USMLE® Step 1 Exam Guide

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What is the USMLE?

USMLE® stands for the United States Medical Licensing Examination® and is comprised of a series of exams—Step 1, Step 2 CK, Step 2 CS, and Step 3. Medical students and graduates must pass each of these exams to obtain medical licensure in the United States. The USMLE is sponsored by the National Board of Medical Examiners® (NBME®) and the Federation of State Medical Boards (FSMB).

The USMLE’s purpose is to assess whether you can integrate and apply the knowledge, values, and skills you have gained in medical school. Successful completion of the USMLE helps demonstrate your competency as a soon-to-be practicing physician to licensing authorities.

What is on the USMLE Step 1?

The USMLE Step 1 is a multiple-choice exam that assesses your knowledge of the basic sciences, principles, and mechanisms underlying human health and disease. The USMLE program provides a Content Description outlining the distribution of disciplines and organ systems covered on the USMLE Step 1. Tested disciplines include:

  • Anatomy and Embryology
  • Genetics
  • Biochemistry and Nutrition
  • Histology and Cell Biology
  • Physiology
  • Immunology
  • Microbiology
  • Histology
  • Pathology
  • Pharmacology
  • Behavioral Sciences

How long is the USMLE Step 1?

  • One-day examination divided into seven 60-minute blocks
  • Administered in one 8-hour testing session
  • Maximum of 40 questions per block
  • Maximum of 280 questions on the overall examination

When should I take the USMLE Step 1?

The timing for US medical students to take the USMLE Step 1 varies by the medical school. Many medical schools have their students take Step 1 at the end of the second year, just after completing the preclinical curriculum. Other medical schools (typically those with a condensed preclinical curriculum) have their students take Step 1 in the third year, after a series of core clinical rotations. Either way, students should complete Step 1 before preparing their residency application. For international medical graduates, passing Step 1 is one of the requirements for certification by the Educational Commission for Foreign Medical Graduates (ECFMG).

When should I start studying for the USMLE Step 1?

Most US medical schools give their students a dedicated study period of 4-8 weeks to focus on studying for the USMLE Step 1. However, many successful students begin studying for Step 1 much earlier, often in parallel with studying their preclinical classwork. Using a question bank (QBank) alongside your first- and second-year classwork can help you assess your understanding of the information you are learning in class and get a head start on preparing for Step 1.

How do I study for the USMLE Step 1?

Start by familiarizing yourself with the 2020 USMLE Bulletin of Information, which contains essential information such as eligibility requirements, test scheduling, exam procedure, and score reporting. To study for the USMLE Step 1, most medical students use a QBank alongside a comprehensive review book.

We recommend our USMLE Step 1 learning platform, the number one QBank for medical students. Our active learning methodology will help you master the information you need to know to pass Step 1, and it will also help you gain a solid foundation of knowledge for future clinical success.

How is the USMLE Step 1 scored?

The USMLE Step 1 is scored on a 3-digit scale ranging from 1 to 300, with most students scoring between 192-268. In 2018, the mean Step 1 score was 230 for first-time takers attending US and Canadian medical schools.

What is the USMLE Step 1 passing score?

The USMLE program provides a recommended minimum passing score, which usually translates to test takers answering approximately 60% of the questions correctly. The current USMLE minimum passing score for Step 1 is 194. The USMLE program has announced that score reporting for Step 1 may change to strictly pass/fail as early as January 2022.

How soon do I get my USMLE Step 1 results?

According to the 2020 USMLE Bulletin of Information, it typically takes 3-4 weeks to receive your Step 1 score.

How many times can I take the USMLE Step 1?

You may take the USMLE Step 1 no more than six times, including incomplete attempts. The USMLE program has announced that the total number of attempts may be reduced from six to four times as early as January 2021.

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