* I felt the first book was easiest of the four total, esp. since I'm good with biochem, genetics. molecular bio., etc. The second book was quite difficult: lots of DETAILED pharm, DETAILED pathophysiology. The third book was the most difficult and seemed to have the most random assortment of questions; in other words, there wasn't an overrepresentation of any of the basic science disciplines in book three. The fourth book was somewhat difficult: I'm not good with radiographic anatomy and neuroanatomy.
The other questions in the fourth book were Ok, but many people who I talked with after the exam had different questions in their fourth books, except for the radiographs which seemed to be present on everyone's test. Thus, the fourth book may have contained a good number of "experimental" questions. Overall, the entire exam was more difficult than I thought it would be, although this is the first time I've taken it or anything like it. I hope that I passed, but I'm quite worried, especially since I can't finish my third year of medical school without a pass on Step I.
I guess I will have to deal with that later though. I'm curious to see other responses, especially of those who may have had the misfortune to have to take both June and October's administration's of Step 1.

* Everyone at Saint Louis U. (a school that normaly scores in the 75% on average) thought it was very hard. There wasn't a single person who was happy, out of about 40 or so people I talked to after the exam. I think the amount of reading on the exam has definetly increased. I was also surprised to see a lot of straight physiology, which is something I had expected to be integrated with other disciplines, such as pathophys. There seemed to be quite a few questions where the answer was simply impossible to find: for example, one question I looked up Goodman and Gillman for pharm, and the answer was not in there, let alone in a smaller text or board review book. In summary, the latest exam required a lot of fast reading, yet still contained some very remote detail memorization, and had some ambiguous questions.

* I just took June USMLE step one & I prepared only from one book ( BESTMED- A comprehensive review for all the basic medical sciences) it was great. When you prepare from a good book like this one, all the tricky questions you answer them without even thinking. I finished 10 minutes before the time & I was so happy. I wish that I read that book a third time! My advice is this; read the relevant notes for the board & the test will be easy!

* I took usmle 1 in June 10-11. And as you wish I can contribute to the list, but I am not sure if I can remember some of the question as well as the choices. But I can give you one example : In a child with PKU, tyrosine can't be made from phenylalanine, therefore tyrosine becomes essential amino acid. Now, maybe the next time the question will be : How do phenylketones appear in plasma and urine of this child? Since there is excess phenylalanine in this child it then becomes phenylketones via tranamination. This is how I can remember questions instead of word by word, which I never have been good at.

First of all I want to say sorry. Because of my message I brought up some kind of confusion. Anyway, I hope most you understood me the right way. Of course nobody who took 800 questions in two days will be able to memorize the exact wording. As you understood it, I was talking about the rough topics. Furthermore, I've got some answers to my message which cleared me up about the illegality of reproducing USMLE questions. Sorry again, I shouldn't have used the term "questions". Concerning the term "topics" I see it this way: Everyone of us use or used the one or other book which may be updated !!every year!!...Some authors talk about so called "high yield topics"...Where do they get the information from? You understand what I mean.

* I admire you very much for your amazing ability of memorization, especially on usmle 1, and in the last book and you can remember >80 questions.Anyway, if,that is so, I wish it was on book 1, that is where the horror story was.

I must agree with you, I did my worst (I think) on book one and my best on book 4. My classmates and I also realized that some got certain questions on their exam and others did not. Maybe it was because we didn't talk about the questions on tests 1 and 2 like every review book advises (obviously we discussed questions on tests 3 & 4). One friend even became disgusted for correctly answering a question that wasn't going to be counted!).

* I went over questions with several friends in between days one and two, because had heard that certain themes would be repeated..& some were. We found very little difference on books 1-3 (only 2 questions were recognized as being different). On book 4, however, there truly were at the very least 40 questions that were different, and probably more. 80 might have been a slight exaggeration in my bitter post-test state of mind. I was also angry because I thought that I did OK on book 1, terrible on book 2, great on book 3 and very well on book 4. I believed that I had a bad first day and made up some ground on day 2, which apparently is not being counted as much as day 1.

