Contents · 9 sections
- What is the USMLE and why a student from Russia needs it
- Step 1 Format
- How it differs from Russian exams
- The standard toolkit: First Aid, UWorld, Pathoma, Sketchy, and Anki
- AnKing, Mehlman, First Aid Rapid Review: what are they
- Ready-made tracks on the platform: the same decks without the setup hassle
- Prep plan: 6–9 months while studying in medical school
- Common mistakes
- FAQ
USMLE Step 1 is the first of three exams required to enter a residency in the United States. Since 2022, it is graded on a Pass/Fail basis, yet it remains the primary filter. We break down how the exam is structured, why students worldwide study using the AnKing Anki deck, and how to master the exact same material without installing Anki or configuring decks.
What is the USMLE and why a student from Russia needs it
The United States Medical Licensing Examination consists of three steps: Step 1 (basic sciences), Step 2 CK (clinical knowledge), and Step 3 (taken after starting residency). International medical graduates must obtain ECFMG certification, with the first two steps being a mandatory part of it. Step 1 is typically taken after year 2 or 3 in the US, while students from Russia usually prepare during years 4–6 or after graduation, once they have a background in clinical subjects.
The exam is valuable beyond the US. USMLE scores are accepted when hiring in certain Middle Eastern clinics, requested by some European residency programs, and the preparation itself is the most structured way to learn fundamental medicine in English.
Step 1 Format
| Parameter | Significance |
|---|---|
| Duration | 8 hours, 7 blocks of 60 minutes each |
| Questions | up to 280 (up to 40 per block) |
| Type | Clinical vignettes with a single best answer |
| Score | Pass / Fail (since 2022) |
| Where it is taken | Prometric test centers; closest to Russia are in Armenia, Kazakhstan, Turkey, and the UAE |
| Cost | Approximately $1,000 per exam plus an international test delivery surcharge |
Subjects: anatomy, biochemistry, physiology, pathology, pharmacology, microbiology, immunology, behavioral sciences, biostatistics. Questions are almost always clinical: "A 54-year-old male presents with substernal chest pain... what is the mechanism of action of the indicated drug?"
How it differs from Russian exams
Three things that are hardest to get used to. First — language: not just English, but also American units (mg/dL instead of mmol/L, pounds, Fahrenheit). Second — mindset: the question isn't "list the classes of antiarrhythmics," but rather "what side effect will develop in this patient." Third — scope: the exam covers everything spread across 2–3 years in the Russian curriculum and tests it all simultaneously.
The standard toolkit: First Aid, UWorld, Pathoma, Sketchy, and Anki
- First Aid for the USMLE Step 1 — an 800-page summary of the entire exam. Not a textbook, but a list of facts.
- UWorld — a question bank most closely mirroring the actual exam. Paid, considered essential.
- Pathoma — pathology videos, 35 hours, the main foundation for Step 1.
- Sketchy — visual mnemonics for microbiology and pharmacology.
- Anki — a flashcard program utilizing spaced repetition. The cards themselves come from pre-made decks.
AnKing, Mehlman, First Aid Rapid Review: what are they
AnKing — the most popular Step 1 deck in the world: around 30,000 cards compiled from several decks (Zanki, Lolnotacop, Pepper) and tagged by chapters of First Aid, Pathoma, Sketchy, and UWorld questions. Its strength lies in source tags and Extra fields containing explanations and images.
Mehlman Medical — PDF reviews and flashcards focusing on high-yield facts: what gets tested most frequently. Great for the final month.
First Aid Rapid Review — the final section of First Aid: one-line "key fact → association" pairs. Hundreds of pairs like "Kayser-Fleischer rings → Wilson disease."
All three exist as Anki decks, and all share one drawback: you must install Anki, find the up-to-date deck version, deal with tags, and configure intervals. Beginners spend a week on this, and some never even reach the first card.
Ready-made tracks on the platform: the same decks without the setup hassle
In the USMLE Ready Tracks section of "Lecture Flashcards," open-source AnKing, Mehlman, and FA Rapid Review decks have been transformed into structured learning paths: 134 tracks, 7,904 English lessons. One Anki card equals one task: question, answer choices, and after answering — the card's original answer, Extra field, and image block under "From the card." Tracks are organized by subjects and organ systems mirroring First Aid chapters: cardiology, renal, endocrinology, microbiology, and so on.
What this offers compared to Anki:
- no need to install or update anything — tracks open directly in your browser and app;
- multiple-choice questions instead of "flip the card" — closer to the real exam format;
- mistake review and daily goals work automatically;
- clicking "Start" creates your personal copy of the track — your progress and mistakes are independent, and lecture limits are not consumed.
Sections missing from decks or specifically required by your syllabus can be added by uploading your own lecture: the section builds a learning path using the same principle.
Prep plan: 6–9 months while studying in medical school
| Period | What to do | Daily time |
|---|---|---|
| Months 1–3 | Pathoma + pathology and physiology tracks; First Aid for completed chapters | 1–1.5 hrs |
| Months 4–6 | Pharmacology, microbiology (Sketchy), biochemistry; start UWorld for completed topics | 1.5–2 hrs |
| Months 7–8 | UWorld 40 questions per day with mixed topics; Mehlman and Rapid Review tracks | 2–3 hrs |
| Last 3–4 weeks | NBME practice exams, reviewing weak systems, complete Rapid Review | 4–6 h |
Key rule: not a single day without cards. 30 minutes of daily review is more important than two hours once a week.
Typical mistakes
Studying First Aid like a textbook from cover to cover without doing questions. Delaying UWorld "until I learn the theory" — the question bank itself is the way to learn theory. Translating everything into Russian — for the exam, you need to think in English, otherwise 60 minutes for 40 questions won't be enough. And the most common one — accumulating flashcards: if you miss a week in Anki, a thousand reviews will pile up, and the deck gets abandoned. In the platform's tracks, reviews don't pile up in an avalanche, but the principle is the same — study daily.
Frequently asked questions
Can you pass Step 1 without UWorld? Technically yes, but among those who passed, there are almost none. The question bank teaches the format in which no deck can train you.
Which year of medical school should I start? After pathology and pharmacology, which is 4th year. Earlier than that, you won't have enough clinical background for vignettes.
Is a C1 English level required? You need medical English: the terms are mostly international, and the colloquial complexity of the texts is low. If you read First Aid with a dictionary but understand it — you can start. For conversational practice, there is a voice simulator in Telegram.
Do the tracks prepare you for the Russian accreditation exam? No, they are in English and follow the American curriculum. For accreditation, use the accreditation test simulator.
See also: Flashcards from the lecture · AI tutor for exam preparation · AI search tool for PubMed articles