How Hard Is USMLE Step 1 Exam? [2023 Updated]

Step 1 is the first test out of three in the USMLE. But how hard is USMLE Step 1 exam? Follow this article to find out the beneficial answer.

June 13, 2022

Is USMLE Step 1 hard? People often say that the first step is the most difficult. This saying appears to manifest for the unaware in the case of the USMLE. But how hard is USMLE Step 1? Taking the first step toward any goal requires a great deal of determination and strength, but the same is true for clearing the USMLE. But how did the USMLE step 1 get such an image of USMLE step 1? The reasons why the USMLE Step 1 is hard are listed below.

how hard is usmle step 1

The reasons why the Usmle Step 1 is hard

How hard is the USMLE Step 1? Read on this part to find the answer to this question.

All of the major clinical concepts are covered in USMLE Step 1.

If you look at the list of contents on which the exam is based, you’ll find that it covers almost all of the clinical concepts in detail. It also contains a lot of what is published in medical journals.

While taking the USMLE Step 1 exam, you must deal with time constraints.

The USMLE Step 1 exam lasts one day and consists of seven 60-minute blocks with up to 40 questions, taking 8-hours total. 

During the exam, some candidates have time limits. They say they hardly had enough time to attempt all of the questions, let alone review the answers.

Unlimited topics but limited questions.

The USMLE Step 1 medical exam is made up of 280 questions. Although the limited number of USMLE exam questions restricts the number of topics covered on the exam, you never know which topic will be tested, therefore you should prepare for everything. As a result, select topics that you believe will be included in the exam and avoid those with a lower chance.

The MCQs asked in the USMLE aren’t your usual MCQs.

Because the USMLE exam is an MCQ-based exam, all you have to do is make the right decision. The “unsettling part” is that these USMLE-styled MCQs are designed to mislead you into selecting the incorrect answer. Also, these are not multiple-choice questions, so more than one option may be right. This is definitely a new challenge.

It is computer-based

Those who have taken online exams before will be well aware that taking a paper-based exam differs significantly from taking an exam on a computer. When you switch from paper-based exams to computer-based exams, your exam speed decreases. As a result, you should practice taking computer-based exams to improve your speed. Practicing USMLE test pattern sample questions online is one good way to do it.

Let’s get started with our free USMLE practice test to enhance your chance of passing your actual exam with a high score on your first attempt.

It lasts 8 hours.

The USMLE Step 1 exam is 8 hours in length, believe it or not. We kept thinking about how much easier it would be if the exam had been spread out over two days.

You’ve found the answer to the question “How hard is the Step 1 exam”, let’s move on to know the common mistakes of the USMLE Step 1 in the next part.

USMLE Step 1 common mistakes

Failure to study one’s weaknesses and make adjustments based on self-evaluations.

It is better to have a high baseline in all subjects rather than being extraordinarily strong in one or two and lacking in the others. As the committed period continues, one must adjust their preparation to meet their weaknesses. Medtutor provides you with a superb representation of your strengths and weaknesses. For example, because you were weak in psychiatry and biochemistry, you spent the last two weeks focusing on these subjects. Each subject’s representation varies on exam day, therefore a well-rounded preparation is needed.

Memorization of the concept-based preparation

You should concentrate on understanding rather than memorizing the concepts of the content you are reading. If you’re having trouble grasping an idea, you can watch videos, make a Google search, or read a short passage from a book. Make an effort to comprehend the connections between subjects. This provides a unique challenge for individuals coming from India, where long, essay-based questions requiring memorization are the norm in medical school exams. Many people struggle with this new approach initially.

Spending insufficient time on media-related questions.

Image/audio/video-based questions make up a significant portion of the exam. Without practice, these can be quite difficult compared to text-based questions alone. Many applicants, in our experience, are reluctant to conduct targeted studies for these types of questions, and as a result, their scores drop.

A dedicated period that is too long.

Some offer young months or even years to study for their STEP 1 test. Try not to burn out by combining the time you need to achieve your target score (if you take the exam scored) or pass (for STEP1 pass/fail).

