Histology on Step 1

[Dan S., MST USMLE TutorMod Reputation: 30]

I hear lots of folks wondering about how best to study histology for Step 1, or how much time to spend on it.

Here’s the short answer to the second part: not much.

And here’s a slightly longer answer: In questions with histology slides, it is almost always one of several clues pointing you to the right answer, and it is almost always the most difficult clue to interpret. You could study loads of histology slides and still see one on the exam that looks different from what you studied. It’s worth knowing which diseases have characteristic histologic findings – that way if you see a histology slide, it’s a clue that the question might be asking about one of those diseases – but being able to interpret those findings is more work than its worth. I’d focus time on illness narratives, lab findings, cell surface markers, etc. that are more easily interpreted. As far as best resource, I think pathoma does a great job of highlighting normal and abnormal histologic findings for key diseases and processes, and I wouldn’t go much beyond that. Hope this helps, and would love to hear others’ thoughts and your follow-up questions!

[Dr. David Delnegro MST USMLE TutorMod Reputation: 26]

A great way to look at it. Everyone is always so afraid of histology and pathology because the wide world of things under the microscope are just that, seemingly endless. However, the world of high-yield histology is very small and limited and as you do practice exams and finish uworld and other question bqnks you shall see exactly what is high yield in these subjects.

If it’s important, it’ll 1) likely be in pathoma and 2) show up multiple times in uworld and nbme exams.

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