been meaning to write this for a while. saw another IMG post asking where to start and it reminded me of how lost i was when i first began prep. nobody at my school had done this recently, no seniors to ask, just reddit and a lot of conflicting advice online
this is what i wish i had known from day one
first — the mindset shift that changes everything
most IMGs start prep thinking about it like med school exams. read, memorize, recall. Step 1 is not that exam. it's an application exam. they will give you a clinical vignette you've never seen and expect you to reason through it. the earlier you internalize this the better your prep will look from week one
don't start with content. start with questions. i know that sounds backwards. it isn't. questions show you what the exam actually wants from you. content makes sense after you know what you're being asked to do with it
building your foundation — what actually matters
First Aid is your bible but don't read it like a textbook cover to cover at the start. use it as a reference while you do questions. it'll make 10x more sense that way
Sketchy for micro and pharm non negotiable if you're a visual learner. the associations feel silly but they stick in a way that straight memorization never does
Anki if you're going to do it, start early and do it every single day without skipping. the reviews compound fast and missing two days turns into a nightmare pile. 20-25 new cards a day is more sustainable than 50 build the habit first
Divine Intervention podcasts completely free and criminally underrated for IMGs. great for building clinical reasoning from early on
on qbanks — the honest take
UWorld is the gold standard, everyone knows that. but as an IMG dealing with dollar conversion the pricing is brutal. Someone on reddit recommended stepgenie to me as an alternative and it worked well for my situation question style is close to NBME difficulty, explanations are step by step instead of dense paragraphs, and it highlights buzzwords in the stem which genuinely changes how you learn to read questions. has an ask AI feature too which is useful when you're stuck on a concept at 11pm and don't want to go down a google rabbit hole. not saying skip UWorld if you can manage it, but if budget is a real constraint it's a solid place to start
the IMG specific stuff
your basic science foundation might have gaps that US students don't have and that's okay but you need to diagnose them early. don't assume weakness, don't assume strength. let your first few NBMEs tell you where you actually stand
also the Step 1 question style is very "american medicine" framing management decisions, next best step, clinical reasoning. if this feels unfamiliar at first that's normal. it clicks with question exposure, not more content reading
on timeline
if you're starting from scratch budget at least 4-5 months of serious prep before dedicated. dedicated should be consolidation not learning from zero. IMGs who struggle most are usually the ones who start dedicated without a solid foundation and try to learn everything in 6 weeks
the mental side
there will be a point where you feel like you're getting dumber the harder you study. your scores won't move, things you reviewed yesterday won't come back, you'll question everything. this is normal and almost universal. it's your brain consolidating not failing. push through it
the gap between how prepared you feel and how prepared you actually are is almost always bigger than you think
happy to answer questions about anything i remember how overwhelming the starting point feels and how much these posts helped me when i was there