Академический Документы
Профессиональный Документы
Культура Документы
Clinical science
Advanced clinical examinations
Comprehensive examinations
http://www.nbme.org/PDF/SubjectExams/subexaminfoguide.pdf
United States Medical Licensing Examination
(USMLE)
http://www.usmle.org/step-1/#content-outlines
USMLE Step 1 Test Specifications
http://www.usmle.org/step-1/#content-outlines
Expanded new USMLE content outline
(available as of April 2015)
For example:
Planned changes for USMLE Step 1
TMDC
Behavioral health
Biostatistics and epidemiology
Evidence based medicine
Gross anatomy and embryology
Microbiology and immunology
Neurology and neuroscience
Pathology and genetics
Pharmacology and biochemistry
Physiology and cell biology
http://www.nbme.org/PDF/Publications/2014Annual-Report.pdf
Interdisciplinary Review Committees (IRCs)
IRC
Cross Step
Step 1
Step 2 CK
Step 2 CS
Step 3 Computer-based case simulations
Step 3
Roles:
Review all questions (including pre-tested items) before going on an
exam, and then on regular 3-year intervals while they are active
questions, for content accuracy.
Remove buzz words (eg, blue sclerae, ragged red fibers).
Check tagging of questions for accuracy.
Determine for which Step or Subject exams each question is most
appropriate.
http://www.nbme.org/PDF/Publications/2014Annual-Report.pdf
Comparison of Subject and Step 1 Questions
More likely to look like traditional More likely that a biochemist who
biochemistry has never taught medical
biochemistry would not even
recognize the question
A 67-year-old man has a restricted diet that includes no fresh citrus fruits or leafy
green vegetables. His teeth are loose and his gums bleed easily. This patients
disorder most likely results from a defect in collagen synthesis that involves
which of the following amino acids?
(A) Arginine
(B) Cysteine
(C) Histidine
(D) Hydroxyproline
(E) Leucine
(F) Methionine
(G) Serine
(H) Tryptophan
SE_ContentOutlineandSampleItems.pdf
Comparison of Subject and Step Questions
A 14-year-old girl is brought to the physician because of a recent growth spurt of
15 cm (6 in) during the past year. She also has had increasing fatigue and
palpitations during this period. Her paternal aunt has a history of palpitations and
severe myopia. She is at the 95th percentile for height and 50th percentile for
weight. Physical examination shows a long, thin face. Ophthalmologic
examination shows dislocated lenses. Cardiac examination shows a
hyperdynamic precordium with early click and systolic murmur.
Echocardiography shows an enlarged aortic root and mitral valve prolapse.
Abnormal synthesis of which of the following proteins is the most likely cause of
this patients disorder?
(A) Collagen, type I
(B) Elastin
(C) Fibrillin-1
(D) Fibroblast growth factor R3
(E) Laminin
(F) Neurofibromin
(G) PAX 6
SE_ContentOutlineandSampleItems.pdf
Comparison of Subject and Step Questions
A 2-year-old boy with mental retardation has chewed the tips of his
fingers on both hands and a portion of his lower lip. His serum uric acid
concentration is increased, and he has a history of uric acid renal
calculi. His 5-year-old brother has similar findings. Which of the following
abnormal enzyme activities is the most likely cause of these findings?
(A) Decreased adenine phosphoribosyltransferase
(B) Decreased adenosine deaminase
(C) Decreased hypoxanthine-guanine phosphoribosyltransferase
(D) Increased carbamoyl phosphate synthetase
(E) Increased phosphoribosylpyrophosphate synthetase
(F) Increased xanthine oxidase
SE_ContentOutlineandSampleItems.pdf
Comparison of Subject and Step Questions
2015samples_step1.pdf
Do you consider this biochemistry?
1. YES
2. NO
A 4-year-old boy is brought to the physician because of slow growth during the
past year. He has had recurrent urinary tract infections since the age of 1 year.
He is at the 10th percentile for height and 25th percentile for weight. Physical
examination shows pallor. Laboratory studies show a normochromic, normocytic
anemia and increased serum concentrations of urea nitrogen and creatinine.
Urinalysis shows a low specific gravity. Which of the following sets of additional
serum findings is most likely in this patient?
Calcium Inorganic 1,25-Dihydroxycholecalciferol Erythropoietin
Phosphorous
A
B
C
D
E
F
2015samples_step1.pdf
Do you consider this biochemistry?
1. YES
2. NO
2015samples_step1.pdf
Do you consider this biochemistry?
1. YES
2. NO
A 15-year-old girl who is a ballet dancer has not had a menstrual period for the past 3
months. Menses were previously regular at 29-day intervals. She has lost weight over
the past year; her weight is 70% of that expected for her height. She is afebrile and
has purpuric lesions on her extremities and trunk. Platelet, absolute neutrophil, and
lymphocyte counts are below the reference range. She has macrocytic anemia. The
most likely cause of these symptoms is a deficiency of which of the following nutrients?
2015samples_step1.pdf
Do you consider this biochemistry?
1. YES
2. NO
(A)
(B)
(C)
(D)
(E)
2015samples_step1.pdf
Do you consider this biochemistry?
1. YES
2. NO