I got my PASS, and I just wanted to share my experience because I feel like there’s so much negativity on Reddit that sometimes does more harm than good.
If you’ve prepared well, understand the core concepts, and have been consistently doing well on your NBMEs, I really don’t think you should go into this exam expecting the worst.
Before my exam, I kept reading posts about how insanely difficult it was, how every question was extremely long, how timing was a nightmare, and how everyone walked out feeling like they failed.
But that wasn’t my experience.
Of course, there were difficult questions. Some were long, some were confusing, and I can remember about five questions that I genuinely had no idea how to answer. But honestly, I expected that.
I went into the exam knowing that there would be around 80 experimental questions spread throughout the blocks. I knew I was going to see things I had never seen before, and I was mentally prepared for that. Whenever I came across something that made absolutely no sense, I just reminded myself that it could be experimental and moved on. Obviously, there’s no way to know which questions are actually experimental.
My goal was to PASS, not to know every single answer.
I tried to focus on getting the questions I knew right first, and then I went back to the ones I had flagged because I wasn’t sure or didn’t know the answer.
And about timing, I honestly didn’t have a problem with it. I actually managed to go through every block twice. Yes, some questions were long, but many were straightforward once you recognized the concept being tested.
If you’re given 30 minutes for 20 questions, not every question is going to require the same amount of time. Some might take longer, but others can be answered pretty quickly if you know the concept.
What really bothers me is how much unnecessary anxiety these posts create.
I walked out of my exam feeling pretty good. I wasn’t thinking that I had failed or that the exam was impossible. But then I opened Reddit, started reading everyone’s experiences, and suddenly found myself questioning everything. I literally started worrying that maybe I should feel like I failed because apparently that’s how everyone is supposed to feel after Step 1.
And I think that’s ridiculous.
I’m not saying the exam is easy, and I’m definitely not saying everyone will have the same experience.
I just wish people would stop making it sound like having a terrible experience is the only normal experience.
You can have a difficult exam and still feel okay afterward. You can encounter questions you don’t know and still feel confident about the rest of your performance.
Please don’t let Reddit destroy the confidence you’ve spent months building.
Trust your preparation, trust your NBME scores, and remember that someone else’s exam experience doesn’t have to be yours.

I promised myself that if I passed Step 1, I would share my experience, especially for those who are struggling with low NBME scores and feeling like passing is impossible.

I took Step 1 on September 17, 2026, and I PASSED!

My preparation was far from ideal. I didn't follow the traditional UFAP approach, didn't finish most of the resources I started, and honestly, I spent a good part of my preparation worrying that I was going to fail.

I'm an international medical student with a decent medical foundation, but when it came to Step 1-specific knowledge, I had a lot of gaps.

I had around 3–4 months to prepare, so I had to prioritize.

My NBME scores

- NBME 25: 47.5%

- NBME 26: 58%

- NBME 27: 58%

- NBME 28: 61%

- NBME 29: 58%

- NBME 33: 65%

- Free 120: 67%

- Real Deal (09/17/2026): PASS

As you can see, my scores weren't exactly reassuring.

I never scored above 65% on an NBME, and the fact that I kept getting scores in the 50s despite studying was incredibly frustrating.

The worst part was the fear of failing. Every time I took an NBME, I hoped to see a significant improvement, and most of the time, it just didn't happen.

But I kept going.

What I actually used

1. UWorld (~72% completed)

I completed approximately 72% of UWorld, using a mixture of tutor and timed modes.

I didn't finish the question bank, and I didn't do a second pass.

What mattered most to me was understanding why I got questions wrong, rather than just memorizing the correct answers.

1. Sketchy Micro (never finished it)

I started Sketchy Micro because everyone recommended it.

But I didn't even finish half of it.

It was useful, but with my limited time, I couldn't afford to spend too much time trying to finish every resource.

1. Mehlman Medical — probably one of my most useful resources

I used Mehlman's PDFs and watched his YouTube videos.

They really helped me understand how NBME questions are constructed, recognize recurring concepts, and focus on what is actually high yield.

I found his material particularly useful during the final phase of my preparation.

1. Dirty Medicine — A LOT of Dirty Medicine

I watched a ton of Dirty Medicine videos.

Whenever I struggled with a concept or needed a quick review, Dirty Medicine was one of my go-to resources.

His explanations and mnemonics helped me remember things that I kept forgetting.

1. ChatGPT — probably the most unconventional part of my preparation

This might sound strange, but ChatGPT genuinely played a huge role in my preparation.

I created a dedicated ChatGPT project specifically for Step 1.

I used it to:

- Analyze my NBME mistakes and identify recurring weaknesses.

- Explain questions I got wrong and why the other options were incorrect.

- Generate concise, high-yield reviews of topics I struggled with.

- Help me distinguish between similar diseases and concepts.

- Suggest potential ways the NBME might test a particular concept.

For example, whenever I got a question wrong about a particular disease, I wouldn't just review that disease. I'd ask ChatGPT to explain the related conditions, how to differentiate them, and what other questions could be asked about the same topic.

This helped me connect concepts instead of learning isolated facts.

