This page contains my experience with the USMLE from a Canadian med student perspective from a 3-year program at the University of Calgary.
USMLE Step 1
As a Canadian med student in a 3-year program, I was a bit worried when I decided to write the Step 1. We don't have summer breaks and our curriculum does not include a lot of the material. However, having written the exam, I think writing the Step 1 right after preclerkship is the ideal timeline if you plan on writing all 3 Step exams.
For those of you at UCalgary, I estimate that we cover ~40% of Step 1 content in our curriculum. I would have failed the exam if I didn't use external resources to study. The Step 1 has a much heavier emphasis on the basic sciences compared to the Canadian curriculum, which is more in line with the objectives of the Step 2 CK and Step 3. We don't learn much of the basic sciences at UCalgary, so you'll likely have to self-learn histology, biochem, embryology, genetics, pathology, and most of physiology and most pharmacology. Furthermore, lots of Step 1 is not relevant for the wards, so be prepared to sacrifice clerkship prep time for Step 1 studying time. As well, unless you're willing to take Step 2 CK in the first 6 months of clerkship, it won’t be possible to apply to USA for residency because their match is earlier than ours, and you need Step 2 CK results prior to the ERAS match.
| Item | Description | Notes |
|---|---|---|
| Resources used in order of usefulness to me. |
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I found UWorld to be invaluable for practice questions. I found Sketchy to be amazing for memorization of random factoids. I didn't use First Aid too much during prededicated, but it was a huge help during dedicated. N.B., I definitely went overkill on resources but felt very comfortable walking out of Step 1. The bare minimum resources I would recommend to pass the Step 1 are UWorld, NBME forms, FIrst Aid, and Pathoma. |
| Pre-Dedicated | I started studying for the Step 1 in January of MS1. I spent an extra 2-3 hours on top of my 2 hours of school content review each day studying after class. I would try to do a 30-question block of UWorld, ~800-1000 Anki cards, and 2-3 Sketchy videos a day. If I was tired or near in-house exams, I would stop all step studying and focus exclusively on school content using Toronto Notes. It was definitely a grind and oftentimes I wondered whether it was worth it to write the exam. In hindsight, although there was a lot of content not relevant to clinical practice, I find small tidbits from it useful during my clerkship rotations. | IMO, the best time to write this exam is right after preclerkship during the summer break in a 4-year program. Since I was in a 3-year program, I wrote it after winter break and had a 3-week dedicated period for studying. |
| Dedicated |
My dedicated period was 3 weeks over my winter break. I started by watching most Pathoma and Dirty Medicine videos and would take hand notes as I went through (I found these to be very high yield resources). At this point, I had completed ~70% of UWorld, and didn't bother to continue doing blocks regularly. Dirty Medicine's mnemonics and high-yield images were fantastic for long-term retention, especially when paired with First Aid. Towards the final week, I focused primarily on weak sections in First Aid by taking handwritten notes, reviewing incorrects on the NBME forms, and watching Step 1 complete reviews on YouTube. The day before the exam, I redid all my incorrect biochem and immunology questions on UWorld and went through the First Aid rapid review chapter. Every 4-5 days, I would take a 4-hour practice exam under exam conditions. I would do these at 8 AM if I managed to wake up by then. The actual exam wasn't too bad in terms of fatigue if you can manage the NBME form length. When writing each block, I would skip any questions I did not immediately know and flag questions I wanted to return to. I would have ~20 min left after answering all questions and reviewing the flagged questions. |
Definitely a grind to get through these weeks. I originally scheduled my Step 1 for Feb 2024 but moved it one month earlier to Jan 2024 because I didn't want to study for Step during clerkship. |
| Timeline |
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I found a 1-year timeline with a 3-week dedicated period to be way more than enough to comfortably pass the Step 1. |
USMLE Step 2 CK
This exam was much more in line with what we learn in our Canadian curriculum than the Step 1. By studying for the Step 2 CK, you will be more than prepared for the MCCQE (just review the Canadian-specific screening guidelines and ethics and you should be good). The Step 2 CK felt like a harder, longer, but better written version of the MCCQE. If you're a Canadian student not applying to the US for residency, the best time to write this exam is with your MCCQE for the reasons above. My goal for this exam was just to pass and not to maximize score, so please take what I say with a grain of salt. YMMV.
| Item | Description | Notes |
|---|---|---|
| Resources used in order of usefulness to me. |
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UWorld + regular clerkship studying + Anki + NBME forms are more than enough to do well on the Step 2 CK. |
| Pre-Dedicated | I started studying for the Step 2 CK throughout clerkship. I would do my Anki cards every day and every second day or so I would do a 20-40 question block of UWorld questions. | |
| Dedicated |
My dedicated period was 2 weeks in May 2025. I started by doing UWSA 1, 2, and 3 to get a baseline. I then would intersperse NBME forms and Divine Intervention 3rd Year NBME Shelf Exams for high-yield concept review. I did 3 NBME forms (10, 13, 14) and the new free 120. These were very helpful and I would encourage you to prioritize NBME forms over the UWSA if you are pressed for time. When writing each block, I would skip any questions I did not immediately know and flag questions I wanted to return to. I would have ~20 min left after answering all questions and reviewing the flagged questions. |
UWorld Qbank - 71% UWSA 1 (Mar 16, 2025) - 246 UWSA 2 (Mar 22, 2025) - 251 UWSA 3 (Apr 12, 2025) - 242 Free 120 (Apr 28, 2025) - 73% NBME Form 10 (May 2, 2025) - 242 NBME Form 13 (May 5, 2025) - 257 NBME Form 14 (May 7, 2025) - 257 |
| Timeline |
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I found a 1.5-year timeline with a 2-week dedicated period to be way more than enough to comfortably pass the Step 2 CK. Final score was in the 260+ range. |
USMLE Step 3
To be updated once I write this exam :)