Usmle Step1

From Wikimd

Usmle Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning.

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Subjects

The topics are:

General principles
Hematopoietic and Lymphoreticular systems
Central nervous system and Peripheral nervous system
Skin and related connective tissue
Musculoskeletal system
Respiratory system
Cardiovascular system
Gastrointestinal system
Renal/Urinary system
Reproductive system
Endocrine system

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Uses of test

Students in American medical schools take this test at the end of their second year of medical school, and it is usually required for progression into the third year of medical school. This test is standardized and it allows medical students to be directly compared with each other on a national basis. Certain specialties within the medical field are exceedingly attractive to the point that there are not enough spots to train all interested medical students. Performance on this test is one of the selection criteria used to find the most desirable students. A favorable score on this test indicates that the medical student has grasped the core scientific knowledge.

A score demonstrating a minimum level of proficiency in the basic sciences is required to pass the USMLE Step 1 examination. Currently 85-90% pass this test on the first try, although, theoretically 100% of students could pass (or fail). The USMLE phased out the use of a percentile based system in 1999. A score report is given as a three-digit and two-digit score. The three-digit score reflects the number of correct questions and the two-digit score is a representation of the three-digit score on a scale of 100%. Most students generally receive a three-digit score from 200-220. Graduates of foreign medical schools also take the USMLE Step 1 and must do exceedingly well to obtain a residency in the United States. Unfortunately, foreign doctors who are admitted into the U.S. for residency training are usually limited to positions in specialties that are leftover after U.S. medical students have chosen first, even if they have higher scores than U.S. medical students. This policy has been seen as discriminatory for quite some time but efforts to change it have been unsuccessful.

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Level of competition

The most competitive specialties as of Jan 2006 in the U.S.A.:

Most difficult to obtain residencies: Radiation oncology, urology, dermatology, neurological surgery (On average 95th percentile or better)

Very Difficult to obtain residencies: Ophthalmology, radiology, ear nose and throat (ENT), orthopedics, General Surgery, anesthesia (On average 75th percentile or better)

After the above specialties, the competition drops dramatically and the number of available training positions increases greatly.

Relatively easy to obtain: Pediatrics, Internal Medicine, Family Practice, Pathology, Physical medicine and rehabilitation, Neurology, Psychiatry.

Naturally, the top programs in any specialty will be difficult to obtain, i.e. obtaining internal medicine at Harvard is still difficult.

Medical students in the 21st century are increasingly choosing specialties that have an easy lifestyle and high pay per hour worked. The selectivity of the specialty does not correlate with the degree of difficulty, i.e., dermatology is not a "harder" field to learn than internal medicine. But dermatology does command a high salary and an extremely flexible lifestyle, and there are very few dermatologic positions available to train in. Therefore in the 21st century, dermatology is an extremely difficult residency to obtain and now attracts the absolute best medical students.

The difficulty of obtaining each residency has changed over time, e.g., radiology and anesthesia 15 years ago were relatively easy to obtain, while internal medicine attracted more of the top applicants.

Most students prepare for approximately 1 month and use commercial test-prep services such as those offered by Kaplan. Steps 2 and 3 of the USMLE are considered easier to be easier to prepare for, leading to the adage that the preparative work for steps 1, 2, and 3 respectively are "two months, two weeks, two pencils."

USMLE step 1 Resources and Online Forums/Discussion Boards

Residentscafe

Test Prep for USMLE Step 1 Wikibook

ValueMD

Resources from the University of Utah

USMLE Highly Tested Topics