Everything you need to know in 2019.

The USMLE Step 1 is seen as one of the most challenging exams a student can take. It is tricky, and arguably the most challenging of the three-part exam series. Understanding what’s on the test and how to prepare for it is important for surmounting this first hurdle in your path to a successful medical career.

What is USMLE?

The United States Medical Licensing Examination (USMLE) is an exam for medical licensure in the United States. It is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME).

The USMLE is a 3 step exam and it evaluates a physician's capability to apply medical concepts, knowledge, and principles in health-related issues. It also determines basic patient- centered skills which are vital to health-care, such as safe and effective patient care. To practice medicine in the United States, a physician with an M.D degree can only apply for an unrestricted license if he passes all three steps of the USMLE exam. U.S. osteopathic medical school graduates can take either the USMLE or COMLEX (Comprehensive Osteopathic Medical Licensing Examination) exam for medical licensure. Students from non-US and non-Canadian medical schools must pass all three steps of the USMLE to get a license to practice in the US, regardless of what their degree is.

USMLE Step 1

USMLE Step 1 evaluates whether a student can apply important concepts of the basic medical sciences to the practice of medicine. Step 1 ensures understanding of the concepts that are a foundation for the competent practice of medicine. Step 1 is structured while considering such a content outline that organizes fundamental science material along the aspects of system and process.

The eligibility criteria to apply for the test as well as to take the test include:

A medical student officially enrolled in, or a graduate of, a US or Canadian medical school program leading to the MD degree that is accredited by the Liaison Committee on Medical Education (LCME).

A medical student officially enrolled in, or a graduate of, a US medical school leading to the DO degree that is accredited by the American Osteopathic Association.

A medical student officially enrolled in, or a graduate of, a medical school that is outside the US and Canada, listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements and that meets other eligibility criteria of the ECFMG. REGISTRATION/ APPLYING/ SCHEDULING.

Student or graduates of a medical school in the United States and Canada must apply for the USMLE Step 1 exam with the NBME.

Students or graduates of medical schools outside of the U.S. or Canada register with the Educational Commission for Foreign Medical Graduates.

During the application process, select a three-month eligibility period during which you wish to test.You will receive an e-mail notifying you that your scheduling permit is available. Schedule your test date. You can schedule your test date in advance (up to 6 months). If you do not take the examination within your eligibility period, you will have to reapply with a new application and fee. Keep in your mind that your application fee is nonrefundable.


As of 2017, a score of 192 is needed to pass the Step 1 exam.


Step 1 is a one-day examination, which is divided into seven blocks, each 60-minute, taken in one 8-hour session. The number of questions on one block will vary, but will not be more than 40.


International medical school graduates should apply through ECFMG, and the registration fee is $895. In 2017, Step 1’s cost was approximately $605.


Step 1 is designed to test the basic scientific knowledge learned during the medical school as applied in the form of clinical vignettes. It includes anatomy, pathology, biochemistry, pharmacology, microbiology, physiology and behavioral sciences. It also includes interdisciplinary areas such as genetics, aging, immunology, nutrition, and molecular and cell biology. Epidemiology, medical ethics and questions on empathy are also important. Some questions assess your understanding of basic facts and definitions, but the major part deals with your problem-solving skill using basic scientific principles.

When to take it?

Step 1 generally requires the most preparation of all of the USMLE steps. The optimal time to take Step 1 is when basic science knowledge is fresh in your mind and you’ve had sufficient time to study. Many people take the test between their second and third years in medical school, after finishing basic science courses.

When can I see my score?

Each Wednesday, scores for Step 1 are released. Generally, it takes three to four weeks for scores to be released. The entity you registered with (NBME or ECFMG) will send you your score once it is s available. Or it will also be posted on their website.

Can I retake the exam?

If you have passed the exam, you cannot repeat it to achieve a higher score, and any failed attempt is permanently recorded. In case you failed, you can retake the USMLE Step 1 exam up to 6 times.

Tips for preparation?

Like most medical students, you’re also probably wondering how to best prepare for medical school and how to improve your score. Here, we will give you some tips on how to make a solid game plan for the right preparation. And you’ll be able to tackle it with confidence and success.

1: Before seriously studying for the test, make a timetable that has proper breaks and time to eat, as well as slots for studying and taking full practice tests. If your schedule isn’t working, change it accordingly so that you can get to all of these activities — each one is important!

