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Despite Step 1 changing to pass-fail outcome reporting only, medical students still expend significant time and effort preparing for this licensure exam. As such, it is important to evaluate the efficacy of the CBSSA and update the results from Morrison et al. (2010)’s study. In addition to investigating examinees’ CBSSA use patterns, this study focused on Step 1 pass-fail outcome and the variables (time in days/weeks in relation to first Step 1 test date) relevant to Step 1 performance identified in the literature. The results should be particularly important for faculty who advise students about Step 1 readiness.