1. USMLE
STEP 1
SURVIVAL
GUIDE

2. Overview Licensing Exams USMLE Step 1 Strategies for Success
Content
Application and Scheduling
Strategies for Success
Special Issues

3. Licensing Exams

4. To become licensed to practice medicine in the United States, one must:
Earn a medical degree
Pass several licensing examinations
Complete one or more years of residency training
Apply for licensure from a state medical licensing authority

5. The National Board of Medical Examiners (NBME)
The NBME is an independent, not-for-profit organization that provides examinations for the health professions.

6. The United States Medical Licensing Examination™ (USMLE™)
The USMLE, co-sponsored and co-owned by the NBME and the Federation of State Medical Boards, is a three-step examination for medical licensure in the United States.
Step 1
Step 2, Clinical Knowledge (CK)
Step 2, Clinical Skills (CS)
Step 3

7. The United States Medical Licensing Examination™ (USMLE™)
The USMLE assesses one’s ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care.

8. The United States Medical Licensing Examination™ (USMLE™)
Results of the USMLE are reported to medical licensing authorities in the United States for their use in granting the initial license to practice medicine.

9. USMLE Step 1 Computer based examination
Assesses whether medical students can understand and apply important concepts of the sciences basic to the practice of medicine.
Step 1 is usually taken at the end of the second year of medical school.

10. USMLE Step 2
A two step examination that assesses whether students can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention.

11. USMLE Step 2 Clinical Knowledge
A computer based exam consisting of multiple-choice questions that focus on the principles of clinical science that are deemed important for the practice of medicine under supervision in postgraduate training.

12. USMLE Step 2 Clinical Skills
Uses standardized patients to test one’s ability to gather information from patients, perform physical examinations, and communicate findings to patients and colleagues.
Usually taken during the fourth year
Five test centers in the United States

13. USMLE Step 3
A computer based exam that assesses whether medical school graduates can apply the medical knowledge and understanding of biomedical and clinical science considered essential for the unsupervised practice of medicine.
Step 3 is usually taken during or after the first year of postgraduate residency training.

14. UMMSM Requirements
Students must pass Step 1 for promotion to the third year
Students must take Step 2 CS and CK as a condition for graduation
Passing Step 2 CS and CK is not a requirement for graduation

15. USMLE Step 1

16. Important Websites USMLE NBME Prometric Test Centers www.usmle.org
Prometric Test Centers

17. 2009 USMLE Bulletin

18. Step 1: Content Anatomy Behavioral sciences Biochemistry Microbiology
Pathology
Pharmacology
Physiology
Interdisciplinary topics, such as nutrition, genetics, and aging.

19. Step 1: Content
Classifies test items along two dimensions, system and process
System
40%–50% General principles
50%–60% Individual organ systems
Process
30%–50% Normal structure and function
30%–50% Abnormal processes
15%–25% Principles of therapeutics
10%–20% Psychosocial, cultural, occupational and environmental considerations

20. Step 1: Format
Step 1 has approximately 350 multiple-choice test items, divided into seven 60-minute blocks, administered in one eight-hour testing session.
Step 1 consists of multiple-choice questions designed to measure basic science knowledge.

21. Step 1: Format Some questions test the examinee's fund of knowledge
The majority of questions require the examinee to:
interpret graphic and tabular
material
to identify gross and microscopic
pathologic and normal specimens,
to solve problems through
application of basic science
principles

22. Step 1: Format
Step 1 includes only single one best answer test questions.
Items consist of a statement or question followed by three to eleven response options arranged in alphabetical or logical order.
Some questions involve interpretation of graphic or pictorial materials.
Examinees are required to select the best answer to the question.
Other options may be partially correct, but there is only ONE BEST answer.

23. Step 1: Reporting
The number of test items you answer correctly is converted to two equivalent scores.
The three-digit score
The minimum passing score is 185.
The mean score for first-time examinees from accredited U.S medical schools is in the range of 200 to 220 (SD +/- 20)
The two-digit score
Is derived from the three-digit score and is not a percentage score.
Is used in score reporting because some medical licensing authorities require a "passing score of 75."
A score of 75 always corresponds to the minimum passing score.

24. Application Process Review the 2009 USMLE Bulletin
Complete your application materials and submit them online at
Request a 3 month eligibility period
Receive a Scheduling Permit verifying your eligibility and authorizing you to schedule the examination

25. Application Process
Follow the instructions on your Scheduling Permit to schedule your test date at a Prometric Test Center at
On the scheduled test date and at the scheduled time, bring to the test center your Scheduling Permit and the required identification.
Take the test

26. 2009 Fee =
$495

27. Strategies
for
Success

28. Strategies for Success Game Plan
Time Management
Resource Management
Study Strategy
Test-Taking Skills

29. Strategies for Success Game Plan: Recommendations
Read all info on the USMLE website
Familiarize yourself with content of exam
Once you develop a schedule and study strategy… stick to it!
Don’t procrastinate
Most of all…

30. Strategies for Success Game Plan: Recommendations
Don’t distress … De-stress!!!

31. Strategies for Success Time Management
Prolonged study ≠ better retention
Develop daily schedule
Keep reasonable study periods
Set aside time to “decompress”
Don’t forget fundamentals of maintaining health and wellness

