When to sit Step 1?

[equium]

Hi all.

I am a first year medical student at a medical school in the UK and am obviously looking to sit the USMLE Step 1 - my question is, when is it best to take it?

It was suggested to me a while ago to take it after 2nd yr (i.e. at the end of pre-clinical medicine). But having looked at some of the questions they ask in Step 1, it is a very clinical exam and I would be seriously lacking in hands-on clinical experience. The only plus side is that the first 2 yrs of medicine are much less busy than the next 3, so it would be a lot easier to set time aside to revise for step 1.

Any advice you can give me would be brilliant!

[Scottish Chap]

Hi all.

I am a first year medical student at a medical school in the UK and am obviously looking to sit the USMLE Step 1 - my question is, when is it best to take it?

It was suggested to me a while ago to take it after 2nd yr (i.e. at the end of pre-clinical medicine). But having looked at some of the questions they ask in Step 1, it is a very clinical exam and I would be seriously lacking in hands-on clinical experience. The only plus side is that the first 2 yrs of medicine are much less busy than the next 3, so it would be a lot easier to set time aside to revise for step 1.

Any advice you can give me would be brilliant!

I know you sent me a PM with the same question yesterday so I'll answer you here for the benefit of other readers in the same position as you.

Basically, you want to take Step 1 only after you have covered ALL of the preclinical subject matter in detail: pathology, pharmacology, physiology, genetics and molecular biology, biochemistry, anatomy, histology, nutrition, neuroscience, anatomy, statistics, microbiology, virology, parasitology, psychology, medical ethics. It is a massive disadvantage to take this exam using only review material to study with.

Keep in mind that medical students in the U.S. take this exam after their preclinical years and so you don't need experience in managing patients to do well on Step 1. Anecdotally, however, I can share with you that friends of mine who attended medical school overseas commented on how they were able to 'reason' through some of the questions based on years of clinical experience if their basic science memory banks were shaky in certain areas.

In your PM, you mention that relatives told you to take it after two years of medical school in the U.K. I might caution against that if you have not covered all of the subject matter mentioned above. Step 1 used to be much more 'basic' and mechanistic in nature. However, as you have discovered by viewing sample questions, it is now very much a clinically-oriented examination these days and requires second- and third-order thinking and reasoning.

Step 2 of the USMLE covers clinical management issues in all of the core medical specialties. That is the exam that really requires patient care experience to secure a good score. Good luck!