Not preparing for the day of the STEP 1 exam

We have never given an exam that was longer than 3 hours prior to Step 1. Step 1 requires a great 8 hours. Candidates may also be required to travel early in the morning, sometimes to a different city or country. Candidates’ scores may drop if they do not prepare for this difficult experience.

Our recommendations:

  • As though you were taking the exam, take breaks during your NBMEs.
  • To make it more like the actual exam, do two NBMEs (or two UWSAs).
  • Set your sleep schedule so that you are most efficient between 8 a.m. to 4 p.m. For example, you had a habit of sleeping soon after lunch. You knew you couldn’t do it on exam day, however. So you’d make an attempt to remain awake until at least 4 p.m.
  • Plan in advance for meals, drinks, and travel on exam day.
  • Ensure you get enough sleep. This is easier said than done, so please proceed cautiously. If you’re going to take a sleep supplement, be sure you’ve taken it before the exam; doing so on the night of the exam could be disastrous.

Failure to do one’s due diligence prior to using resources

There are numerous posts online that indicate what resources high scorers used. However, the majority of these do not explain how to best are using these resources.

We recommend that you take some time within your which was before period to learn about the resources and how to use them.

Pass rate of USMLE Step 1

Step 1 Administrations

Examinees from US/Canadian Schools2020 Number Tested2020 Percent Passing2021* Number Tested2021* Percent Passing
MD Degree203430.97230780.95
1st Takers197720.9822,280.96
DO Degree52740.9553650.94
1st Takers52350.9653090.94
Examinees from Non-US/Canadian Schools2020 Number Tested2020 Percent Passing2021* Number Tested2021* Percent Passing
1st Takers117420.87169520.82

* Data for examinees who tested in 2021 and reported through February 2, 2022.

** ‘Repeaters’ represents exams given but not the number of examinees.

how hard is usmle step 1

How to study for step 1?

You’ll hear a lot about this exam during your first couple of years of medical school. Since the information can be overwhelming, we’ve broken it down into five key elements to consider as you prepare for Step 1.

  1. Understand the importance of Step 1

It’s no secret that the route to becoming a doctor is long and difficult. However, medical students will frequently hear their instructors discuss the USMLE Step 1 as the most significant set of exams they will ever take.

The USMLE Step 1 exam determines whether you understand and can apply key science concepts that are fundamental to medical practice. The concepts and mechanisms underlying health, disease, and possible treatments are given significant consideration. It is vital to pass this exam on your first attempt since it demonstrates a medical student’s mastery of basic science knowledge and their ability to solve problems using those concepts.

Multiple-choice questions make up the majority of the eight-hour exam. The passing standard for the USMLE Step 1 was changed in January 2022, moving to a pass/fail scoring system. A passing score is now 196 or higher out of 300 possible points.

  1. Start studying when you start studying at medical school 

It’s not the kind of test you want to cram for at the last minute when it comes to USMLE preparation. Studying for Step 1 can take a long time considering the vast amount of material covered in this section of the exam.

The USMLE Step 1 is normally taken at the end of the second year of medical school, but it’s a good idea to start preparing early.

Keeping your USMLE Step 1 preparation top of mind as you work through those courses can be helpful. Step 1 will be testing you on the material you’re expected to learn over those first couple of years of medical school. Studying USMLE materials while taking core classes gives you a different perspective on the material and helps you prepare for the test months before you start studying.

Specific resources will vary depending on your medical school’s student support services, even though some schools provide students with USMLE study materials. SGU, for example, provides many leading USMLE prep question banks to its students, some of which are integrated into the course curriculum. These can assist students in determining which concepts they have comprehended and which may require additional attention.

  1. Use the right resources for your learning style

As you work through your USMLE Step 1 preparation, you’ll come across a variety of recommendations for books to read, study plans to follow, and more. However, there is no such thing as a one-size-fits-all method that will work for everyone.

Because each student’s learning style is different, you must first figure out how you best absorb new information. Some students get themselves into trouble because they believe they can study better on their own.

You can review a variety of study guides and other resources on your own, but he recommends forming a peer study group if you find that you work best with some assistance or in the company of others. You might also participate in a live review course offered by a variety of online suppliers.

  1. Maintain your focus as you study for the USMLE Step 1 exam.

If you’re not absorbing the subject, sticking to a strict study schedule won’t help. So how can you tell if you’re on path? Keeping track of your grades and class rank is the most effective way to do this.

