Since it's that time of year when many people are cramming for Step 1 and anxiety is running very high, I wanted to share a few thoughts about this test now that I am just about on the other side of this entire medical school process. This test freaks a lot of people out, and for good reason. You spend the first two years with it looming over your head as you cram in the basic sciences. Every class forces you to ask: do I learn the material for the school exam or the boards? What is important for the boards? All of a sudden, 2nd year is over and, boom, you are dumped into the library to spend a month or so cramming for this beast of a test. And, if you do not do well, you are told that you will jeopardize your chances of getting the residency that you want. It makes for a month or so of stress and misery, which is often compounded by talking with classmates and freaking out over the test together.
In retrospect, studying for and taking Step 1 was one of my lowest points in medical school and it caused a huge amount of stress. I did some things well and some things poorly when studying. But, in the end, it really did not play a huge role in my residency applications and having a mediocre score did not stop me from getting to where I wanted to go. Yes, there are score cut-offs at some programs and in some fields ie radiology, ortho, etc. But if you talk to 4th year students, I bet they can give you examples of people in their class who matched quite well with terrible scores and people who didn't match/did not get their top choices with very high scores. So keep in mind that this test is not the be-all and end-all. Even if you do not get the score that you hope to get, remember that there are many ways to compensate for the score on your residency application, i.e. good grades on clinical rotations, strong letters of rec, and rotating away at a place you want to go and doing well there.
Just try to keep it in perspective is the best advice I can give you. Other than that, try to have some semblance of normality in your life for a couple of hours each day while studying. Take breaks to exercise, spend time with friends/family, and eat well. It will keep your mind clearer and make your studying more effective. No matter how far behind you feel in your studies, do not reschedule your test date! From what I saw from others who did, the extra time was not that helpful and just led to more stress. Get this beast over with and take a real vacation for at least a couple of weeks before you start 3rd year. And avoid stressful situations while you study. This may mean leaving school and heading elsewhere to study if you find other medical student studiers to be more anxiety-producing than motivating.
Finally, do questions. Buy an online question bank like Q-Bank or USMLEWorld and do questions, questions, and more questions. I wish I had put down the freaking First Aid and done more questions for Step 1. I think that was what was most lacking in my studying. Remember, the test is testing your ability to answer test questions and not your entire knowledge base. Doing more questions will help you with timing, re-focus your studies when you can't read anymore, and expose you to the material that is most likely to make up a good chunk of your test.
Okay, now that you have read this post, take a deep breath and get back to studying/doing questions. Remember, this is just the first of 3 hurdles on the road to getting a medical license, and this too shall pass.