2: Make sure to take a practice test before preparing to see where you stand. It will help you to make room in your schedule. It will direct you to take into account how much you have to learn and your expected rate of progress should be. Take your final practice tests sometime before your actual test date so you have enough time to sharpen your skills if the test doesn’t go as you wanted.

3: Study what you don’t know. Spend time on your weak points. It’s easy to fall into the trap of studying the subjects you’re already a master in.

4: Try different learning techniques. Use mnemonics to help with memorization. You can also make flashcards to memorize concepts. Studying flash cards repeatedly is a good way to learn.

5: Favor depth over shallow breadth. Study thoroughly. Look for explanations. Asking yourself “why?” and “how?” often helps to focus the mind and comprehend the logic behind a concept.

6: If you are retaking the test, focus your preparation on the areas in which you did not excel before. The score report from your previous test gives your performance details for each category and it will allow you to see where you need to work.

7: Be Realistic. Use your time wisely. Generally, students require several months to master the material. If you’ve been away from the material or have limited time to study each day it will obviously take longer. Be patient and give yourself enough time to learn.

8: If you are serious about your Step 1, consistency is the key. An Independent study is a good approach, but if you have limited time or you don’t understand the material well, you should take help from preparation courses. Anyways, anything less than your best effort will not do.

9: Be sure to do as many full-length practice tests as possible in a test-like setting to ensure you are finishing blocks in the allotted 60 minutes and preparing your body for a long test day.

10: Keep materials Simple and few. Too many different sources often complicate study, and the last thing you want is resource overwhelm. Stick to one resource and utilize it fully.

11: Adjust your study technique every 4 weeks to address areas of difficulty. As you make your way through your studies, you will uncover areas of weakness. Don’t be reluctant from the tough spots. Lean into the challenge. If you embrace the harder areas head on, you will feel more empowered as you chip away at them and slowly but surely gain mastery.

12: On the test day, get to the test site a little early and have a current picture ID with your signature, along with a printed copy of your scheduling permit. Get a great night’s sleep the night before the exam. Bring a lunch, snack, and ear plugs on test day. You should answer all the questions. Wrong answers do not count against you.

13: During the test, your mere focus should be on the block you are in, complete it, clear your mind, and move to the next block. Be sure to check all your answers before finishing a block. Familiarize yourself with how the tests work beforehand. You will have more time for the break in the test by skipping tutorials, Stay Positive. This is a tough process. Allow yourself for failure. But whenever you stumble, pick yourself up, dust yourself off, and try again! You WILL make it for sure.

Preparation resources:

There is a range of different resources that you can utilize to prepare for the USMLE Step 1.

Text Books:

One of the best strategies is to use your textbook to learn the material. You have studied for these books before and so it will be easy to re-read them.

Preparation courses:

Test-prep courses offer structured classroom lectures and preparation materials. Some medical schools offer preparation courses as part of the curriculum. If your school has a good course available, it’s worthwhile to avail yourself of the opportunity to take them.

Online courses:

One of the best sources which students find optimal for preparation for step 1 is a private prep course. It can save you a lot of time. You don’t have to scour the web looking for videos and material for different topics. You invest a little bit in them and they make your life so much easier. It is a great way to build your concepts (which matters in step 1) and watching them repeatedly will aid you in memorizing it. If you are struggling with the material, have been away from the content or simply find no other source helping you enough then an online prep course is your go-to source. There are well-known companies offering them like Dr. Najeeb Lectures.

They have a video library of all the topics included in USMLE step 1. The best thing is that in this way you can prepare for your test in the comfort of your own home and according to your timetable. Question banks are essential for USMLE Step 1 preparation. They provide hundreds of questions that students can take as full tests, blocks, or by category — either timed or untimed. But always go for them when you are sure that your concepts are clear, preferably after a prep course or at least along with it. Once you’ve decided which prep course you’re going to enroll in, and which question bank and books you’ll be using to study, you are halfway there. Though the USMLE Step 1 may be one of the most challenging exams you’ll ever take, with diligent and focused work, it is possible to be prepared and confident when you walk in on test day. Now, go crush your exam! Good luck!


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Reference: USMLE Step 1 Official Website.



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