Because the USMLE Step 1 covers the topics you’ll learn in your first two years of medical school, your academic performance will be a direct reflection of your overall understanding of the material. If you are having academic problems, you should seek help as soon as possible.

As your exam day nears, consider how you will use your time. Too many distractions may cause you to lose focus on your last preparations.

  1. Take advantage of USMLE practice exams 

Completing practice exams is one of the most efficient USMLE preparation techniques. This is the most accurate way to imitate the actual procedure. Many medical students and instructors recommend taking the National Board of Medical Examiners (NBME) practice exams, which are designed to the same requirements as the USMLE tests.

It’s worth noting, however, that your score on a practice exam can be a little inflated. When taking practice NBME exams for Step 1, we recommend deducting 15 to 20 points from the scores obtained in the comfort of your own home or apartment. Because of nerves or other variables, students frequently score lower on the actual test day.

FAQs – How hard is USMLE Step 1?

Is Step 1 the hardest exam?

On the basis, it appears to be similar to any other standardized exam, but tell that to a medical student and they will shudder. People have unofficially claimed that USMLE Step 1 is the most challenging and important of the three parts of the USMLE series.

How hard is it to pass Step 1?

According to the NBME/FSMB, in 2022, the passing score for Step 1 was 194, with approximately 60% of all questions successfully answered.

Is it easy to just pass Step 1?

The truth is that Step 1 is still a monster of an exam. It is without a doubt the most difficult of Step 1, Step 2, and Step 3. This exam’s raw body of knowledge, along with rote memorization, far vastly outstrips any other exam a medical student has taken or will take until their medical boards.

How long should you study for Step 1?

Start thinking in terms of hours rather than days, weeks, or months when planning your USMLE study schedule. Students taking the USMLE Step 1 exam should focus on studying for at least 500-600 hours or 10 hours a day for 6-8 weeks.

What is the highest USMLE Step 1 score ever?

Although the USMLE program does not disclose how the three-digit score is calculated, Step 1 scores theoretically range from 1 to 300, most examinees score between 140 and 260, the passing score is 196, and the national mean is approximately 232 and the standard deviation is approximately 19.

What happens if you fail Step 1?

If you fail the USMLE Step 1 test, you can take it again up to six times. Within 12 months, you can only take Step 1 three times. Your fourth and later tries must take place at least 12 months following your first try. They must also be at least six months after your third attempt.


With so much depending on your success in the USMLE, it’s possible to feel nervous as the first section of the exam series approaches. However, you now know the answer to the question “how hard is USMLE step 1?” You also have some expert recommendations and a better idea of how to study for Step 1 thanks to this.

Don’t forget to take our free USMLE practice test at Medtutor to get familiarized with the format as well as the questions of the actual exam to strengthen your knowledge and skills, as a result, enhancing your chance to pass the USMLE exam with a high score on your first attempt. Good luck to you!


Is USMLE Hard? 10 Study Tips to Pass the USMLE 2023

Is USMLE hard? This post includes the reasons why the USMLE is that difficult as well as 10 useful study tips to pass the USMLE exam. Check them out!

June 13, 2022

The USMLE, or United States Medical Licensing Examination, is a three-part exam that is necessary for a medical license in the United States. In other words, if they wish to practice medicine in the United States without supervision, all medical students, foreign or domestic, must take the test.

Is USMLE hard? The test is well reputed for being one of the most difficult in the world. Medical students who have already completed the three steps tremble at the prospect. Why is that? It’s a long test that needs knowledge of more than ten different medical specialties. Let’s take a quick look at the different components of the test.

is USMLE hard

What are the three steps in USMLE?

The USMLE is a three-part exam that takes a long time to complete.

The Step 1 exam, which is the most difficult of the three, lasts 8 hours and is divided into eight portions. A computer delivers 40 multiple choice questions in each part or block. The 280 questions include anatomy, biochemistry, behavioral sciences, microbiology, immunology, pathology, pharmacology, and physiology, among other topics.

