Done with Step 1!! My Experience and some universal advice

Just finished the infamous Step 1 exam!
all 368 questions! 8 Hours.

Okay. I've thought a lot about what kind of advice to give from my experience. I realized that telling about what I studied, whats best, and how gives very little benefit to anyone because of A) I only had enough time to study one way, and I have no way to form a comparative opinion, and B) because what works for me may not work for you. There are many good resources, and we all start from different starting points. So, I'd like to give some more universal advice that everyone can appreciate instead, anything else would feel irresponsible and arrogant. My way was not necessarily the best way for you. If you want to ask me directly, feel free.

However, here was what I thought was (and sorry if this is repetitive from other sources) the best use of my time.

*Uworld, the Doctors in Training Program, and Of Course First Aid*
*The NBME exams and simulating test day was essential, and making it 8 hours was really the hardest thing for me, and I think it would have been no matter how prepared I was. It's just a long exam!
*The way I feel about these are if had I done without ANY one of these things, I would not have been ready for the exam. Period.

But everyone knows to do some sort of comprehensive review and a question bank or two, you can find that advice anywhere. Here's my more general advice:


1) General Advice

• Make sure you pick Something, whatever feels right for you and STICK TO IT. You pretty much only get one chance before you burn out (also it would be nice to nail it the first time) and so trust that the choice you make is the best one, and use it to your benefit as best you can. After going through my review process, I was extremely fatigued, tired of studying and ready to be done, and I can only guess you will be too. Going another round NEVER crossed my mind as an option, I think I would have lost it. 
• Avoid Burning out! Studying for 5-10 weeks i think works for about everybody. It's fairly widely accepted that 6-8 weeks is enough time to prepare. I agree 100%.  I think timing is so important when making a study plan because you start forgetting things after a while, and mental fatigue or burnout can negatively impact your performance on the exam. You should try to tackle the Step in your prime. Some people I know moved their exam a little earlier so as not to burnout before taking it, remember its a LONG exam, and fatigue really does play a big role in your performance!

• Find some source of motivation early on. Be it someone else to study with (preferred), imagining what you plan to do after its over (haha, or not do), or just periodically closing your eyes and imagining the feeling of the moment you step outside the testing center when its all over... something to keep you going. It will undoubtedly be a lengthy, uncomfortable, and agonizing process to prepare, but its only a couple months of your life, and you'll get through it. That is if you decide to dedicate the 10-12 hours that some sources say the top students reported doing. I tried it, and this is really an in-humane way to live for 6-8 weeks. So you need something to keep you going if you want to stick with it. 
• Some people take longer and a more relaxed study schedule, but I agree that studying everything efficiently in a shorter amount of time, and focusing completely on your ultimate goal of Rocking This Exam is the absolute best way to go!!

3) Picking an Exam Date

• One thing I learned from Kaplan is that you should ONLY take the exam when you KNOW you will be ready for it. If youre barely passing the assessments, don't take the Step! Its that simple. You can use the NBME exams, or a number of other practice assessments to measure this, Kaplan, Uworld, the USMLE website etc have assessment exams for example. I can't responsibly comment on what I took or what was my best assessment, because I couldn't do all of them and I don't trust the online forums completely. Again, pick one or more, and trust its the best choice for you. Just make sure you do one! If you don't assess yourself, how will you know you are ready? The more the better probably. 
• Practice taking over 300 questions atleast Once!! I recommend more than once, and doing it in the fashion of the exam. No water, no food except on breaks, limit your break time.. You want to feel that endurance effect, and to live out the exam anxiety so it is not foreign to you on test day.
• This is important!! KNOW your prometric center in the US. Let me clarify some things: Each center offers different exam times. The center I went to offered 8am, 10:30am, and 1:30pm exam start times! Also... Know that these centers are NOT just for Step 1. There are people tackling the GRE, MCAT, Tech exams, Law, .... and a variety of other exams, and depending on how busy of an area the center is in, depends on whether or not you will have a lot of available spots to register for. 
• This is important because you may want to change the date of your exam while you prepare. I did. Many people I have spoken to did, and so may you. You do not want to be confined by the availability. Note the first bullet, you want to take the exam when you are ready, not when the test center is ready. Don't mind the date change fees either, your bank account doesn't know when you are ready to take the exam either. Get familiar with the testing center you plan to use, (or even have a backup if youre an indecisive person). On the Prometric Testing Website, you can check the availability often and see how availability of days and/or exam times change, and don't wait too long to change it, your exam time slot, or day can be lost if you don't act!
• Its also important (especially if you are preparing in Grenada and plan to travel to take the exam to different time zones). Good news! you may not have to change your sleep schedule to take the exam during your optimal performance time, say if you are waking up at 8am in Grenada, and sign up for a 130pm spot on the westcoast you will be just fine.
• Not that important, but just be aware of time changes like daylight savings, I actually had my exam very close to the time change and you want to be ready for it. Even while anticipating it, it took some time of adjustment. 

