USMLE Step I: The Basics

The USMLE Step I is a test of the preclinical sciences; Behavioral sciences, anatomy, physiology, biochemistry, pharmacology, immunology/microbiology, and pathology. 350 clinically oriented multiple choice questions divided into 50 question, 60 minute blocks. This gives you roughly 72 seconds to both read and answer every question. The Step I is a computer based exam. The USMLE does provide two white boards and markers for you to write on if needed. These boards are not graded and are discarded after the exam is over.

You are allocated 45 minutes of break time which you can arrange according to your own schedule, however, a break cannot be taken until you have completed an entire block. Of the 350 questions, you will not be graded for 50 of them. These are experimental questions for future exams and statistics. Unfortunately, you do not know which questions these are as they are unmarked and mixed in throughout the exam. Answer options can range anywhere from as little as 3, to as many as 11. Since there is no negative marking it is in your best interest to attempt every question of the exam, even if you have to guess.

The final scoring report provides both a three digit and a two digit score. The three digit score is the amount of answer you got correct. The two digit score is a bit more complex. Although it's not a percentage, its a way to compare your score to someone who took a comparative exam in the past. Passing is set at a two digit score of 75. As international medical graduates (IMG's), your goal is to obtain two digit scores in the 90's, essentially aiming for 99's. If you fail the exam, you are allowed to take it again after a period of 3 months. However, there are some programs that will no longer consider your application if you have failed (there are also some that will). If you pass the exam, your score is valid for a period of 7 years. Additionally, you cannot retake the exam in those 7 years if you passed, and your initial score is the one that will stick with you. Thus the motto is to prepare for the test to pass with the highest score possible, in your first attempt.

'Competitive' scores vary for each program, and each specialty. The general consensus is that pediatrics, family medicine, internal medicine, and to an extent, psychiatry, are all the easier fields to match into for IMG's. This is because the quantity of positions is high and the requirements are low. On the contrary, plastic surgery, radiology, dermatology, anesthesiology, opthamology, and emergency medicine are the harder fields to match into. In addition to extremely high board scores, these programs admire extensive research publications in well known journals and multiple LOR's from well known U.S. physicians. Keep in mind that these are some SOME of their requirements.

The Step I can be taken anywhere in the world, including Karachi, Pakistan. The fees are approximately $850 U.S. dollars, plus another $150 if you decide to take it outside of the U.S. Click here to register for the Step I and for further information.

I hope this served as a general overview. If you have anymore questions regarding the Step I, please post them below. Thanks.

"California Letter"

The state of California requires International Medical Graduates (IMG's) wanting to apply to programs in the state of California be required to submit a "California Letter" AKA- the PTAL. This takes about 1 year to complete and as of the time of this publishing, costs an extra $500.

More information regarding the PTAL can be found below including forms:
http://medbd.ca.gov/
http://www.medbd.ca.gov/applicant/application_international.pdf