It goes without saying that sitting any exam is likely to be a stressful experience. When it comes to Step 1, there are lots of things you can do beforehand to minimize your stress levels. This will help you make the most of your prep, and keep calm on the day. 

1. Make a study schedule and stick to it
A quick Google search will yield lots of advice about creating a study plan for Step 1. You could also use companies like Cram Fighter who specialize in creating personalized study schedules. 

Keep in mind how you learn and what's worked for you in the past. There's lots to cover so making a detailed plan before you start will help you feel confident that you’re not missing anything out. 

Sleeping well is key to effective preparation, so in your schedule don't plan to study right up until you hit the hay. 

2. Schedule time for breaks and relaxation
Intense, non-stop studying will wear you out and prevent your study times from being effective. Scheduling downtime for friends, family and hobbies will help to relax and rest your brain between study periods. 

Cramming the night or morning before your exam can cause increased anxiety too, so plan to have the night off before test day.

3. Don’t bottle up your concerns
Talk to your peers, and within just a few moments you'll feel better knowing that your anxieties are shared by lots of other students. And there’s always the Office of Student Affairs on your campus. They’ll have helped hundreds of students deal with exam- or study-related anxiety over the years, and will have plenty of helpful advice and tips on how to manage.

4. Treat the exam like a sporting event
It's an oft-used analogy, but thinking like an athlete can really help you to focus and prepare. Whatever you want to succeed in, whether it's USMLE or a marathon, you need to look after yourself. Eat the right foods, sleep well and do regular exercise.

5. Practice against the clock in the final few weeks
You need to get used to working at the right speed to make sure you're on track for a high Step 1 score. Lots of online resources, like the Pastest Qbank, feature a test mode option which replicates the Step 1 timings. Using this in the weeks leading up to the exam will help prepare you for the real thing.

6. Plan for your test day
Do your research beforehand so you know where you're going and what you need to take with you. Know the rules about what you can take into the exam, breaks, and what time you need to be there. Leaving these details to the last minute will just give you another thing to worry about right before your exam. 

7. Plan to do something you enjoy after the test
It’s always tempting to stand around with the other candidates dissecting the questions and trying to compare your performance. This is almost always a negative experience, so plan to avoid it! Arrange to do something you enjoy immediately after your exam, whether it's meeting a friend for dinner, exercising or going for a walk. This will act as a motivator before and during the exam, and will serve as a well-deserved reward when those 8 hours are up.