This thread is great, I'm looking to work in America also, (although, I dare say I'm looking a bit early, I only start medicine at St Andrews this September.)
I'll be doing 3 years at St Andrews, and then the last 3 at Glasgow probably, when would be the best time to start studying towards step 1? I know I'd probably sit it in the summer of year 5 (of my 6 year course), but I'd be keen on getting started as early as possible after hearing how hard it is. Should I just continually work on it alongside my course?