Biochemistry and USMLE Step I exam (I)



Since I have been teaching Biochemistry to American students for some years, I felt obliged in doing some kind of “Meta analysis” of the public information available about Step I exams, mainly from Review books, Review courses, sample questions released by the boards, and comments and student observations in Internet.


From these observations, I got some ideas about the presence of Biochemistry in the Step I exam. Of course, there is not a serious statistical analysis that validates the results of this “metaanalysis”, so the results belong to the subjective field.


Once again, the idea of sharing these ideas is to help those students that already have studied all the Biochemistry content for this exam, and that would like to revisit those topics that apparently are very high yield in the Step I exam.



The first question about Biochemistry that students preparing for the USMLE  asks:


How much Biochemistry appears in these exams?


   These are some comments posted in Internet from students that already had the exam:


“Anyway, I didn’t feel like one particular subject dominated my exam although I seemed to have very little biochemistry overall and perhaps a lot of behavioral science oddly enough”


Another unexpectedly scanty topic. Few questions;…”


“a grande total of 3 genetics/biochem questions. “


It didnt seem like there was a lot of biochem but too much genetics for me.”


“Biochem I really didn’t notice that much”


“i didn’t have much cell or biochem or embryo”


   But the following students had another experiences


“I unfortunately did have (what seemed like) a lot of biochem questions..”


had PLENTY of behavioural science and biochem.


“I did have a lot of Biochem/Genetics, ,,,


…“good number of path, biochem, and lot of physio,


Lots of Biochem and Molecular Bio thats not found anywhere…”


“…heavy biochem/molecular biology/immunology (I think I had at least 3 electrophoresis gel/DNA hybridization type things per question block).”


 Biochem, was a KILLER, tons of questions on this stuff, I had no idea…

…Its was VERY hard, I had no knowledge of any of the questions being asked so I guessed on all of it. THIS IS WHAT PROLLY FAILED ME ON THE EXAM
All in all, I’m not sure how I did. I thought I was doing good until the 5th block and then the bio chem questions started to come… I’m sure I ended up failing because of these questions so make sure you pay close attention to the Biochem.“I will report the next time I take my step 1 as I’m almost 100% positive I failed because I didn’t understand the biochem questions. Good luck to all
I’ll try to answer q;s if you hav any.  …I don’t really know where the biochem came from. It was more molecular but some Amino Acid stuff as well…”


“I took the exam on 9/23. I think I probably had the same exam as you from the way you described it. Lots of Biochem and Molecular Bio thats not found anywhere…”


Something more specific in terms of questions? Some numbers?


biochem- not much at all, maybe 10 questions


Biochem- Most biochem questions were easy… I got maybe 10-15 biochem


Biochem 15 SPECIFIC questions “


Biochem/molec bio: ( 20-30 Q)”



Of course, there are different opinions and different experiences, depending on the exam that was generated in each case.


According to the experiences and opinions I have had the chance of knowing, we can classify the answer to the question “How much Biochemistry in the Step I?” in these groups:



A lot                           44 %


A few                         33 %


10-30                         22 %




I guess that an approximated average would be around 10 % of the total questions


Which topics students describe as High Yield topics?


It will be the subject of a future post!


Relarted posts:


 1.- My list of Step I High yield topics in Protein structure and functions.



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