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Just took the step this morning, and finally I can go back to reading for pleasure ! .... even if only for just a month.. 
The exam took me about 4.5 hrs. Showed up around 8 am, dealt with all the security and formalities, sat down, worked 150 questions, took a five minute break, came back and worked the 200 left, filled out the survey (cursing the poor quality MRIs), and left about 1 pm. The first couple of blocks went pretty fast, and then all of a sudden the questions either got really long or really complicated. If the question had a complicated graph or chart, I just marked it and came back in the end.
Overall, I didn't think the exam was really easy or really hard. I know, that's a weasel answer, but i guess I felt that most of the questions were on the easier side. The question stems, on average, weren't as long as I had expected them to be, although they were much longer than the NBME assessment question stems and shorter than the qbank questions i managed to experience before the refund. Most of the questions took a little bit of extra reading, but there was still a decent number of short questions that were directly presented and required a quick, direct answer.
I think that overall the questions can be divided into four categories: the easy ones that you can answer blindfolded, the moderate ones that require a little thought but deal with common things, the harder ones that require some close inspection to catch the little details and relationships, and then the near-impossible ones that either deal with something you've never considered before or never heard of. Fortunately, there weren't many of the last category, but it was kinda fun to just take a wild guess and then look them up later to see if whether I have ESP or just plain suck at guessing.
Subject breakdown on my exam (out of 350 questions):
Majority of questions were pathology related. Probably over 100 of the questions covered information I learned in mainly the pathology texts. Quite a bit more crossed subjects and dealt with micro, genetics, biochem, anatomy, etc.
There weren't as many "pure" physiology questions I as I had expected. Most of them involved either an incredibly over-complicated graph, or a series of arrows going up or down for a set of variables. If you don't know what I mean, I can explain later. I bet about 30 questions were pure physiology. Absolutely no computation physio questions. I couldn't believe it. Respiratory and renal physio showed up the most.
My exam was really heavy in pharm. Probably about 60 questions. Antibiotics, endocrine and autonomics were really tested, but surprisingly CNS wasn't. Not that I care, cuz I hated learning about those 10,000 drugs used to treat the jitters.
Behavioral had about 30 questions, including biostats. Patient-doctor relationship Q's were really obvious. No questions on development. Not a single question on defense mechanisms! I was bummed. Substance abuse, psychiatry, stats were thoroughly tested. Nothing too awful.
Biochem was a heavy hitter. Including genetics in the group, I'd say about 40 questions dealt with this topic. Pedigrees abound, but biochemical pathways were surprisingly lite. Regulation was important though.
Anatomy had about 25-30 questions; Embryology had about 15-20 overall (I'm not joking!); Neuroanatomy had about 15-20. Xrays (about 5) were easy and of good quality, histology pics were kinda small, but of crisp quality. MRIs (about 5) can suck my butt. You could barely see what was going on, but fortunately I could pretty much figure out the right answer (common structures were tested). Lots of drawings and diagrams, but nothing ridiculous.
OK, micro and immunology. About 30 micro and 15 immunology questions. Immunology got kinda frustrating at times, with many questions having two answers that seemed correct, but only one was apparently "more correct". Pure micro was simple. Bacteria and viruses were equally represented. One or two on the fungi. One or two on protozoa. Exactly two on the worms.
Books I used for the subjects:
Pathology: BRS Path and Robbin's Review of Path. I also set aside four of my five study days to read through most of the chapters of Robbin's Basic Pathology (especially those dealing with common diseases) for the detail.
Physiology: BRS Physiology is all I needed. Unfortunately there were still insane graphs that made me sit there and fiddle through them, but they were all solvable in time.
Biochemistry: First Aid is a good starter. If you use only this source, you probably won't do well on this stuff. BRS Biochem, while thick and boring to read, is a fantastic source for the detail needed to answer the most difficult questions. I used mainly the BRS.
Pharmacology: First Aid is actually a solid source for this material. However, there are going to be common drugs brought up that deal with concepts or aspects that arent covered in FA, so if you want to clean up on this section, you're going to need something more comprehensive. If your school has a good pharm department and/or course syllabus, that might be the level of detail needed. I read through Lippincott's pharm, but I did that along with the course, and it covered things in more detailed than I ever want to consider again in my life. FA and course syllabus for pharm.
Microbiology/Immunology: First Aid is decent, but misses a ton of important points, especially with microbiology. The best way to ace this stuff is to just have a firm foundation in both subjects from your course. Micro made ridiculously simple is a better source than FA, but it can miss a lot of extra details too. Combine FA with MMRS and you'll be prepared for a majority of the questions. I've heard that HY Immunology is a great source, but I never got to it, and plus I took an Immuno course senior year in college, so I didn't really study for it much. Just don't neglect immuno, there's a lot more than you think.
