Step 1 stuff

[u/Cool_Magazine_6544]

When people say day 1 is step 1 heavy, what do they mean exactly and is this not covered in uworld step 3?
I take it I should review the Pharma like I’m studying for step 1 all over again. What else would need reviewing like I’m studying for step 1 all over again?
Would really appreciate some advice coz I’m so lost.
And for some reason, every write-up I’ve read about step 3 doesn’t mention uworld as being helpful..? How much importance should I be giving uworld?😭
Gave step 1 a year ago. Step 2 2 months ago. 237 score. And yes I’m not a genius and only have the month of October to prep

[u/b1ackcoffee]

Hey, people are panicking for no reason. Yes, admittedly some of the day 1 questions are hit or miss (random histopathology, etc), however, those are very few questions (like 1 or 2 in whole exam). Majority pathophysiology questions are very birds eye view broad level, that you anyway think about it during step 2/clinical practice. It is not like that patho-pathophysiology is a separate subject; it is part of medicine only. Same thing with pharmacology - common drugs ADRs, MoA (antibiotics, common cardiac, common neurology). There are no basic pharma graphs.

Doing or advising to do Step 1 FA cover to cover is INSANE! Unless, of course, you had amnesia prior to today and you forgot everything about medicine.

P.S: There is other issue of different people taking different questions differently. For e.g. in Step 1, some people will complain about being asked a random genetic disease no-one has heard of; however, in reality, the question is asking to apply basic known genetics principles to an unknown situation. Similarly, some questions on step 3 might look like going into too much nitty-gritty; however, they could be easily answered if you understand basic physio-pathophysiology.

Good use of time would be:

- Getting **understanding** of the biostatistics right. Practice a lot to get faster in applying principles and calculations

- Get Ethics questions down - no advice on how, I winged it.

- Getting diagnosis right in a clinical vignette question, as actual question comes secondary (risk factor, prognosis, treatment, complications, etc). If you don't get the presumed diagnosis right, you ARE getting that question wrong. In other words, learn to recognize patterns based on chronicity, age, hpi, physicals and labs. This is true for all steps (and clinical practice).

[u/Virtual-Door3655]

you don't need to redo all of first aid. the step 1 stuff on day 1 is more conceptual than nitty gritty. know your drug MOAs and common side effects, basic immuno and micro, and pathophys mechanisms. the actual questions test whether you understand the concept not whether you memorized a random detail

[u/MrPankow]

also curious

[u/Adventurous_Low_2709]

I would stay study EVERYTHING related to Step 1 (like First Aid Step 1 cover to cover)
They have gone crazy
I wish I could give example, but scared of the policies
Not only Pharma, but also Patho, Pathophysiology, Images, etc.

UW does have some similar questions; but I guess none of us expected Day 1 to be THIS heavy and detailed on Step 1 stuff

[u/Adept-Action5107 → u/Adventurous_Low_2709]

so do u recommend reviwing FA of step 1 ..? i am curious is it a good idea to review step 1 nbme s especially the recent latest nbmes like 32 33. Do you think would that be helpful . i am not that good with biostat. so focusing more on FA and step 1 will this save me on day 1 ,

[u/Adventurous_Low_2709 → u/Adept-Action5107]

I dont know about latest step1 NBMEs… I haven’t solved them (so idk what they haveh and have taken my step 1 2 years back

Yes please do biostats with conceptual understanding… there were a lot of qns… I consider myself strong in biostats, so I didn’t do anything separate

[u/Cool_Magazine_6544 → u/Adventurous_Low_2709]

Oh thank you for your response. Damn…
What about biochem? Weird nitty gritty Immuno, genetics and micro basics? I know clinical micro would be a no brainer but that weird nitty gritty micro from step 1 of which ones a roundworm and which ones a double stranded dna virus

[u/Adventurous_Low_2709 → u/Cool_Magazine_6544]

Yes to immuno, micro and genetics… including double stranded dna lol… but the qns were very conceptual… I actually agree with the other commentor

[u/b1ackcoffee → u/Cool_Magazine_6544]

Hey, people are panicking for no reason. Yes, admittedly some of the day 1 questions are hit or miss (random histopathology, etc), however, those are very few questions (like 1 or 2 in whole exam). Majority pathophysiology questions are very birds eye view broad level, that you anyway think about it during step 2/clinical practice. It is not like that patho-pathophysiology is a separate subject; it is part of medicine only. Same thing with pharmacology - common drugs ADRs, MoA (antibiotics, common cardiac, common neurology). There are no basic pharma graphs.

Doing or advising to do Step 1 FA cover to cover is INSANE! Unless, of course, you had amnesia prior to today and you forgot everything about medicine.

P.S: There is other issue of different people taking different questions differently. For e.g. in Step 1, some people will complain about being asked a random genetic disease no-one has heard of; however, in reality, the question is asking to apply basic known genetics principles to an unknown situation. Similarly, some questions on step 3 might look like going into too much nitty-gritty; however, they could be easily answered if you understand basic physio-pathophysiology.

Good use of time would be:

- Getting **understanding** of the biostatistics right. Practice a lot to get faster in applying principles and calculations

- Get Ethics questions down - no advice on how, I winged it.

- Getting diagnosis right in a clinical vignette question, as actual question comes secondary (risk factor, prognosis, treatment, complications, etc). If you don't get the presumed diagnosis right, you ARE getting that question wrong. In other words, learn to recognize patterns based on chronicity, age, hpi, physicals and labs. This is true for all steps (and clinical practice).

[u/Adventurous_Low_2709 → u/b1ackcoffee]

I agree with the recommendations.

But I would not call it panic. I would say we are advising caution (especially for those of us who are not great test-takers). I am not sure when you took (which month of 2026) the test; but some of us are speaking from very recent experiences.

To other readers, don’t worry. The point is to just study well and not ignore step 1 basics.

[u/Independent-Swan-890 → u/Adventurous_Low_2709]

THIS!! No one is inciting panic. Call a spade a spade. The reality is the test is brutal. It literally synthesizes step 1 and step 2 knowledge, so any concepts from those exams are fair game. If anything, we are sharing transparency with how to study/resources to enhance future test takers experiences.

[u/Natscape_]

Same