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A list of the best resources available for your Step 1 preparations

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The most common question I get is, “what books/resources did you use?”  Like many med students, I experimented with lots of resources and learned tons from trial and error.

Below are the collection of the resources I found most useful, and the ones I would recommend to a close friend.

“Affiliate Disclosure: Some of the links below are affiliate links, which means we will earn a commission if you purchase one of these products. This commission comes at no additional cost to you, and doesn’t impact whether an item is included on this list or not.” 


First Aid for the USMLE Step 1: The resource virtually 100% of medical students use for preparing for the USMLE Step 1.  If you don’t yet have an electronic copy, I strongly recommend you do so.  Read how I used First Aid to master pharmacology here, and how I used it to raise my score from 236 to 270 here.



Rapid Review Pathology (Goljan): Still the best book for learning pathology.  Detailed enough that I was able to teach myself many of the pathophysiologic mechanisms I still use and apply today, it is condensed enough that you can be efficient with your studies.  I recommend using the electronic/Kindle version to make searching for particular topics faster.


Costanzo Physiology: The best combination I found between depth and brevity for learning physiology.  I used this book as a medical student to learn physiology with my classes, and found its explanations to be the clearest of difficult subjects, particularly for difficult subjects like renal physiology.



How the Immune System Works: By far the best book I’ve ever read on integrating/applying immunology.  Either before/while taking immunology, or during your Step 1 studying, if you’re pressed for time I suggest you read the first chapter, as it gives a fantastic overview of the entire immune system…in a dozen pages!  The link above is for the Kindle version.  If you’d like, the paperback version link is here.


Clinical Microbiology Made Ridiculously Simple: My preferred book for learning microbiology.  Combining both useful mnemonics as well as actual explanations for understanding how infectious diseases initiate, progress, and are treated, it is the book I always recommend to the students I tutor for learning this difficult subject.


  • AnkiThe program that launched it all. THE best program using spaced repetition, based on memory science to ensure you have maximal retention for the least amount of work. Best of all: it’s free!
  • AnkiMobile: Mobile version for Anki (for iPhone, iPad, iPod Touch). My only regret is that I didn’t get this sooner. If you intend to use Anki, I strongly recommend purchasing this, as it has made my reviews seamless, whether I’m studying on the bus, between classes, or in little breaks during a clerkship.  I have been amazed at how little review I have to do when I get home, because of all of the cards I do throughout the day!
  • Sunsama: Fantastic program to help with productivity, focus, and self-improvement. Quickly set your weekly and daily goals, with time tracking to see just how much you’re studying per day. Use the link here to get a 30-day free trial (normally only 14 days).
  • Self-Control: I have a hard time studying when I’m also on the internet. With this app, you can 1) completely block all internet (“white-list” function with no websites listed), 2) completely block the internet EXCEPT for designated sites (“white-list” function with certain websites, like Wikipedia, allowed), or 3) block only particular websites (“black-list” function for particular sites, like Facebook). Free, open-source app.
  1. Mark S says:

    I bought your flashcards and am considering signing up for the course, does the course cover more than what is in the step 1 deck? Are there more cards I can add to my deck as part of the course? Also, does the course have videos to explain all of the cards in the step 1 deck? thanks for the help!

    1. Yousmle says:

      Hi Mark,

      Thanks for your question. The Course covers much more than the Step 1 deck, and has very little in the way of overlap with those cards. The cards that are associated with the Course are virtually 100% different from the Step 1 cards, and often go more in depth on topics, as well as cover much more in the way of question interpretation. You can sign up for a consultation to learn more about the Course and how it can help you master more in less time here:

      Dr. Palmerton

  2. Prapti says:

    As per the new USMLE guidelines, from 2022 there wouldn’t be any scores considered, instead only pass/fail would be considered.

    So, if I give step 1 in 2021 and step 2 in 2022, how will the scores be considered for me?

    1. Yousmle says:

      Thanks for your question. I don’t know that the announcement was that only pass/fail would be considered – it is rather that only pass/fail will be reported. If you take Step 1 in 2021, you will have a score, and it most likely WOULD be considered, especially if you apply in a cohort of applicants who have scored Step 1 exams.

