Took the test 4 weeks ago score reported to my old med school today. I finished USMLEworld with an average of 60.5% did about 900 questions. I am in my first year of internship (IM), did one month ICU, one month medicine wards, and was on Endo elective (gave me time to study.) I studied in my spare time in clinic maybe 1-2 hours per day for 3 weeks. The CCS cases are very easy, I couldn't figure out what a kid had but otherwise the diagnoses are pretty obvious you just have to remember the management featured in First Aid. I also read all of first aid. I had to have this thing done by the end of my prelim year, but otherwise I think it is wise to wait till you finish first year just because you will have more experience managing conditions. The test is mostly management which makes it different than step 2 which seems to focus more on diagnosis. Time was not much of an issue. The question stems aren't that long. I finished most blocks with about 15 minutes to spare. I had tons of extra time on the CCS cases because they end when you do enough stuff. Anyhow I passed and got a 245 don't know the 2 digit but I guess that it is between 97-99. To all those studying, good luck, it really isn't too rough. Nothing is as rough as step 1.