Of course, ChatGPT can make mistakes, so I didn't treat every answer as automatically correct. I tried to verify important information against trusted resources.

1. My handwritten notebook — one of the best things I did

This was probably my favorite technique.

Every time I encountered something I couldn't memorize, kept forgetting, or repeatedly got wrong, I wrote it down in a notebook.

Not long explanations. Just short, high-yield facts, associations, mechanisms, and mnemonics.

As the exam approached, I reviewed this notebook every 2–3 days.

By the final days, I had repeatedly reviewed the exact concepts that I personally struggled with.

I think this made a huge difference in my retention.

The final weeks

My biggest problem wasn't necessarily a lack of studying. It was the fact that my NBME scores weren't improving the way I wanted.

Going from 61% on NBME 28 back down to 58% on NBME 29 was especially discouraging.

I started questioning whether I was actually ready.

But instead of trying to restart everything or finish every resource, I focused on my weaknesses, reviewed my handwritten notes, watched targeted videos, and continued practicing questions.

Eventually, I scored 65% on NBME 33 and 67% on the Free 120.

These were my best results, but I was still nervous going into the real exam.

I took it anyway, and thankfully, I passed.

What I learned

1. You don't have to finish every resource.

I didn't finish UWorld, Sketchy, or everything I originally planned. I had to accept that I couldn't do it all.

1. Identify YOUR weaknesses.

It's easy to spend hours reviewing things you already know because it feels productive. But targeting my weakest areas helped me much more.

1. Active recall and repetition are incredibly important.

My handwritten notebook was simple, but repeatedly reviewing the things I kept forgetting was one of my most useful strategies.

1. Don't underestimate free resources.

Dirty Medicine, Mehlman PDFs, and YouTube videos helped me tremendously.

1. Use AI intelligently.

ChatGPT wasn't a replacement for UWorld or NBME questions. It was a tool that helped me understand concepts, organize information, and make my studying more targeted.

1. Don't blindly copy someone else's study schedule.

Some people need six months. Others need less. Some finish UWorld twice, and others don't.

Find what works for you.

One important disclaimer

I'm NOT recommending that anyone take Step 1 with low NBME scores.

I knew I was taking a risk, and the uncertainty was extremely stressful. My eventual pass doesn't mean that these scores guarantee success for anyone else.

If you have the time to improve your practice scores and build a safer margin, absolutely do that.

I'm simply sharing my experience because I know how discouraging it can be to read posts from people scoring 75–85% while you're struggling to break 60%.

You can make progress even when your scores aren't improving as quickly as you'd hoped.

My preparation wasn't perfect. I made mistakes, wasted time on some things, and didn't finish everything I wanted.

But I kept adapting my strategy instead of giving up.

And in the end, I passed.

I hope this helps someone who's currently struggling with their NBMEs.

Feel free to ask me anything about my preparation, resources, or how I used ChatGPT for Step 1.

Good luck to everyone preparing. You've got this!

How I Passed Step 1 on My First Attempt (Exam Date: Oct 5)
I passed today, and I want to share what worked. This is my own experience, so take what's useful.

February to March: Starting at the Bottom
I started dedicated study in February and scored 32% on form 26. I expected it, because I started at the bottom for the MCAT too. I was told to do 80 questions a day, and I did that for a month, but I didn't retain much. After a month I was at 42% on form 27.
I decided my problem was content, so I switched to 40 UWorld questions a day plus content review for the rest of the day. I later realized I was doing that wrong too, and I was stuck at 48% by the end of March.
Many of my peers had already taken the exam and passed, and that got to me for a bit. Then I decided I was running my own race and wasn't competing with anyone. I delayed my rotations, which most people start in April.
April to May: Slow Progress
I went from 52% to 54% by the end of May. Improvement was painfully slow, but I stopped caring. I've never been the smartest or fastest learner, but I have endurance and mindset, and I knew I'd get there eventually.
June to August: The Key Change
My goal was the 60s, but I was stuck. So I asked myself what was tripping me up most. The answer was that I couldn't differentiate between similar pathologies, like placental abruption vs. accreta vs. previa, or measles vs. rubella vs. mumps.
I had been using the AnKing deck the whole time. What changed was that I started making my own cards with AI:
After missing a question (say, on breast pathology), I stopped unsuspending AnKing cards.
I asked the AI how Step might test that concept differently and what other pathologies they might use to trick me.
I had it build a high-yield clinical differentiator table.
I screenshotted the table and used image occlusion on multiple rows.
This way I was constantly seeing the differentiating details Step cares about. I did this consistently for every NBME and UWorld question I reviewed, and I hit a 60% by the end of July.
The second realization: I had taken forms 26 to 30 months earlier and never reviewed them properly. I had been so focused on finishing questions and Anki that I set them aside. When I redid forms 26 to 33 and actually reviewed them, I found that concepts repeat constantly. Form 26 might ask about rubella and form 27 about measles, so a deep review of 26 helps you get the next one right.
If you start this Anki + AI differentiator method from your very first NBME and take your time with review, the process will be much faster than it was for me. It seems simple, but it took me months to figure out.
September: Final Stretch
I scored 65% and 65% on my last redos, then 63% on the free 120 in the third week of September. I planned to test the first week of October. My tutor told me I was ready: I knew the content after eight months, and what remained was test-taking and pacing.
Then form 34 came out, I took it in the last week, and I got a 61%. I freaked out, cried, and had a rough episode. I called my support system, and they reminded me how far I'd come. I had a 63% on the free 120, a 97% on the AMBOSS SA, and two 65% scores on retakes of NBMEs I hadn't revised. I had proof I knew the content, so I treated the 61% as a chance to catch last-minute details.
Test Day (Oct 5)
I prayed throughout this process and asked for peace on test day, and I felt calm instead of anxious. Take the free 120 at the testing center if you can. It helps you control the controllables. I walked out thinking it was a 50/50, and the exam felt like a mix of the free 120 and form 32. Today I got the P.
Takeaways
Do a deep review of every NBME, including early ones, because concepts repeat.
Build differentiator tables with AI and add them to Anki with image occlusion.
If something isn't working, change it.
Mindset is huge. Pray, study hard, and trust yourself.

