USMLE Step 1
Encyclopedia
The USMLE Step 1 is the first part of the United States Medical Licensing Examination. It assesses whether medical school students or graduates can apply important concepts of the sciences fundamental to the practice of medicine. US medical students typically take Step 1 at the end of the second year of medical school. Graduates of international medical schools must also take Step 1 if they want to practice in the US. Graduates from international medical schools must apply through ECFMG and the registration fee is $780. From January 2010, the NBME registration fee for the test is $525, with additional charges for applicants who choose a testing region outside the United States or Canada.
computer testing sites.
, medical ethics
and questions on empathy
are also emphasized. Each exam is dynamically generated for each test taker; while the general proportion of questions derived from a particular subject is the same, some test takers report that certain subjects are either emphasized or deemphasized.
based system in 1999. Examinees receive a three-digit score and a two-digit score; the latter of which is not a percentile. The three-digit score is a scaled score with a mean of 221 and a standard deviation of approximately 23. The three-digit score is calculated using a statistical percentile that ensures that scores from different years are read on a common scale, since the exam is known to get progressively more difficult as the years go on. The two digit score is a scaled score that defines 75 as the minimum passing score, which is equivalent to a 188 on the three-digit scale. The three-digit score is more commonly used. As of October 3, 2011, USMLE began the process of eliminating the reporting of results on the two-digit score scale to any parties, including residency programs, other than the examinee and any state licensing authority to which the examinee sends results.
A score of 188 is needed to pass the test. At present, the national mean score is 221, with a standard deviation of approximately 23; an increase from the previous two means, which were 218 (standard deviation of 23) and 215 (standard deviation 20). Many residency programs use a "cutoff" score for Step 1, below which applicants are unlikely to be considered.
take this test at the end of their second year of medical school, which is usually required for progression into the clinical third year. The test is standardized and thus allows for a direct comparison between medical students nationally, although the USMLE test scores were not designed for this purpose. Performance on this test is also one of the selection criteria used in the NRMP match program for residencies
. A passing score on this test indicates that the medical student has grasped the core scientific knowledge taught during the 'basic sciences' years.
Format
The exam used to be an eight-hour computer-based test taken in a single-day, composed of seven 48-question sections with a total of 336 multiple-choice questions. Beginning May 15, 2010, the exam reduced the number of questions from 48 to 46 per section, for a total of 322 questions. One hour is the time provided for each section, allotting an average of a minute and fifteen seconds to answer each question. Between test sections, the test taker is allotted a cumulative 45 minutes (during the test day) for personal breaks. (There is a 15 minute tutorial at the beginning of the exam, which the test-taker can choose to skip and have that time added to break time.) If the taker finishes any section before the allotted one hour time limit, the unused time is added to the break time total. The test is administered at any of several PrometricPrometric
Prometric is a U.S. company in the test administration industry. Prometric operates a test center network composed of over 10,000 sites in 160 countries...
computer testing sites.
Subjects
Step 1 is designed to test the knowledge learned during the basic science years of medical school. This includes anatomy, behavioral sciences, biochemistry, microbiology, pathology, pharmacology, and physiology, as well as to interdisciplinary areas including genetics, aging, immunology, nutrition, and molecular and cell biology. EpidemiologyEpidemiology
Epidemiology is the study of health-event, health-characteristic, or health-determinant patterns in a population. It is the cornerstone method of public health research, and helps inform policy decisions and evidence-based medicine by identifying risk factors for disease and targets for preventive...
, medical ethics
Medical ethics
Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.-History:Historically,...
and questions on empathy
Empathy
Empathy is the capacity to recognize and, to some extent, share feelings that are being experienced by another sapient or semi-sapient being. Someone may need to have a certain amount of empathy before they are able to feel compassion. The English word was coined in 1909 by E.B...
are also emphasized. Each exam is dynamically generated for each test taker; while the general proportion of questions derived from a particular subject is the same, some test takers report that certain subjects are either emphasized or deemphasized.
Scoring
The USMLE phased out the use of a percentilePercentile
In statistics, a percentile is the value of a variable below which a certain percent of observations fall. For example, the 20th percentile is the value below which 20 percent of the observations may be found...
based system in 1999. Examinees receive a three-digit score and a two-digit score; the latter of which is not a percentile. The three-digit score is a scaled score with a mean of 221 and a standard deviation of approximately 23. The three-digit score is calculated using a statistical percentile that ensures that scores from different years are read on a common scale, since the exam is known to get progressively more difficult as the years go on. The two digit score is a scaled score that defines 75 as the minimum passing score, which is equivalent to a 188 on the three-digit scale. The three-digit score is more commonly used. As of October 3, 2011, USMLE began the process of eliminating the reporting of results on the two-digit score scale to any parties, including residency programs, other than the examinee and any state licensing authority to which the examinee sends results.
A score of 188 is needed to pass the test. At present, the national mean score is 221, with a standard deviation of approximately 23; an increase from the previous two means, which were 218 (standard deviation of 23) and 215 (standard deviation 20). Many residency programs use a "cutoff" score for Step 1, below which applicants are unlikely to be considered.
Effect on Residency Matching
The USMLE score is one of many factors considered by residency programs in selecting applicants. However, at present, this test is the only standardized measure of all applicants. The median USMLE Step 1 scores for graduates of U.S. Medical Schools for various residencies are charted in Chart 6 on page 9 of "Charting Outcomes in the Match" available at http://www.nrmp.org/data/chartingoutcomes2011.pdfUses of test
Students in American medical schoolsMedical school in the United States
Medical school in the United States is a four year graduate institution with the purpose of educating physicians in the field of medicine. It provides a major part of the medical education in the United States.-History:...
take this test at the end of their second year of medical school, which is usually required for progression into the clinical third year. The test is standardized and thus allows for a direct comparison between medical students nationally, although the USMLE test scores were not designed for this purpose. Performance on this test is also one of the selection criteria used in the NRMP match program for residencies
Residency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
. A passing score on this test indicates that the medical student has grasped the core scientific knowledge taught during the 'basic sciences' years.