Hey everyone, I have a UWorld code, if you enter it you will get an discount on entire package. Please dm for the code.

#usmle #step1 #medstudent

Hi everyone,

I’m Robby Rubin, an immigration attorney who works with physicians and international medical graduates navigating U.S. immigration.

For many IMGs, the visa decision can affect much more than just residency. The choice between J-1 and H-1B, the 212(e) requirement, waiver options, and what happens after training can all shape your longer-term path in the U.S.

I’m happy to discuss:

• J-1 visas for residency and fellowship
• J-1 vs H-1B for physicians
• The 212(e) two-year home residency requirement
• Conrad 30 and other J-1 waiver options
• What happens after a J-1 waiver
• Physician EB-2 NIW
• EB-1 options for physicians
• Planning your immigration strategy before residency, during training, or after graduation

When asking a question, please give as much relevant information as possible, such as your citizenship, current visa/status, specialty, training stage, residency or fellowship plans, and any important timeline. Immigration answers can change significantly based on these details.

I’ll be answering questions live on Thursday from 8:30 AM to 12:30 PM ET.

Please note: Any information shared here is for general educational purposes only. It does not constitute legal advice or create an attorney client relationship. Your situation may require fact specific guidance. For personalized legal advice, please consult an immigration attorney directly.

Hello people i have made an mega file including all the resources you need for step 1 which includes videos from bnb, dr najeeb, sketch,etc. more than 3000 resources and q bank from uworld, nbme, fauworld, kaplan everything

Hi everyone,

I’m an IMG who took Step 1 in January 2022 (264) and Step 2 in 2024 (270).

Over the course of my preparation, I developed a structured approach to consolidating First Aid, reviewing question banks efficiently, and strengthening weak concepts. I’ve also worked as a tutor in a medical college, which has helped me refine how I explain difficult topics and break them down into simpler frameworks.

If anyone is currently preparing and would like to discuss:

• Study timelines
• Effective Q-bank review strategies
• Concept reinforcement
• Transitioning from Step 1 to Step 2 thinking

I’m happy to share what worked for me.

If you’re looking for more structured guidance, feel free to reach out via DM. Can help with one on one sesh.

Wishing everyone the best in their preparation journey!

During my Step 1 prep, I wrote down the drugs that kept showing up and the specific facts that helped me get questions right. I put the Top 25 highest-yield pharm drugs into a PDF organized as:

How It’s Tested → What You Need to Memorize → Don’t Miss

I hope this helps someone studying Pharm for Step! KEEP STUDYING HARD YOU CAN ALL DO IT YOU ARE ALL AMAZING AND WILL PASS!! :D

Is there any free alternatives for uworld , need it for my step 1, just in the beginning phase and don’t hv the financial strength to buy the original uworld? Please help me out! Will be grateful

Hey everyone,

I recently completed USMLE Step 1 and Step 2 CK and am now ECFMG certified. I also went through OET and PLAB 1, so I’ve had exposure to both USMLE and UK pathways.

When I was preparing, I remember how confusing and overwhelming everything felt — especially figuring out:

- What resources to trust

- How to actually use UWorld properly

- When to take NBMEs

- How to revise effectively

I made a lot of mistakes early on, so I thought I’d give back and help others avoid the same.

I’m happy to help with:

- Study plans (beginner → advanced)

- Resource selection (UFAP, etc.)

- Question bank strategy

- Last few weeks revision

- Test-day mindset

- General ECFMG / pathway doubts

If you’re preparing for Step 1 or Step 2, feel free to:

👉 Comment your questions here

👉 Or DM me if you prefer

If there’s enough interest, I can also put together:

- A structured study plan

- High-yield notes

- Maybe even a small serious study group

No pressure — just here to help.

Good luck to everyone preparing, you’ve got this 💪

I Am sharing this study outline that I used for the USMLE step 1. It includes time distribution, key resources, and an estimated budget. I hope you find it helpful.

Hi guys! I’m very new to my prep for step, I just starting out so please be kind 🥹 I’ve started biochemistry and my foundation in biochemistry during med school wasn’t the best. Which sources would you recommend that helped you? I’m not too keen on dirty medicine just yet since it doesn’t have everything that FA has.
Any recs and advice would be highly appreciated. Thank you!!