From you’re fellow 500 MCAT scorer to 1st time Step passer

Happy to answer any questions.

NBME-28: 63%
NBME-30: 66%
NBME-31: 61%
NBME-32: 63%
NBME-33: 65%
NBME-34: 70%

Testing in 6 days,Should I go for it?
left with free 120

Just to clarify, I’m not posting this to scare anyone who hasn’t taken the exam yet. Everyone gets a different form, and I might have gotten a harder one. Or maybe I was just mentally exhausted that day, even though I slept well the night before. I honestly don’t know, I’m just trying to see if anyone had a similar experience.

I took Step 1 after finishing all the NBMEs (even the old ones) and UWSAs. My scores went from 66–68% to 79.5% in nbme 34.
But the real exam felt so much harder. A lot of questions required 2nd/3rd order thinking, and even when the questions felt familiar, the answer choices were tricky. I also felt like my concentration was worse than usual and that's what terrifies me.
What bothers me the most is that I made mistakes on easy questions I normally wouldn’t miss. Even micro, which is usually one of my stronger subjects, had me stuck between two options on simple recall questions.
I answered everything, but I genuinely felt like I wasn’t performing at my usual NBME level. The exam was exhausting, and I feel like I lost easy points on an already difficult form.

Has anyone had good NBME scores, felt like they underperformed on the real exam, especially on many easy questions that exsit in FA just needs to remember , and still passed?
I know feeling terrible after Step 1 is common, but knowing I made mistakes on things I should’ve known is what’s really stressing me out.

took Step1 last week. Walking out, I felt pretty normal, not amazing, not terrible, just “I think it went okay” feeling.

But over the past few days, questions keep popping into my head and I’ve counted somewhere around 30–35 that I’m pretty sure I got wrong, including several easy ones I almost never missed on NBMEs. Not crazy hard stuff, the basic stuff I almost never got wrong on NBMEs. Every time I remember one i feel worse, and now I’m second-guessing the whole exam.

NBMEs were fine and I took them under test like conditions (timed, online, with short or no breaks between blocks).

For those who went through this, did you also remember a bunch of easy questions you got wrong after the test? Did you end up passing? Is the "trust the NBMEs scores" really true ?

My exam is in 4 days and I just feel like I not ready enough.

NBME 26 - 49%

NBME 27 - 66%

NBME 28 - 65%

NBME 29 - 64%

NBME 30 - 68%

NBME 31 - 70.5%

NBME 32 - 74.5%

NBME 33 - 67%

NBME 34 - 80.5%

Free 120 - 71%

Each time I gave the tests I felt like im gonna get below 65 percent (even in the one I got 80.5). Idk it normal to feel like I'm getting decent scores through luck? Im extremely nervous about my exam.

I cant postpone the exam

Those who took 34 online and scored in 60s, what passing % it showed you?

I'm testing in 10 days and freaking out.

I was doing nbme 25 and 26 when i was still studying and had done half of the content. I got a score of 50%ish. My boyfriend told me to prep well and start doing the old nbmes so i woukd waste resources.

Last week I did nbme 20 - 84%. I did nbme 21 yesterday and mega score drop, 60% again.

Im sad af

As the title

I need your advice.
I am preparing for step1 but haven’t taken any nbme yet.
I finished all the major systems (UWorld ONLY) except psych
I keep thinking that i am forgetting everything and that i don’t know anything. Whenever I solve a mixed block i get bw 65-90%. It really motivates me but at the same time i have almost 50% of questions flagged as i wasn’t sure or didn’t remember the concept and i was guessing.
A day after a day, i am feeling burnt out and less energized to finish my to do list.
What do you suggest i do? Should i do my first nbme?

Hi I recently took my school's CBSE and I was having a difficult time with time management. I had practiced for USMLE STEP 1 type of format 20 question 30 minutes and did okay on UWorld time at home and for NBMEs. If anyone has tips for time management or test taking strategies I would greatly appreciate it!