Behavioral: BRS Behavioral all the freakin' way. This book covers nearly everything. The 2% of important info it doesn't cover can be found in FA. Do NOT use FA as your primary source for Behavioral unless you already have a strong background in the subject.
Anatomy: I borrowed HY anatomy from our library, but I didn't really like it. Half of the board questions dealt with stuff covered in FA, the other half were "pray and take your best guess" kind of questions. I actually think it's more important to work through these questions and take an educated guess than to review all the info in a book. I'm probably making little sense, but I loved anatomy and retained a ton of it, yet there were still quite a few questions that made me go "what the hell??? I never even considered this might be a question!"
Embryology: If you can get your hands on Langman's Embryology, read it. Well, don't read it cover to cover, just skim through and read the clinical correlation boxes. There are a ton of them, and they all deal with high yield material. I hated HY Embryology, but if you like it, use it. Most of the embryo on my exam dealt with concepts (meaning you had to understand the big picture, not just little facts). FA is probably sufficient for most people, but again for some reason the NBME honchos decided that I needed an overdose of embryology, so i'm glad I had a little more detail.
Neuroanatomy: HY Neuro is fantastic. Neuro is such a broad subject, and i think questions can come from any one of HY's chapters in any number, so just make sure you read through it twice or so and pay attention to Fix's helpful hints near the beginning. Easy points.
I purchased both NBME Assessment exams and worked through them about 1 week before the exam date. I purchased Qbank one month ago, worked through about 40 questions, and got a refund later that same day. I could post a whole 'nother thread on why I don't like Qbank, but I don't think I will, because I'll probably get drawn and quartered by everyone on here.
The actual step questions were most similar to the NBME assessment exams, just a little longer. Qbank tended to have questions that were incredibly complicated, took way too long to read through and answer, or dealt with the same friggin' disease in half the questions.
Overall, it was a positive experience. I'll post my score whenever I get it, plus how I did on the NBME exams, shelfs, etc., for comparison. If I forgot to mention anything, just let me know.
Sorry about the length.... it's strangely unnerving to have free time, and I feel like I have to be doing something or I'm wasting time.
The exam took me about 4.5 hrs. Showed up around 8 am, dealt with all the security and formalities, sat down, worked 150 questions, took a five minute break, came back and worked the 200 left, filled out the survey (cursing the poor quality MRIs), and left about 1 pm. The first couple of blocks went pretty fast, and then all of a sudden the questions either got really long or really complicated. If the question had a complicated graph or chart, I just marked it and came back in the end.
Overall, I didn't think the exam was really easy or really hard. I know, that's a weasel answer, but i guess I felt that most of the questions were on the easier side. The question stems, on average, weren't as long as I had expected them to be, although they were much longer than the NBME assessment question stems and shorter than the qbank questions i managed to experience before the refund. Most of the questions took a little bit of extra reading, but there was still a decent number of short questions that were directly presented and required a quick, direct answer.
I think that overall the questions can be divided into four categories: the easy ones that you can answer blindfolded, the moderate ones that require a little thought but deal with common things, the harder ones that require some close inspection to catch the little details and relationships, and then the near-impossible ones that either deal with something you've never considered before or never heard of. Fortunately, there weren't many of the last category, but it was kinda fun to just take a wild guess and then look them up later to see if whether I have ESP or just plain suck at guessing.
Subject breakdown on my exam (out of 350 questions):
Majority of questions were pathology related. Probably over 100 of the questions covered information I learned in mainly the pathology texts. Quite a bit more crossed subjects and dealt with micro, genetics, biochem, anatomy, etc.
There weren't as many "pure" physiology questions I as I had expected. Most of them involved either an incredibly over-complicated graph, or a series of arrows going up or down for a set of variables. If you don't know what I mean, I can explain later. I bet about 30 questions were pure physiology. Absolutely no computation physio questions. I couldn't believe it. Respiratory and renal physio showed up the most.
My exam was really heavy in pharm. Probably about 60 questions. Antibiotics, endocrine and autonomics were really tested, but surprisingly CNS wasn't. Not that I care, cuz I hated learning about those 10,000 drugs used to treat the jitters.
Behavioral had about 30 questions, including biostats. Patient-doctor relationship Q's were really obvious. No questions on development. Not a single question on defense mechanisms! I was bummed. Substance abuse, psychiatry, stats were thoroughly tested. Nothing too awful.