The Step 2 exam is broken into two parts and takes two days to complete. The first is the USMLE Step 2 CK (clinical knowledge) exam, which assesses a student’s knowledge of clinical sciences such as surgery, internal medicine, pediatrics, obstetrics, and gynecology. It lasts 9 hours and 45 minutes, including a 45-minute break. The test is divided into eight sections, each of which has no more than 40 questions.

The second part is called USMLE Step 2 CS (clinical skills), and it is not a multiple-choice test like the first. Instead, students must evaluate and diagnose patient-like actors in a realistic setting. Students must effectively diagnose and treat the patients using their clinical expertise. The test lasts eight hours, with a 50-minute break in between.

The USMLE Step 3 exam is the last section of the examination. It’s also a two-day test, with the first session lasting 7 hours and the second session lasting 9 hours. Between the two days, there are a total of 500 questions. The test’s last phase assesses if a student is ready to practice medicine in a professional setting without supervision.

Is the USMLE exam hard?

Is USMLE the hardest test in the world? It’s hard to say whether the USMLE is the most difficult test in the world because one would have to compare hundreds of tests from throughout the world. However, the USMLE is unquestionably one of the most difficult exams in the world.

Anyone who has studied the test structure, format, number of questions, time limit, and, most importantly, the material will agree that the USMLE is not an easy exam.

Let’s go through “how hard is the USMLE” and some of the major reasons why the USMLE is one of the most difficult exams in the world.


The first and most important reason for the USMLE exam difficulty is its length. Consider this. The test is divided into three sections. Two of the three processes take two days to complete, and each step takes at least eight hours. On top of that, you only get a 45-minute break in the middle of it all.

Not only is this mentally difficult, but the sheer number of questions is also an issue to consider. There are several hundred questions in each phase of the exam, and there is no certainty that the questions will follow a topic. The test includes a vast list of subjects, and questions might be on any of them.

Substantial Syllabus

The scope of topics covered by the USMLE exam is astounding. To grasp the immensity, we don’t even need to consider the entire exam. Students must prepare for eleven disciplines in Step 1 of the test alone:

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

Steps 2 and 3 have their own content requirements and cover tens of disciplines. It should come as no surprise that handling such a large number of issues is incredibly tough.

Preparation time aligns with Medical School requirements

You could believe that studying for the test is easy since you can study for hours each day. The main issue is that USMLE step 1 is required at the conclusion of your second year of medical school. This implies that you must prepare individually for the USMLE on top of your medical school’s already rigorous study schedule.

You can imagine how tough it would be to balance all of that, especially if you had any jobs or internships. Students in their fourth year of medical school frequently take the second step of the test. The second step has the same set of challenges as the first. How about the final step? The third step is performed after the first year of residency, therefore you’ll have to study for it while completing your obligations as a resident.

Multiple-choice questions that are tricky to answer

Most people who have taken the SAT or GRE believe that multiple-choice questions make the test more convenient. This may be true of other standardized examinations, but not the USMLE.

Sure, you must choose from a set of options, just as in any other MCQ test, but the options are all very near to being accurate. Furthermore, the questions are meant to deceive you into answering erroneously because all of the options look to be right. This reality is exacerbated by the time limitation. You have just over a minute to read the question, consider it, and then select an answer.

How to pass the USMLE exam 10 study tips for Step 1, Step 2, and Step 3

The following study suggestions will help you improve your test score and performance percentile whether you’re taking the USMLE Step 1, Step 2, or Step 3.

We’ll go through 10 study ideas that can help you prepare for the USMLE.

In the conclusion, there are three additional tips!

Let’s get going!

Tip 1: Make and follow your study plan

The first point to remember is to make your personal study plan.

The USMLE covers a wide range of topics and having a study plan can help you stay on track and prepare for all of the information that will be assessed. Your study plan will keep you organized by reminding you of which topics to study on which days when to take practice examinations, and when to take vacation days.

During your allocated USMLE study session, your study plan will be employed largely. On average, students devote 4-6 weeks to studying for the USMLE.

You may need more or less time to prepare for the exam, so trust your instincts about how much time you’ll need.

Bonus Tip: Keeping up with the content studied throughout your first two years of medical school can help you prepare for the USMLE.

is USMLE hard

Tip 2: Start with the material you don’t know

The second piece of advice is to start with the material you don’t know.