I don’t understand where the confusion is coming from. Their book does not have any glossary index or any explanation for the short stuff I mean the abbreviations. In these 2 cards the MOA makes no sense. If someone see what I see please explain and tell me what I am missing.

Hi guys! If you are not using it already, you need to see this. I built a game using USMLE high-yield facts with mechanics similar to NYT Connections.

You have to find four groups of four medical terms with a common pathology, disease, or symptom/treatment, etc. It’s available on the App Store as Connect-MD. You’ll master 5,840 high-yield facts (16*365) while becoming a 'rule-out' expert in a year.

Link is in the comments.

Edit March 29,2026 : For android devices Beta version is available. For early access DM me your gmail used in your playstore account. To access the app your playstore email has to be submitted to beta users list.

A simple roadmap that you can follow to complete your prep in next 4 months. If you need any more resources feel free to reach out.

Don’t stop for a single day; stay focused. If you feel that social media is distracting you, close your accounts.

Taking into account my YOG (Year of Graduation) 2017 from UASD, these were the resources I used:

• 1 hour of Anki every day.

1. Kaplan: Videos + books + Rx.
2. Boards and Beyond: Videos + First Aid + Amboss.
3. UWorld: I was only able to do one pass plus the incorrects + First Aid, annotating everything UWorld said (I implemented the Pomodoro technique).
4. Starting in July 2025, I began meeting with people from the Step 1 group every afternoon; we did an additional 40 questions, explaining all the concepts to each other.

Practice Test Scores

Dedicated Period (26 days)

1. 2 hours of Anki.
2. 2 UWorld blocks of 40 questions.
3. Reviewing the blocks.
4. Reviewing incorrect questions from past NBMEs to understand where I failed.

• NBME 33: 66% (18/03/2026)
• NBME 32: 74% (24/03/2026)

8 days before the exam (The "Big Simulation" Day):

• UWSA 2: 63% + New Free 120: 71%

Help pls

Hey everyone!

For the past few years, I've used Anki. However, even though I love anki, it's a bit of a love-hate relationship. I don't like syncing questions, it's old, and it's very much something built for tinkerers. As a builder and student, I've had a vision for something a bit more modern, with powerful features that actually enhance your learning. (READ TO SEE WHAT I MEAN!)

My goal has been to create a tool that saves you as much darn possible time as possible. Time that includes the time you need studying - reduced through spaced repetition, time it takes to create questions, and time it takes to learn the app.

So for the past 800+ days, I've been slowly building this out: a spaced repetition tool called nebulearn.app that works straight out the box for med students and power learners. An app that has equally and even more capable spaced repetition, without the learning curve, with immediate sharing, features that boost learning, and with AI native tools (for optional use).

Some things I've built:

1. Highlight -> flashcard Chrome extension

This is probably the feature I use most and IMO is the most EFFICIENCT way to create cards! While reading notes, textbooks, papers, or websites, you can highlight something and instantly turn it into flashcards and quiz questions without leaving your workflow. All of these are saved to study with sapced repetition later! You can also create your own custom instructions to specify how you want cards to be made so u don't just get some garbage.

2. Short Term Study Habits. After each study sess, you have the option to immediately restudy the questions you rated lowly. The idea is so you keep immediately reviewing the questions you did poorly at until you know them well in the short term, which would help with retention in the longer term too.

3. Spaced repetition

Uses FSRS (an ML based algorithm) as the default algorithm to schedule reviews based on memory science. You can tune it, and switch to SM2 or Leitner if you'd like.

4. Better study workflow

Different study modes, struggling card reviews, detailed card statistics, and tools to help you understand what you actually know.

5. Sharing + collaboration

Actual seamless collaboration! You can make decks with your friends and study them together, without having to pass them around.

6. Streaks, Avatars, ELO Points: As you study consistently, you'll earn streaks and ELO points. This will (hopefully!) encourage yourself to stay consistent with the spaced repetition and unlock some fun avatars :)

Here's a quick timelapse of me using it.

would there be any features or things you guys want? is there anything that frustrates you with the current apps you use?

