USMLE Step 1


The USMLE step 1 is the one of the three examinations that you must pass in order to become a licensed physician in the United States. The purpose of USMLE step 1 is to test your understanding and application of important concepts in basic biomedical sciences, with an emphasis on principles and mechanisms of health, disease, and modes of therapy. USMLE Step 1 is a one-day Computer-based Test that can be taken at the end of  second year of medical school. 

It emphasizes basic science principles. Specifically, Step 1 covers Anatomy, Behavioral Science, Biochemistry, Microbiology, Pathology, Pharmacology, and Physiology. Interdisciplinary areas such as genetics, immunology, and nutrition are also tested. The exam consists of approximately 350 questions given in 8 hours of testing time. There are seven 60-minute blocks, in each block you have to answer about 50 questions. You will be able to skip back and forth among questions, but ONLY within a block of questions. Once the hour is over, you will be unable to return to those 50 items. The test items aren't grouped by clinical subject but are presented in a random, interdisciplinary sequence. All USMLE questions are in one best-answer format. There are no matching questions on the computerized USMLE Step 1.

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USMLE Step 1 Specifications


1.   Systems

40-50 % General Principles

50-60 % Individual Organ Systems cardiovascular, Hemopoetic/ Lymphoreticular, Gasterointestinal, Nervous / Special Senses, Renal / Urinary, Skin / Connective tissue, Reproductive, Musculo-skeletal, Endocrine, Pulmonary / Respiratory

2.    Process

30-50 % Normal structure and function

30-50 % Abnormal Processes

15-25 % Principles of therapeutics

10-20 % Psychosocial, cultural, occupational and environmental considerations.

    If you experience any computer problem during the examination, notify a proctor immediately. In the rare event of a technical problem, testing software is designed to allow the test to restart at the point of interruption with no loss of testing time. However, it is possible that a technical problem may occur that requires that your examination be rescheduled. In that event, you will be allowed to test at a later date at no additional charge.


The total fee for Step 1 or Step 2 consists of the examination fee plus the international test delivery surcharge, if exam is taken outside USA or Canada. Examination fee for each exam is currently $570 and the international test delivery surcharge varies from $100 to $245 depending on the country of exam. Please visit ECFMG to find the accurate fee applicable to you.




Important Facts to Know - If passed the exam cannot be retaken to improve the exam.