While this may seem self-evident, it’s easy to fall into the trap of wanting to study stuff you already know since it gives you confidence. Focus on neurology first if cardiology is one of your stronger courses but neurology has been a topic you’ve struggled with.

Starting with your weak topics may make you feel unprepared or ignorant, but keep in mind that you are starting with the things you are least familiar with on purpose.

This is a good opportunity to figure out your weakest points since you will be most motivated and active at the beginning of your study session.

Going with your trouble points will allow you to spend more time reviewing and recalling them throughout your academic career.

This repetition will aid memory retention.

Tip 3: Practice makes perfect

Third, complete as many practice questions as you can, especially during your designated USMLE study session.

Completing practice questions has been proved to be one of the most effective ways to prepare for the USMLE.

There has previously been data that suggests that completing more practice questions corresponds with a better USMLE score.

UWorld is an excellent resource, but you are free to select the question bank that best suits your needs.

Practice problems may start as soon as your first 2 years of medical school; however, they are critical throughout your dedicated study period.

Although answering practice questions is beneficial, it is also vital to examine the exact answers to each question as well as the reasons for each answer choice.

This leads us to the fourth point.

Tip 4: Go over each answer choice’s explanation

The fourth piece of advice is to go through each practice question’s answers as well as the explanations for each answer choice, including erroneous ones.

It’s just as crucial to understand why one answer option is wrong as it is to know why another is accurate. You’ll also be capable of learning a variety of high-yield topics in a specific question.

If the question asks you to recognize the diagnosis, for instance, you can read the explanation to understand more about each situation listed as an answer option.

You can use various resources to improve the explanations if you need to go over the subject again.

Tip 5: Mark incorrect practice questions and go through them again

The final technique is to keep track of which practice questions you get incorrect and which questions you get right but had to guess on.

You’ve now established a question bank using the information you missed on your first attempt. Read through all of the marked questions once you’ve walked through the whole question bank for the first time.

Re-flag the problems you continue to get wrong on the second attempt, then repeat the exercise. If time allows, you will eventually know the bulk of the question bank.

Tip 6: Use practice exams to simulate the actual USMLE

The sixth recommendation is to take practice tests, also known as self-assessments, to replicate the actual USMLE.

The NBME and UWorld self-assessments are quite similar to the USMLE, although you are free to use any other practice test site.

During your devoted USMLE study session, you should strive to take at least three self-assessments.

When you finish most self-assessments, you’ll get expected results and a breakdown of your weak and strong subjects.

This data will provide you with helpful feedback and allow you to make any required improvements to your studies.

Additionally, practice tests can help you build endurance and stamina for the actual USMLE, which has 280 questions (for Step 1).

Tip 7: Limit your use of your cell phone and social media

Limiting your mobile phone and social media usage is our seventh recommendation.

We sometimes underestimate how much screen time we spend on our phones each day, and it soon adds up. Distractions might reduce our effectiveness over time and cause us to miss our daily learning objectives.

Put your phone in airplane mode or put it in another room if feasible. It is permissible to keep your phone with you if you have an urgent need to do so. Use your phone and social media during breaks, which leads us to our next point.

Tip 8: Take a break in between studying sessions

Take pauses between study sessions, which is the ninth recommendation.

You can study the topic for the day in the morning, complete practice questions in the afternoon, and review the knowledge learned that day in the evening.

Between each study session, make sure to take a rest. You can exercise, move outside, snooze, meditate, watch TV, catch up on texts, use your phone, or do whatever else you want during this time. This will assist you in recharging and is also beneficial to your physical and emotional wellbeing, which leads us to our next suggestion.

Tip 9: Maintain your emotional and physical well-being

The ninth suggestion is crucial. Make sure you look after yourself.

Studying for the USMLE can be difficult, and it frequently necessitates devoting time away from family and friends.

Maintain your physical and emotional well-being. You can boost your overall health by going to bed as well as getting up around the same time daily, eating properly, exercising, relaxing, or doing anything else you enjoy on a regular basis. During your designated study period, you should also take three full days off.

On your day off, you can spend much more time enjoying things you like, including visiting your relatives, talking with friends, shopping, hiking, or doing anything else.