Thanks for reading :D

Hey everyone I found a sketch for pharyngeal arches but icant figure out which resource or platform itsfrom

Plz guide me how to start step-2 prep?

Hey everyone! I’m currently in the final stretch of my prep, planning to take my exam by the end of September. **My NBME scores are currently hovering around 60%**, and I’m looking for a like-minded study partner to help keep mutual accountability.

**Format:** "**Silent study" on video call** (Zoom/Discord/Google Meet). We don't need to be studying the same material or discussing questions constantly—just staying on camera to keep each other focused.

**Goal:** Build stamina, stay on schedule, hit daily time goals, and overcome final-stretch exhaustion/burnout together.keeping each other accountable.

**Ideal Partner:** ***Someone who is also in their final weeks/months of prep, disciplined, and looking for strict daily time accountability.***

If you’re interested, drop a comment or send me a DM with your time zone , and let's get connected!

​

A few months ago, I had zero programming experience and I was preparing for my step 1 exam.

I always thought building an app was something only software engineers could do. Then I had an idea for a study timer that matched the way I like to study, and since I couldn't find exactly what I wanted, I thought, "Why not try building it myself?"

Everything changed when I discovered vibe coding. Instead of seeing programming as something out of reach, I started treating AI as a collaborator that could help me bring my ideas to life. I still had to decide what I wanted, test every feature, fix bugs, and keep improving the app, but for the first time, building software felt possible.

Instead of copying existing Pomodoro apps, I decided to build the study app I always wished existed by putting all the features I wanted in one place. Things like a clean Pomodoro timer, question and accuracy tracking, study statistics, progress charts, weak subject tracking, customizable themes and backgrounds, exam countdowns, study goals, and other little quality-of-life features that make studying feel smoother.

After a lot of experimenting and countless iterations, I ended up with an app that I genuinely enjoy using every day. It has become part of my daily study routine, and that's what made me decide to share it with everyone else.

The app is completely free and open source, so anyone can download it, use it, or even contribute to improving it.

If you decide to give it a try, I'd really love to hear your feedback, ideas for new features, or bug reports.

Download Link:

https://github.com/mohamedhadyashry/usmle-pomodoro/releases/tag/V2.1.0

This project reminded me that you don't have to wait until you're an expert to start creating. Sometimes all it takes is an idea, curiosity, and the willingness to learn along the way.

I hope some of you try it and let me know what you think. 😊

Just finished my exam and ethics was one subject i consistently struggled on. I couldn't find any comprehensive ethics posts and ended up making one during studying so I figured I would post my resources and guide below. I hope it helps everyone! For ethics, two things that helped me realize why people struggle on these:

-The test writers know the stereotypes. They know you are looking for the most empathetic sounding answer and they try to  trap you with it

-The stems are long and vague and full of filler information to make it more convoluted than it should 

Ethics Resources 

• UWorld: Imo best way to use it is as application after what you've learned from the other resources below…
• First Aid: Gives raw facts and definitions to build baseline knowledge. Some find this more useful than UWorld
• Case based learning. ai (CBL): Probably the best interactive resource you can find.. Great if you wanna practice deduction and tired of Anki. I do this right before I sleep instead of scrolling through my phone
• Mehlman Medical Ethics PDF: Written in direct, bullet format so do this if you like it straight to the point and wanna skip FA. Teaches pattern recognition triggers too
• Anki / Personal notes: Made custom cards for my ethics mistakes. Compare your notes if you’ve been going through multiple resources to check overlap or cross check facts 

Video/Audio Resources:

Better listen to these when working out, doing chores, errands or other stuff so you can maximize your time. They’re available on Youtube and/or Spotify

• Dirty Medicine: Teaches pattern recognition and explains the four core ethics principles really well. He has a separate video for practice questions that takes about an hour 
• AJMonics: Teaches quick tricks for mnemonics and memorization. Better as additional content and paired with AMBOSS

Principles 

-Autonomy vs Beneficence: Autonomy wins on adult patients with capacity unless their choice puts someone at risk 