32. Strategies for Success Resource Management
You can’t review it all – so stick with what has worked for you!
Class notes
Videos
Textbooks
Board Review Books
On-line materials
Tutors

33. Strategies for Success Resource Management
USMLE Prep Courses
Kaplan
Princeton Review
Falcon Review
USMLE World
UMKC: Institute for Professional Preparation

34. Strategies for Success Resource Management
USMLE Study Guides
First Aid USMLE Step 1
USMLE Step 1 Secrets
High-Yield Comprehensive USMLE Step 1 Review
Underground Clinical Vignettes USMLE Step 1
BSS: Body Systems Review I
USMLE Step 1 Recall: Buzzwords for Boards
Rypins' Basic Sciences Review
Kaplan USMLE Step 1 Home Study Program
Rapid Review Series: USMLE Step 1
Deja Review: USMLE Step 1 Essentials
Cracking the Boards: USMLE Step 1
Board Simulator: Normal and Abnormal Processes
Laughing Your Way to Passing the USMLE
Step-Up
BSS: General Principles in the Basic Sciences
Rypins' Q&A for Basic Sciences Review
Blueprints Q&A USMLE Step 1
PreTest: Clinical Vignettes USMLE Step 1
USMLE Step 1 Made Ridiculously Simple
PreTest Self-Assessment and Review
Rapid Preparation for the USMLE Step 1
Lange Practice Tests for the USMLE Step 1
Research & Education Assn: USMLE Step 1
Lange Q&A: USMLE Step 1
Appleton & Lange Outline Review for USMLE Step 1
Laughing Your Way to Passing the USMLE

35. Strategies for Success Study Strategy: Study Smart, Not Hard
You can’t know everything!
Ask yourself, at this point in your career:
What is vital information?
What is recall information?
What is “forget it” information?

36. Strategies for Success Study Strategy: Study Smart, Not Hard
Be an active learner
Use visual elements where possible
Pick out relevant information
Look for overlaps between subject areas
Write questions rather than notes
Use study groups… wisely!
Assess – study – reassess

37. Strategies for Success Test-Taking Skills: Practice Exams
NBME Comprehensive Basic Science Exams (free) – this spring, before and after the Transition Block

38. Strategies for Success Test-Taking Skills: Practice Exams
USMLE Step 1 Orientation and Practice Materials
The software has over 100 practice test items and a software tutorial
Cost = Free

39. Strategies for Success Test-Taking Skills: Practice Exams
USMLE – Computer Based Testing (CBT) practice session at the Prometric Test Center
The Practice Session is a maximum of 3.5 hours and is divided into three 1-hour blocks of 50 multiple-choice test items each.
When you complete the session, you will receive a printed percent correct score
Cost = $42

40. Strategies for Success Test-Taking Skills: Practice Exams
University of Missouri - Kansas City (UMKC) Computer Based Tests
Diagnostic Exams (2) = $45 each
The output from this test will assist in pinpointing weaknesses and strengths as you prepare for the exam
Mock Board Cost = $45
Seven blocks, 50 questions per block, timed exam
Provides a realistic day of testing. The test, once begun, requires up to eight hours for completion, just like the USMLE
A comprehensive diagnostic report is produced to help the student focus his or her study time for maximum effectiveness

41. Strategies for Success Test-Taking Skills: Practice Exams
NBME - Comprehensive Basic Science Self-Assessment
Standard-Paced: four sections, 50 items each, up to one hour to complete each section
Self-Paced: four sections, 50 items each, up to four hours to complete each section
Immediate feedback, profiles indicate relative strengths and weaknesses
Profiles similar to those Step 1 candidates receive
Score interpretation guide provides approximate Step 1 corresponding total score to assessment score
Cost = $45

42. Strategies for Success Handling “One best answer” questions
Read each question carefully and understand what is being asked.
Try to answer the question first, then look at the option list.
alternatively, read each option carefully and eliminate those that are clearly incorrect.
of the remaining options, select the one that is most correct.
If unsure about an answer… guess!!!
unanswered questions are automatically counted as wrong answers.

43. Strategies for Success Handling “One best answer” questions
DON’T SKIP questions. If you don’t know it when you see it, you’re probably not going to get it later.
DON’T spend too much time on an individual question.
NEVER CHANGE your answer.
SCAN for trigger phrases or words.
GUESS consistently.

44. Strategies for Success Preparing for the Day of the Test
Decompress a few days before the exam
Check out the test center / confirm your test date
Get all of your papers in order
Get a good night’s rest

45. Risks for Failure
Consistently marginal / poor academic performance during the first two years of medical school
Prior history of problems with board type exams (MCAT, SAT).
Performing poorly on mock exams
Thinking you can’t fail
Thinking you can’t pass
Not putting in the time / effort to prepare.

46. Special Issues The Seven Year rule Testing accommodations
Irregular behavior
When things go wrong

47. Summary: Strategies for Success
Game Plan
Manage Time Wisely
Study smart, not hard!
Manage resources
Practice, practice, practice
Take care of yourself

48. USMLE Step 1 Mean Scores: 2004 - 2008

49. USMLE Step 1 Pass Rates

50. YOU CAN DO IT!