  3. rthompson13 says:

    Hey Alec! Question. I’ve been using your “pathos to pres” method since med school (current peds resident), which has been one of the most powerful habits that I have acquired in my medical education. Thanks for that! However I am a late adopter of Anki, just now making cards for the first time, and am running into some issues. Each card for a disease has the core ideas for pathophys, presentation (hx and PE), diagnosis, and management. For particularly complex diseases, especially when it comes to the pathophys, I am finding that the cards are too long, to the point that reviewing them can be laborious. I try pretty hard to cut out extraneous details and focus only on the essential “quick and dirty” material, but still, some are too long. I thought about breaking the complex diseases into two cards — e.g. one half with pathophys and presentation, the other with dx and mgt. However, in my mind, all of the components of the disease are related, i.e. the pathophys explains the presentation which explains the diagnosis and management. So I feel that just quizzing myself on half the disease will lead to more fragmented learning and memorization, as opposed to seeing the disease as a logical whole. Wondering if you have any ideas. Thanks

  4. Aaron says:

    What are your resource recommendations for step 2CK?

    1. Yousmle says:

      UWorld is the most important, as question interpretation is by far the most important skill for the exam:

  5. Khola Rasool says:

    If I take step 1 next year.And apply for match in 2023.Will my score be considered ?

    1. Yousmle says:

      Hi! I’m not sure I understand your question. Virtually all programs will require a Step 1 score for you to get serious consideration, so your score would have to be available at the time you apply, or before.

  6. Omer Issachar says:

    Hello Alec,

    I am a non-US IMG and I am hoping to get in a fellowship program after completing general surgery residency in my country.
    Are you familiar with any score (step 1 or 2ck) requirements or cutoffs? I don’t know much about the process of fellowship acceptance, as much of the articles I read on line are about residency programs…
    Can you please refer me to a credible source?
    Thank you again!

  7. Hailey Hayes says:

    My name is Hailey and I’m about to start my 3rd year. I was wondering if you had any advice for preparation/resources to use for shelf exams as well as Step 2? Please help!

  8. Smit Shah says:

    Hello Alec

    Can you tell me where should I search for the answers and EXPLAINATIONS of NBME forms 20-21-22!!!

    Hope to hear from you soon


    1. Smit Shah says:



  9. Midian Ambo says:

    Do you have anki deck for step 3?

  10. Ashley says:

    Hi Alec,
    I recently signed up for the online course and I wanted to ask with the short timeline that I have before my exam ( around a month), what videos from the online coruse would you suggest that I place at the top of my priority list (I’ve been having a little trouble balancing uworld + question review, anki, first aid, and yousmle online course videos).

  11. disqus_Q6ZaF3D1gE says:

    Hi Alec,

    I finished my Step 1 last September, and scored a 218. As you can imagine I wasn’t too thrilled.

    I am planning on giving my Step 2 CK this August. I am thinking about buying your Step 2 Anki deck and adding that to my daily prep. (

    If you can offer me any advice, it would be greatly appreciated!

    1. Yousmle says:

      Great question! I had a student who was in the exact same situation – you can read about her experiences here:

      The big picture thing to keep in mind is that Step 1 is half knowledge/mastery, and half question interpretation. Step 2 is MUCH more about question interpretation, so whatever you do, you want to make sure you are improving your ability to read/understand each question, as they are much more challenging in that regard.


  12. josh says:

    Hey Alec,

    I cannot break 233 and I don’t know hwat is the problem. I would really like to get a 250 and my exam is on the 24th of May. People say to just redo Uworld. Do you think this will be adequate?

    Thank you,

  13. Destiny Uwaezuoke says:

    Good Evening Alec,

    I just finished up my 2nd year and now I am about to prepare for Step 1 to take it by March 10th.

    I have been using FirstAid, UWorld, USMLE-Rx, Pathoma, Sketchy Pharm & Micro, DIT, & I would like to begin using your Anki cards as well, but I am having trouble creating a feasible schedule considering this mountain of resources.

    I took a mock CBSE exam last October and got a 150, then I had to sit for a CBSE exam in December in order to officially be done with 2nd year, with the limited time, I was able to raise my score to 199, but I would love to get at least a 240 on the real thing.

    Can you give me any advice?

    I truly, truly appreciate your time.

