USMLE Step 1 Exam for Foreign Students
United States Medical Licensure Exam (USMLE) is a licensing examination required to practice, do residency and fellowships in the USA. It is divided into three steps and here we will discuss the USMLE Step 1. The USMLE Step 1 is a standardized test that assesses a medical student’s ability to apply basic science fundamentals to the practice of medicine. The test is administered jointly by the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB).
When to take USMLE Step 1 Exam
Students take USMLE Step 1 following their second year of medical school but as a foreign medical graduate, your application process for a U.S. medical residency differs slightly from that of a student who completed their education in the United States. Most importantly, before you can apply for a residency in the US, you must get certification from the Educational Commission for Foreign Medical Graduates (ECFMG).
Although you do not need to pass the USMLE Step 1 before taking the USMLE Step 2, you must achieve a passing score on both exams before you become eligible to take the USMLE Step 3. Also, you must pass USMLE Step 1 Step 2, AND Step 3 before your ECFMG certification becomes official.
USMLE Step 1 Application Process
The first step of the ECFMG certification process is filling out an application. Any foreign medical student or graduate can apply, as long as you have earned (or are in the process of earning) a medical degree from a school that is listed in the World Directory of Medical Schools. To start the process, you will need to go to the ECFMG website and request an identification number. From there, you can log in and start filling out the application.
USMLE Step 1 Educational Requirements
You need to have completed at least four years of medical study at one of the medical schools that are listed in the World Directory of Medical Schools, and you need to provide documentation that you have completed all of the necessary credits for graduation. It is important to note that you can apply for ECFMG certification while you are still finishing your degree, but you will not be awarded a certificate until you have received your medical diploma and submitted your final transcripts.
USMLE Step 1 Format
The USMLE Step 1 is a one-day examination, with a total of eight hours. It is divided into 7 blocks, each of which is 60 minutes long. Test takers are allowed 45 total minutes during the test for personal breaks. If you finish any section before the allotted hour is up, you can add that time to your personal break total. Six breaks total are allowed. There is no set number of questions on each block of the test but the USMLE guarantees that there will be no more than 40 questions per block and no more than 280 questions on the exam as a whole.
All of the questions on the USMLE Step 1 are single-item multiple-choice questions. From these options, you must choose the best answer. Only one answer is correct.
USMLE Step 1 Syllabus
USMLE Step 1 covers the basics of medical science. In general, you will be tested on the information that you would learn in the first two years of medical school in the United States. During these years, the training for U.S. medical students consists primarily of didactic coursework and laboratory exercises (as opposed to clinical training).
However, you should be aware that in some countries, the medical training does not align with that of the United States — in terms of timing and/or content — so you need to tailor your study efforts specifically for the USMLE, not necessarily reviewing everything you learned in medical school.
The questions on the USMLE are created by examination committees made up of medical experts from institutions in only two countries: the United States and Canada. These experts include medical school faculty members, teachers, research investigators, and clinicians who come together to decide what it is important for future U.S. medical residents to know about basic medical science.
In general, the USMLE Step 1 covers the broad principles of basic science and the functioning of human organs and organ systems. It includes questions within 8 traditionally defined disciplines and 5 interdisciplinary areas.
The traditionally defined disciplines are:
- Behavioral Sciences
- Biostatistics and Epidemiology
The interdisciplinary areas are:
- Molecular and Cellular biology
- Nutritional sciences
Along with the ability to know all the information on these subjects you also need to be able to read and interpret relevant graphs and tables, identify pathologic and normal specimens (including both microscopic and pathologic specimens), apply your knowledge to specific clinical problem-solving questions for the USMLE Step 1 Exam.
There is also heavy emphasis on how these topics apply to organ systems. These types of questions normally make up between 60 and 70% of the total content of the test.
Organ systems are covered on the USMLE Step 1 are:
- Blood and Lymphoreticular System
- Behavioral Health
- Cardiovascular System
- Endocrine System
- Gastrointestinal System
- Nervous System and Special Senses
- Renal and Urinary System
- Reproductive System (Male and Female)
- Respiratory System
- Skin and Subcutaneous Tissue
- Musculoskeletal System
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