Resource Reviews Ranked Guide 12 min read

Best Step 1 Study Resources 2024: Complete Tier List (Ranked by Residents)

These rankings are based on a synthesis of aggregated survey data from Step 1 veterans — residents and fellows who sat the exam within the last 3 years and can assess which resources actually translated to exam performance. The tier system runs S (essential, highest ROI) through D (niche or low-value for most students). This is not a paid ranking. No resource company has reviewed or influenced these results.

Data: 2024
Source · Survey of 500+ US residents and fellows (2023–2024)
Last refreshed
2024-09
1
Tier S Question Bank $329/yr ★ 4.9

UWorld Step 1 QBank

Core exam prep, self-assessment, building clinical reasoning

The undisputed gold standard. UWorld's question explanations are often better teaching tools than the questions themselves. Two full passes through UWorld, tracking weak topics, is the cornerstone of high-scoring Step 1 prep. Percent-correct benchmarks: target 60%+ on first pass, 70%+ on second.

Pros

  • +Best explanations in any QBank
  • +Closest to real exam difficulty and style
  • +Detailed performance analytics
  • +Tutor mode + timed mode + custom blocks

Cons

  • Expensive ($329/yr)
  • Can feel overwhelming if started too late
2
Tier S Reference Book $60 ★ 4.8

First Aid for the USMLE Step 1

The central reference — annotate everything else to it

First Aid is not a learning tool — it's a high-yield fact repository. The correct use is to annotate it continuously: when UWorld, Pathoma, or Sketchy teaches you something, you write it in the margin next to the relevant First Aid page. By test day, your annotated FA is a personalized high-yield bible.

Pros

  • +Comprehensive high-yield content
  • +Tested and refined over 30+ years
  • +Integrates with every other resource
  • +Inexpensive

Cons

  • Dense — hard to read cover-to-cover
  • Needs annotation to realize full value
3
Tier S Video Lecture Series $100 ★ 4.9

Pathoma

Pathology — the highest-yield Step 1 subject

Dr. Husain Sattar's 35-hour video series is the best single resource for Step 1 pathology, which comprises ~35% of the exam. His conceptual approach — teaching mechanisms rather than memorization — means knowledge transfers to novel vignettes. Non-negotiable for any serious Step 1 studier.

Pros

  • +Best teaching style in medical education
  • +Mechanisms > memorization
  • +Pairs perfectly with First Aid pathology
  • +Compact (35 hours total)

Cons

  • Pathology only (supplement with other resources for pharmacology, physiology)
4
Tier S Spaced Repetition Free (Anki) + free deck ★ 4.8

Anki (AnKing Deck)

Long-term retention of high-yield facts

The AnKing deck (community-maintained, ~30,000 cards) is the most-used Anki deck among US medical students. Used consistently from MS1, it builds the factual scaffolding that makes UWorld and First Aid click. Warning: this is a supplement to active learning, not a replacement. Card-review-only approaches without conceptual understanding underperform on USMLE-style vignettes.

Pros

  • +Free
  • +Spaced repetition = best retention science
  • +Massive community support
  • +Covers all First Aid content

Cons

  • Time-intensive (100–200 reviews/day)
  • Must be started early (MS1/MS2)
5
Tier A Visual Mnemonics $180/yr ★ 4.7

Sketchy

Microbiology and Pharmacology

Sketchy's mnemonic-based visual stories are polarizing — students either love them or find them gimmicky. For Micro and Pharm (two dense, memorization-heavy subjects), most high-scorers use Sketchy. The images are sticky, the coverage is high-yield, and the accompanying Anki cards integrate well with AnKing.

Pros

  • +Unmatched retention for Micro/Pharm
  • +Visual learners' dream
  • +Anki integration available

Cons

  • Expensive if bundled with other Sketchy subjects
  • Not useful for pathology or physiology
6
Tier A Video Lectures $149/yr ★ 4.6

Boards & Beyond

Physiology and Biochemistry conceptual understanding

Dr. Jason Ryan's video series is the best alternative to Kaplan for building conceptual foundations, especially in physiology and biochemistry. Many students use B&B during dedicated study for a rapid 'relearn the mechanism' pass before doing UWorld blocks on that system.

Pros

  • +Clear explanations
  • +Keyed to First Aid chapters
  • +Shorter than Kaplan (more efficient)

Cons

  • Requires UWorld for application practice
  • Less comprehensive than Kaplan
7
Tier A Question Bank $299/yr ★ 4.5

AMBOSS QBank

Second QBank for additional practice after UWorld

AMBOSS is the best second QBank for Step 1 — not a UWorld replacement. Its questions skew harder than the real exam (by design), and its integrated knowledge library is excellent for understanding concepts in context. Best used after completing a UWorld pass, to expose gaps with novel questions.

