USMLE Vault · Step 1
You Already Did UWorld. Here Is the 12-Week Plan.
For the student who finished most of a question bank six to twelve months ago and cannot tell how much of it is still in their head.
Let us describe your situation and you tell me if it is wrong.
You have done a lot of UWorld. Maybe 60, 70, 80% of it. Your average was respectable. But it happened over six months or more, in bursts, around a job or a posting or an internship — and now, when you open a random block, you get questions you know you have seen before and cannot answer.
So you are stuck between two bad options. Start again, which feels like admitting the last six months were wasted. Or push forward, which feels like building on something you cannot verify is there.
Both options are wrong, and the reason is the same. You do not have a knowledge problem. You have a retention and sequencing problem, and those are fixed in weeks, not months.
Step 0 · The audit — before you study anything
Do not open a book until you can answer these four questions in writing. This is the same audit I run with every student on day one.
| Measure | Why it matters |
|---|
| % of UWorld complete | Tells you how much is left, not how much you know |
| Your average | 65% and 45% are two completely different plans |
| Over what timespan | The number that actually decides everything |
| Which systems are untouched | These are the ones that will surprise you on a form |
The third row is the one nobody measures. 70% of UWorld at a 65% average sounds strong. Done across six months, it is not a foundation — it is a memory of a foundation. The early systems have decayed, and no amount of new questions repairs that, because new questions test what you have, not what you have lost.
Weeks 1–5 · Consolidate every system
Not new content. Not a fresh pass of the question bank. Consolidation — putting back what leaked out, in the order you originally built it.
1
First Aid, page by page, with the First Aid Guide. All 646 pages carry what is actually tested from them, an ELI5 explanation, the best video for that topic, and MCQs on that exact page. This is the fastest way to rebuild a system you have half-forgotten.
See a real page → 2
Page-by-page MCQs as you read, then that system’s UWorld questions straight after. The page MCQs tell you the page is back; the UWorld block tells you whether it survives a vignette. Familiar is not the same as known — and that gap is exactly why your old average is misleading.
What about the 30% of UWorld you never did? Leave it. You are not trying to finish a question bank in these five weeks; you are trying to make the 70% you already did mean something again. The unfinished blocks come back later, and by then they are easier.
Week 6 · Foundation Anki, then your first NBME
🗂️
First, the whole book back — in six days. Run the
Foundation Series Anki deck: ~2,400 page-mapped cards,
two systems a day, 350–400 cards, six days for all 646 pages. The First Aid page number is on every card, so a hesitation sends you straight to the source page.
The full six-day protocol → 📝
Then the form. NBME 26 first, in blocks — the easiest one, taken for confidence rather than judgement. Never as a cold baseline: you only get eight forms. Then 27 and 28 as your real baseline, once Anki, First Aid and AMBOSS 200 are done across every system.
Offline, always.
10 blocks of 20 questions, 30 minutes each, first pass finished by minute 23 so you keep 5–7 minutes spare.
The exact order, 26 through 33 → ·
the pre-NBME protocol → Never attempted a form before? The
NBME section inside University has it taught end to end — how to give your first NBME, and how to give NBME blocks. Two videos, free. Knowing the content and knowing how to attempt the paper are separate skills, and the second one is the difference between your real score and the score you get.
Roshni scored over 75% on this form. Five weeks earlier she had 70% of UWorld done at a 65% average and could not tell you what she still knew. Nothing new was learned in those five weeks. It was all already in there — it just was not reachable.
Weeks 7–9 · NBME Anki, and repair the weak systems
1
The NBME Series Anki, system by system. Roughly 3,500 cards distilled from the retired forms. Never form by form — forms are how the questions were packaged, systems are how your knowledge is stored. Finish every system before you attempt the next form.
How to run it → 2
Mehlman’s video playlist for whichever systems are still weak. Not all of them — only the ones the last form exposed. Sort the playlist by date and watch the last three years.
How to use him properly → 3
Both decks are taught inside University. Which deck does which job, how to set it up, how many cards a day, and how to run a deck system by system rather than drowning in a backlog. Free, and worth the twenty minutes before you start.
Roshni went to 83% here. Same student, same book, one more pass — done as active recall rather than rereading.
Weeks 10–12 · The endgame
1
Mehlman’s High-Yield Arrows — one dense multi-system document, kept open throughout and run hard the week a score stops moving. It is the highest-yield thing available in a plateau.
2
The Neil Randy PDF — his whole library broken down system by system. Not just biostats: cardiovascular, CNS, psychiatry, ethics, biochemistry. Worth
5–10% on its own. Run it before a form, and again before the exam.
3
A full-length assessment — a real exam day. An NBME is half an exam: it measures knowledge but never trains eight hours of stamina.
The Vault assessments are 14 blocks of 20, 280 questions, ~7.5 hours, with a 12-section report and no fake 3-digit prediction.
Assessment 2 is free → 4
Then the forms that decide it. 29 and 30 after the repair round, then
31 in 10 blocks of 20,
32 paired with the Med School Guru Free 120, and
33 with the real Free 120 — each pairing is 320 questions across 14 blocks, which is the shape of the actual day.
Ready means above
67–68% on 31, 32 and 33, consecutively and progressively. One good form is noise.
What each form is for → Roshni held above 75% across all of them, then passed. Twelve weeks from an audit that read “70% of UWorld, 65% average, six months, mostly forgotten.”
The whole thing on one screen
| Weeks | What | Checkpoint |
|---|
| 0 | The audit — four numbers, in writing | You know where you stand |
| 1–5 | Consolidate every system: First Aid Guide + page MCQs | Systems are reachable again |
| 6 | Foundation Anki — whole book in 6 days — then NBME 26, offline | The book is back, and a real baseline |
| 7–9 | NBME Series Anki system by system · Mehlman on the weak systems | The gaps close |
| 10–12 | HY Arrows · Neil Randy · a full 14-block assessment · forms 29→33 | 67–68% × 3, climbing |
What was actually missing
This is the part worth being honest about. Roshni was not a weak student, and the plan above is not a secret. She was scattered — plenty of effort, no sequence, no way to tell whether a week had worked.
🧭
Clear direction. What to do tomorrow morning, decided in advance, so no day starts with a decision.
📆
Daily accountability. The thing that keeps week seven looking like week one.
How that works → 🎯
Correct guidance at the decision points. When to take a form, when to stop consolidating, when a score means move on and when it means repair.
Two ways to get those. The plan itself is free and it is on this site —
four questions and the twelve weeks build themselves around your date, with the pages, the blocks and the cards named for each day. If you would rather have someone watching the numbers with you and making the calls, that is what
mentorship is — direction, daily accountability, and a second opinion on every decision that matters. That is the whole difference between Roshni’s twelve weeks and her previous six months.
See the Step 1 mentorship programme →
📞
Or just book a call and we will work out whether twelve weeks is realistic for you.
Thirty minutes, one to one. Bring your four audit numbers — how much of the question bank you finished, your average, the timespan, and which systems you never touched — and I will tell you honestly whether your date holds, what the first five weeks should look like, and whether you need mentorship at all.
calendly.com/marish-usmlevault/30min →
Everything referenced here.
The six months were not wasted.
They are just not reachable yet. Twelve weeks, built backwards from your date.
Build my 12 weeks →