Well got through it, somehow...
Fortunately for me, MEN never showed up on my test.
I did the worst at the beginning and end sections. The beginning because I was like, "OMG I'm actually sitting for the REAL step 1!!" and the end because I was simply exhausted and couldn't think straight. I think they put so many sections in the exam intentionally to make it a test of endurance. But I feel I did ok in the middle once I hit my stride, I think. (still made some idiot mistakes... totally blanked on the mechanism of colchicine, grr)
Most of the anatomy was extremity anatomy, especially brachial plexus and leg compartment. I wonder why this is. The perineal spaces came up once or twice, though.
I was the only one taking USMLE in the room. Everyone else was taking COMLEX, which seems to be a much shorter test... but at least we don't have to give our thumbprints every time we enter the room!
Be sure you pack some food of some sort. And caffeine. Lots and lots of caffeine.
As far as difficulty, I'd say it was harder than the official practice USMLE questions but easier than Qbank. Qbank has a lot of useless trivia that is not tested in the real thing...
... however, "useless trivia" does NOT include anything involving enzymes. Know your enzymes front and back! And not just the obvious ones either. If nothing else, know the glycolysis pathway and the folate-B12-methotrexate-related pathway (can't even remember what the whole thing is called, lol). The biochemistry quota of the test is met via enzyme questions.
For ethics questions, the answer is always the most mushy, politically correct, empathetic answer on the list. You must understand their feelings!
Non-ethics psych questions were rare on my test. Review your personality disorders and you should be set.
Parasites only showed up a couple times, but there were a lot more viral questions than I would have preferred.
Signature toxicities of cancer drugs was another favorite.
Well good luck all... and yes, I am an idiot for always blanking on the MEN syndromes.
