After the United States Medical Licensing Examination (USMLE) shifted the Step 1 licensure exam to pass/fail, there have been limited studies to analyze changes in student study strategies.

Surveys were distributed to third- and fourth-year medical students at the University of Michigan Medical School (UMMS). The response rate was 66%.

The largest proportion (18.81%) of students chose 8 weeks of study time. 40.59% of students increased the length of their study period. To determine time allocated for dedicated study, 37.26% of respondents consulted near-peers who had already taken Step 1. Students also considered prior experiences with standardized tests (15.57%), personal reasons (14.62%), and conversations with school advisors (13.21%). 44.55% of students studied for 9–11 h a day, and 42.57% studied for 5–8 h a day. 52.69% of students scored between 70 and 80% on their final practice NBME test before their Step 1 exam. One hundred percent of respondents passed the exam. Exam non-extenders achieved higher end average practice test scores with shorter study periods. No differences in Step 1 study time or intensity were found when comparing students by intended specialty competitiveness.

Our results demonstrated patterns in study strategies for the new pass/fail Step 1 exam that may prove useful for curriculum design and schedule plan for future cohorts.