You should take the remainder of the day off after each NBME or practice exam.

Tip 10: Make a list of what you don’t know and review it every night

The final advice is to have a notebook with you when studying and jot down quick one-liner notes as you come across facts you don’t remember.

The facts you are less familiar with will be committed to memory by reviewing this notebook each evening.

3 Extra Tips for the USMLE

Here are three more tips to help you prepare for the USMLE.

Change up where you study. Changing your surroundings, instead of studying all day in your room might sometimes assist you to get more and more productive (as long as it does not distract you too much).

Make no comparisons to others. You may study differently than others and progress at a different rate. We all learn and study in various ways, so do what makes you feel most comfortable and trust yourself.

Select the USMLE materials that best suit your needs. At least one primary resource, such as First Aid, a practice question bank, and three self-assessments, should be used.


Is USMLE hard? The answer is yes.

To summarise, the USMLE is difficult. The tried-and-true strategies of doing a lot of practice questions, studying early and effectively, and using high-yield test prep materials will all help you succeed.

With our 10 helpful study tips for three steps of USMLE, you will have a clear study plan and full confidence to ace the exam.

Save time, improve your scores, and grow in your profession!

Let’s get started with our free USMLE practice test to pass your actual exam with a high score on your first attempt.


USMLE Score: What Should You Know About USMLE Passing Score?

USMLE score is always a topic of interest for many USMLE candidates. Right now, let’s follow this article to find out beneficial information.

June 13, 2022

USMLE score and its changes raise a competitive debate among the community, especially among those who want to take this medical exam. So what should you know about the USMLE score range and USMLE passing score? Let’s begin with us!

USMLE score

USMLE Scoring

After taking the Step 1 test, students are now given a pass or fail grade on their performance. The United States Medical Licensing Examination (USMLE) transitioned out the utilization of a percentile-based scoring function in preference for a three-digit and two-digit adjusted scorecard in 1999. After October 2011, two-digit adjustments were not published already to any parties other than the examinees who took the test. It was announced in April 2013 that the two-digit score will be fully removed from the score report.

However, while the United States Medical Licensing Examination plan does not reveal how the three-digit scoring system is determined, Step 1 rankings philosophically range from 1 to 300, with the majority of examinees scoring in the range of 140 to 260, the passing score being 196, and the nationwide standard deviations being approximately 232 and 19. Following the National Resident Matching Program’s 2016 results, a mean score of 233.2 was achieved by conventional medical seniors in the United States who were assigned to residency training.

In 1994, the median Step 1 score for candidates remained 200, but the average score in 2018 was 230, a significant increase. For example, a score of 200 would position the test taker in the 9th percentile in 2021, but a score of 230 would have placed the examinee in the 93rd percentile in the same year. It was initially decided that an overall mean of 200 with a confidence interval of 20 would be used for the USMLE scoring system. It is important to note that the measure has never ever been reset, therefore a score of 200 in 1994 represents the same amount of controversy as a rating of 200 in 2021.

Until the USMLE Step 1 exam is changed to a pass/fail format (at the earliest, in January 2022), your Step 1 score will continue to have the same weight as it did before as a determining element in your residency application. Step 1 scores are now utilized as an objective criterion for determining eligibility for admission to (or exclusion from) certain specializations or programs. This weight will most likely move to your Step 2 CK score if Step 1 becomes pass/fail, but Step 1 will remain to be significant since the USMLE® is contemplating mandating a passing grade on Step 1 in order to proceed to Step 2 in the future.

Two modifications to the United States Medical Licensing Examination Step 1 might occur at the same time in early 2022. First and foremost, the publication of Step 1 scores will be limited to pass/fail exclusively for administrations occurring from now through January 26, 2022. Second, in accordance with best practices for licensing and certification tests, the USMLE program examines the lowest passing grade of each Step exam every 3 to 4 years as part of its quality standards for registration and licensing exams. As part of the usual review process for the minimum passing score for Step 1, which involves extensive input from authorities.

In addition, medical instructors, and subject matter experts, the Step 1 minimum passing score is now being reviewed. Regardless of whether or not the USMLE Management Committee determines that a modification to the minimum passing score is necessary, the change will become effective for examinees who take Step 1 on or after January 26, 2022. While the date of the regular review process and the impending change to pass/fail scoring reporting may coincide, the standard review procedure is unconnected to the upcoming shift.

