The USMLE Step 1 is the first part of the United States Medical Licensing Examination. It aims to assess whether medical school students or graduates can apply important concepts of the foundational sciences fundamental to the practice of medicine. Graduates of international medical schools (outside the US or Canada) must also take Step 1 if they want to practice in the US. Graduates from international medical schools must apply through ECFMG, and the registration fee is $915.
The exam is currently an 8-hour computer-based test taken in a single-day, composed of seven 40-question sections with a maximum 280 multiple-choice questions. One hour is provided for each section, allotting an average of a minute and thirty seconds to answer each question. Between test sections, the test taker is allotted a cumulative 45 minutes (during the test day) for personal breaks. (There is a 15-minute tutorial at the beginning of the exam, which the test-taker can choose to skip and have that time added to break time.) If the taker finishes any section before the allotted one hour time limit, the unused time is added to the break time total.The test is administered at any of several Prometric computer testing sites.
While the USMLE program does not disclose how the three-digit score is calculated, Step 1 scores theoretically range from 1-300. Most examinees score in the range of 140 - 260, the passing score is 194 and the national average is 229. From 1 Jan 2022, the USMLE Step 1 examination will be reported as pass/fail rather than a three-digit score.
Step 1 is designed to test the knowledge learned during the basic science years of medical school as applied in the form of clinical vignettes. This includes anatomy, behaviouralsciences, biochemistry, microbiology, pathology, pharmacology and physiology, as well as to interdisciplinary areas including aging, genetics, immunology, nutrition, and molecular and cell biology. Epidemiology,medical ethics and questions on empathy are also emphasized. Each exam is dynamically generated for each test taker; while the general proportion of questions derived from a particular subject is the same, some test takers report that certain subjects are either emphasized or deemphasized.
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