Spaced repetition with Anki is non-negotiable
Every high performer uses spaced repetition in some form. The Anking deck (a maintained, tagged, image-rich derivative of Zanki + Lightyear) is the current community consensus. Start unsuspending cards by system or by First Aid chapter, aim for 100–200 new cards a day during pre-dedicated, and 300–500 reviews a day during dedicated. Consistency matters more than daily volume — a five-day break is very hard to recover from.
How to use UWorld correctly
UWorld is a learning tool, not just a question bank. Do questions in timed, random, 40-question blocks from your first day of dedicated. Review every question — right or wrong — the same day, and take notes on any concept you missed directly into your Anki deck or First Aid margins. Aim to complete the bank once during dedicated and a partial second pass on incorrects. UWorld percent-correct scores correlate reasonably well with NBME performance after you have completed at least 40% of the bank in random-timed mode.
NBME self-assessments predict your actual score
The NBME Comprehensive Basic Science Self-Assessments (CBSSA) are the single best predictor of your Step 1 outcome. Take one at the start of dedicated for a baseline, then one every two weeks. The Free 120 (official practice items) and the most recent CBSSAs are the closest match to the real exam interface and question style. A CBSSA equivalent-score above the passing threshold on three consecutive tests is the standard readiness benchmark.
A realistic 10-week dedicated schedule
Most successful Caribbean and US MD students report 10–12 weeks of dedicated study after basic sciences. A typical week: 40 UWorld questions per day (timed random), 300–500 Anki reviews per day, one to two hours of targeted First Aid review on weak systems, and one full-length NBME every 10–14 days. Take one full day off per week — sustained 7-day weeks lead to burnout and score plateaus.
Common mistakes that lower scores
The most common self-inflicted score drops come from: starting UWorld too late, doing UWorld in tutor mode (which trains you to look at answers instead of testing recall), spending more than a week on any single subject, skipping the Free 120, and treating First Aid as a textbook to be read cover-to-cover rather than an index to be searched.
