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Everything You Need for USMLE Step 1

Step 1 is a memorization marathon. Biochem pathways, pharmacology, pathophysiology: thousands of concepts that need to stick. We built tools specifically for that.

PHARMACOLOGY · BLOCK 3
Question 9 of 40
Mechanism1:24
A 34-year-old woman has episodes of headache, palpitations, and sweating. Her blood pressure is 182/110 mm Hg. Plasma free metanephrines are elevated and imaging shows an adrenal mass.
Hint: Name the tumor, then think about which receptors its catecholamines hit.(B) Pheochromocytoma: irreversible alpha blockade comes first.(A) A beta blocker alone leaves alpha unopposed and can trigger a hypertensive crisis.
Which drug should be started first, before surgery?
APropranolol
BPhenoxybenzamine
CHydrochlorothiazide
DLisinopril
PHARMACOLOGY · BLOCK 3
Question 9 of 40
1:24
A 34-year-old woman has episodes of headache, palpitations, and sweating. Her blood pressure is 182/110 mm Hg. Plasma free metanephrines are elevated and imaging shows an adrenal mass.
Which drug should be started first, before surgery?
APropranolol
BPhenoxybenzamine
CHydrochlorothiazide
DLisinopril
Hint: Name the tumor, then think about which receptors its catecholamines hit.(B) Pheochromocytoma: irreversible alpha blockade comes first.

Step 1-Style Questions

Practice questions that mirror the actual USMLE Step 1 format. Single best answer, clinical vignettes, and mechanism-based scenarios, all mapped to NBME subject blueprints.

BIOCHEMISTRY · GLYCOLYSIS12 due
QUESTIONRate-limiting enzyme of glycolysis?
ANSWERPhosphofructokinase-1 (PFK-1)
AgainHardGoodEasy
Back in 3 days · spaced repetition

Memorize Step 1 Facts

High-yield flashcards covering biochem, pathology, pharmacology, and every Step 1 subject. Spaced repetition makes facts stick before exam day.

Biochemistry › Amino acids
Catecholamine synthesis
Tyrosine
L-DOPA
Dopamine
Norepinephrine → Epinephrine
Quick check: 2 of 2

Lessons for Every Subject

Interactive lessons with flowcharts, diagrams, and visual explanations across anatomy, physiology, biochemistry, pathology, pharmacology, and more.

Rezzy, the Oncourse AI study mate

AI That Understands Medicine

Ask Rezzy anything, by text or voice, and get instant answers tied to NBME blueprints, Harrison's, and First Aid.

9:41
Pharmacology
Compare ACE-I vs ARBs
Where each one blocks
AngiotensinogenreninAngiotensin IACEAngiotensin IIAT₁ receptorVasoconstriction · aldosteroneBradykininACEInactiveACE-Ibuilds upCough · angioedemaARB
ACE-IARBs
Bradykinin↑ dry cough, angioedemaNot raised
ExamplesEnalapril, lisinoprilLosartan, valsartan
BothHyperkalemia · avoid in pregnancy
Make flashcards on this
Quiz me on RAAS drugs
Ask Rezzy anything
Exam angle
Cough with ACE-I but not ARBs is a favorite way to test bradykinin.
Make 5 flashcardsQuiz me on this

Stay on Track, Stay Current, Stay Connected

Covers all Step 1 subjects with analytics, research-linked explanations, and a connected student community.

STEP 1 READINESS
Block done · 29 / 40▲ 5 this week
58OUT OF 1004 of 11 subjects ready
Knowledge17 / 25
Coverage15 / 25
Exam Instinct13 / 25
Application11 / 25
Pathology80Strong
Biochemistry52Developing
Pharmacology63Developing
STEP 1 READINESS
Block done · 29 / 40▲ 5 this week
58OUT OF 100
Knowledge17 / 25
Coverage15 / 25
Exam Instinct13 / 25
Application11 / 25
4 of 11 subjects ready
Pathology80Exam ready
Biochemistry52Developing
Pharmacology63Developing

Know Exactly Where You Stand

Know exactly where you stand across every Step 1 subject, and track your progress as you go.

Kept currentTHIS WEEK
Notes
Autonomic pharmacology
Reviewing… Updated
Questions
Renal physiology
Reviewing… Updated
Flashcards
Antimicrobials
Reviewing… Updated

Content That Stays Current

Medicine evolves, and so does our content. Our AI continuously improves notes, questions, and flashcards to stay accurate and exam-relevant.

