When is the best time to take the USMLE Step I? I know that for residencies in EM/IM and EM/Peds (ACGME)that the USMLE is helpful if not required for most. Also, Does your first year of a 5 year Residency program count for your AOA internship year? I know they just changed the rule on that. Thanks Peter--- Soon to be CCOM student.