  14. Ravi Patel says:

    Hi Alec,

    Thank you so much for experiences and advice on your website.
    I do have a couple of questions though.

    1) Should I go through USMLE world question by question by doing a block a day or should I use UWorld as a way to test myself by setting a day and simulate taking the exam (and then go back and evaluate each question)?

    2) I just started second year. Should I immediately start doing UWorld even though I have little knowledge of pathology, microbiology, and pharmacology?


  15. Ala Joul says:


    what are the resources you advice for:

    1. anatomy ( gross, neuro, embryo)
    2. Biochemistry ( + genetics)
    3. pharmacology
    4. Behavioral Sciences

    and what is your opinion in ( pathoma) for pathology?

    Thanks very much

    1. Yousmle says:

      Great question – there aren’t a ton of good resources, at least not that I would highly recommend. Obviously I’m biased towards the pharm deck (, which is all you will need to master pharm for Step 1. As for the others, learning information from class well, if that’s an option, is good, as are FA and question banks. I like the Pathoma videos, although the text is a little sparse it seems.

      1. Ala Joul says:

        Please ALEC,
        1.What are the resources for biochemistry, behavior, anatomy ( in addition to FA, Qbanks) you advice for ?

        2. So do you advice goljan text and pathoma videos?

  16. FJ says:

    Hi Alec,

    How do you combine step 1 and 2 Anki decks without the software warning against too many decks? I’m having this problem. The system warns that the spaced repetition may lose efficiency because of too many decks. Should I retire step 1 deck by deleting? Would the information be lost?
    Hope to hear back from you.
    Thanks for everything so far.

      1. FJ says:

        Thanks for the link. I have tried the strategies there, but the message keeps coming up. I attached a zoomed-in photo of the message that keeps showing up. Should I be worried?

        1. Yousmle says:

          Just responded to your email as well, but this message isn’t something to worry about. There’s no negative effects, just be sure to do your cards every day, particularly doing all of your old reviews.

          1. FJ says:

            Thank you!

  17. Alvin Anthel says:

    Hello Alec,
    What is your approach for gross anatomy?

    1. Yousmle says:

      It’s usually a pretty obvious answer – if you don’t see it initially, don’t try and squint to see something, but take a step back and re-assess. Hard to explain without an actual picture, but as long as you remember that the vast majority of answers are “hit you over the head” obvious, you should have a better idea of what to look for!

      1. Alvin Anthel says:

        Thanks. But what i meant to ask was, are there any resources that you would recommend specifically for gross anatomy? Or would you say that the resources you’ve posted (First Aid, UWorld, etc.) will be enough for the anatomy questions?

        1. Yousmle says:

          QBanks and FA should be enough for a reasonable foundation.

  18. Till says:

    Hi Alec, obviously medical students consult your advices and are keen to know everything about your way to pass the USMLE Step 1 exam as high as you did. Perhaps, it would be of interest for you to work together with us, as we are offering medical ressources as well? For further information, please write me a mail. Big thanks in advance, Till

    1. Yousmle says:

      I’m happy to hear of opportunities to collaborate – feel free to e-mail me at

  19. Samira says:

    Alec thank you so much for your anki cards and your web with all the study tips , you are really great.
    I’m sad i only saw them until now and i’m taking my step 1 in 2 weeks. I would really love to jump on my points i’m on 209 on nbme 16 , i’m a little bit scared. I read your article about the qbanks, i already finish all usmle even incorrect ones. Now i don’t know if it will be better to do other qbank like kaptest or just stay with uworld as i only got 2 more weeks. My weak areas are biochem and pathology usually. I don’t now what could you recommend me in this short time ? thank you so much in advance.

    1. Yousmle says:

      Hi Samira,

      Thank you for your kind words. My most concise information on the topic is found in the Step 1 cards, which you can find here:

      Hope this helps!

  20. Tess says:

    Hi Alec,

    Your site is great! I downloaded the free micro Anki deck and I’m just trying to understand how you intend for me to read/use some of these. For some cards, it seems as though the answer is with the question. For example, the front of one card reads “Legionella pneumophila – classic presentation
    Labs show hyponatremia. L. pneumophila is a Gram-negative rod.”

    and the back says “Very high fever in a smoker accompanied by diarrhea, confusion, and cough causing chest pain
    Organism? Characteristic labs?”

