# First Year to Final Year

> MBBS mapped against Step 1 year by year — what to study each year, in what order, and the annotation habit that makes it compound.

URL: https://usmlevault.com/blog/med-school.html
Canonical: https://usmlevault.com/blog/med-school.html

## Summary

Maps the four years of MBBS onto Step 1 content, arguing the syllabuses are the same material in different formats. Year 1 builds physiology, anatomy (read First Aid first, then the textbook) and neuroanatomy from Najeeb; year 2 is the highest-value year with micro via Sketchy, then pathology system-wise, then pharmacology; year 3 is either the exam year on a 24-week plan or consolidation; final year has total overlap with medicine, surgery, paediatrics and OBGYN. The one habit that makes it compound is annotating every extra point into the First Aid page instead of a separate notebook.

## Key facts

- Second-year subjects — pathology, pharmacology, microbiology — are the three largest content blocks on Step 1
- Year 2 order is fixed: microbiology, then pathology, then pharmacology (pharm makes no sense before path)
- Sketchy Micro: ~85 organisms over six days, video then PDF, same-night MCQs
- Pathology: Pathoma first, then First Aid with the Guide, Robbins last; 3–5 days per system
- Pharmacology: 5–6 days per system, each video watched twice, FWRT method
- Year 3 exam plan is 24 weeks: 2 weeks foundation, 16 weeks systems, 6 weeks NBMEs
- Final year: eleven systems, about ten days each, plus twenty buffer days — about four months of systems
- Final-year per-system order: micro → First Aid with the Guide → lecture platform (Marrow/DAMS/PrepLadder) → Mehlman in one day → Anki the next → UWorld until last two blocks hold above 65%
- Core habit: annotate every extra point into the First Aid page, never a separate notebook
- First Aid Guide decodes all 646 pages

## Covers

how to study USMLE during MBBS, Step 1 in first year MBBS, second year MBBS USMLE plan, Step 1 in final year MBBS, when to start Step 1 prep, Sketchy Micro in med school, Pathoma vs Robbins order, annotating First Aid during med school

## Source

USMLE Vault — https://usmlevault.com
Author: Dr. Marish Asudani

Updated: 2026-08-26