99% of IMGs begin with biochemistry. A week later, a lot of them quit, because biochemistry cold is just that difficult. They decide Step 1 isn't for them, when the only thing wrong was the order.
Don't make that mistake. Nothing on this page asks you to study biochem harder. It only changes when you study each piece.
Start here · before page 1
Biochem: micro and pharm first
Biochem has no Micro or Pharm pill of its own. Where biochem meets micro and pharm, it is inside the systems: the insulin videos open endocrine, and the 3 Dirty Medicine lipid metabolism videos are recommended right before the lipid-lowering drugs in cardio pharm. These are the full guides.
Microbiology
Pharmacology
Where this system sits
The order: easy systems first, cardio last
Biochem has no slot of its own in the order. Each piece goes right before the system that needs it, and the systems run easy first, cardio last. Tap a system to open its guide.
- 1Renal6 days · the easy one, start hereOpen →
- 2Respiratory6 days · same method as renalOpen →
- Before it: Biochem nutrition, 1 day, right before GI · where it sits
- 3GI7 daysOpen →
- 4Reproductive7 daysOpen →
- Before it: Biochem carb and lipid metabolism, 1 day, right before endo · where it sits
- 5Endocrine6 daysOpen →
- 6Immunology5 daysOpen →
- Before it: Biochem cellular, molecular and amino acids, right before heme-onc · where it sits
- 7Heme-onc6 daysOpen →
- 8MSK6 days, no dermOpen →
- Before it: Dermatology, 3 days, after MSK · the derm block
- 9Psychiatry5 daysOpen →
- Before it: Genetics and ANS, right before neuro · genetics
- 10Neurology7 daysOpen →
- 11Cardiovascular7 days · always lastOpen →
Biochem is never a block of its own: each piece sits right before the system that needs it. The whole method, once: how to study any system →
The one idea everything hangs on: biochem is a prerequisite, not an opener. Almost everyone studies it in the worst order — all of it, cold, on day 1 — so they understand none of it and forget what stuck before the systems that use it arrive. You do the opposite: split it into pieces and drop each one right before the system that needs it. Same biochem, completely different retention.
The math (why this isn't optional)
~64 h → 30%
Front-loaded as 1 block: more hours, low retention by the time it's tested.
~35 h → 80%
Split & placed before each system: fewer hours, it actually sticks.
~29 h saved
A whole extra system's worth of time — and you remember it.
The 3 rules
- Never open biochem on day 1. It's a prerequisite, not a foundation block. Cramming 40+ pages cold in week 1 is wasted — you'll forget it before week 6 when HemOnc, Endo and Neuro need it.
- It's not 1 block — it's pieces, each placed before the system that depends on it. Sickle cell is 1 amino-acid swap (glutamic acid → valine). Learn it in isolation and it's a fact you lose; learn amino acids the week before HemOnc and it's obvious.
- Where you study it matters as much as when. Do it in the Vault biochem section: every First Aid page broken down, the best video for the topic on the pages that need one, a concept walkthrough, page-by-page MCQs so you test the second you read, and an ELI5 for the pages that usually make people cry.
Open Biochemistry in the First Aid GuideFirst Aid pp. 32–92, page by page: Focus On, ELI5 and the MCQs on every page. Opens straight into biochemistry.
Open Biochemistry →The 7 placements (actual schedule order)
2
🧬 Metabolism — Carbohydrates
→ right before EndocrineGlycolysis, glycogen storage, insulin — diabetes is built on this.
Then: Endocrine in 6 days → Spend 1 day on carbs and lipids together, active reading in the First Aid Guide, right before endo.3
🧬 Metabolism — Fats / Lipids
→ right before EndocrineEvery steroid hormone — estrogen, cortisol, testosterone — is built from cholesterol.
Then: endocrine (same day as carbs).4
🧬 Cellular — organelles, signaling
→ after Immunology, right before HemOncCell signaling and the machinery cancer hijacks.
5
🧬 Molecular — DNA/RNA, mutations, lab techniques
→ after Immunology, right before HemOncMutations, oncogenes, and the molecular tools tested alongside cancer/immuno.
6
🧬 Metabolism — Amino Acids
→ after Immunology, right before HemOncHemoglobin is amino-acid chains; antibodies are proteins; heme synthesis & porphyrias.
Pieces 4–6 feed: Immunology in 5 days → · Heme-onc in 6 days →Total biochem ≈ First Aid pages 32–92 · ~138 page-by-page Vault MCQs.
How you run each biochem day
- Read the Vault page (First Aid open) → watch the attached HY video for the hard pages.
- Do that page's MCQs the same day — test the moment you read.
- Hit a brutal page? Open the ELI5 for it before moving on.
