USMLE Step 1 is the first step towards residency in US. It assesses whether medical school students or graduates understand and can apply important concepts of the sciences basic to the practice of medicine. It covers the following subjects: Anatomy, Physiology, Biochemistry, Genetics, Behavioral Medicine, Statistics, Microbiology (including Parasitology), Ethics, Pathology, Pharmacology, Histology, Immunology, Molecular Biology, and Epidemiology. 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 350 multiple-choice questions (MCQs) divided into seven blocks each consisting of 50 questions. 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.
The scores are reported with a three digit score and a two digit score. As of January 1, 2007, the passing score has been raised to 185 from a previous score of 182. The average score is approximately 215. If the student passes the exam, he or she may not repeat the exam to achieve a higher score. But if a student fails the exam, the exam can be taken multiple times.
The scores are valid for 7 years after taking the exam. 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 usually accept applications with higher Step 1 scores. The Step 1 exam is arguably the hardest and most important examination a medical student will take during his/her career .
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