First Aid has been the gold standard for Step 1 preparation for years.

It’s the testing resource common to almost every medical student who plans on taking Step 1. All new USMLE preparation materials and resources are instantly compared to it. At first glance it can be quite intimidating because it feels like a dense collection of seemingly random facts and diagrams. It was never intended to be a stand-alone study resource because of the broad range of topics it covers. It lacks background and context out of necessity. It’s a study tool that has a bit of a learning curve of its own.

First Aid doesn’t mention everything, but if it is mentioned then you definitely need to know it. That is to say, there is very little minutia in First Aid.

Even in the era of a pass/fail Step 1 it remains a useful resource. Not only because memorizing its contents will effectively guarantee a passing score. First Aid for the USMLE Step 1 is beloved by so many because it can be used to simplify studying for Step 1 and be your compass as you navigate medical school.

No matter what your goal is for Step 1, these three applications of First Aid will get you a ton of benefit out of it.

In the words of Inigo Montoya, “Let me explain…….No, there is too much. Let me sum up.”

You will need other resources to study to supplement First Aid. Don’t get me wrong, it is solid, but as I mentioned before, it is just the essentials. When you are shopping around for study resources, you should cross reference them with First Aid to make sure that the content matches up. If you are seeing similar topics, then you know the other resource is presenting high-yield information and is worth your time and money. Integrating several different resources will build a more complete understanding of each topic because each resource includes varying degrees of detail.

It is also useful for sifting through your course materials and determining what is good and what is extraneous. There will be some variability in how your program organizes their curriculum and sometimes first and second year courses prioritize clinical pearls over high-yield board fodder. Which is great. And this information will help you eventually. But it may not help you on Step 1.

I found it useful to check First Aid to assess whether high-yield topics were present in my lectures. And to be sure they presented all the pertinent points. If not, then I knew to spend a little extra time reviewing to keep pace with what I needed to know for Step 1.

Whether it’s flash cards, question banks, or text books, you should see similar themes as those mentioned in First Aid. I would recommend resources that draw from the information within First Aid for things like flash cards and question banks. This will give you confidence that you aren’t spending effort out in the weeds chasing down low-yield facts.

When you feel like making a study schedule, it can be overwhelming to figure out which topics to cover. For this I would routinely turn to First Aid. First aid is really well organized into principles and organ systems. Divide the topics up by days, weeks, or months depending on how fast you want to cover the material. When we made our first Step 1 study plan we just entered all the main chapters and sections of First Aid into an excel spreadsheet and started marching through those topics in all of our resources.

You’ll notice that a lot of your other resources will tend to organize themselves similarly to First Aid. This makes it really handy to supplement flashcards and quiz questions and have them all tie in to what you’re covering in First Aid.

As you make your way through the sections of First Aid you’ll notice that it feels painfully slow. With each section you become more efficient. Same for multiple passes. Each time you pick up more and more of the information. So what changes within your study plan isn’t the topics you cover, but rather how quickly you are able to move through them.

The authors of First Aid envisioned it as a databank for all the requisite knowledge to perform well on the USMLE Step 1 exam. They attempted to combine all the high-yield information into one place. The authors mention this just before the first section. It is recommended to seek out other resources, study them, and bring all the extra information back to First Aid. That way you have a central location for everything you have learned, and you don’t waste time searching several different texts to find your notes.

Get yourself some super fine point Sakura Pigma Micron Pens to write with, assign a specific color for each resource, and then start filling the margins with everything you learn that’s not listed in First Aid. You will get so familiar with the pages of First Aid that specific sections will appear in your mind as you answer USMLE style questions. This is also why your first pass through your resources seems to take forever. You spend time compiling a central location for everything you know about Step 1 topics. But it’s well worth the effort.

Each time you sit down to review a topic you will have all of your information at your finger tips and know exactly where it came from.

I know a lot of you probably prefer to have an electronic note taking system, but I can tell you from experience that this method works. My Anki library also served as a peripheral brain during step prep. This way I had a physical database as well as a searchable database with Anki. Taking hand-written notes helped me to synthesize the information and forced me to digest it as much as possible before putting it in First Aid. It required a little more effort and processing than just “copy+paste”.

This is a plug for a specific resource that I think is the perfect companion to First Aid and really helped us get tons of benefit from it.

USMLE Rx360 is a combination of flash cards, short videos, and a qbank that is all linked to the sections in First Aid. This means that it tracks along perfectly with the book. The flashcards and videos provide more context to topics. We would take notes from the videos, work through flash cards, then try to talk through the section in First Aid until we had it memorized or at least understood it well enough to teach it to someone else. Finish it off with a few qbank questions. This was a really effective system.

The flash cards do not have spaced repetition programing (or at least not when we used it) so we still relied on our Anki deck for that. We used the Zanki step deck which was heavily sourced from First Aid, Uworld, and Pathoma (more on this in a future post).

The question bank wasn’t as good as UWorld, but the explanations were clear and we learned plenty. It was also helpful to prepare for our course work by having some practice problems to work through that we could select by topic. We completed it during our first and second year courses and felt super prepared heading into UWorld and dedicated Step 1 study.

I would definitely recommend it as a companion to First Aid. It takes a lot of the guess work out of studying and combines multiple methods of review in a single platform. I would still supplement this with resources like Pathoma, Sketchy medical, and Anki flash cards.

Try these applications to get the most of First Aid. It really is an excellent resource and should earn a spot in your Step 1 study arsenal.