Pros

  • +High-quality knowledge library
  • +Questions test deeper conceptual understanding
  • +Excellent for re-do after UWorld

Cons

  • Harder than real exam (can be demoralizing early)
  • Expensive to stack with UWorld
8
Tier B Textbook Series $130 (7-book set) ★ 4.1

Kaplan Lecture Notes

Students who need detailed conceptual foundation before doing questions

Kaplan is the most thorough resource on this list — which is also its weakness. The 7-book series covers more than Step 1 will ever test. Most students who read it cover-to-cover run out of time before completing QBank. Better used selectively: Kaplan Biochemistry and Pharmacology chapters are excellent; use Pathoma/B&B instead of Kaplan for Pathology/Physiology.

Pros

  • +Thorough and detailed
  • +Good for students who need deep understanding before doing questions

Cons

  • Too long for most students' timelines
  • Pathology and Physiology sections inferior to specialty resources
9
Tier B Free Video Lectures Free ★ 4.3

Ninja Nerd Science (YouTube)

Physiology lectures — excellent free alternative to paid resources

Ninja Nerd's physiology series on YouTube is genuinely excellent — detailed, mechanistic, and free. For students who can't afford Boards & Beyond or Kaplan, Ninja Nerd covers the same ground at comparable quality for physiology. Not comprehensive enough to be a standalone resource, but exceptional for targeted subject review.

Pros

  • +Free
  • +High-quality physiology content
  • +Great for reinforcing UWorld explanations

Cons

  • Not comprehensive
  • No integrated QBank or analytics
10
Tier C Audio Review Free ★ 4.2

Divine Intervention Podcasts

Listening review during commute / last-minute pass

Dr. Divine's rapid-fire podcast episodes are best used as a high-yield final review in the last 2 weeks before Step 1. Each episode covers a major topic in 20–40 minutes. Not a substitute for UWorld or First Aid, but excellent for locking in key distinctions before the exam.

Pros

  • +Free
  • +Efficient (listen during commute)
  • +High-yield focus
  • +Excellent for last-minute review

Cons

  • Audio only (harder to retain visual/diagram content)
  • Not a complete resource

How to Build Your Step 1 Resource Stack

The biggest mistake students make is using too many resources. The optimal stack is: (1) UWorld as your primary learning engine — do questions, learn from explanations, not the reverse; (2) First Aid as your annotation hub — everything you learn gets cross-referenced here; (3) one conceptual video series (Pathoma for pathology, Boards & Beyond for physiology/biochem); (4) Anki for retention; (5) Sketchy for Micro/Pharm if you are a visual learner. That is it. Adding AMBOSS, Kaplan, and a second Anki deck fragments your time and hurts more than it helps.

The Timeline Question: When to Start Each Resource

In MS1: Start Anki immediately (AnKing deck), using subject-based filtering to review content you are actively learning in class. This builds the long-term retention foundation. In MS2: Add Pathoma and Boards & Beyond alongside your coursework. Begin UWorld on 'tutor mode' for subjects you have completed. In dedicated study (6–12 weeks pre-exam): Switch to timed, full-block UWorld. Use First Aid as your daily review. Complete one full UWorld pass and start a second. Add NBME practice exams starting 4 weeks out.

Frequently Asked Questions

Is UWorld alone enough to pass Step 1?

For most students, UWorld alone is not sufficient. While UWorld's explanations are excellent, Step 1 requires a breadth of factual knowledge that benefits from complementary resources. The minimum effective stack is UWorld + First Aid. Students who add Pathoma (for pathology) and Anki (for retention) consistently outperform those using only UWorld. That said, doing two full UWorld passes with focused review of wrong answers is more valuable than doing one pass of UWorld plus three other question banks.

Should I use Kaplan or Boards & Beyond?

For most students, Boards & Beyond (B&B) is the better choice: it is shorter, more focused on high-yield content, and keyed directly to First Aid. Kaplan is more detailed and comprehensive, but most students do not have time to complete it in a dedicated 8-week block. The exception: students who are very early in their preparation (MS1) may benefit from Kaplan's thoroughness when time pressure is lower.

How many Anki cards should I do per day for Step 1?

During MS1–MS2 alongside coursework: 100–150 new cards per day with 100–200 due reviews, depending on your pace. During dedicated study: focus on reviews rather than new cards — aim for 200–300 reviews per day of high-yield material. The AnKing deck has ~30,000 cards; you likely won't (and don't need to) mature all of them before the exam. Prioritize cards tagged for Step 1 high-yield content.

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