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The emphasis on Step 1 is definitely more memorization with some critical thinking mixed in. The reason it's so difficult is, besides the large amount of information the questions can be pulled from, most of the questions require 2-3 steps.
For example, rather than ask you what drug you would use to treat condition X, they would ask:
"A patient presents with symptoms Y and Z and physical exam finding W. What is the mechanism of action of the drug you would use to treat this condition?"
So you have to correctly diagnose --> come up with drug of choice --> remember its mechanism of action. There are more critical-thinking based questions but it's all based on content you have to know. Hence the 12 hour study days.
Sounds like a beast. I'm glad I won't have to worry about this for 3 years hopefully.😀