Dr. E's exact schedule: 59% baseline NBME to a Step 1 pass in 34 days
A US MD student, MS3, with clinical rotations already started. He took a short break to get Step 1 done, and went from a 59.5% baseline NBME to a PASS in 34 days. Here is every step, in order, with the receipts.
Where he started
On Aug 25, 2026 he took a baseline NBME and scored 59.5%. These were his 4 blocks:
| Block | Score |
|---|---|
| Block 1 | 31/50 |
| Block 2 | 27/50 |
| Block 3 | 24/50 |
| Block 4 | 37/50 |
I audited him, and the problem was clear. He had never reviewed all the systems properly, and he had never gone through First Aid properly. So the plan started there, not with more questions. (If you are not sure what a baseline should look like, read Taking Your First NBME and the exact NBME order.)
The 34 days, with the receipts
Every score below is from my own tweets, posted on the day. Read it top to bottom: the date, the score, what he did, and the receipt.
The audit: no proper pass through the systems, no proper pass through First Aid.
He ran the FA Foundation Anki deck (the same deck as the General Series Anki): a curated deck that ties every First Aid page to 2–3 question-style cards on the important topics, about 2,400 cards. That is how he went through the whole book. Alongside it, he did the Pepper Micro Sketchy deck in about 8 days. (How to run micro: Sketchy Micro and micro by system.)
From 59.5% to 74.5%, after the Foundation deck and micro.
I made him take NBME 28, 29 and 30 as timed blocks of 20 questions, 2 blocks at a time, rather than as full forms. (How to review an NBME: the NBME review protocol. How to work each question: the NBME MCQ protocol.)
Then system-wise revision with the NBME Booster Anki deck. It picks up the high-yield topics from NBME 20 to 33 and divides them by system. He did the Booster for forms 20 through 31, because NBME 32 was next.
8 days after the 74.5%. That is 59% to 78% in 20 days.
34 days after the 59.5% baseline. (The last stretch and the exam day itself: the last 2 weeks and the day before and exam day.)
The result came in. A US MS3, in the middle of rotations, from a 59.5% baseline to a pass.
The schedule, in 1 table
If you only save 1 thing from this page, save this order.
| When | What he did | Result |
|---|---|---|
| Aug 25 | Baseline NBME, then a full audit | 59.5% |
| Next 8–9 days | FA Foundation Anki (about 2,400 cards) + Pepper Micro Sketchy deck in about 8 days | — |
| Sep 6 | NBME 31 | 74.5% |
| NBME 28–30 | Taken as timed 20-question blocks, 2 at a time | — |
| Then | NBME Booster Anki, system by system, forms 20 to 31 | — |
| Sep 14 | NBME 32 | 78% |
| Sep 28 | Took Step 1 | — |
| Oct 15 | Result | PASS |
In his words
I called him after his result. 2 lines from that call, word for word:
Use the same tools
Everything he used is written up. Start with the deck that matches your gap.