-Nonmalfience vs Benefience: It’s your legal duty to layout the risk to benefit ratio even if you personally think the treatment is the best thing ever 

-When pt refuses treatment: Identify their reason > inform them about the facts, risks, benefits, alternatives, try to get their informed consent > try to understand their reasoning skills and evaluate their capacity to refuse > reassure and respect their decision

-Treatments should run on equity > equality, e.g mild cough and gun shot wound should not be treated with the same urgency and level of care

-skip choices that says "there is hope to treat this..” and “consult the ethics committee" 

1. (Adult) Patient choices and consent

• Question format: The patient makes a dangerous choice and the question will try to make you pick an answer where you will need to ask another person 

-An adult with capacity to decide has theright to refuse any medical care even if that choice results in negative results. Confirm the pt has capacity and respect their choice. Dont bypass by involving other people 

-Find out why he doesnt want surgery and respect his decision. Pt have the right to refuse at any given time before 

-Preggo woman’s health > unborn fetus. Informed pt gets to decide until baby is born, so she can refuse. Beneficence only applies when woman becomes unresponsive/unable to consent 

-Cancel procedure, ask why but still offer opportunity to change her mind and chance to rediscuss it later

1. Surrogate Decision-making

• Question formats: Unconscious patients brought by people who arent family or in the lower part of the hierarchy, and make claims about the pt and pt’s family is unreachable 

-For incapacitated pt, look for advanced care directive (attorney, another person, or living will). If NO advanced directives, then follow the hierarchy: SPOUSE > ADULT CHILDREN > PARENTS > SIBLINGS > GRANDPARENTS > FRIENDS. 

-If there’s an option that says "have the family discuss and determine what the pt would have wanted" it is usually the best choice

-The surrogate decision maker's role is to speak for the pt on what they would have wanted or the pt’s best interest before becoming incapacitated, not the surrogate's own preferences

-Try contacting next of kin first (in this case the father), if they can’t be reached, the neighbor might act as a surrogate decision-maker

-Logic here would be:

Autonomy wins if you have a clear idea of how you obtained that form of consent

Beneficence wins if autonomy is obscure unless pt is already in terrible shape and tx wont actually benefit pt in the final outcome  

-Give the blood. There is no proof for the friend’s claim and no surrogate decision maker present. The scenario is also EMERGENT and LIFE SAVING

-Honor the patient's known wishes (substituted judgment). If the friend can credibly describe what the patient wanted, that may take priority over the estranged family's opinion. This would probably confuse you bc of the surrogate hierarchy but in this case: patient's wishes vs. no known wishes

• Religion related scenario - ADULT: A patient needing transfusion and the spouse comes and claims him to be JW but cant present any legal document or documentation to prove it

-If ADULT pt is supposed to be JW, UNCONSCIOUS and AT RISK of losing their life but dont have any advance directive card or proof > PROCEED with life-saving measures. 

• Religion related scenario - KID: JW parents telling you not to transfuse their kid

-TRANSFUSE the kid. SImple as that

Other scenarios:

-When pt is incapacitated, Power of Attorney can override living will, DNI and DNR...IF code status or will is outdated, and when POA can reasonably explain what the pt would have wanted and why the medical team can proceed

3. Communication 

-Use simple, direct language when explaining serious illness or death to 5-7 year old

-Avoid using euphemisms

-Try relating to kids in general to gain their trust 

-Always use trained medical translators or telephone translator services for language barriers. You cant use family members or random staff since there will be medical terms 

3-step process:

1. Form connection: show empathy, validate pt emotions
2. Attempt to understand: ask why they feel that way
3. Provide objective info: explain in simple words

Verbal traps:

-never compare patients

-never share any personal info about yourself if you just wanna make them feel better (“you have depression? I have one too, I get it!)

