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Library Study Guide
Complete Study Curriculum

Master USMLE Step 1 · Step 2 CK · Step 3 & MCCQE1

A comprehensive, phased study plan that integrates all foundational sciences, clinical knowledge, and patient management topics using the Bridge IMG library resources.

4
Phases
28+
Weeks
150+
High‑yield topics

Phase 1: Foundation Building (Weeks 1–8)

Goal: Establish a solid grasp of core basic science disciplines. Use the content maps as your primary reading material, and start the QBank early (20–30 questions/day).

Week 1–2: Biochemistry & Genetics

  • Biochemistry – metabolism, molecular biology, vitamins
  • High‑yield: Methionine synthesis (B12 deficiency), fat malabsorption (vitamin A), familial hypercholesterolemia (LDL receptor), unconjugated bilirubin (pigment gallstones), purine metabolism (uric acid calculi), ATP synthesis (mitochondrial myopathies)
  • Genetics: Down syndrome, chromosomal inversions, folic acid deficiency
Use: Biochemistry content map and Step 1 QBank (Biochemistry section)

Week 3–4: Gross Anatomy & Embryology / Histology & Cell Biology

  • Gross Anatomy & Embryology – horseshoe kidney (metanephros fusion), spinal cord lesions (C7), medial longitudinal fasciculus, MCA territory
  • Histology & Cell Biology – unmyelinated nerve loss (pain/temp), decreased E‑cadherin in gastric adenocarcinoma, type II pneumocytes in ARDS
QBank: Anatomy/Embryology & Histology sections

Week 5–6: Microbiology & Immunology

  • Microbiology – Ebola (RT‑PCR), pertussis (macrolides), EBV, enterovirus (meningitis), SCID (RAG1/2), allergy desensitization (IgG), Candida, Pasteurella, Lyme disease, pediatric neutropenia
Use: Microbiology content map + QBank

Week 7–8: Pathology & Pharmacology (General Principles)

  • Pathology – emphysema, Goodpasture, Marfan, aortic dissection, urothelial carcinoma, Barrett esophagus, osteoporotic fractures, left atrial myxoma, obesity hypoventilation syndrome
  • Pharmacology – drug interactions (ciprofloxacin/warfarin), ACE inhibitor hyperkalemia, MAO‑B inhibitors, amphetamine toxicity, methotrexate rescue, alcohol withdrawal (GABA), NSAIDs (dysmenorrhea)
Integration: Start using Integration Tables to connect diseases with biochemistry and pharmacology.

Phase 2: Systems Integration (Weeks 9–16)

Goal: Study each organ system holistically, integrating anatomy, physiology, pathology, pharmacology, and clinical reasoning. Increase QBank to 40–60 questions/day, mixed by system.

Week 9–10: Cardiovascular System

  • Cardiovascular content map – embryology, anatomy, histology, physiology, pathology, pharmacology
  • High‑yield: left ventricular hypertrophy, aortic dissection, Marfan (stretched annulus), MCA stroke territory, RV infarction hemodynamics, atrial fibrillation (amiodarone), heart failure/PE diagnostics

Week 11–12: Respiratory System

  • Respiratory content map – embryology, anatomy, histology, physiology, pathology, pharmacology
  • High‑yield: emphysema (PFTs), asthma step‑up therapy, COPD exacerbation, tension pneumothorax, ARDS repair (type II pneumocytes), pertussis (macrolides)

Week 13–14: Gastrointestinal System & Hepatobiliary

  • GI content map – esophageal varices (octreotide, endoscopy), Barrett esophagus, gastric adenocarcinoma (E‑cadherin), biliary atresia, pigment gallstones, appendicitis, IBD, celiac disease

Week 15–16: Renal & Urinary System

  • Renal content map – horseshoe kidney, urothelial carcinoma, Goodpasture syndrome, uric acid calculi, ACE inhibitor hyperkalemia, acute kidney injury, chronic kidney disease

Phase 3: Clinical Application (Weeks 17–24)

Goal: Transition to clinical reasoning. Master Step 2 CK clinical scenarios and Step 3 CCS simulations. Continue integrated QBank (60–80 questions/day).

Week 17–18: Internal Medicine & Surgery

  • Cardiology: atrial fibrillation (amiodarone adverse effects), aortic valve replacement radiology, heart failure vs. PE (BNP vs. D‑dimer)
  • Pulmonology: asthma step‑up, COPD exacerbation, tension pneumothorax
  • GI: bleeding varices (octreotide, endoscopy)
  • Surgery/EM: RV infarction hemodynamics, acute stroke imaging (CT angiography), cardiac tamponade (FAST, pericardiocentesis), spinal cord contusion

Week 19–20: Pediatrics, Obstetrics & Gynecology

  • Pediatrics: osteogenesis imperfecta (audiography screening), reactive attachment disorder, CF exacerbations, normal adolescent development vs. oppositional defiant disorder
  • OB/GYN: hypothalamic hypogonadism (exercise‑induced amenorrhea), postmenopausal bleeding (endometrial biopsy), gestational diabetes screening, Rh isoimmunization (RhoGAM), ectopic pregnancy

Week 21–22: Psychiatry, Ethics, & Patient Safety

  • Psychiatry: panic disorder, GAD, somatic symptom disorder, lithium toxicity, bipolar disorder (manic phase)
  • Ethics: surrogate decision‑making, advance directives, reporting impaired physicians, disclosing bad news (Down syndrome), interpreter use
  • Patient Safety: handoff errors, wrong‑site surgery prevention, standardized orders, C. difficile precautions

Week 23–24: Step 3 & MCCQE1 Integration

  • Step 3 CCS simulations – COPD exacerbation (ventilation refusal), DKA with cerebral edema (mannitol), sepsis (Vibrio vulnificus), acetaminophen overdose
  • MCCQE1: Canadian ethics (MAiD, resource allocation), thyroid nodules, pleural effusion, AKI (rhabdomyolysis), central DI, hypothyroidism (menorrhagia), tic disorders, postpartum hemorrhage, SIDS prevention
Practice: Step 2 CK Clinical Scenarios and CCS Simulator daily.

Phase 4: Review & Consolidation (Weeks 25–28)

Goal: Rapid review of weak areas, simulated full‑length exams, and final test‑taking strategy.

  • Revisit USMLE Topic Mapping to identify gaps.
  • Use Integration Tables for quick cross‑discipline recall.
  • Take 2–3 full‑length practice exams under timed conditions.
  • Focus on high‑yield facts: Study Strategy final week advice.
  • Review Library for last‑minute references and concept maps.
Last Week: No new material; light review, sleep, and confidence building.
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