Took it 6/19. I don't think the date you take the test on determines which difficulty of test you get (but I could be wrong).
To contribute to the general consensus: I was incredibly surprised by the difficulty of the test. There were a lot of questions that were on topics I knew well, but asking for details frequently one or two steps outside of the scope of my studying. Things which really would have required me to UNDERSTAND the biochemistry pathway, not have memorized the chart from first aid. No amount of time studying would have changed my ability to answer many of them. I'm not sure, anymore, how to advise people to be ready. Obviously, knowing the core curriculum (Uworld/FA/Pathoma) well is essential, but that was really only a small portion. It is certainly not enough -- but i'm not sure what WOULD be enough, short of practicing clinical medicine or memorizing Robbins.
The extra 30% of the exam fell into two categories
1. Questions that felt more like it was an IQ test that just happened to use the vocabulary we had learned in medical school. These were designed to be something you hadn't seen before, in less time than you would need to sit there and really sort it out.
2. Questions that were definitely straightforward knowledge questions but were from weird, out-there, peripheral topics that I never expected detailed fact-based questions on. It's all fair game.
This exam was not about preparation. It required, in order:
1. Cleverness and the ability to think on your feet
2. Memory (having the type of memory that remembers things from random classes first year, and not as much about memorizing first aid -- though of course that helps)
3. Preparation - the only variable which we have any control over. Sucks, but i guess sticking with the classic prep is still your best bet, even though the exam seems to be changing.
I was guessing the whole time, and racing along trying not to run out of time. I was in solid (but not great for SDN) 240-245 territory on NBME's, 71% UWorld timed random. It felt like I got a 220 or below. Of course everything is on a curve, but I can't imagine I didn't fall at least 10 points from my NBME's. I'll update with how it ends up.
What I learned from all of this? I regret studying so hard, especially to ultimately sit for a test that was so much of an unpredictable, wild ride. I regret stressing out about this exam for a year, and neglecting real life in exchange for what was ultimately probably no more than 5-10 points on a test. It won't change your life. It isn't worth what we give it. What I learned from Step 1 is that this doesn't end ever, and if you don't choose to hold medicine and all of it's crazy expectations and pressures and competition at arms length it will suck out your soul in exchange for a prestige-addicted ego and a 60 hour-a-week job.
Best of luck.
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