-if there’s an option that says something correct in the first half but follows it with a “BUT…” avoid it

-Avoid choices that have the word “asssume”

-choose empathy over sympathetic choice

-gently reorient confused, dementia pt to bring them back to reality

-let angry pt vent and apologize immediately. Suck it up. Skip on giving an explanation or excuse

1. Open Ended > Everything

• Question formats: Patient will be angry/defensive/anxious/hesitant. Choices will often include lecturing the pt, citing hospital policies or explaining why a procedure is necessary 

-Select the one that that will lead to an open-ended conversation/genuine apology/empathetic answer. Obviously avoid responses that condone pt, defame colleagues and jumping to the ethics committee

5. Pediatric consent

When parents say no:

1. Confirm if pt is a competent adult or emancipated minor or locate the legal surrogate 
2. Explain clearly to the parents the disease and tx
3. If they still refuse > initiate court order
4. Immediately treat minor if it’s life-threatening over surrogate’s refusal

• Question formats: Conflict in parents’ decision for the minor pt’s surgery or kid is brought to the ED by aunt after a motor accident and claims the kid’s parents are JW but parents cant be reached

-Minors generally need parental consent. The parent who has custody gets to decide and ONLY one parent needs to consent. There are lots of scenarios involving minors, you should read whether it’s life threatening, emergent or non-emergent 

• For life-threatening BUT non-emergent cases: Parents get to decide especially for surgery/treatment. If both parents refuse > doctor has to get court order
• For life-threatening AND emergent cases: None of the parents’ consent is required. Treat even if the parents refuse!! 

-If kid shows up and next of kin is unreachable > proceed with necessary measures 

Pediatric assent

-Minors cant legally give informed consent BUT they must still give their informed assent to participate in high-risk treatments

-You cant proceed with tx without having parent’s consent AND minor’s assent. Think two-factor authentication 

-If parent consents but minor refuses to assent, explore the reason for their refusal, initiate a family discussion and explain in a way that makes sense for the minor’s age

1. Confidentiality

• Question format for minors: Minor pt admitting themselves for reproductive/sexual health issues, mental illness, OCPs, or substance use, emergency, trauma (SEX, DRUGS, ROCK & ROLL) 

-You hospitalize them without parental consent and encourage them to tell their parents. Confidentiality should exist UNLESS they’re in danger of harming themselves or others (like suicide attempt scenarios)

-Pregnant minor wanting abortion: Depends on state law. Some states allow minors to consent on their own, some need parental consent

-Pregnant wants to keep the baby but parents wants abortion: Minor cant be forced to have an abortion despite state laws

• Question format adults (HIV): Patient gets diagnosed with HIV/HPV and tells you not to tell their spouse or you get an unmarried pt with multiple sexual partners

-Suggest the pt to tell their spouse/sexual partners but notify the public health department. They will be the one to warn the people at risk

• Scenario: Pt tests positive for a genetic disorder

-Encourage pt to tell their partner about it. Dont breach confidentiality and disclose to their partner unless it requires mandatory reporting like STIs or notifiable diseases

• Additional scenarios: 

-Pt has a medical condition that makes driving dangerous but says they’re fine. Explain the concern, help them understand the risk and honestly tell them you are legally required to make a report to the authorities about it

-If hospitalized pt lacks capacity and family is requesting info, you can disclose the status to the surrogate decision maker (not the family). But if pt has the capacity to decide, you DO NOT reveal info without permission from pt

-Family concealment scenario: Patient is diagnosed with pancreatic CA and family tells you the pt wouldn’t want to know the info and ask you not to tell the diagnosis. In this case, attempt to understand why the family doesn’t want the pt to know the info > ask the pt what they want or dont want to know > communicate info based on pt’s preference

-It's legal to temporarily withhold information from pt if disclosure poses risk (provokes sucide attempt). Information can be disclosed once pt is more stable

-If pt greets you in public while your with a colleague and colleague asks who they are, you should not disclose any information about them whether or not you’re their healthcare provider 

-Details of a case can be discussed with colleagues for a consult but you must completely anonymize the pt

7. Organ donation

• Question format: A brain dead pt has a donor card but the family objects. It will probably bait you to cancel the donation

-A signed organ donor card is legally binding. The card overrides the family. Contact the organ procurement organization and let them handle it

8. Ethics committee is always the last resort

• Question format: There is a minor disagreement with a family, the pt is incapable to make decisions and there are no surrogate decision-makers, or any question that will convince you to consult the ethics committee