LAST SET
Pharmacology block
29 / 40
Enzyme deficiencies cost you 5 questions this week.
FOCUS NEXT
Biochemistry: metabolism
15 questions · 20 min
START

Time Where It Matters Most

Identify weak areas and allocate study time where it matters most.

Practice That Feels Like a Game

Quick games built on high-yield medicine. Play one between study sessions to keep concepts fresh and find out what you haven't locked in yet.

Probe:Sharpen Your Diagnostic Reasoning

Dr. Holmes reads out one clue at a time and you say your answer out loud. The fewer clues you need, the better you know it.

1
CLUE 1
A harsh systolic murmur at the left sternal border.
CLUE 2
The child squats to ease cyanotic spells.
Dr. Holmes
Clue one. A harsh systolic murmur at the left sternal border.
Dr. Holmes is speaking…

Synapses:Link Concepts. Build Connections.

Step 1 is all about connecting biochem, physiology, and pathology. Synapses turns those connections into a game so they lodge in long-term memory.

Create groups of 4!
Test your STEP 1 knowledge
00:08
LosartanAtenololEnalaprilAmlodipine
MetoprololValsartanRamiprilVerapamil
NifedipineEsmololIrbesartanCaptopril
LisinoprilDiltiazemNadololOlmesartan
LIFELINES
RESETCHECK
Perfect guess! Wohoo! 🎉

Image Rush:Recognise It Before Time Runs Out

Label anatomy and identify clinical images against the clock. Build the visual recall you need for image-based questions.

15Label them all0
123
1Aorta
2Superior vena cava
3Right atrium
Aorta

Clinical Rounds:Work the Case, Make the Diagnosis

Take a patient history, choose investigations, and make a diagnosis. Review your feedback to sharpen your next clinical decision.

Learners love Oncourse

Real feedback from learners using the current Oncourse app.

Becca
BeccaUS MD student · MS1

As a US MD student Oncourse has combined all of the resources into one amazing efficient resource. Rezzy helps me break down the hardest concepts and has made my studying 10x better. It's a life saver.

USMLE
Dr. Amanda
Dr. AmandaUSMLE · 99th percentile

Oncourse keeps me motivated to learn every day… I love the high yielding flashcards and maintaining the daily streak.

USMLE
Dr. Tawfiq
Dr. TawfiqResident

Genuinely impressive platform for med students, there's no app like it right now! Especially the games like Image Rush & Clinical Rounds!

USMLE

Get Oncourse Max

Simple, student-friendly pricing. Experience the future of learning with your personal AI study mate.

Weekly$8.99per weekPay week to week.Get started
Annual$79.90per year7-day free trial. Works out to $6.66 a month.Sign up for free
Monthly$14.99per monthPay month to month.Get started

Prices in USD. Every plan includes Step 1, Step 2 CK, and Step 3.

Frequently asked questions

Is this aligned with USMLE Step 1 blueprints?

Yes. All content is mapped to NBME Step 1 content specifications: organ systems, disciplines, and physician tasks as defined in the most recent blueprint.

How does Synapses help with Step 1?

Synapses trains concept-linking under time pressure. You group related terms, beat the clock, and compete on leaderboards, which builds the associative memory that Step 1 high-yield questions test.

How long is the free trial?

Start free and explore questions, flashcards, and lessons before upgrading. No credit card required.

When should I start using Oncourse for Step 1?

Most students start 4–6 months before their exam date. The spaced repetition system works best with time: the earlier you begin, the more recall loops you complete before test day.

Does Oncourse work on mobile?

Yes. Oncourse is available on iOS and Android. Study on your phone, tablet, or desktop. Progress syncs automatically across all devices.

How much does Oncourse cost?

$79.90 a year with a 7-day free trial, $14.99 a month, or $8.99 a week. Every plan includes Step 1, Step 2 CK, and Step 3.

Rezzy, the Oncourse AI study mate

Start your Step 1 prep

Master the concepts that show up on exam day. Q-Bank, flashcards, games, and AI built for memorization.

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Oncourse is an independent exam-preparation product and is not affiliated with or endorsed by the FSMB or NBME. USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME).