The exam was not that hard and the difficulty level varied from block to block.
I took 3 blocks in a row - break for 10 min - 2 blocks - 5 min break - last 2 blocks. So, I finished the exam 45 min early :)
Before the exam, I was worried about the type of questions in the exam. After asking my colleagues and adding my own experience, I think I can summarize it in the following points:
There are 46 questions in each block, divided into the following segments (on average):
• 15 EASY Qs (straight forward – 2 to 3 lines in each question)
• 15 MEDIUM Qs (half page long, secondary or tertiary type with labs)
• 16 CHALLENGING Qs (mostly half page long- with full of tables, figures and graphs.
Those Qs were divided into:
10 Qs where I was familiar with 75% of the information in each question and had to figure out what was going on. Most of the time, I was able to nail the options down into 2 choices and choose the best one with being 75% sure of my answer.
Now, the remaining 5-6 Qs were tough. Herein, I was familiar with 50% of the qs but I couldn’t really nail them down into less than 3 options. You use your educated guess talent in answering this type of qs. Interestingly, they brought three questions on lab techniques (Western blot, PCR and ELIZA) and my answers to those qs were based on my research background :)
Overall, the difficulty of the exam was somewhere between UW and NBME as questions were more comprehensive and longer than NBME but less sophisticated than UW.
I got used to mark only the questions where I think I can go back and do sth about them. The questions that I will never know the true answer no matter what, I used to select the best answer and move on. That way, I was able to finish each block with 6-8 min remaining. I was able to go over the marked qs starting from easy to difficult ones.
Subjects covered in my test: 70% Pathology, 10 % behavioral (gave me hard time), 10 % pharma, and 10% miscellaneous
Here are some advices:
The most important thing in your studying especially patho is actually UNDERSTANDING the concepts that you are learning and knowing how to apply them. They will always find new and confusing ways to test your knowledge so the best thing you can do is make sure you understand the big concepts on a pretty deep level. They are very good at figuring out whether or not you truly understand a concept on a deep level.
My study plan:
I think that First Aid is enough to cover major parts of the exam. Every single WORD in First Aid is really important (esp. in biochem, behavior, pharma and microbiology). I was able to achieve that by going 4 times over it and one more time in the last week. Try to start reading and studying this book as soon as possible.
UW was the best source of Qs in my case. I think that at least 15 % of the concepts I was tested on were covered in UW. Now, try to start the UW after you finish the FA once. I always got used to do random qs but never subject based. Knowing the explanation of each q is highly important. In fact, knowing the explanation of wrong answers is more important than knowing why the correct one is correct. Take the UW as an educational but never as an assessment tool of your performance.
I got used to take photos of high yield tables, figures and photos in UW (ooops illegal :P). I revised them on the night before the exam and guess what, 3 pics in my test were directly from there.
Saving time in exam:
I think what really made me relaxed throughout the exam and never felt that I am running out of time in any block is that I memorized the normal lab values of important stuff on the night before my exam. I only opened the lab values twice in this exam.
Now, regarding the big books:
I went over Kaplan Anatomy and I highly recommend it. This is the only book that I needed to go over until my last revision (other than the FA, of course).
I went over the BRS patho and BRS physio twice but I stopped afterward because found that low yield stuff started pulling my head away from the high yield ones. It is good you go over them once so you understand what you read in FA.
The Kaplan Qbook was not as useful source as I thought -at least in my case.
Furthermore, taking step 1 after my clinical years helped me in answering 5-7 questions more but this shouldn’t be the reason for you to delay the exam.
That is my experience with STEP1 and I wish all the best for those who are willing to take it.
Please feel free to ask any question and always consult those who took the exam before you plan your studies.