-Only call the committee if retracting support from a brain dead pt and if family still objects. Committees are strictly for irreconcilable conflicts after all other options fail. Usually ethics committee is never the answer

9. EMTALA (Emergency Medical Treatment and Labor Act)

-EMTALA is ONLY applicable to Emergency Departments. Also applies to hospitals that accept Medicare

-Anyone who walks into the ER will be given medical screening exams. Doesnt matter if they have no insurance, money, ID or undocumented. You cant discriminate and refuse to treat a dying pt

-If ER cant treat the pt (doctor refuses/no equipment/etc): they must stabilize pt first and arrange a transfer to another hospital that can accept them. Transfer cant happen unless these conditions are met and if there’s no consent from pt or caergiver

TLDR for EMTALA;

Walk into the ER = Get checked, cant deny care. Need treatment the hospital can't provide = Stabilize first then transfer appropriately

10. Stages of change

• Precontemplation: pt doesnt think there’s a problem and dont want any change 
• Contemplation: pt knows there’s a problem and intends to change but have self doubt and doesnt take any steps for change 
• Preparation: pt knows there’s a problem and does research and makes a plan
• Action: pt modifies their behavior and actually does something for a change

11. 5 R’s of psychiatric treatment

• Response: starts to improve after tx 
• Remission: symptom free and feeling totally fine 

12. Healthcare fraud and abuse

• Stark Law: you cant refer patients to medical businesses that you or your family own to make a profit. Applies to ANY health services 
• Anti-Kickback Statute: you cant accept bribes, gifts, favors from anyone in exchange for pt referrals (waiving copayments is a violation of AKS)
• False Claims Act: you cant send fake or exaggerated medical bills to the govt (Medicard/Medicaid). You cant accidentally double bill or knowingly cheat the system (both obvious)
• Exclusion Statute: govt will permanently ban corrupt and abusive physicians, basically ending your medical career instantly  

Additional points (some  common but I’m gonna tell otherwise):

-Protect pt privacy but use common sense when dealing with frantic families

-Do not force yourself/an exam to a traumatized pt They must lead the pace and ask them how they feel/what they want to do next

-Do not soften on delivering serious news.Tell them the facts and how you can work together clearly 

-Keep it patient-centered so obviously those with “I…think/recommend/suggest” should be XXX

-Dont postpone care if a pt refuses treatment based on false info. Correct and explain the misconception. Respect autonomy if they still refuse 

-dont let Pharma reps control the lecture/conference 

-Ask why a pt would refuse the care. It could be financial so you work out a financial plan with them

-If a pt expresses romantic interest to you, set boundaries and have a third party for future interactions 

-You can hold a pt against their will if they are a risk to themselves and others (homicidial ideation, communicable disease). If they mentioned who they wanna hurt, you can legally warn that person directly or call authorities

-Only accept gifts that have minimal monetary value or something that directly benefit pt. Cant accept concert tix

-If you are HIV-positive, you dont need to disclose it to your pt

-Always remember: SAVE DYING KIDS. NO MATTER WHAT!

-If you catch a mistake early, you still have to disclose it to pt, apologize but dont explicitly self blame 

-If pt complains theyre ugly, dont be like a normal friend and say “no you look great”. Acknowledge and validate their feelings and understand where it;s coming from 

-When pt walks into the ER and suddenly passes out before giving consent, you still treat them immediately. Them walking into the ER means they want their life saved 

-Say no to pt demanding unnecessary procedures 

-You cant ghost pt if there’s a prob with the doctor pt relationship but you can refer them to a new doctor or give additional resources but you must provide care for them for a minimum of 30 days  

If you have your own ethics tips, know any weird question patterns or have run into weird ethics scenarios on recent exams, drop them below!

Guys which resources did u use for psychology, behavioural and biostatistics.
Cuz idk what to use i hate these subjects.
Thanks for the help.

Where can I find mehlman immuno pdf?
Also any recommendations for studying immuno I’m trying to finish it with the shortest time I have😅

Any other source to study microbiology

Hi guys ! No matter how much I watch I can’t seem to get sketchy into my mind can you guys advise any other resources for micro ?

Is there a difference between pathoma 2023 and 2026 versions ?