    To me, it seems like the question is on the back (giving the case presentation and then asking to identify/name the organism and list lab characteristics), but the front is less clear. I read the part about labs and I’m not sure what I’m supposed to be answering. This is a basic example, obviously, but if you could walk me through your thought process regarding what to put on front and back of cards, how to group info for this, and which cards to allow to be “reversed” in the Anki program, I’d really appreciate it!

    Thanks again for this awesome resource. Once I learn to use Anki, I’ll definitely be purchasing your Step 1 deck!

    1. Yousmle says:

      Hi Tess,

      Thank you so much for your question. The reason there is a question on the “back” side is that they are “reversed” cards, meaning that the question of one becomes the answer of another. This cuts down on the amount of time you will have to spend editing cards, since if you edit one card, it will automatically edit the other card.

      There is an explanation of this process that I wrote here:

      Thanks again for your question!

  21. Yao Peng says:

    Thank you so much for sharing your ankis! They are of great help with my anki card making. I especially like the part that you separate the cards in subjects,which is really convenient for my review.

    But I still have a couple more questions about the exam preparation. Recently more and more feedbacks have come back saying step 1 exam is now putting more emphasis on step 2 ck, for example, showing more questions asking ‘what’s the next step’. And a lot of questions about the clinical statistics have shown up, such as ‘what’s the complication rate of XXX’. I wanna ask how can we prepare for this part even we haven’t reviewed CK yet. any good advise?

    1. Yousmle says:

      Hi Yao,

      Thank you so much for your message and for your kind words. As time progresses, Step 1 has taken on many elements of Step 2 CK, including having longer clinical vignettes, as well as, as you point out, questions that may even be considered management questions. In general for these, remember that a second-year medical student should still be able to answer them, so often times the answer can be found by using physiologic principles, just like most other Step 1 questions. My best advice is to practice doing questions, and as you practice, instead of thinking of the questions as simply testing a piece of rote knowledge, that instead they are testing your understanding of particular pathophysiologic processes, and that you likely know the knowledge required to answer the question.

      I hope this helps! Best of luck in your studies!


  22. Rahul Prasad says:

    Do you have a suggested book list for clerkships? Your resources for Step 1 prep were invaluable!

    1. Yousmle says:

      Am working on it, hopefully will be out soon – hope you signed up for the newsletter, as I also give clerkship/Step 2 tips there, as well!

      1. Rahul Prasad says:

        Excited for your book list!

  23. Michelle Landry says:

    Dear Alec,

    I purchased your deck and gotta say i’m liking it so far. However, i have a few questions. Will knowing the 1200+ cards give me the basic foundation on the content or are there some high yield info that are left off? You mentioned that you add info that students are most likely to miss but does that mean that the cards dont include basic concepts that students do not struggle but are considered high yield/must know info? I guess what i’m asking is how much do i need to supplement in addition to your anki deck?

    Thank you,

    1. Yousmle says:

      Hi Michelle,

      Thank you so much for your question. There is no one a resource out there that is going to teach you everything you could possibly need to learn. There is way too much information, so instead of trying to teach everything, I limited the decks to the things that students struggle with the most typically. This will allow you to supplement the cards on your own, with cards that will target things that are weakest to you!


  24. Kevin Mathew says:

    hey Alec. Hope you are doing good.
    Your advice for step1 and deck of course helped me a lot in my step 1 preparation. Hats off to you.

    now Its Step 2 CK time. Any advice? what should i focus on other than uworld & your deck? is MTB useful?

    There are some new additions of hospital management Qs and patient safety any idea how to prepare for those.

    unlike step 1 there is hardly any solid plan for CK.

    Thanks mate

    1. Yousmle says:

      Honestly, for Step 2, as well as even Step 3, the most important thing is working on your interpretation of the questions, and understanding what each sentence is telling you. The knowledge itself, while still extensive, builds on the things you have already studied, as well as your clinical experience. Typically, I recommend that you focus on doing mainly questions, since that will help you the most with improving your interpretation skills.

  25. karunya kalangi says:

    Hello Alec,

    I found your website accidentally while searching for stuff related to USMLE. And I’m glad i found it. Your emails encourage and guide me. I’m from India and I’m planning to take my step 1 this august. Can you please enlighten me on websites or subscriptions to solve questions. I heard from many preparing for USMLE that U-world is good.

