Doctors & Future Doctors From All Over The World!: USMLE Step 1

Step 1

USMLE Step 1 assesses whether medical school students or graduates understand and can apply important concepts of the sciences basic to the practice of medicine. As of 2007 it covers the following subjects, in both systemic (general and individual anatomical characteristics) and procedural (functional, therapeutic, environmental, and abnormality) themes:

Anatomy,

Physiology,

Biochemistry,

Pharmacology,

Pathology,

Microbiology,

Behavioral sciences,

Interdisciplinary topics, such as nutrition, genetics, and aging.

US medical students usually take Step 1 at the end of the second year of medical school. It is an eight-hour computer-based exam consisting of 322 multiple-choice questions (MCQs) divided into seven blocks each consisting of 46 questions. As of summer 2008, some questions include audio and video. Each block must be finished within an hour. The remaining hour is break time. An optional tutorial about how to use the computer program of the exam is offered at the beginning of the exam and takes 15 minutes. This time is deducted from the hour of allotted break time. A quality assurance survey is presented at the end, provided some of the original eight hours is left over.

The scores are reported with a three digit score and a two digit score. As of January 1, 2010, the passing score has been raised to 188 from a previous score of 185. The average score is approximately 221 and the standard deviation is 23.If the student passes the exam, he or she may not repeat the exam to achieve a higher score.

While not recommended by the creators of the USMLE, the Step 1 score is frequently used in medical residency applications as a measure of a candidate's likelihood to succeed in that particular residency (and on that specialty's board exams). More competitive residency programs such as Radiology, Ophthalmology, Plastic Surgery, Orthopedic Surgery and Dermatology usually only accept applicants with high Step 1 scores. The Step 1 exam is arguably the hardest and most important examination a medical student will take during his/her career.

The USMLE score is just one of many factors considered by residency programs in selecting applicants. The median USMLE Step 1 scores for graduates of U.S. Medical Schools for various residencies are available in Chart 10 on page 11 of "Charting Outcomes in the Match" available at http://www.aamc.org/programs/cim/chartingoutcomes.pdf

The cost for the exam in 2010 is $505 and will increase to $525 in 2011.