How I Managed to Pass NPLEX 1: One Woman’s Success Story and Practical Tips

Found this image on, credited to Nora.
Found this image on, credited to Nora.

Congratulations on another completed academic year! Not to rain on everyone’s parade but, for many of you, there is a giant basic sciences board exam looming in the not-so distant future. So, there are websites out there on tips for studying for NPLEX 1, but they are annoyingly vague. I remember looking at said sites, and felt like grabbing whoever put the sites together, taking them by the shoulders and giving them a good shake yelling, “just tell me what to do!” I’m going to try to deliver that. But, I can’t offer any guarantees. Every year, NPLEX is different, with a different random focus. Some years it’s crazy hard, some years CCNM students do really well, other years the questions seem to be obsessed with biochemistry. I can only be candid about my own study strategy and what worked for me, attaching real-life experience to the wonders of a standardized board licencing exam.

I don’t know about anyone else, but naturopathic medical school exam schedules have brought out my inner crammer. It’s gotten to the point where I can’t study for anything unless I know that there is a final the next day. And even then… So, when faced with the prospect of 3 months to study for 2+ years of cumulative material, I had no idea where to start. I’d never done anything like that before and had no idea how I’d pull it off. Luckily I managed to. Here’s how. 

1) Take the month of May off. Work, travel, take an NPLEX course if you think you have to (I didn’t), sit on a patio with a beer every day, or sit in front of your books, twiddling your thumbs wondering how you’re going to work up the courage to do this. Just don’t open those books. Not yet. May is yours. Let the last 2 years ebb and flow in your subconscious mind while you enjoy some nice weather and update the photos of your friends and family so that you have new ones to look at to remind yourself of what their faces look like while you’re in 3rd year and retreat to your secluded ashram of stress. But 3rd year’s not your problem now. It’s only May. And, May, it’s all yours.

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2) June 1st, buy your book. That book would be First Aid for the USMLE Step 1. Your new bible, available at the U of T bookstore in the medical section. It costs $48 for the current year’s issue. Friends of mine bought back copies, from as far back as 2009, for around $10. It’s worth it to get a current copy, though, as they tend to correct mistakes or update information (though there’s not a whole lot that changes when it comes to basic pathology). Just so you know, US and Canadian medical school students take a similar exam called Step 1 after their second year. Turns out, NPLEX is so similar that you can just use the med school students’ (much) cheaper study guide, which is also better and has pictures and isn’t impossible to read or full of mistakes like some other NPLEX study books on the market that happen to cost 3x more and are full of awkwardly-worded, impossible-to-understand explanations. I’ll name no names. Just, please, buy First Aid. In fact, watch this video a classmate of mine posted last year if you’re not yet convinced.


Oh, and FYI, you can skip the parts about pharmacology, which is awesome. That’s not ’til NPLEX 2. Oh, and another thing: because I did abysmally poorly in 2nd year microbiology I also bought Clinical Microbiology Made Ridiculously Simple used for $10. Since it seemed that NPLEX 1 was 90% micro, going through that easy-to-read book really paid off. So, you might need more than one book. As naturopathic doctors, we praise individuality.

3) The next 2 weeks serve as your psychological buffer. OK, now that we’re in June, take another 2 weeks off. So far you’ve taken the 4 weeks of May off, now you’re taking the first 2 weeks of June off, you’ve bought your book and you’re ready to go. Most people I’ve talked to advocate studying for NPLEX for a solid 2 months – June and July – however, once June rolled around I was stressing over the fact that I hadn’t started studying, but I still didn’t actually start studying. I believe that, for a test like NPLEX, you really need 2 weeks of a buffer time between your vacation and starting your study schedule. Now, the first 2 weeks of June aren’t really real time off, you’re still occasionally going to the library, freaking out, looking at cheat notes on the Gmail account and watching random Youtube videos about jaundice, you just haven’t started studying yet. And that’s fine. It will come. Fear and motivation are directly correlated.

4) Get grateful. It might seem like NPLEX is a giant pain in the gluteus maximus but, really, think of it as a gift (you might as well, because either way you’re writing it). It’s what separates us from the people who get fake degrees from a back-corner alley and do acupuncture in their basements somewhere. It makes us real professionals. It’s also a great opportunity to learn some of the stuff we’ve crammed through in the past 2 years. And learn it you will.

5) By June 15th, set up your study routine. For me, I knew there was no way I was going to get this thing written if I didn’t have a routine to adhere to. There’s nothing worse than having a vast summer day ahead of you and then realizing it’s 9 pm and you still haven’t taken the plastic wrapper off your new First Aid for the USMLE Step 1. So, my strategy was simple. I got a job. I worked full-time at an English language school teaching ESL from 8 am to around 2 pm near Yonge and Bloor in Toronto. It took me the first few weeks on the job to get used to lesson planning and creating stellar classes. By the time the middle of June rolled around, I had my teaching routine down and therefore my afternoons were free to dedicate to dear old NPLEX 1. Every day I packed my First Aid, gave classes until 2 pm, organized things for the next day’s class and then headed first to Starbucks to unwind with a coffee and a granola bar, and then to the Toronto Reference Library where I studied until around 6 pm. Then I’d go home, eat and keep the evening for myself. The job not only puffed up my bank account, it helped keep me regular. (Part of that might also be thanks to the daily Starbucks).

