Step 1 Exam Experience By Armia Kirlos Ephraim Michael

The Night Before the Exam

I went to bed at 9 PM but couldn’t sleep till 1 AM although I used to sleep at 9 PM from 2 weeks before the exam.

I woke up at 7 AM {an hour before my alarm!} and took my breakfast, then arrived at the Prometric center at 8 AM.

I finished check-in procedure within 15 minutes but I asked them to wait 10 more minutes before starting my exam because my heart was beating at 150/minute.

I started my exam at 8:30 AM and still there was severe palpitation.

So, I decided not to skip the tutorial just to give enough time for my palpitation to stop.

I just saved 5 minutes of tutorial (of total 15 minutes), so it was added to the break time (I got a total 50 minutes of break).

My First Block

Thank God first few questions were easy so the palpitation went out.

I did all questions in their order… even questions I didn’t know the answer I picked some answer and marked them to revise it at end of block. But I wasted a long time in those difficult questions and the time ran out. When the 5 minutes alarm went off I still had 8 questions to answer.

Then I took a break of 3 minutes at my seat and decided to change strategy in the next blocks.


Second block

My new method was not waste much time for very difficult questions, just mark them to do at the end.

I marked about 11 questions and I had 20 minutes to answer it later. It went well – when I finished the questions I still had about 3 minutes.

Then I took a break to eat something. I signed out and took 10 minutes break. You should plan beforehand, as the check-in procedure takes about 3 minutes.

Block 3-7

I then did block 3, 4 then 15 minutes break,

Then block 5 then 10 minutes break,

Then block 6 then 5 minutes break,

I did blocks 3-7 by the same method I used for block 2

So, time was not a problem (except block 1).

Exam Questions (Length and Difficulty)

They were more or less the same length as NBME questions mostly like NBME-15 (I didn’t do NBME-16, so I can’t compare) – more difficult than NBMEs but less difficult than UW q bank.

Types of Question  

About 10% (4-5 questions in each block): very easy direct questions, just remember basic information. The topics are covered well in First Aid.

About 50% (20-25 questions per block): easy questions, 2 or 3 step simple integration of information; for example, they mention symptoms of some disease and then ask you on about the mechanism of treatment. Covered very well by UW and FA.

About 20% (8-10 questions per block): need deep thinking. I answered them by exclusion; i.e. other answers mostly wrong so this one may be right.

About 10% (4-5 questions per block): difficult. For example, after deep thinking I had about 2 answers and wasn’t sure which one is correct so I picked one based on a random guess.

About 10% (4-5 questions per block): very difficult, I didn’t know any information about it before; so, picked any answer.

Questions which I marked was of last 2 types


Was the Questions Covered in First Aid and UW?

Yes (except anatomy), FA covered most information but remember that the exam isn’t about just remembering the information (Google can’t answer it), UW is the must for this exam.

Anatomy was the most difficult part; even FA, UW, and Kaplan aren’t enough for it.

Media-based Questions

Heart sounds: about 2 heart sound based questions, you can change the site of the stethoscope, very easy, I answered it from questions only; didn’t need media to answer them.

NO videos

Images: you can answer questions without using the images, they are just to confirm your answer. All were easy common images.

Feel free to ask questions and I’ll be happy to answer.


Armia Kirlos Ephraim Michael

If this experience helped you, make sure to check out the following experiences:

USMLE Step 1 Experience – 259 – Dr. Peter – IMG from Russian

USMLE Step 1 – 261 Experience – Dr. Ezz – Egypt

USMLE Step 1 Experience – 256 – Dr. Karim

December 25, 2017
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