Preparing for the USMLE Step 1 exam can feel daunting. From personal experience, I know that late nights spent doing flashcards and practice questions can make passing the exam seem almost impossible. However, it is achievable – I passed, and you can too.

Depending on your programme, you may have more or less time to prepare. Whether you are in the Graduate Entry Medicine (GEM) or Direct Entry programme, you must pass RCSI’s diagnostic exam before you are eligible to take the USMLE Step 1.

To prepare for the diagnostic, I began studying shortly after the start of Med 3. I watched one unit per week on Boards and Beyond and completed 40-question blocks on AMBOSS at least once a week. This is a solid strategy if you have plenty of time, though if you are on a tighter schedule, it may be better to focus more on practice questions. A week before the diagnostic, I stopped watching Boards and Beyond videos and focused almost entirely on answering as many questions as possible.

My goal was to get accustomed to sitting for long periods and maintaining focus – the diagnostic tests endurance as much as knowledge. Before the diagnostic, I also reviewed topics I was struggling with using YouTube resources such as Melhmann Medical and Dirty Medicine.

Once you pass the diagnostic, the next step is taking the actual USMLE Step 1 exam. RCSI provides a six-month subscription to UWORLD to support your preparation. I recommend using UWORLD as much as possible before the exam. In the final weeks leading up to your test date, try mixing UWORLD with past NBME questions to simulate the real exam experience, so you feel confident and comfortable on test day. W

hen you feel ready to take the exam, you will need to book a test date by registering with the Educational Commission for Foreign Medical Graduates (ECFMG). Once registered, the ECFMG will help you find testing centres near you. I chose to take my exam over the summer in Canada, but you can book a test centre in Dublin if you feel ready sooner.

If I could offer one piece of advice, it would be to make steady, daily progress. Rome was not built in a day, and you will not be ready for this eight-hour exam without consistent preparation. Take it one day at a time, and before you know it, you will have accomplished your goal.

Best of luck and happy studying.