6) 4 hours a day is all it takes. Absolutely everyone you talk to about NPLEX will tell you, with doe-eyed honesty, “treat studying for NPLEX like a full-time job. Study 8 hours a day and take frequent study breaks. Then leave your evenings and weekends free.” As Nonna would say, “Bully-shit.” I don’t know anyone who spent 8 hours a day studying for NPLEX. 4 hours a day is the threshold amount of time that anyone can spend reviewing things. It’s probably a scientific fact. I spent a consistent 4 hours a day with my First Aid for Step 1 book. And, when it got closer to the actual test, I studied on weekends. It just happens that way.

7) Now, do your thing. When I study, I need to take notes to kinesthetically implant the knowledge in my brain. For some people, it’s flashcards. Others make flow charts and still others have photographic memories. But, those people probably aren’t reading this post, so, who gives a care. This is the part where your individuality can shine. Using The Book as a guideline, make your notes and do whatever you need to do to make sure the magic Book’s information somehow gets into your brain. Starbucks coffee usually helps with this. Make sure you have ample supply.


8) 1 to 2 weeks before the exam, start doing practice tests. At the Toronto Reference Library I found an amazing Kaplan USMLE Step 1 practice test book from a few years back. I checked it out of the library and worked my way through the book’s practice quizzes. There are other versions of these books, one even made by First Aid, available online as well (the Gmail account has a copy). The tests are incredibly hard, but nicely explain to you why you failed each question and why the right answer is righter than the one you dim-wittedly picked. It’s much appreciated. I consistently, up until we wrote NPLEX, scored about 40% on those tests. I did, however, do much better than 40% on NPLEX, so fear not. Aim for the moon, and fall among the passing.

9) Take the weekend before NPLEX off. Don’t study the weekend before NPLEX. I never used to believe this piece of advice before because, as I mentioned, I am used to racing through the course material the night before a final. This actually is impossible to do with NPLEX. There’s too much. I learned that, because this isn’t a cramming exam, but a long-term memory thing, it’s better to allow your brain some time to do its neuroplasticity dance. Eat fatty fish at every meal, try to abstain from excessive alcohol or gluten if you’re sensitive. Exercise. Try not to freak out.

10) Write NPLEX. Bring the things NABNE tells you to bring. There’s a list somewhere. Wear comfortable clothes. Bring layers, bring water. Bring some naturopathic performance-enhancers: examples of uppers are gingko extract, rodiola and the ginsengs, and downers are Neuropas, Rescue Remedy, GABA, nervines, etc. Create your cocktail, give it a test-drive before exam day and then, on your big day, put it into action. While waiting to write the test, try not to talk to too many people. Never discuss things you’ve studied, don’t talk about exam questions. And just go for it. Bring an Advil too. I had a terrible headache the day of, as I usually get when I reintroduce CCNM after a period of elimination.

11) After NPLEX, take time off. You’ll need to. Not to be a fear monger, but 3rd year is a living hell. The only good thing about 3rd year as a naturopathic medical student is that it’s over before you know it. In May you simply emerge from a brief intense stay in your cave of stress and wonder where all your loved ones have gone. They might have given up on you, but it’s important to remain optimistic. In 4th year, I’ve heard there will be more time to win back their affection again. That being said, right after NPLEX, before 3rd year starts, take some time off, spend it with friends, family, hobbies, travel and live your life. Because for the next 8 months, you won’t have one.

Happy Studying!

Related articles:

Another Failed Attempt at Studying for NPLEX 1

7 Reasons Why Summer Studying Doesn’t Have to Suck


24 thoughts on “How I Managed to Pass NPLEX 1: One Woman’s Success Story and Practical Tips

  1. I wish someone had given us this advice!!! Excellent job and I agree 100% with the strategy as I used basically the same one!

      1. Do you know where I can find a list of NPLEX certified practitioners for northern California?

      2. NPLEX certified? Not sure. I think you need to look at the California board, not sure what that is? and look for a list. If they passed nplex they will have a licence.

  2. I started studying June 18th, write around where you suggested. Any sooner would have been over kill for sure. I also whole heartedly agree with the four hour a day rule. That’s the most focus you’ll have anyway. You don’t want to burn out by committing more time to the books than the brain and memory can realisticly handle.

    1. Yes, it seems the consensus is June 15-22nd. But definite serious studying begins in July. Totally leaving things to July is way too risky to recommend. I would say, starting feeling the pressure around beginning of June and the heat around mid-June. Serious studying, July. Definitely. Thanks for the feedback! And, yes, I know it’s really possible to over-study since it’s impossible to be 100% prepared for an exam like this.

