medical training: self-care during step 1

I took the USMLE Step 1 last summer. This 8-hour exam many consider to be the major stepping stone, or perhaps more aptly called hurdle, in medical school training. You can find many resources online on how to prep for the exam (too many resources, actually) that guide you on what tools to use, what the best study schedule is, how many hours a day to devote to questions, you name it. You can find forums full of anxious and overwhelmed medical students comparing practice test scores, asking others “am I ready to take the exam yet or should I push it back a few weeks?”

In all the lead-up to these weeks of dedicated Step 1 study time, I found very few resources on how to cope mentally with this rite of passage. Some folks online wrote about proper self-care during this period which for them usually consisted of adequate sleep and going to the gym–the latter, bless their hearts, isn’t exactly what refuels me during periods of stress. I tend to go more for watching angsty British/Scandinavian dramas, but to each her own.

I also found very little material out there for how to cope with the self-doubt that is all too pervasive during these times of preparation. Maybe you were lucky and never encountered this in your studies, but self-doubt has been an ever present friend to me throughout medical school that really nestled in during Step 1 preparation.

I wanted to share on this blog some techniques and tools that I found helpful to support me mentally and emotionally throughout my Step 1 study period. I hope you will find some of them useful, too!

(1) Location, location, location.


Just a few steps away from where I studied every day–I took this photo on one of my daily walks

I could not have done this test without the support and physical presence of my family. Personally I couldn’t imagine being on my own for a number of weeks without the ability to go downstairs and get a hug and a brief “you can do this!” from my folks. Gimli our pet Cardigan Corgi was, as always, a welcome comfort. Our sweet pup passed away this past October and I’m so grateful I got to spend so much time with him over the summer.

(2) Physical activity

For me, this didn’t mean going to the gym and reading Step 1 material on my iPad. Blech I can’t think of anything less relaxing! I had some foot issues over the summer but once able I made sure to walk around the neighborhood as often as possible. I also found a group class on Groupon that incorporated yoga into 2-3 mile walks on the beach. It was so refreshing to spend time with people who were not studying for an exam or in a medical field.

(3) Mail

Ask your friends and family to send you handwritten letters if they aren’t typically snail mail types. From my little second-story lookout I could see the postman come up the walk every day at 3pm and I was always so excited to see if an envelope for me was in the mail.


Sweetest card from my best friend, Kimmy

What if your friends and family aren’t snail mail people, or you just really like getting an excessive amount of attractive cards? Send yourself letters! I know, it’s shocking. Here’s what I did.

Go to and pick out 3-4 of the prettiest cards you can find (use my promo code MREJFR4C to get $5 credit). This website is fantastic–you can write a message inside the card online and it turns it in to typed “handwriting” and posts the letter for you. I filled mine with quotes, poems, and Bible verses that I liked. You can also schedule the cards to be delivered at certain dates, say 1-2 weeks apart, so that they arrive steadily throughout your study session. It feels really weird at first but I promise it is so much fun!

(4) Decorate your study area


Leave these around the house wherever you might see them throughout the day

I worked in a little bedroom that looked out over the ocean, and I covered my desk and windows with anything that made me smile like cards, quotes, Bible verses on index cards, and photos.

(5) Cover that horrible First Aid book with something less horrible


A little better now

In giant white letters on a blue and red background it screams “USMLE STEP 1 OMG YOU WILL FAIL THIS EXAM THIS EXAM IS SO IMPORTANT FEAR ME” or at least that’s how it looked to me. So I covered it up with some contact paper that I bought on Amazon and it made working through this book much more tolerable.

(6) Sign off Facebook and Instagram

For me this was a no-brainer, since I knew seeing other people talk about their studying would only enhance my anxiety. For you social media might be an important way of reminding yourself that there are other things out there than medical school and an exam, so it might actually be vital for your happiness. Just be thoughtful about it before the study period begins.

(7) Read these two books and keep them with you

There are books on mindfulness written by lawyers for those recent law graduates studying for the bar exam. Ironically, there aren’t similar books for medical students taking Step 1, because why would doctors bother talking about mental health? (That was sarcasm). In any case, I bought these two books about bar exam prep that were so helpful and very applicable to my situation. I encourage you to give them a try–the references to actual bar exam material are few and really they focus instead on test-taking mental health strategies more generally.

(8) Use supportive podcasts and apps

I listened to a lot of podcasts especially when I was feeling discouraged or overwhelmed. Here are some of my suggestions:

And of course, please feel free to reach out to me if there’s any way that I can help. I’m always willing to send an encouraging letter if you need it! Just fill out your info on my website contact form. 🙂



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