4) How to study

• Please don't take this advice as God's gift to studying for the USMLE, I am just offering what I thought helped me, and hopefully it may help you.
• Ok, Rule #1: Get answers wrong. This is a great thing. Each time is an opportunity to learn something you didnt know, or better yet, something you thought you knew well, but still got wrong, and FIX IT. This is good. embrace this. That's why doing as many questions as you can really helps you.
• Don't wait to do questions all at the end. Example, you think you know everything about statins. Now its 2 weeks before the exam, you're hauling full speed through a question bank and what do you know, youre getting questions about statins wrong!!! Now you feel like a dope and getting anxious that theres 2 weeks left and you still are getting things wrong you thought you knew! The solution. DO QUESTIONS EARLIER. This is the overall principle: You Will be tested on topics that you know, and you can easily anticipate this, I mean... Most ALL the high yeild stuff is in First Aid!. BUT HOW THEY WILL BE TESTED will be different, and if you do not do the questions in order to anticipate all the different ways a piece of information can be manipulated and asked from different angles in questions, you'll be caught off gaurd. Example: Huntington's disease. You could probably tell me everything about this disease, triplet repeats, chromosomes, symptoms, age of onset, blah blah blah, you probably also know it causes caudate atrophy. Like I said, you know it. But can you point to the caudate on a CT Scan of the brain? That's the likely different angle the USMLE will use against you. You must practice, and practice early as you review to get exposure to as many of these types of questions as you can. 
• Although I thought it was helpful going through all of my fully annotated first aid the few days before the exam, it was terribly painful.  It is incredibly frustrating spending hours reading/studying things you (at this point) know very well, but its an invaluable review. 
• I also made a list of things from day 1 of things I didn't know, don't know well, or probably wouldn't remember. I enjoyed going over this much more because it felt fresh and much more accomplishing to read. I would review it before going to bed everynight as the list got longer until it becomes part of me. When I was tired of reading repetitive things, I would go over this list to see if I was retaining it.  
• For each Question bank you use... Use them as a learning tool. You may feel compelled to use it as an asssment tool with all the numbers and percentages and whatnot, but commit to reading the explanations of the right answer, AND the reasons why the answer you thought was right, was in fact wrong. This will be a lot of the learning you'll do. Use the NBME and other resources for assessment. 
• Take Days Off!! Your mental health depends on it. Do fun things. Loosen up. Don't be all work and no play. You've been studying in medical school for 2 years already, can you seriously admit that you have studied for 6-8 weeks straight without going out? If your answer is no, then you already know better and know this advice is important. Take breaks. You deserve them. Especially the day before. It feels good to give that day of rest to kill the momentum of the anxiety and anticipation you feel for this great exam, and take the edge off. I thought it was invaluable to help me sleep that night.

5) The Exam Day

• I still feel that theoretically, if I knew Everything for the exam, enough to get 100%, I still think I would have fallen short because of this: The hardest part of the exam for me was how long it was, and dealing with mental fatigue can affect your performance. The physical endurance of performing, deducing, and reasoning for that long is part of the exam. You have 8 hours and 368 questions. It is very long. Anticipate this, and do what you can to keep yourself as alert and functional as possible during those 8 hours to do your best! So...
• Know yourself, and plan your breaks out ahead of time (you can do this by using the assessments)
• See when you need to goto pee from all the coffee you drink, or start to lose focus or what and plan for it!
• Get a good night sleep
• Eat long-lasting energy foods, and don't overeat! Eat light (you can snack on your breaks between blocks)
• Register for an exam time that works for you (if you can help it). 

Finally, and most importantly, Goodluck! Some of the questions you will endure will seem foreign to you. You should expect some bogeys. Some of the questions you do get, will, in part be luck. But a lot of them are anticipatory. Believe in yourself, know that the effort you have put in will pay off, and know that if you did what you planned to do in the first place, you should feel proud and ready to do the best you can. 

Great luck to you all!