BEYOND 275

IN THE BEGINNING

I honestly do not remember the lightbulb moment when I decided to become a doctor. Neither do I remember the exact moment I decided to write The USMLE Steps. Those moments aren’t registered in my brain, for reasons I can’t explain. But the journey that got me to this point — writing this little article to you — I cannot forget.

I’ve had my own moments of failure, and I’ll tell you for free: those moments make this victory all the sweeter. Academic validation hits like a chilled bottle of Coca-Cola.

I remember after high school, I had to sit for JAMB — the unified examination every high school student had to write to get into university. There was a lot of expectation, a lot of “I know he’ll kill that exam.” Why wouldn’t they say that? I was the best graduating student in my high school.

I went into that exam seemingly prepared and confident, but I didn’t know my journey wouldn’t be that straightforward.

The results were released, and I barely passed the general cut-off mark of 200. I checked, and I had scored 202. That score felt even worse than failing, because to get into medicine I needed something close to 300 or above. But my path took me on a different journey.

I had never heard of JUPEB, Diploma or Foundation Studies before, but when you’re in the whirlwind, you find alternatives — and this was mine. My alternative route into medical school, to becoming the doctor I’d always wanted to be and yes all those names are for the same thing

JUPEB was basically A-Levels. It was the real survival of the fittest. Imagine a class of over 500 students fighting for fewer than 20 slots. What were the odds you’d be among that 20? To make the cut, you needed straight A’s in Physics, Chemistry, and Biology — and I had never been an all-A’s student.

Yes, I know I said I was the best graduating student from my high school. But I wasn’t an all-A’s guy. An annoying B or two always crept into my report card. Yet here I was, supposed to be faultless — excellent without the “B” blemish.

This is an article in retrospect, so you can probably guess that I did get straight A’s. Yes, I did, thankfully. But the lesson here is this: sometimes your path takes you a different way, just so you can prove to yourself that you can do it.

SET A TARGET AND DRAW UP A PLAN

Now I’m in med school. My dreams are within reach. It will take me six years, after which I’ll be done, write my external exams, start internship, get my car, get married, and start residency in internal medicine. “The road to becoming a consultant before 30” — or so I thought.

But here in med school, strikes were a constant. Academic staff, non-academic staff, consultants — you name the association, and at some point they all went on strike. Then add COVID: a frustrating year that made me question my sanity, sitting at home 24 hours a day, seven days a week, doing absolutely nothing. In hindsight, I could have explored other interests, but sadly, I didn’t.

Still, I had an amazing journey in med school — amazing mentors, friends turned brothers, teachers and classmates now colleagues. From the moment I saw my first distinction on a staircase, to the moment I saw my last one on my bed, and everything in between.

I remember how tough it was in my first few weeks and months in college. I had less than a handful of friends I knew from my JUPEB days, but thankfully, I survived.

On a relatively typical Monday, AMSUL (Association of Medical Students, University of Lagos) — my med student association — organized an orientation and invited a few seniors to speak to us. One of them was Festus, then a 500-level student and now a cardiology fellow in the US. He walked in wearing his typical, finely starched white shirt, spoke to us, and introduced us to his tutorial group, Gem Tutors.

Gem Tutors was a lifesaver — like a small family, with tutors as guides and students trying to learn and solve questions together. Festus always taught us more than just medicine. He taught us test-taking strategies, life lessons on time management, the importance of having a plan (no matter how small), and much more. He was my first mentor in med school, and I’ll always be grateful to him — and to every tutor from Gem Tutorials: Drs. Bel, Salau, Kenny, Bayo, Chibueze, and Henry. You are all truly amazing.

I’m currently a pathology tutor at Gem Tutorials, focused on hematology and blood transfusion — my own way of trying to add the same value I received as a student there. This is my fifth-year teaching, and I hope I get to continue in some form, because I love it. There’s something amazing about seeing people come in with questions and leave filled with answers.

Festus opened my eyes to the USMLE — through how he taught, the materials he used, and the possibilities available if I chose that path. And I decided that somehow, someway, I would.

Starting med school, I had a plan: to become a consultant at 30. Here I am, far from that — but it was still a plan. And although I won’t be a consultant at 30, I’m still checking things off that master plan.

CHINONSO’S PLAN

The Road to 275.

Setting up a plan for writing the USMLE Steps is like staring down a marathon before you’ve even tied your shoelaces — but I tried to tailor it to my strengths. I knew I was a genuinely fast reader, but I couldn’t retain information unless I thoroughly understood the concept, so I built my plan around filling that gap.

