# The 16-Week Step 1 Plan

> A four-phase 16-week Step 1 plan: 9-day foundation, 10–12 weeks of systems in a fixed order, 8–10 days of revision, then NBMEs from form 27.

URL: https://vault-guides.vercel.app/timeline.html
Canonical: https://usmlevault.com/blog/timeline
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## Summary

A screenshot-friendly four-phase Step 1 timeline. Phase 1 (days 1–9) finishes Sketchy Micro's ~85 bugs at ~20–22 organisms a day plus 45 high-yield pharmacology videos at 3 an hour over ~3 days. Phase 2 (~10–12 weeks) runs every system through the same loop — micro revision, Vault plus First Aid page by page, Mehlman only if UWorld is under 65%, Foundation Anki, then UWorld blocks — in a fixed order with biochem split into seven pieces placed before the systems that need them. Phase 3 (8–10 days) is pure consolidation with daily micro, 2–3 Anki systems a day, and timed NBME-26 blocks. Phase 4 is NBMEs starting with form 27 in 20-question blocks under exam-day timers.

## Key facts

- Four phases: Foundation (days 1–9) → Systems (~10–12 weeks) → Revision (8–10 days) → NBMEs
- Sketchy Micro order and counts: DNA viruses 13, RNA viruses 13, parasites 13, fungi 12, gram positives 10, gram negatives 19, indeterminate/myco/spirochetes 7 — ~85 bugs at ~20–22 a day (4 per hour)
- Read from First Aid instead of Sketchy: TB, coronavirus, HIV, malaria; skip entirely: Bunyavirus, Arenavirus
- High-yield pharmacology is 45 videos at 3 per hour, about 3 days, mechanism-first
- System loop: micro revision (~4h) → Vault + First Aid page by page with MCQs → Mehlman only if UWorld < 65% (sort playlist by date, last 3 years) → Foundation Anki (~2 days per system) → UWorld blocks; averaging >70% on the last 4–5 blocks lets you skip Mehlman and Anki
- System order and days at a 10–12 hr pace: Renal 6, Respiratory 6, Biochem-Nutrition 1, GI 7, Reproductive 6, Biochem-Carbs 1, Biochem-Fats 1, Endocrine 6, Biochem-Cellular 1, Biochem-Molecular 1, Biochem-Amino Acids 1, Immunology 5, Heme/Onc 6, MSK 7, Dermatology 3, ANS 1, Psychiatry 5, Biochem-Genetics 1, Neurology 8, Cardiovascular 6, Biostats & Ethics 3, General Pathology 1 (optional), General Pharmacology 1 (optional)
- Biochem is split so each piece lands before the system that needs it — Nutrition before GIT, Carbs/Fats before Endocrine, Cellular/Molecular/Amino acids before Immuno–HemOnc, Genetics before Neuro
- Phase 3 daily pillars: 1 hour micro revision, Foundation Anki 2–3 systems/day, and in the last 5 days 2× NBME-26 blocks/day (20 questions in 30 minutes)
- Two-phase block method: first pass in ≤23–24 minutes at max 80 seconds per question, flag and move on, then a second pass on flagged questions
- First real NBME is form 27, given in 20-question blocks with three timers: 30-min block, 55-min total break, 6-hour exam (~5h questions + 1h breaks); major break every 40 questions
- NBME loop: give 27, then 28, 29… review every question right and wrong, run NBME Booster to break a stuck score, repeat until consistently at target

## Covers

16 week USMLE Step 1 study plan, Step 1 system order schedule, when to do biochem Step 1, how many days per system Step 1, first NBME which form, NBME 27 timing, Mehlman 65% rule, Step 1 timeline foundation phase

## Source

USMLE Vault — https://usmlevault.com
Author: Dr. Marish Asudani

Updated: 2026-08-26