Exam Experience

Let me start by saying how great it feels to be done with Step 1! It’s like having a two ton load lifted off your back. These past 7 weeks were tough, and I’m so glad it’s over. Now let’s get to the juicy stuff. Here’s my exam experience:


I woke up at 7:00 a.m. ate a well balanced breakfast and had my first caffeine dose of the day. I had to fight off urges to grab my First Aid book and look through some of the pages I had previously marked but didn’t have time to look at. I was feeling a bit anxious to get through the day, but I was confident in my abilities and I knew that I had studied enough to do well on this test. I grabbed my bag and stuffed into it enough food for a picnic:
• 2 club sandwiches (roast beef and chicken)
• Container of fruit salad
• Container of canned corn kernels.
• Bottle of Diet Coke
• 2 small bottles of water
• 2 Snickers chocolate bars
• 1 can of Red Bull

I arrived at my test center at 8:30. I signed in, had my fingerprints taken, and put all of my belongings (including my wallet, cell phone, and watch) in a locker. I was given 2 laminated boards and 2 markers. I honestly think they should rethink the marker thing because writing stuff out with thick tipped markers like the ones they provided wasn’t very feasible, especially when I had to write down equations and solve them. They should at least try to provide markers with thinner tips.

I headed over to my computer and signed in with my candidate number (you also have to enter your candidate number each time you sign in after a break). I started the tutorial and just made sure that my headphones were working. I skipped the rest of the tutorial. I wrote down some mnemonics and facts on my board that would save me time later (I’ll share these in my next post). I then took a deep breath and started my first block. The first 5-10 questions on my exam were VERY clinically oriented, to the point that I honestly thought that they had made a mistake and had me doing the USMLE Step 2! I made educated guesses for these first 5-10 questions and moved on. As I discovered anatomy questions and biochemistry questions, I quickly realized that I was overreacting and that this definitely was the USMLE Step 1. As I progressed through the first block, I calmed down and regained my focus. Overall, the 1st block on my exam was the second hardest block in my exam. I finished my block with 5 minutes to spare so I decided to take a 5 minute break to eat half a sandwich.

After pulling my pockets inside out to prove to the proctor that I wasn’t bringing anything into the test area, I signed in and went back to my computer to start the 2nd block. The second block was definitely the easiest on my exam. I finished it with more than 10 minutes to spare. The 3rd, 4th, and 5th blocks were also fairly easy (compared to USMLE World at least) and I finished with 7-10 minutes to spare on each block. I used the extra time to take well deserved breaks during the blocks to eat and keep my energy up. I had a can of red bull after the 4th block to keep my brain from shutting down during the latter half of my exam.

The 6th block on my exam was brutal! It was by far the toughest block on my exam. For most blocks I marked about 5 questions. On this block I marked at least 14 questions. I had 10 minutes of break time left and used it all after the 6th block. At this point, I had only 1 block left. I was so glad that this was my last block. Freedom was just an hour away. The seventh block was easy, and I was glad because at this point, my brain could only perform simple tasks. After my last block, there was a short survey I had to fill out. After being in that room for 8 hours, I honestly just wanted to leave. I filled out the survey and left the test room for the last time ever. I headed home satisfied with my performance, and already feeling anxious as to how I scored.

Let me finish by saying that time was never a big issue for me on the exam. The questions were just as long as the ones in USMLE World. I even had some 1-2 line questions. I always had more than 5 minutes to spare on each block (except for the 6th block, which I finished with 2 minutes to spare). So for those of you worried about the new exam format, don't worry! If you're managing your time well on USMLE World timed blocks, then you won't have a problem on the actual exam. I generally tried to pace myself at 1 question per minute. Check every 10 minutes to make sure you're on track. Half way through each block, I would always check to make sure that I still had more than 30 minutes remaining. If you're having trouble finishing a full USMLE World block in an hour, practice practice practice!