My class recently had to take the Comprehensive Basic Science Examination administered by the NBME. I've heard it's supposed to reflect the general content of the USMLE Step 1 and your score on it will somewhat indicate your preparedness or lack thereof for the actual board exam. I felt it might be worth it to relay what I thought of the exam to you guys. Whether this exam really means anything or not, I'll leave that up to you, but it might be helpful. Breakdown of our particular exam: Out of 175 questions, about 5 were Biostatistics, about 5 were Embryology, about 15 were Behavioral, about 20 were Biochem, about 10 were Gross Anatomy, about 10 were neuroscience, about 30 were Physiology, about 25 were Microbiology/Immunology, about about 20 were Pharmacology, about 20 were straight up Pathology, and about a total of 15 questions involved Cell Biology, Genetics, or MicroAnatomy. Random Comments: About half the Biochemistry involved Vitamins. There was the usual one urea cycle question. There was the usual pedigree. About half of the physiology questions were ones with answer choices consisting of combinations of arrows going up, down, or neither (no change) and you have to match them to physiologic variables. Almost zero questions on parasites and fungi. Almost no questions on antimicrobials (just two, which surprised me). Most Pharm questions covered autonomics, cardiovascular, endocrine, and CNS evenly. Embryology questions were surprisingly easy. Anatomy questions were not. Surprising number of Cell Biology questions. For example, here's a huge case presentation of a disease, and the question will ask you for the ultrastructural changes seen in the cell, yikes. Most behavioral questions involved ethics or doctor-patient relationship (what would you say, or what does what this patient says mean). We had to identify one histology slide, interpret one xray, interpret one drawing, identify the lesion on two cross sections. More immunology questions than I expected (they even repeated a question, although it was worded differently). One physiology equation you had to know. Almost NO questions dealing with molecular biology.. just some PCR stuff. Like one or two questions on molecular genetics (dna, rna, etc). From what I've been hearing about the actual Step 1 exam, a lot of this information fits. (like the emphasis on physiology, doctor-patient relationship questions, endocrine system emphasis, etc.) Hope some of this helps.