# Giving Step 1 in Third Year

> A 24-week third-year Step 1 plan: 2 weeks foundation, 16 weeks across eleven systems, 6 weeks of NBMEs, with the 65% and 67–68% thresholds.

URL: https://vault-guides.vercel.app/year-3.html
Canonical: https://vault-guides.vercel.app/year-3.html

## Summary

Lays out two routes to sitting Step 1 in third year — cross-integrating during years one and two, or starting cold in third year — and gives a full 24-week plan for the latter. Stage 1 is two weeks of foundation: Sketchy Micro (~20 organisms/day, ~6 days) then high-yield pharmacology (~3 days). Stage 2 is sixteen weeks across eleven systems at about ten days each, running a six-step loop ending in UWorld, with renal first and CNS/cardio last. Stage 3 is six weeks of NBMEs: 7–10 days of consolidation, then the forms in a set order, with 31, 32 and 33 deciding readiness.

## Key facts

- 24 weeks total: 2 weeks foundation, 16 weeks systems (weeks 3–18), 6 weeks NBMEs (weeks 19–24)
- 16 weeks is the timeline for someone whose content is already built; 24 is the number when starting cold
- Eleven systems at roughly ten days each; renal first, CNS and cardio last
- Biochem is not a system — it is seven pieces, each placed before the system that needs it
- Per-system loop: micro revision → First Aid + Guide → college material → Mehlman (one day) → Anki (the next day) → UWorld
- UWorld runs until the last two blocks hold above 65% — the score ends the system, not the calendar
- NBME order: 26 in blocks, 27 as the first real assessment, 28 in blocks or skipped, 29, NBME Booster for forms 20–29, 30 in blocks, then 31, 32, 33
- Readiness = above 67–68% on 31, 32 and 33 consecutively and progressively (68, 67, 68 is a plateau; 67, 70, 73 is ready)
- Every NBME offline, 20 questions in 30 minutes, first pass finished by 23 minutes leaving 5–7 minutes spare
- Consistently under 65% on 27 or 28 means do not book a date
- NBME Assessment 2 is free; simulate a full day by combining two forms into 14 blocks
- Author did all three Steps in 11 months: 16 weeks Step 1, 6 months Step 2 CK, 45 days Step 3; two students replicated it, one scoring 259 on Step 2 CK

## Covers

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## Source

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

Updated: 2026-08-26