How to Build a Study Routine as a First-Year Medical Student (M1 Study Guide)

Building an effective M1 study routine comes down to three things: the right resources, a repeatable schedule, and a willingness to adjust.

Your first year of medical school brings a big shift—the sheer amount of information, and the speed at which it’s taught, takes getting used to. Even though each program structures its curriculum differently, much of what you’ll learn is now standardized for exams like the USMLE Step and COMLEX Level.

As you move through your first year, you’ll start to see which study methods actually work for you and which don’t. Establishing a steady routine early and keeping your resources organized will help you figure this out faster. The more consistent you are, the sooner you’ll refine the study approach that suits you best.

This guide will help you identify the study framework that works best for you. After we share different routines, resources, and tools to build your schedule, you will be well on your way to a successful M1 year!

Types of Study Routines

The most popular study routines tend to be a combination of third party resources (Sketchy, B&B, Pathoma, etc.), spaced repetition (usually through Anki), and then practice questions (Amboss, or USMLERx). For those with in-house examinations, any slides or material provided to you may also be of value within your routine. 

As you approach different blocks, the resources you utilize may vary, but you may observe that a skeleton routine helps with consistency. Above all, the most important aspect is the foundational understanding - just going through the motions will not achieve the comprehensive knowledge tested by NBME. If this means trying something different works better for you, lean into that. For example, some medical students swear by Anki, while others have not used it since week 1. 

Depending on how your exams are structured, you may have a few options to start from. Since we have NBME exams at my school, I can rely on third party resources to convey the material I need, and I reinforce it with the tools I mentioned earlier. A day of studying for me looks like this:

Week 1 of New Block to the 2nd to Last Week of Exam

Block 1 (AM): Complete Anki Reviews

• I complete all my review cards in the morning; this allows me to refresh the information from the earlier days, which are usually related/foundational to the consequential topics. This way, its easier for me to recognize patterns. 
• Note, some people prefer doing this at a different time, or not at all. 

Block 2 (AM/PM): 2-4 New Videos + Associated Anki (Max 200 new per day)

• In-house slide revision to connect learned concepts.
• With these videos, I organize a weekly checklist to track my progress through the lessons. This also includes any lessons I feel like require multiple passes. 
• For example for Pulm, I would watch a B&B video, and then follow it up the next day with the Sketchy video for the same topic. Going through multiple passes helps me retain the information and offers multiple points of consolidation and retrieval. 

Block 3 (PM): Remaining Videos/Anki OR 10-15 Relevant Practice Questions

• Depending on the length/intensity of my day, this block of studying is somewhat optional for me. Some of my peers will save all practice questions until a week or few days before the exam, and some of my peers do not do any practice questions at all. I prefer doing a few when I frontload just to visualize how the information may be presented in a question, and aim for understanding over accuracy in the first few weeks.
• If I stay on track, it usually gives me multiple days prior to my exam to focus on connecting all the dots and learning from practice questions. Frontloading all my content reassures me that I've seen everything pertinent for the big picture at least once, and allots some time to hammer in smaller details as needed. 

Week before Exam

Block 1 (AM): Anki Reviews

• Closer to the end of a block, these tend to take me longer. I try to prioritize newly reviewed content, in which I create a subdeck dedicated to that. 

Block 2 (AM/PM): No new content, only review by rewatching or using a different resource. 

• Practice questions and thorough revision of those. I like to aim for at least 2-3 blocks of 30 per day.
• If this a final exam, I usually also save a day just for mid-block revision within this week.
• By the last week, I aim to zero out new content, and fill in conceptual or “fun fact” gaps. I’ve found that Pathoma videos are great for revision for me, especially this close to the exam.
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Practice questions help me get into exam mode and analyze what the week will be best spent reviewing.

Some medical students prefer watching/attending the in-house lectures live, and this would be best if you are someone who learns well from a lecture format, prefers in-person, or appreciates the ability to directly inquire about slide content. This would also be helpful because it is a built-in review of the slide deck your institution provides, which may highlight information your professors (usually the same people who curate your exam) determine is highest-yield. For example, in my Week 1+ schedule, Block 2 may be replaced with the in-house lecture and flashcards you make yourself, or revision of the slide deck after. 

The sweet spot is a combination of both in-house and third-party resources. In-house is great for the sequential checkpoints, while third-party is more boards focused, parallelly preparing you for your block exams and Step. 

When to Do Practice Questions (And How Often)

Practice questions are an outstanding tool that fit well into the fast-paced nature of the blocks. While I personally find a healthy inclusion of a few questions every few lessons, it is usually recommended to start larger blocks of questions closer to the exam day. For those who like to isolate the type of studying by days, you may choose to save all practice questions and review for the weekend. Many third party resources include their own small quizzes after the lesson/video they present. 

