left to cover.

The hare had to spend more time revisiting all the blocks she had initially just read through.

Over a period of time, the tortoise had just a handful of subjects to cover while the hare had to go through all the subjects slowly to learn them in-depth.


This simple trick can help you focus on relevant information, as well as to know whether you have an in-depth understanding of the topic you learned. For each disease you learn, ask these three questions:

  1. What’s the pathogenesis of the disease?
  2. What’s the presentation of the disease?
  3. What’s the connection between the two?

Quick Insights…

  • 50% of Step 1 test is about the knowledge, and the other 50% is about knowing how to apply that knowledge. For USMLE Step 1 success, both are necessary; neither alone is sufficient.
  • It is MUCH better to spend much of your time to learn things in-depth, so you never have to go back to learn.

Step 1 is huge, and First Aid is a massive amount of content. It’s almost impossible to study every subject thoroughly. That’s why it’s important that you concentrate much of your time on high-yield information in the book.  

To help you improve your ability to apply knowledge, prepare and answer questions strategically, NYCSPREP has a plan for you. Get in touch with us today!

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