For the purpose of this article, I won’t go into the cost of the exams and all that — my friend Raphael has an article covering that, “My Unconventional Match.” This section is meant to give you explicit insight into my practice methods, preparations, and practice scores.

I fully decided to go into “Step Mode,” as my friends and I called it, in January 2025, after discussing with them what I needed and gathering all the study materials and various plans out there. Seeing all the effort and time it would take, it felt like an immovable mountain. I guess I had to become an unstoppable object.

From mid-February to October 1st, 2025, I prepared for Step 1 and wrote the exam on that date — a bit later than I’d originally scheduled, since med school graduation and induction fell in that same window, and my friends and I wanted to throw one final party in med school before it all ended (more on these friends soon). I divided my preparation into three phases of about 6–8 weeks each.

Phase 1: Gathering Knowledge

This was the most boring phase of them all. I used three materials: Boards & Beyond (BnB) by Dr. Jason Ryan, First Aid for the USMLE, and Anki. I also decided to start jogging and doing a little working out during this period, since I knew I’d be sedentary for a while and didn’t want to put on much weight.

My typical day went like this: wake up around 5am, watch two BnB videos, do a bit of Anki, then head out for a run between 6 and 6:15am. Back by 7am, I’d shower and continue BnB videos until about 10am, then have my typical breakfast — almost always bread and something else — before napping until noon. From noon, I’d watch videos until 3pm, and then it was time to consolidate with Anki. I did my new cards right after watching the videos to see what lapses I had, then went back to First Aid to fill those gaps, using the Omega (Lightyear) deck. By evening, I’d switch to “due cards” — reviewing the previous day’s material. Dinner was usually around 7–8pm, and I finished up around 9–10pm daily. I repeated this schedule, or some variation of it, for the first two months, until I’d watched all the videos and cleared every new Anki card.

Phase 2: Application of Knowledge

This was the most fun phase, because I finally got to start answering questions — but it was also the most intense. I had a minimum of 14-hour days, every day, for 6–8 weeks, working through Uworld.

I typically woke up on or before 7am and started my day with three blocks of untimed, random Uworld questions, covering the first 30–40% of the bank before eating, showering, and reviewing. At first, each block took about 1 hour 10–20 minutes to answer, and reviews took nearly 3 hours. Once I cleared that first 30–40%, I switched to timed blocks and kept going until I finished. Around this point I sadly gave up my morning jogs — I needed to conserve energy — and swapped it for something more relaxing during my breaks instead. My scores fluctuated early on, starting in the mid-60s with time always running out, but I kept at it, and eventually finished Uworld at 75%, comfortable with the timing.

Through it all, I kept up my Anki daily, and started listening to relevant episodes of the Divine Intervention Podcast (DIP) — on microbiology and drug of choice, ethical principles, and whatever subtopic I was struggling with that week.

Phase 3: Practice Tests

I took every practice test I could get my hands on — all the NBMEs from 25 to 32 (as of then), UWSA 1 and 2, and the Free 120. This phase was the shortest but the most anxiety-inducing, because my exam was only weeks away, and I kept thinking: what do you mean I’m seeing questions and I can’t remember the answer, or I don’t even understand what’s going on?

My scores told the story of that anxiety fading — from the mid-60s on NBME 25 to 86 on NBME 32. That jump came down to fixing what I’d been doing wrong early on: poor test-taking strategy, poor interpretation of images and concepts, and unnecessary anxiety. So, I changed my approach. I hyped myself up every morning before each practice test, simulated real exam-day conditions down to my food and pacing, and paired it all with rigorous review of every question and concept I found even mildly challenging. Slowly, the improvement showed.

I scored 256 and 246 on UWSA 1 and 2 respectively, and the Free 120 was an eye-opener into the exam’s actual template. Divine always said that in every question, there’s a key concept the test writers are really asking about — sometimes you have to ignore the image, find that concept, and the picture becomes clearer on its own. Honourable mentions from this phase go to Randy Neil’s Biostats and the Mehlmann PDF, particularly on ethics.

On test day, anxiety tried to creep in, but I hyped myself up as usual and treated it like just another practice test — same pacing, same food, same everything.

