I took STEP 1 back in February 2023, and after the exam, I jotted some notes down on my overall experience, lessons learned, and advice. I think at the time I was hesitant about posting STEP 1 related content before results were released, but that’s not a concern anymore now in July 2023 (I passed, yay :)).

Anyway here are my thoughts on what to expect on test day! In the coming days there will be more blog posts on my STEP 1 experience, especially with regards to lessons learned & other reflections.

General Format

STEP 1 is consisted of seven 60-minute blocks (each with 40 questions), a 15 minute tutorial section, and 45 minutes of break time (total 8 hours). You can actually take the breaks whenever you want, there is just a timer that goes down as you take it. If you skip the tutorial, that time is added to your break time (and I think the same is true if, for example, you finish a section 15 minutes early–I believe those 15 minutes can be used as a break too, though I personally used all my time on the sections so I can’t confirm or deny whether or not that’s true haha).

My Experience

The start time that was given to me on my registration was 8:30, so I arrived at the test center at around 8:00… though I think you should feel free to arrive even earlier! There were other tests going on at Prometric at the time so there’s quite a line to get everyone checked in, finger printed, searched (they used a metal detector and made me turn out my pockets!), and situated. Even though I was technically 30 minutes early, my Prometric proctor gave me an exasperated look and told me I was late 😅. Of the people taking STEP 1 that day (I can’t confirm how many exactly there were, but I think it was just a few), I was actually the last person to arrive. No harm no foul though, I still began on time, but my proctor did stress me out a little bit with that comment.

You are allowed 45 mins of break time (1 hour if you skip the 15 minute tutorial!). I took a 5-10 min restroom and water break after every 2 sections (I skipped the tutorial!) so that it looked like:

blocks 1 & 2
10 min break
blocks 3 & 4
lunch for about 20 mins
blocks 5 & 6
10 min break
block 7

I ended with about 10 minutes of break time to spare and was so glad to be done! I was really surprised that I did not feel as exhausted as I thought I would—once I hit a flow state, I was able to really just settle down and do the questions.

For “lunch”, I packed a wrap and some fruit, granola bars, and coffee–but because of the exam-day jitters, I ended up only eating some fruit and a granola bar. Somehow the adrenaline kept me going because my stomach wasn’t grumbling at the test or anything, but after I left the testing center I was definitely hungry. I did remember when I took the MCAT, I only ate fruit for the lunch break and it worked, so I was fairly sure taking STEP on just some fruit and granola bars would be fine too–but I did pack extra food just in case I needed something “more” to keep me going and I’m glad I did that!

What to expect if you’re taking the USMLE

What to bring:

• Your USMLE scheduling permit
• Government issued ID
• snacks and water! I brought a lot of fruit. I was a little too anxious to eat (I knew I would be) so I just brought a lot of fruit and a protein bar, which I knew would give me enough energy to get through the test. If you’re someone who would prefer to eat something more like a meal, I would suggest bringing something simple, along the lines of a sandwich.

Basically, minimize the things that you bring–there will be a locker at the testing center for your water and food, but it’s pretty small so plan accordingly.

What to wear:

• comfy clothing!
• no watch, minimize jewelry—I saw this girl come in with so many bracelets and she had to take time to take them all off and put them in a locker.
• minimize your pockets! This piece of advice might feel so silly—but on test day they actually have to do a metal detector scan and make you turn out your pockets each time you re-enter the test room. I wore a pair of jeans that had front pockets, back pockets, and little baby pockets inside the front pockets… (oh my). This check in process every time you get back into the test eats up your break time. So just wear something without pockets guys!

Post-Exam

I thought the exam was actually really similar to the Free 120. It was similar in terms of content covered to the NBMEs, but the questions were much much longer. A really quick test-taking advice would be to read the last sentence of the question stem and the answer choices first so you know what they’re asking and how much information you’d have to gather. That helped me save a LOT of time. In addition, something that (strangely) helped me was to go from the last question first. I don’t know, I did this during the MCAT as well and it has just really helped me with my time management. I always find myself running out of time if I go from question 1… but somehow if I do last-question-first, time management was never an issue.

About 48 hours after the fact, I started thinking I got everything wrong and panicking–I feel like that’s actually a common reaction, but actually I think the reason for that is that we just tend to remember all the things we’re not so sure about. If this sounds like you, take a deep breath and calm down! Enjoy the post-exam period, and don’t overthink it, because what’s done is done, and you can’t go back and change your answers at that point. You just have to wait the 2 weeks to find out the results.

Final Thoughts

Overall, my exam experience was really positive—I thought the proctors and everyone working at Prometric was really nice, and honestly it put me at ease.

That said…. I’m still really glad it’s over!