  3. Thank you! Will be referencing this in the future….also found the tips helpful for my online physics course this summer. With teaching yoga and managing the advertising of our group, writing, and physics …not sure I’ll have enough time or energy to get a ‘real job’ going (though the extra dough would be nice), but I am thinking hard about the routine aspect and my Google calendar organized by hour. Vatas love our routines.

    1. Yeah, you don’t have to worry about it for some time but, when you need it, you know the information is there! Having a routine is great for having any kind of summer project and especially great for vata types, you’re right. Good luck with your summer activities!

  4. Hey Talia,
    I just decided to give a read to this… and it all came back to my mind…
    I left home to Puerto Rico the day of the last exam in May… went to New Orleans and Texas for a break within the break, spent whole month of June doing an Ashtanga Yoga Teacher Training…
    July came in fast, I came back by the 5th and started studying on the 7th… my birthday was on the 16th so I took some more days off… Studying must have started somewhere in the 8th or 9th!
    I thought to myself, you have one month to get over all these books. And I really did overdo it. I read 2 BRS books (physiology & pathology) which answers all questions that I never learned or was taught in school, studying Micro/Anatomy from Jay’s review, studied Biochem from my own class summaries & Jay’s review, some immuno & embryo from USLME I, and one final overview of Anderson’s review. Since I started later, I studied about 6 hours a day, and I did a lot of Yoga. Read that again, Lots of Yoga. I cannot highly recommend to do lots of it…. Yes, studying is doable in one month…. but then again, the exam did not test me on anything I studied for… It was more about the art of picking the right answer…

    1. Thank you, Jorge for sharing your experience. I felt like I was going into NPLEx blind, I wasn’t sure what I needed to study, if I should take a course, if I could work. There were few resources or guides to studying and the 3rd and 4th years had mixed things to say. For this article I just wanted to outline my study strategy, which by no means will work for everyone. I’m happy that some people are writing that this particular strategy worked for them and I’m glad that other people have chosen to share their experiences as well. You’re right, a huge chunk of the test is left up to chance – will they ask me things I’ve studied? I’d never written the MCAT or any board exam before and had no idea how it would play out. I think doing the practice tests really helped me get into the mindset and feel more confident by the end, but it’s impossible to really feel and “be” prepared for a test like this. I also had a severe headache, nausea, diarrhea the day of the test (a huge serotonin- gut reaction from anxiety). Anyways, thanks for sharing!

  5. WOW! Thank you soooooo much for this! I really needed information on how to go about studying. I am a first year Naturopathic Medical Student, and I want to start a studying regime, now. So, when it comes to the NPLEX, are there books that will prepare you for NPLEX 1 or are those available only when we take NPLEX 2? Should I just purchase USMLE books? First two years are basic science, so it does make sense to purchase the same book needed for conventional medical school. I will most definitely bookmark this awesome page. You gained a fan. Thanks again for this post! 🙂

    1. Hi, Krystal,

      The best thing you can do to prepare for NPLEX 1 at this stage (first/second year) is to learn the information presented to you in class, as NPLEX 1 is essentially a review of that. And, as I stated in the post, you don’t need to worry about getting started studying until about mid June of the summer after 2nd year. Don’t over-study! That being said, I recommend buying First Aid for the USMLE Step 1. It can be a useful tool for our pathology, diagnostics, clinic course we had to take in 2nd year. However, it presents a very brief explanation that should be expanded upon by more in-depth background information that you get from your course books, so it really does function as a helpful review test, but maybe not so helpful as your go through the information for the first time. “Healing Mountain” is the naturopathic book I eluded to in the post. I didn’t use that one, just First Aid and Kaplan for the USMLE Step 1. Sometimes I referred back to course notes but not often. I do that more now in clinic than I ever have before.

      Hope that helps! Enjoy 1st and 2nd year! And enjoy the journey!

  6. Thank you for being charmingly honest and helpful!!! Def will buy the book and feel less freaked about 8 hrs/day studying 🙂 4 hrs way more my style

  7. I waited till the very last weekend to study. I didn’t really care if I passed or not. Personally speaking, I would have to say that approaching this as well as life with minimal stress proves far more beneficial that stressing out over things. You either know your stuff or you don’t. Studying for 2 months and walking in trembling with anxiousness negates all the study anyhow.

  8. Hi Dr. Talia. Thanks for the informative post. I know it has been a while since you’ve written it but it is still super helpful today. I totally agree with the 8 hour a day thing. Every resource recommends treating studying like its a full time job. But I am always wondering what if you have to work part-time or even full time! (Personally I don’t have the luxury of not working 8 hrs/daily for two plus months.) Anyways, did you apply this same practice (4hrs/day etc) when you took part two. or did you do something a little different? I plan to take part 2 in February so I am really struggling with strategy. I would really appreciate your insight! Thanks in advance 🙂

    1. Thanks, Michelle, glad it was helpful! I did the same thing with part two: I taught English from 8 am to 2 pm and I studied for 4 hours a day (2 pm to 6 pm). I started studying weekends closer to the date! For part two though I used Vinnie’s Book (forget what it’s called) and Healing Mountain Practice exams. I was also starting a new relationship at the time, haha. It was a crazy few months!

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