25 Things You Should Know About Your USMLE Step 1 Exam Day

Preparing for the USMLE Step 1 exam is quite stressful. By the time exam day rolls around, your head is jam-packed with all sorts of facts and mnemonics. Who has room for basic logistical details? Here are some things I wish I had known about the exam day before I actually took Step 1.

1. Map out the route real well the day before. If you can, drive out to the site beforehand. Keep in mind that traffic patterns might be different in the morning.
2. Eat a good breakfast. 
3. The test center I went to was set up with a lobby with lockers with a small hallway that connected to the two rooms with computers where I actually took the exam.
   
4. Items that you CANNOT bring into the testing area (the rooms with the computers) are: cell phones, PDAs, calculators, watches of any type, pagers, recording or filming devices, radios, coats, jackets, head wear, gloves, book bags, backpacks, handbags, briefcases, wallets, books, notes, written materials, scratch paper, food, candy, gum, or beverages. No iPods!
   
5. However, you can store these items in the lockers provided. The lockers to keep your stuff are pretty small (1 cubic foot). Don't bring more than you need to.
   
6. Be prepared for any temperature. 
7. Wear layers. If it is cold, you'll be fine. If it is warm, you can peel the layers off. On my day, the room was easily 85 degrees F because the A/C in the building had broken down.
8. Wear comfortable clothes and shoes. 
9. You cannot take your own earplugs, although this rule might have changed.
   
10. If you wear contacts, you might want to consider wearing your eyeglasses instead. Remember, you're going to be staring at a computer pretty intently for 7 hours. 
11. While you can bring a book to study during the breaks, don't! This will just stress you out even more without really adding anything to your test-taking skills. 
    
12. Do NOT look up answers to questions you're unsure about during the break. What's the point? If you got it right, nothing changes. If you got it wrong, it'll distract you the rest of the day.
13. If you really must bring something, try First Aid for the USMLE Step 1, Pharmcards, or some general review sheets. 
14. You have an hour of break time, but do not feel you need to use all the time up. The sooner you get done, the sooner you can get out of there and celebrate!
15. There's a lot of time wasted at the beginning, photographing you and signing you in.
16. Make sure to bring a passport, driver's license, or other government ID to sign in!
17. You'll probably see a few familiar faces and a few unfamiliar ones. You can try making small talk if you want, but most people are not really up for it.
18. The proctors really have no idea about any of the Step 1 test content. 
19. The room itself is filled with only computers, chairs, and test-takers. There are proctors, but they typically sit outside the room, and monitor the examinees view closed-circuit camera. 
20. Not everyone at the test center will be taking Step 1. On my day, I saw an intern I knew taking Step 3 for example.
21. Pack a light lunch, something that does not need any special heating or storage. I think I had a Coke, PB&J, and some fruit. Water would probably be a better choice, but I like Cokes no matter what colas do to my kidneys!
22. Don't expect to be done with Step 1 before 5pm, but some people are able to finish as early as 3pm.
23. If you can, arrange for someone to pick you up after the test. You'll probably be somewhat fatigued and it's nice to not have to worry about driving, especially through rush hour traffic. 
24. The test bulletin states "There are no waiting facilities for family and friends at the center; plan to meet them elsewhere after the examination ends," but in reality, they can either wait in that lobby area or just outside in the parking lot. The "they" should be one person though. Celebrate elsewhere after you finish!
25. Any other concerns? Check out the USMLE Step 1 2009 Bulletin or links to other Step 1 resources including other examinees' experiences.