Crush Step 1 With: Nicholas Spendlove

Step 1 is a monster. There’s nothing like it. It could easily be said that no test requires more study, has more influence, demands more hours of preparation or creates more anxiety disorders. That being the case, there is great deal of resources and information dedicated to helping medical students learn what they need to in order to do well on it.

With all the information that’s out there and available, however, it can be difficult to determine what’s valuable, and how to apply it to yourself and your own studies in order to be effective. Bearing that in mind, we thought that it would be a good idea to talk to students who have done exceptionally well on Step 1 and simply ask them how they did it. What better source of information could there be on Step 1 and how to succeed than those who have actually done it?  Seems legit, right? We think so. This series in our blog, Crush Step 1 With:, highlights students from all over who have achieved higher than a 245 on Step 1, and helps break down how they were able to do it. Straight from the horse’s mouth, as they say. The reality is that there is no magic bullet for Step 1 because everybody is unique, but through this series we hope to be able to help you find that something that works for you. Enjoy!


Where are you from and what school did you go to?

I’m originally from South Jordan Utah, but I came down to Texas to go to school at UT Southwestern


What residency are you planning on going into?

I’m not entirely sure. I’m just wrapping up third year though, so I’m starting to feel the pressure! Right now, I’m considering ophthalmology.


When did you start to get serious about Step 1 preparation?

I didn’t get serious until my dedicated study time (we had six weeks of dedicated), but I did do a little bit of studying during spring break of my second year. We had two weeks of spring break and I studied during one of those weeks for a couple hours per day.


How did you juggle coursework with Step 1 studying?

I didn’t do any studying for Step until dedicated, so there was no juggling. I focused really hard on my coursework during that time and I feel like that ultimately did help prepare me for Step 1 to a degree.


 What resources did you use for your Step 1 prep/how were you able to use them to effective?

I tend to be a very organized person, so the first thing that I did was create a solid schedule. I’ll talk more about that in a second, but I used FA, UWorld, Pathoma and Anki decks. I was able to fit in three passes of FA, all the UWorld questions once, and two passes of Pathoma. The reason that I started during spring break and ultimately did so many passes of the material is because my first pass of anything is basically worthless. For me, the first pass of any material is just to set the tone before I can start effectively learning. What I did during spring break was basically just to prime the pump. During dedicated I had a specific routine where each day I had chapters of FA and Pathoma scheduled to get through, as well as a number of UWorld questions. The first half of my dedicated time was more geared toward Pathoma and FA, while the second half was more focused on UWorld and questions. During the first three weeks, I probably did between 20 and 40 questions per day, and by the end I was doing about 120 per day. The other thing that I did was that as I was studying, I would make flashcards on Anki and at night I would study those flashcards, as well as any that I made previously. I would also spend about an hour each morning reviewing flashcards, especially pharmacology and drugs, to get the day started. I also forgot to mention that during spring break I did make flashcards of every drug in FA that I used during dedicated. This schedule ultimately worked out well for me, but it was pretty heavy. I studied every day from 6am to dinner, then after dinner until 10pm. I did that Monday through Saturday and took Sundays off. I’ll be honest, it was miserable and I hated it, haha!


What advice would you give to a student starting medical school about preparing for Step 1?

Find something that motivates you and draw strength from it! For me, it was my family. I’ve got a wife and three kids that are counting on me and have come along for the miserable ride that is medical school, so it’s been important to me to do exceptionally well so that I can get where I want to be and take care of my family. My family is extremely important to me and motivate me a lot.

Step 1 is obviously extremely important, but you have a life and you need to find a way to enjoy it. Don’t kill yourself preparing for Step 1! It’s easy to get carried away with studying, especially with all the stress associated with med school and Step 1, but it’s extremely important to be able to keep things in perspective and find time to enjoy things.

Try not to become too cynical/jaded during medical school. It’s easy to let happen because med school is brutal and terrible, especially leading up to Step 1 and then during rotations, but try to stay positive. That positive attitude will ultimately help you be more effective.


High-Yield Questions:

What are you watching on Netflix?

We’re actually more movie watchers than anything else. We most recently re-watched the second Avengers movie.


What is your favorite restaurant?

I love Mexican food. Anything Mexican food! Texas has been great for that.


If you hadn’t gone into medicine, what would you have done?

I know it’s cliché, but I never really considered anything else. I was a scrub tech before medical school and I fell in love with medicine there. This is just what I’ve always wanted to do.


Thanks, Nick! Good luck moving forward!

Leave a Reply

Your email address will not be published. Required fields are marked *