* I just took the june exam. generally, the first aid recommended review books did not help much. if you had some clinical experience, it could be a plus. This year, a lot of stress on hypertension and reproductive endocrinology. Behavioral sci was complete common sense. you could totally blow it off and still be fine.

* Message: I took the step 1 last week and feel it was quite difficult specially the first two copies.Wonder how other examinee are feeling.I will also be taking step 2 in August and my confidence is some what shaken at this time.Any suggestions?Thankyou

* Reply: I took the step 1 in this month as well. To tell you the truth, I also think it was difficult, though the difficulty was not in the depth of the materials but overemphasising certain topics and lot of confusing questions to which no logical answer could be given. On the other hand, I think you can not know how well you have done unless you get the results. Your conclusion on your performance is based on the questions and answers you remember and this at most covers a quarter of the approximately 8oo questions. So who knows. I will also try the step 2. I tried it a year ago and colud not make it, but let me tell you that there is an extensive overlap between the two parts and the material you have studied for the first part will certainly be big help in the step 2. So good luck and study well. if you get your positve results let me know. All the best. q.

* Message: I just took it. it was difficult in the sense that I don't have enough clinical background. Endocrinology was the big topic. It may be different in august. I found the first aid high yield topics very important, especially x-ray(id pneumonia, pneumothorax(was on the exam)), ct-scan and mri of the abdomen and different sections of the head. histology, try to id cells or special structures under em, microscopic slides, and don't forget how they look in hand drawing. pharm was not a favorite topic. But captopril came up in several questions. Need to know beta2 agonists and autonomic drugs. Path and phys were mixed together in the clinical sceneries. Most of the questions this time were 1 case per question therefore they were taking a long time to finish the test. try to answer the questions in the alotted time. Most of them gave you the dx and ask you something else therefore you must understand your path and phys to choose the answer that you think may be the best. Straight answers were about 10% of the whole test and required memorization. If you know firstaid inside out then you are ready for step1. Biochem and embriology also are important. You need to know how kariotyping looklike (1 question for trisomy). Behavior science is very important topic and easy to get the score. Last but not least, sorry for my typing. Idon't know how to type and I am too lazy to use shift key. kn

* I took the step 1 two weeks ago and also felt it was difficult. But I don't think you can tell how well you have performed based only on your memory and feeling. The final score is a reflection of percentile distribution, not the actual number of correct answers, so it depends not only on your performance, but on other examinee's performance as well. The test was difficult to you, it may be difficult to others too. So, be confident and concentrate on your second test. Good luck.

* I prepared by taking the NMSR review course. Not only did it help me focus on all the relevant areas, but it reveals what sorts of questions come up in which topics. I highly recommend it. As for books, I have used many. I've used mostly the Board Review Series (BRS) on all the relevant topics. I especially recommend Behavioral Science BRS since it's very short and sweet. You get all the relevant text if you take the NMSR course, and I consider that sufficient. I realized that the smaller and quicker a review is, the more likely one is to remember all the information. For pharmacology, I used the Lange review book (the orange one, or whatever is the latest). For biochemistry, I used Lippincott's (Champe & Harvey). I did use the Lange review book for microbiology, but I would recommend "Clinical Microbiology Made Ridiculously Simple." Its advantage is in the ease in which it trains you to remember useless facts.

I take it by cell biology atlas you mean a histology atlas. I did study from one when I first took the course, but I've largely neglected it since. From what I remember of the questions on the exam, you are unlikely to be faced with a slide that is so indecipherable as to defy your ability to determine even its tissue of origin. Now genetics -- I did not read anything at all. Genetics comes fairly easy to me. I took so many undergraduate courses in molecular biology that they are soldered into my brain now. I did a small token review from the notes provided by NMSR. All the genetics books I've seen have been excessive, providing more information than one needs to know or overlapping it with biochemistry. I hope that's what you wanted to know. If not, feel free to write me e-mail. (click on my handle above).
                                                       Good luck.