Here’s my general advice for doing well in Internal Medicine (IM): pick a study resource and stick with it consistently. During intern year, most residents take STEP 3 or COMLEX Level 3, so your initial goal should simply be to pass the exam. I took STEP 3 in October of my intern year. My study approach was limited to using Anki and UWorld, and I did just fine despite only studying for 2–3 weeks and not even finishing the full UWorld question bank.
After completing the exam, give yourself a month or two to focus on adjusting to intern life—that alone can be a tough transition.
By December of intern year, I realized I wasn’t learning some of the high-yield points my peers were picking up from rounds or didactics. So, I bought MKSAP independently and committed to doing 10 questions per week consistently. Occasionally, I would add an extra block related to topics I encountered that week on the wards.
I also made a habit of selecting questions relevant to my patients. I would think critically about why certain MKSAP-recommended approaches weren’t followed in real life, and then discuss those differences with attendings and co-residents. This helped me distinguish testable knowledge from real-world clinical decision-making.
Toward the end of intern year, I started to get burned out on MKSAP, so I switched to the MKSAP Anki decks to reinforce what I had already learned. Throughout my second year, I completed about 50% of the ABIM and MKSAP decks. I moved slowly and focused on truly understanding the material, often looking up one concept per day based on my clinical experiences. I mainly used the decks as a reference tool to support patient care.