- Move on only once the last page is locked.
The 7 pieces are Vault-only: no
Mehlman, no separate Anki deck, no
UWorld block of their own while you're in the systems. Short, surgical, and reinforced by the system you start the next day. The Mehlman, Anki and UWorld pass happens once, at the end (below).
Each biochem piece, hour by hour
Clock times assume an 11-hour day: 9 AM–1 PM, 2–6 PM and 7–10 PM, with lunch and dinner in the gaps. Shift the clock to your day. Keep the order.
Before GI · Nutrition1 day · First Aid pp. 63–70
9 AM–1 PMpp. 63–65 · essential fatty acids, the vitamins, vitamin A and the first B vitamins
2–6 PMpp. 66–70 · B6 to B12, vitamins C, D, E and K, zinc, malnutrition, ethanol metabolism
Before endocrine · Carbs and lipids1 day · First Aid pp. 71–79, 84–85 and 87–92
9 AM–1 PMpp. 71–79 · rate-limiting enzymes, glycolysis, PDH, TCA cycle, electron transport, HMP shunt, fructose, galactose
2–6 PMpp. 84–85 and 87–92 · glycogen and the storage diseases, fatty acids, ketones, fed vs fasted, lipoproteins
7–9 PMRedo every MCQ you missed today, with the page open. Endocrine starts tomorrow.
After immunology, before heme-onc · Molecular, cellular, amino acids
1 day each on the Vault scheduleDay 1, 9 AM–6 PMMolecular, pp. 32–43 · DNA replication and repair, mutations, gene expression
Day 2, 9 AM–6 PMCellular, pp. 44–53 · the cell cycle, organelles, the cytoskeleton
Day 3, 9 AM–1 PMAmino acids, pp. 79–83 · the amino acids, heme synthesis and the porphyrias. Heme-onc starts after this.
Before neuro · Genetics1 day · First Aid pp. 54–62, then ANS
9 AM–1 PMpp. 54–58, with the MCQs on every page
2–6 PMpp. 59–62. Inheritance, the trinucleotide repeats, Huntington and fragile X are the parts neuro leans on.
7–9 PMRedo every MCQ you missed today. ANS is next, then neurology.
Want a day-by-day schedule that tells you exactly what to study next? The Vault builds it around your exam date.
Build my schedule →
The final biochem pass, towards the end
★ After every piece is done, before revision · 3 days at most
Towards the end, take a couple of days and do biochem once more as a whole, in the same order as any system. It won't take more than 3 days.
- Read the entire biochem section of the First Aid Guide. pp. 32–92. You've seen every page already, so this is fast.
- Watch the Mehlman Medical biochem videos. Active application: how the exam asks each pathway.
- Do the FA Foundation Anki biochem deck. 138 cards (as of October 2026), the page number on every card.
- Solve UWorld biochem with the RPSR method, every miss reviewed back in First Aid.
Run the FA Foundation Anki · Biochemistry deck138 cards (as of October 2026), First Aid page by page, with the page number on every card. Opens straight into the deck.
Open the deck →The final pass, hour by hourTowards the end, once all 7 pieces are done
Day 1, 9 AM–1 PMThe First Aid Guide, pp. 32–53 · molecular and cellular, read fast
Day 1, 2–6 PMpp. 54–70 · genetics and nutrition
Day 1, 7–10 PMpp. 71–92 · metabolism
Day 3UWorld biochem in 20-question tutor blocks, every miss reviewed back in First Aid. Then revision starts.
Then revise it again and again
After the final pass, biochem never goes away. You keep revising it, each time with a different tool:
- The First Aid Guide. The biochem pages, read fast, MCQs on the pages you've forgotten.
- The FA Foundation Anki. The biochem deck again, inside your full First Aid revision. All of First Aid in 6 days →
- The NBME Booster Anki. The biochem deck, 329 cards (as of October 2026), built from retired NBME forms. How the Booster works →
- Finally, the Neil Randy PDF, biochemistry section, and his biochemistry playlist. The free sheets →
PDFThe Neil Randy PDFGo to the biochemistry section. Free in the University section of usmlevault.com.
▶Neil Randy · USMLE Biochemistry playlistThe last revision layer.
Lock rules — what can't change
🧬And every biochem piece stays before its system: Nutrition before GIT · Carbs & Fats before Endocrine · Cellular, Molecular & Amino Acids after Immunology, before HemOnc · Genetics before Neuro.
Bottom line: stop treating biochem as a wall you climb at the start. Slice it into 7 small pieces, drop each right before the system that uses it, do it in the Vault, then close with a 2–3 day final pass and keep revising — and it stops being the subject that makes people quit. It becomes the easiest 30 hours on your calendar.
