What is the Step 1 Exam?

The United States Medical Licensing Examination (USMLE) Step 1, also known as the Step 1 exam, is a one-day computer test students typically take following their second year of medical school. The exam assesses a student’s ability to apply important science concepts that are fundamental to the practice of medicine. Like many medical students, you might consider Step 1 as the single most important test of your educational career since it’s a critical way to demonstrate the type of doctor you’ll be once you enter the field of medicine.

Who is Eligible for the Exam?

In order to sit for the test, you must fall into one of two categories at the time you apply for the exam as well as on the day you test. First, medical students who are enrolled in or a graduate of a medical school in the U.S. pursuing a Doctor of Osteopathic Medicine (D.O.) degree program accredited by the American Osteopathic Association (AOA) are entitled to take the exam. Second, medical students who are enrolled in or a graduate of a medical school in the U.S. or Canada pursuing a Doctor of Medicine (M.D.) degree program accredited by the Liaison Committee on Medical Education (LCME) may take the exam.

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When Should You Take the Exam?

Although Step 1 is administered year-round, most students take the exam at the end of their second year. However, because many residency program directors consider the test to be the most important factor in choosing graduating medical students for their programs and because the test thoroughly assesses how well a student can apply their attitudes, values and skills to patient-centered, real-life scenarios, it’s important to have a strong plan to prepare for the exam. Ideally, you should take Step 1 by April, but avoid doing so until you’re extremely confident you’ll pass with a high score.

What is on the Exam?

The Step 1 exam can be completed in eight hours, and the test is divided into seven blocks that each take one hour to finish. Although the exact number of questions on each block will vary, there are a maximum of 40 questions per block. Between test sections, students may take a total of 45 minutes for personal breaks. If a student finishes a section before 60 minutes is over, the unused time may be added to his or her total break time. The USMLE indicates that the exam covers topics related to several traditional disciplines, including physiology, pharmacology, pathology, microbiology, biostatistics and epidemiology, biochemistry, behavioral sciences and anatomy. The exam may include additional content from disciplines such as nutrition, molecular and cell biology, immunology, genetics and aging.

How Can You Prepare for the Exam?

Preparing for Step 1 can be accomplished in a number of ways, including completing review programs, using question banks, watching videos and reading review books. As you start to study for the exam, keep in mind that you don’t need to know every little detail pertaining to medicine as the exam only tests your knowledge and understanding of the general principles of basic medical sciences.

Although knowing this won’t make the test any easier, it will help to give you some perspective and direction in terms of preparation and focused study. The USMLE Step 1 exam can be conquered with solid prep support, strong discipline and the right attitude.