Now, Step 2

I’d noticed a few challenges with my Step 1 prep and made subtle adjustments going into Step 2, though the core three-phase structure stayed the same. First, though, I took 2–3 weeks off — binge-watched series, went out with friends, and caught up on sleep. Then November came, Step 1 was behind me, and it was time to start again.

For Phase 1, I skipped BnB videos entirely this time — partly because I was running out of time, and partly because I just didn’t want to. Instead, I did Anki every day (the Omega deck for Step 2, plus Divine Intervention’s decks) for about a month, easing myself into the Step 2 mindset.

In Phase 2, I spent the first 1.5 months on the AMBOSS question bank, doing about two blocks a day with daily review, before moving to Uworld for another 1.5 months. I finished AMBOSS at 75% and Uworld at 82%. From there, I moved into the Clinical Mastery Series (CMS forms), working through the three to four most recent blocks in each of the eight available disciplines — 30 blocks in total.

Phase 3 was all NBME 9–16, UWSA 1 and 2, every available Free 120 (old and new), and a review of the SPEX 86 questions. My scores climbed from 257 on NBME 9 to 271 on NBME 16, with a peak of 272 on NBME 14. UWSA 1 and 2 came in at 263 and 272, and I scored 87% on the new Free 120. Through all of it, I kept tapping away at my anki cards & listening to DIP podcasts — now tailored to Step 2 content — for whatever I needed

On test day, I felt genuinely overwhelmed. The questions felt longer than expected, time felt like it was moving faster, and I hit a brain block at one point. But I stuck with what had worked for me in practice, made small “in-game” adjustments where I needed to, and kept hyping myself up through to the end.

Honestly, this exam felt like a whirlwind. But the lesson here is simple: ask questions, talk to people, make a plan, and stick with it if it’s getting you the results you want — but never be afraid to make small in-game adjustments along the way.

SUPPORT SYSTEM

The importance of a support system cannot be overemphasized, particularly in a herculean task like writing these exams.

Firstly, my family. Over the course of preparing for these exams, I faced my share of family challenges. A family member fell seriously ill and spent days in the ICU, in a foreign country, so I couldn’t even visit them all I had were pictures. That was the single most frightening image I’d seen in my life. That image is burned into my memory for good. It made me appreciate the different battles even the most successful people quietly carry.

My mum is my rock, my prayer warrior. She calls me a name in my language that I don’t think I’m ready to reveal yet. My siblings look up to me to set the pace, and I know that comes with its own pressure — but they’ve never once made me feel like I wasn’t doing enough, even on the days I felt like I wasn’t.

Over the course of preparing for this exam, I did it alongside a couple of close friends, Rasaq and Ay. Those two are more than friends, and I’m immensely proud of them. Rasaq and I wrote both Steps on the same days — we even took our NBMEs within hours of each other, then called to complain about those “wicked question writers” and the topics we prayed we’d never see again. We did everything together: the flights to Ghana, the bus rides back to Nigeria, the Airbnb we stayed in. I did it all alongside my friend, and I believe that played a huge part in this success.

It would be a big oversight to talk about support systems without mentioning NDV — No Dirty Vibes. These guys are my brothers, and the goal has always been that we win together in everything we set out to do. We started this friend group just to have fun, and we’ve had an amazing time — with plenty more still to come. Remember the party that made me restructure my entire Step 1 timeline? That was the party of the year with this crew — a beach party to remember.

Raph, Easymoney Sniper, Dr. Mike, Rasaq, Ay, Victor Grey, Folly, Jude, Timi, and Charles all brought their own strategies for tackling every concept, question, and study material. It felt like a whole community was taking these exams with me — the perfect mix of Dr. Mike declaring “Nonso, 278 or nothing” and Raph trying to convert everybody into Rad Bros. An amazing bunch, truly.

There are others who supported me emotionally throughout this journey — Ifunanya, Ejemeare, Eniola, Osose, and more than I could ever name here. But I’m sure you all know how I feel.

Thank you!

No one climbs a mountain like this alone, no matter how solitary the studying may feel. Behind every practice score and every exam date is a quiet network of people carrying pieces of the weight with you — family praying you through, friends grinding beside you, and others simply checking in to remind you that you’re not invisible. If there’s one lesson here, it’s this: build your people before you need them, because you will need them

GOD DID!!

This last section is for the biggest and most important part of everything: God.

He truly showed up and showed off. He is the greatest, and I cannot say thank you enough.

He came through in so many ways, and showed me — again and again — that He still sits in heaven and controls everything.

Hold onto Him