The USMLE Step 1 Exam: Ten Things you NEED to know to Succeed!

The USMLE Step 1 Exam: Ten Things you NEED to know to Succeed!

By: BoardVitals




So, your United States Medical Licensure (USMLE) Step 1 exam is on the horizon. It can be particularly overwhelming to face your first real exam that affects your medical career, but keep in mind that you succeed at this! The purpose of this exam is to test each medical student’s ability to apply basic science fundamentals to the practice of medicine. BoardVitals, the leader in question banks for specialty board certification, has compiled this guide to detail the many questions that may run through your head as you prepare. Here are ten things you need to know to succeed…


(Disclaimer: BoardVitals is a paid sponsor of #LifeofaMedStudent and thus has a financial relationship with the website. Wherever you choose to purchase your study materials, I personally believe practice questions are hands-down the most important factor in successful board exam preparation.)


1. What is the Step 1 exam format?

The Step 1 exam is a computer-based test taken in one day over an eight hour period. It’s all multiple choice and includes seven 60-minute sections of no more than 40 questions.The total exam will not exceed 280 questions.


TIP: Time might be against you for this test, so it’s important to keep pacing in mind while you study. We suggest compiling a set of 40 USMLE practice questions and setting a timer for 60 minutes when you study.


Each test taker is allowed 45 total minutes during the testing period for personal breaks. If you finish any section before the allotted hour is up, you can add that time to your personal break total. Six breaks total are allowed. There is an optional 15 minute tutorial period at the beginning of the exam. If you choose to skip the tutorial you can add the 15 minutes to your total break time.

During the test, you are only allowed to bring soft foam earplugs into the examination room. Nothing else is allowed – no bags, electronics, phones, or even jackets are allowed. Be sure to check with the exam monitor prior to entering the test room for complete details.


2. How do I apply for Step 1?

Student or graduates of a medical school in the US and Canada must apply for the USMLE Step 1 exam with the NBME. Tests are administered by appointment year round.


3. How much does the test cost?

As of 2017, Step 1 costs $605.


4. What is covered on the exam?

According to the NBME USMLE Step 1 Content Outline, the test covers the following categories:

  • Anatomy
  • Behavioral Sciences
  • Biochemistry
  • Biostatistics and Epidemiology
  • Microbiology
  • Pathology
  • Pharmacology
  • Physiology
  • Aging
  • Genetics
  • Immunology
  • Molecular and Cell Biology
  • Nutrition


TIP: Some questions test your understanding of basic facts and definitions, but the majority deal with your ability to solve problems using basic scientific principles. For example, you’ll be asked to interpret graphs, identify gross and microscopic pathology and normal specimens, and apply concepts and principles relevant to individual organ systems.


5. When should I take the test?

Most people take the test between their second and third years of medical school, after finishing basic science courses and before a clinical clerkship. Many have success taking it within two months of finishing basic courses because material is still fresh in their minds, combined with an extra month or two of studying.


6. What is needed to pass?

The minimum passing score for the USMLE Step 1 exam is 192. This test is notoriously difficult and will require you to carve out ample time to prepare.

Did you know? The national average score for the USMLE Step 1 exam in 2015-2016 was 233.


7. When do I get my USMLE test results?

Scores for Step 1 are released each Wednesday and it usually takes three to four weeks for scores to be released. You will receive an email from NBME when your score is available. It will also be posted on the NBME website. If you don’t receive an email within two months, it’s recommended that you contact the registration entity directly.


8. I passed Step 1 but I’m not thrilled with my score. Can I retake it to raise my score?

Unfortunately, the answer to this is no, so make sure you are well prepared the first time. Your USMLE scores will be an important variable when you decide what specialty you want to match into for residency.


9. I didn’t pass the first time. Can I retake the exam?

Yes. You may take the USMLE Step 1 exam a maximum of three times within a 12-month period. Your fourth attempt must be at least 12 months after your first attempt, and at least six months after your most recent attempt.


10. Want free practice?

Practice questions are easily the best way to keep track of your progress, find weaknesses, and improve your score. Check out these 4 free USMLE Step 1 practice questions

For additional questions, BoardVitals offers a free trial of its 1,600+ questions for USMLE Step 1, as well as Step 2 and Step 3 exams.


BoardVitals - pass the USMLE Exam


BoardVitals is a leading provider of online board review question banks, maintenance of certification, and continuing education activities for physicians, nurses, and other healthcare professionals. Bringing together content from major publishers, universities, and leading healthcare providers, BoardVitals provides the largest and most up to date training and assessment platform in medicine. Using machine learning and professional crowd curation, the company is able to update content daily and improve medical knowledge as new information is published. BoardVitals has been used by 150,000+ practitioners and is trusted by more than 400 leading medical institutions including Johns Hopkins, Mount Sinai, Harvard and Yale.


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