Home » When Should I Begin Preparing For The USMLE in Europe

When Should I Begin Preparing For The USMLE in Europe

16 min


An IMG wearing scrubs standing in front of the European Union flag.


The USMLE Step 1 exam is a crucial component of the medical licensing process in the United States, regardless if you are studying in the United States, Europe, or anywhere else in the world. For medical students in Europe, preparing for this exam can be a challenging and stressful experience. The key to success on the exam is to start studying early and to use a variety of resources to thoroughly cover the material. In this blog post, we will explore the best time to begin studying for the USMLE Step 1 exam as a medical student in Europe and provide tips and strategies for maximizing your study efforts. By understanding the content and format of the exam, creating a structured study plan, and using a variety of resources, you can increase your chances of passing the exam. 


What is the USMLE Step 1 Exam?


The USMLE Step 1 exam is a standardized examination administered by the National Board of Medical Examiners (NBME) that assesses the medical knowledge, concepts, and principles of students who are in the process of completing their medical education and preparing to enter clinical practice. It is the first in a series of three exams that are required for medical licensure in the United States.

The Step 1 exam is a multiple-choice test that consists of approximately 280 questions. It is taken over one day. It has 45 minutes for breaks and 15 minutes for exam tutorial time. If you watch the tutorial in advance at home, you will have 60 minutes of break time to split and use as you see fit during your exam. There will be seven 40-question blocks and around 60 minutes for each block giving you approximately 90 seconds per question. It covers a broad range of topics, including anatomy, physiology, biochemistry, pharmacology, microbiology, pathology, and behavioral sciences. The NBME website (https://www.usmle.org/prepare-your-exam/step-1-materials/step-1-content-outline-and-specifications) provides comprehensive content outlines for the exam which provides more information on what could be tested. The website describes the proportional representation of topics on the exam by systems, disciplines, and testable physician competencies.

The exam is designed to evaluate the student’s ability to apply scientific principles to the practice of medicine, as well as their knowledge of the diagnosis and management of common medical conditions. The Step 1 exam is typically taken by medical students at the end of their second year of medical school. It is an important factor in the residency matching process, as many residency programs used to use the exam score as a criterion for selecting applicants. However, starting last year, the exam transitioned from a scored to a pass-fail system. With this transition, residency programs are expected to focus more on Step 2 scores when considering applicants. However, Step 1 remains an essential board exam for medical students, and passing it is a vital component of becoming a doctor in the United States. 


Who Can Take the USMLE Step 1 Exam?


For foreign medical students, the Step 1 Exam needs to be certified by the Educational  Commission for Foreign Medical Graduates (ECFMG) can only be taken if their medical school is listed in the World Directory of Medical Schools.


When Should You Take the USMLE Exam in Europe?


The USMLE Step 1 exam is typically taken by medical students in the United States at the end of their second year of medical school. However, the timing of when to take the USMLE exam may vary for medical students in Europe, depending on their individual circumstances and the requirements of their medical school or residency program.

In general, medical students in Europe who are planning to apply for residency positions in the United States should aim to take the Step 1 exam as early as possible, to have a passing score available for the residency application process. Another major consideration is that it is prudent to take the exam when the foundational sciences are freshest in the minds of students. Since the first three years of medical school in Europe are pre-clinical and theoretical, taking the exam at the end of the third year should position students best to answer questions on the exam. 


When Should You Start Studying for the USMLE Step 1 Exam?


The amount of time it takes to study for the USMLE Step 1 exam will vary depending on an individual student’s study habits, medical school curriculum, and other personal factors. However, most medical students spend at least several months preparing for the exam.

In general, it is recommended that students start studying for the Step 1 exam 1-4 months (depending on the student) before the exam date, in order to allow sufficient time to cover all of the material and to practice with UWorld questions. This may mean setting aside dedicated study time each day or week, reviewing course materials and/or Anki and First Aid, and practicing with sample questions. 


How Do I Start Studying for the USMLE Step 1 Exam as an IMG From Europe?


To begin studying for the USMLE Step 1 exam in Europe, there are several steps you can take:


  1. Review your medical school curriculum: Familiarize yourself with the material covered in your medical school courses, and make sure you have a good understanding of the basic concepts and principles that will be tested on the Step 1 exam.
  2. Develop a study plan: Determine how much time you can realistically set aside for studying each day or week and create a schedule that allows you to cover all of the material and practice with UWorld questions. The pomodoro technique which splits the day into periods of focused study time and breaks can be used to work through regimented schedules during dedicated and help boost productivity. 
  3. Gather study materials: Consider using review books or study guides that cover the material covered on the Step 1 exam. First Aid for Step 1 is a highly comprehensive review book for the exam that covers the highest material tested on the exam using examples, mnemonics, and illustrations. The rapid review feature at the end of First Aid is also very useful. Besides this, spaced repetition using Anki has also been proven to be effective in studying for this exam. You may also want to use online resources such as practice questions or review videos. UWorld remains the most trusted question bank. Since there are over 3200 questions for Step 1, many students start doing these questions in their first year of medical school so that they have already seen all questions at least once before they get to the dedicated study time for the USMLE exam. For pathology, many students have reviewed Pathoma videos by Dr. Sattar, as being easy to understand, clear, and concise. For pharmacology and Infectious Disease, Sketchy videos can be a useful tool, especially for visual learners. Boards and Beyond is another video resource but is much more comprehensive than the other resources and is best used as a reference in conjunction with First Aid. Finally, NBME practice exams taken in a similar simulated environment as the actual exam is the best way to get ready for the test. There are countless other resources to study for the exam including USMLE Rx, Kaplan, Golijan pathology videos and Master the Boards, however it can be easy to get overloaded with resources and experience decision paralysis. Testing out which resources work best for you in addition to UWorld and then sticking with those resources for the study period is the key to preparing well for the exam.
  4. Seek support: Consider enlisting the help of a tutor or joining a study group to help stay motivated and on track with your studies. A tutor can help in keeping yourself accountable and meeting your goals. They can also help you create a personalized study plan that takes into account your strengths and weaknesses and maximizes your study efficiency. Finally, study groups or tutors can also provide helpful tips and strategies for effectively navigating the exam, including time management and how to approach different types of questions. To learn more about 1-on-1 tutoring with Elite Medical Prep, schedule a complimentary consultation today!
  5. Take practice exams: As you get closer to the exam date, practice taking sample exams under realistic testing conditions to get a sense of the time pressure and content of the actual exam. There are currently 6 NBME practice exams and 1-2 UWorld sample exams. While taking exams is important, reviewing them is also equally if not more important. A ratio of 1:2 is usually recommended for the time taken to finish an exam to the time taken to review the exam. 


Remember to take breaks and allow yourself time to relax and recharge between study sessions. This means keeping in touch with family and friends, eating nutritious, meals and getting in regular exercise during the study period. It can be easy to forget to do these things which can impact your mental and physical health. Hence, focusing on your health is of the utmost importance during this period. It is also important to be flexible and adjust your study plan as needed based on your progress and any changes in your schedule.


Finally, it is important to note that the Step 1 exam is just one of several factors that are considered in the residency matching process. Other factors may include the medical student’s academic performance, clinical experience, research experience, and letters of recommendation. Therefore, medical students in Europe who are planning to apply for residency positions in the United States should also focus on building a strong overall application profile in addition to preparing for the Step 1 exam.

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