For example, Sketchy includes five questions after each video, highlighting the high-yield or harder to understand concepts. After these questions, at the end of the study day (Block 3), I use ChatGPT or AMBOSS to tackle some questions. Using these resources also helps me determine the logic behind my incorrects or the more challenging questions, as they both provide very clear explanations with links to additional resources if needed. 

It is also recommended to include UWorld questions later on in M1, as you have some blocks under your belt. These are considered to be the closest to the NBME style questions of the resources available. For those with shortened preclinicals, it becomes even more important to include Step-directed resources and practice into daily studying. 

Some resources that provide practice include this rank list:

UWorld

• Pros: Most like Step format, concise explanations
• Cons: Recommended to be saved until closer to Step

AMBOSS

• Pros: Vast knowledge base- every pertinent concept is linked to more information if needed. 
• Cons: Can be more detail intensive than sought by NBME. 

USLMERx

• Pros: Great to solidify foundational details
• Cons: Not always in NBME format. 

How to Build Your Personalized Schedule

1. Start With Fixed Commitments

Sync your school's required sessions and block schedule into your calendar first so your study time builds around fixed commitments, not the other way around. 

I’m a big fan of merging my Canvas calendar into my Notion/Google calendar account. It’s not always seamless, but it ensures that a majority of my due dates and required sessions migrate over to my personal calendar, saving me the task of scheduling those manually. I wasn’t always a diligent calendar user, but with all the sessions/events/due dates, I decided this would be a good time to create an extra layer of insurance- there are some events that get scheduled so far out in advance, I only recall scheduling them because of my calendar. 

2. Decide on Your Core Study Resources

Choose 2–3 vetted third-party resources (like Sketchy, Anki, and Pathoma) based on whether your school tests in-house or NBME style, then stick with them for consistency.

As I’ve mentioned, there are many vetted third party resources. The first question to address is whether you school tests in-house or NBME exam style. Once you have that answer, you can divide your time accordingly, prioritizing material from school and third party board resources. Ask upperclassmen, locate resources that have been the most effective per block, and test them out to see which you connect with best. 

3. Add in Active Study Time

Reinforce new material daily through active recall — flashcards, spaced repetition, or self-quizzing — rather than passive re-reading or re-watching.

To reinforce the material, select your most preferred method of revision. This is more personalized, because the most important factor here is actively enforcing what you have learned, while observing gaps in your knowledge to fill. If you don’t like Anki, that is okay! There are many other ways to practice active recall - for example, USMLERx has its own flashcards feature that pre-organizes everything by topic for you. If you like Anki, that is good too, the prebuilt decks are geared towards board prep from day 1.

4. Schedule Breaks and Wellness

Protect daily time for exercise, rest, and social connection; consistent recovery isn't a distraction from studying, it's what makes studying sustainable across a full block.

I’ve noticed my retention improves when I make time for what I love and what makes me feel better. It might seem obvious to take breaks, but sometimes content can be so overwhelming, the only right option feels like studying every moment there is energy to do so. At some point, there are diminishing returns. Only so many hours of the day can be spent actively learning and recalling! The best method is to progressively build upon your foundation day by day. 

5. Adjust Based on What Works

Reassess your routine every few weeks and trust your instincts.  If a resource or method isn't clicking for you, it's okay to swap it out even if your peers swear by it.

If you find yourself gravitating towards certain resources over others, trust your intuition. Our school offers OME, which works for some students, but was not for me. Conversely, I like to listen to Divine Intervention (Step Review) podcasts while driving, which is not everyone’s style. Even with Sketchy, I use it everyday, but for many it is preferential for the Bugs and Drugs portion of their pre-clerkship.

Final Tips and Reminders

• You don’t need the “perfect” routine on Day 1
• Be consistent, not perfect
• Track what’s helping you retain and apply knowledge
• Don’t compare yourself too harshly—adapt what works for you

Conclusion

M1 year represents a significant shift from the passive studying methods of undergrad to active, intentional learning that demands consistency and structure. The most effective approach combines third-party resources like Sketchy and B&B with spaced repetition through Anki and regular practice questions, while maintaining flexibility to adapt based on what works best for you individually. 

Your study routine is ultimately a personalized tool designed to help you build comprehensive understanding day by day, not a rigid identity that must be maintained perfectly from the start.

M1 year was a new challenge for me. For many of the blocks, I felt like I had very little foundational knowledge. Compared to undergrad, where the studying was passive, in medical school I had to be more active, intentional, and focused. It became important to maintain a reliable routine, inclusive of balance between rest and productivity.