Are the Step Exams harder in the summer?

The Step exams, a crucial milestone for medical students on their journey to becoming licensed physicians, has always been a subject of much discussion and speculation. Recently, there have been rumors and concerns that the exam administered during the summer months or just certain months in general, have been tougher compared to other times of the year. This notion has led to heightened anxiety and a plethora of complaints among students who sat for the exam this summer.

Step 1 and Step 2 are designed to assess a medical student's ability to apply medical knowledge, skills, and understanding of clinical science necessary for the provision of patient care under supervision. The exam is comprehensive, covering a wide range of topics including internal medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry, and preventive medicine.


Both step exams are administered year-round, and the content is updated periodically to reflect the latest in medical knowledge and practices. The question of whether the exam is more difficult in the summer compared to other months is intriguing but requires a nuanced understanding.

The National Board of Medical Examiners (NBME), which develops and administers the USMLE, ensures that the exam content is consistent throughout the year. The questions are drawn from a large pool and are designed to be equivalent in terms of difficulty, regardless of when the exam is taken.

Statistical Equating: The NBME employs a process called statistical equating to ensure that scores are comparable across different test administrations. This means that variations in question difficulty are accounted for, and the scoring reflects a standardized level of performance.

Now that we have established that the NBME uses complex statistical analysis to keep exams consistent through out the year where does this perceived increase in difficulty come from?

From our experience it likely comes down to one thing. Preparedness!

See most US MD and DO students take their step exam between May to July. This falls in line with their school calendar and the seasonal break they often have.Thus anyone who is taking it from August onwards has several reasons for taking out of "cycle".

This can range from being held back, study difficulties, not being prepared, etc. Now if you follow my logic, most (not all) people who are taking it in the later months may not be the most prepared and thus we find evidence of this perceived increased difficulty.

So to answer your question: NO! There is no actual difference in difficulty.

Regardless of when the exam is taken, preparation is key to success. Here are some strategies to help manage the perception of difficulty and improve performance:

Early and Consistent Study: Start preparing well in advance of your scheduled exam date. Consistent, daily study sessions are more effective than last-minute cramming.

Practice Exams: Take full-length practice exams under timed conditions. This will help you become familiar with the format and pacing of the exam, reducing anxiety on test day.

Self-Care: Prioritize your physical and mental health. Regular exercise, adequate sleep, and healthy eating can significantly impact your ability to study effectively and perform well on the exam.

Peer Support: Form study groups with peers to discuss challenging topics and share study resources. However, be mindful of the potential for increased anxiety from peer discussions about the exam's difficulty.

Professional Resources: Utilize review books, online courses, and question banks. Plus you can use Predict My Step Score to determine if/when you are ready.