Biochem was a heavy hitter. Including genetics in the group, I'd say about 40 questions dealt with this topic. Pedigrees abound, but biochemical pathways were surprisingly lite. Regulation was important though.
Anatomy had about 25-30 questions; Embryology had about 15-20 overall (I'm not joking!); Neuroanatomy had about 15-20. Xrays (about 5) were easy and of good quality, histology pics were kinda small, but of crisp quality. MRIs (about 5) can suck my butt. You could barely see what was going on, but fortunately I could pretty much figure out the right answer (common structures were tested). Lots of drawings and diagrams, but nothing ridiculous.
OK, micro and immunology. About 30 micro and 15 immunology questions. Immunology got kinda frustrating at times, with many questions having two answers that seemed correct, but only one was apparently "more correct". Pure micro was simple. Bacteria and viruses were equally represented. One or two on the fungi. One or two on protozoa. Exactly two on the worms.
Books I used for the subjects:
Pathology: BRS Path and Robbin's Review of Path. I also set aside four of my five study days to read through most of the chapters of Robbin's Basic Pathology (especially those dealing with common diseases) for the detail.
Physiology: BRS Physiology is all I needed. Unfortunately there were still insane graphs that made me sit there and fiddle through them, but they were all solvable in time.
Biochemistry: First Aid is a good starter. If you use only this source, you probably won't do well on this stuff. BRS Biochem, while thick and boring to read, is a fantastic source for the detail needed to answer the most difficult questions. I used mainly the BRS.
Pharmacology: First Aid is actually a solid source for this material. However, there are going to be common drugs brought up that deal with concepts or aspects that arent covered in FA, so if you want to clean up on this section, you're going to need something more comprehensive. If your school has a good pharm department and/or course syllabus, that might be the level of detail needed. I read through Lippincott's pharm, but I did that along with the course, and it covered things in more detailed than I ever want to consider again in my life. FA and course syllabus for pharm.
Microbiology/Immunology: First Aid is decent, but misses a ton of important points, especially with microbiology. The best way to ace this stuff is to just have a firm foundation in both subjects from your course. Micro made ridiculously simple is a better source than FA, but it can miss a lot of extra details too. Combine FA with MMRS and you'll be prepared for a majority of the questions. I've heard that HY Immunology is a great source, but I never got to it, and plus I took an Immuno course senior year in college, so I didn't really study for it much. Just don't neglect immuno, there's a lot more than you think.
Behavioral: BRS Behavioral all the freakin' way. This book covers nearly everything. The 2% of important info it doesn't cover can be found in FA. Do NOT use FA as your primary source for Behavioral unless you already have a strong background in the subject.
Anatomy: I borrowed HY anatomy from our library, but I didn't really like it. Half of the board questions dealt with stuff covered in FA, the other half were "pray and take your best guess" kind of questions. I actually think it's more important to work through these questions and take an educated guess than to review all the info in a book. I'm probably making little sense, but I loved anatomy and retained a ton of it, yet there were still quite a few questions that made me go "what the hell??? I never even considered this might be a question!"
Embryology: If you can get your hands on Langman's Embryology, read it. Well, don't read it cover to cover, just skim through and read the clinical correlation boxes. There are a ton of them, and they all deal with high yield material. I hated HY Embryology, but if you like it, use it. Most of the embryo on my exam dealt with concepts (meaning you had to understand the big picture, not just little facts). FA is probably sufficient for most people, but again for some reason the NBME honchos decided that I needed an overdose of embryology, so i'm glad I had a little more detail.
Neuroanatomy: HY Neuro is fantastic. Neuro is such a broad subject, and i think questions can come from any one of HY's chapters in any number, so just make sure you read through it twice or so and pay attention to Fix's helpful hints near the beginning. Easy points.
I purchased both NBME Assessment exams and worked through them about 1 week before the exam date. I purchased Qbank one month ago, worked through about 40 questions, and got a refund later that same day. I could post a whole 'nother thread on why I don't like Qbank, but I don't think I will, because I'll probably get drawn and quartered by everyone on here.
The actual step questions were most similar to the NBME assessment exams, just a little longer. Qbank tended to have questions that were incredibly complicated, took way too long to read through and answer, or dealt with the same friggin' disease in half the questions.
Overall, it was a positive experience. I'll post my score whenever I get it, plus how I did on the NBME exams, shelfs, etc., for comparison. If I forgot to mention anything, just let me know.
Sorry about the length.... it's strangely unnerving to have free time, and I feel like I have to be doing something or I'm wasting time.
