USMLE Step 1 Exam
The USMLE Step 1 exam covers the contents of the first 2 years of medical school (pre-clinical sciences). The subjects include:-
| Gross Anatomy | Pathology |
| Neuroanatomy | Pharmacology |
| Histology | Microbiology |
| Embryology | Immunology |
| Physiology | Behavioural Science |
| Biochemistry | Biostatistics |
| Genetics |
This may appear mind boggling at first sight but actually many are subtopics in the major subjects. The reason for this classification is that many books are written for these specific topics separately.
Time to prepare for the exam depends from person to person. Generally IMG's prepare for about 3-6 months for the exam.
Exam Registration
The application for the USMLE exams may be submitted online or via regular mail as described in the introduction.Once registered the applicant receives the Orange permit card which is used to register for the exam either by phone or online (Thomson Prometric). Along with the permit the examinee will also receive a CD containing 3 blocks of sample questions and the software tutorial.
Exam Design
Step 1 is a one day exam. The total exam duration is 8 hours. The exam consists of 7 blocks of 50 questions each which have to be finished in 1 hour. So the actual exam time is 7 hours. There is a 15 minutes tutorial to let applicants get familiar with the software and 45 minutes of break time. So the total duration of the exam totals to 8 hours.Applicants are allowed to take a break after finishing a block but not during a block. The applicant may take as many or as few breaks as he likes as long as he does not leave the exam room in the midst of a block. Also note that once a block has started, it has to be finished before the applicant may take a break. If a block is closed without completing it there is no way in which it may be opened again.
If the tutorial is finished earlier then the remaining time gets added to the break time. Similarly if a block is finished earlier then also the time gets added to the break time. This extra time cannot be used to extend the time of some other block.
Each block will contain a mix of questions from the various subjects. No particular subject is more important than others. To put it crudely every subject is as important as the thickness of the book used for exam preparation and therefore every book should be read thoroughly.
Questions on the exam
Questions are multiple choice type and may carry between 3 to 10 choices per question. Most of the questions are framed in a clinical scenario. All questions carry equal weightage and there is no negative marking.A point to note is that not all questions on the actual exam will be scored. They are there for experimental purposes to analyze if they are suitable to be scored in future exams (e.g. some questions may be too tough, too easy or wrongly framed). According to the USMLE website anywhere between 10-20% of the questions on the exam may not be included in the final score. So if you are talking a long time on a particular question, you may want to select your favorite letter and move on.