    1. Yousmle says:

      UWorld is quite good, I’d also recommend Kaplan if you’re planning on doing 2 QBanks and not just one.

  26. Daniel says:

    Hello Alec,

    My name is Daniel and I am a first year medical student, currently planning to start my board studying during the summer and projecting to take my boards next year. I found your resources, online, very useful but I just did not know where to begin (topic wise) and what to start with as far as making the Anki deck.

    Could you shed some light on where and what I should begin with to kick-start my board studying? Do I just jump straight into QBank and start making Anki cards for the questions that I hit in QBank?

    Thank you so much for everything.

    1. Yousmle says:

      Hi Daniel,

      Thanks so much for your question. I recently published a post on this exact topic, which you can find here:

      I hope this answers your questions!

  27. SA says:

    Hi Alec, what resources do you recommend for step 2 CK? My exam is in 3 months. Did you use Anki for step 2 as well and how did you make them, by Uworld? Thanks!

    1. SA says:

      One more you recommend studying for step 2 as system-based, and doing questions in a system based way or random mode? Thank you.

      1. Yousmle says:

        I had a very similar approach for Step 2, and used Anki after doing USMLE World questions. The main resource I used was UWorld. These are the same cards that are available on the website, .

        ypically, if you are scoring below passing, I would do it by system, but if you are scoring above passing, I would probably do it random.

        Best of luck!


  28. Elvina Lingas says:

    Hi Alec, I have purchased your pre-made Anki deck, could I transfer it to Anki mobile? If so, how? Thanks

    1. Yousmle says:

      Thank you so much for your message. Here is a link to the help guide to come up with instructions for how to transfer the deck to the mobile app

  29. Jihyun G says:

    Hello Alec, I am interested in purchasing the pre-made anki deck. When I do click on “Buy it now”, it brings me to a page that states that my shopping cart is empty so I am unable to purchase it. Could you let me know if this could be remedied?

    In addition, Is the deck primarily made from the USMLE world objectives and is it comprehensive and divided into sections based on the organ system? I would ideally like to use it for my main deck to save time.

    Thank you!

    1. Yousmle says:

      Hi Jihyun,

      Thank you so much for your message. The Step 1 deck is largely made from USMLE World objectives, as you state, although it also includes many other cards that I made from classes, etc. that explain some of the most important topics for Step 1. It is not divided into organ systems, as I preferred to study mixed – you can certainly search the cards for specific topics that you want to study. It is not “comprehensive” in the sense that it covers every single topic imaginable – I have tried this in the past, and it is too overwhelming for students to do all 17,000 cards I made. Instead, it covers some of of the most important topics that I’ve found are covered in Step 1, as well as many core topics students that I have worked with tend to struggle with.

      Here are the links to each deck: Step 1 Deck , and Step 2 Deck . You can add one/both of them to your “Cart” (if you want to add both, click on one, then come back to the e-mail and click on the other – they should both end up in your cart). For a limited time, you can get the same discount as before ($45 for both, as opposed to $30 for each) if you put in the coupon code “COMBO”. If you do it this way, you can get the decks immediately!

      Best of luck!

  30. Alex GOodell says:


    Do you have any other book recommendations? Many of your best “pathogenesis to presentation” cards here are concepts that were never covered in my class material or in my path/phys/pharm books. What are you core sets of books other than FA and HTISW?


    1. Yousmle says:

      Hey Alex!

      Thank you so much for your email, and for your kind words. Unfortunately, there are not many great books that seem to cover the pathogenesis to presentation style. A lot of the explanations have come from me just writing down interesting things I found in classes, in question banks, in lectures or conferences, from attendings, or other books. It wasn’t like I used one specific resource for everything.

      I have tried to share his many of these explanations as possible both in the website, as well as the decks I share. I will update the resources page with any books that I recommend that I come across!

      Best of luck!


      1. Radha says:

        Hi Alec, I downloaded the sample deck. I also down loaded the anki. But I am not able to open the sample question. How do I see the questions? Please let me know.

        1. Yousmle says:

          Great question, did you download the program onto desktop computer? If so, be sure to import the deck from the Anki program itself, rather than trying to double click on the deck and open it separately.

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