What kind of score do you want to get on Step 1? The quick answer is that it is dependent on the situation. The current passing score for Step 1 is 194, which is the bare minimum. The score you would aim to get, on the other hand, might be anything from 238 and 251, based on the level of competition in your selected specialization. Medical specialty, family practice, anesthesiologist, and diagnostic imaging were the extremely highly specialized courses for MD graduates in the United States in 2020, according to the Bureau of Labor Statistics.

Those specialties with the highest matching scores had a Step 1 score range ranging from 220 to 249, and the proportion of first-year residents who were linked within those categories in 2020 was between 60% and 66%.

Due to a large number of specialty choices available, there are also a large number of possible score ranges to strive for. Prior to beginning your devoted learning time, be sure to do some preliminary research to see if or not your target range corresponds to the requirements of your chosen specialty. An average USMLE score ranging from 230 to about 245 is generally regarded as acceptable, while a score between 245 and 255 is often considered particularly excellent, according to certain sources.

USMLE passing score changes

USMLE Step 1 will convert to a Pass/Fail rating system no earlier than January 2022, according to an announcement made on February 12, 2020. The passing grade score for the USMLE has been raised as a consequence of the various increases in the average and interquartile range USMLE results from the year 2003 up to now; self-governing studies have found that practitioner conversation usage was conscientious as a full implementation component of UWorld, or Kaplan conversation banks, or self-assessments. For Step 1 examinations conducted before January 26, 2022, the USMLE has decided that three-digit score results “remain to be recorded via the three-digit numerical number on all USMLE publications.”

Residency programs’ use of Step 1 scores

The medical profession has blasted the USMLE and residency programs for establishing a “barrier that was never supposed to exist” by utilizing Step 1 results as the primary screening mechanism in choosing candidates for a residency interview. Overweighting a screening test, which is not backed up by evidence and in which the exam was not created, is a common practice among residency managers.

Step 1 was intended to be a Pass/Fail test, and the grades were not supposed to imply anything beyond that. Resident program directors use scores to reduce the number of major applicants to a reasonable size so that they may conduct a more comprehensive evaluation of the surviving submissions. Many residency program administrators fear that the switch to Pass/Fail may exacerbate the difficulty of “applicant screening.”

USMLE score

In the last several years, a three-digit numerical score on the test has been utilized as the primary factor in determining whether or not a medical interview is granted. Step 1 score has been mentioned by residency program administrators to be their most essential criteria for choosing graduate practitioners, notwithstanding the absence of evidence or statistics to support such practice. In Charting Outcomes in the Match, you may see the average USMLE Step 1 scores for different residency programs.

Researchers concluded that “Step 1 is not exact nor does it indicate academic achievement above a particular threshold.” Since the usual error for cutoff scores is just around eight points, there may not be much of a difference between two candidates with scores that varied by up to a factor of 15. Among the numerous reasons for the USMLE’s decision to return to the Pass/Fail assessment of Step 1 starting in 2022 is the detrimental effect on student learning, expense, egregious wasting of student time, and an effort at reducing racial prejudice.

Unanticipated outcomes

During their preclinical program, students began preparing for Step 1 and raised the complexity of their coursework to a maximum of 11 hours per day for a month before the test. Their medical school curriculum was often ignored in favor of 3rd-party study resources. Despite the fact that this “parallel curriculum” resulted in an elevated Step 1 score, individuals were often missing lectures and courses.

Discrepancies in USMLE passing scores based on race

Efforts to reduce the Step 1 score hurdle that adversely impacts certain cultural/racial groups have been made since 2001 “Students from underrepresented populations in medicine are at a disadvantage when residency application is screened based on Step 1 results.” Step 1 results for black and Latino pupils are much lower than for white students. [25] White candidates’ mean USMLE Step 1 scores (223) were much higher than those of black and Hispanic applicants (216). An African American was anywhere from three to six times less likely to be given an interview than a white person with the same score.

“When Step 1 results were used to evaluate candidates for interviews, a considerably larger percentage of Black students have rejected interviews,” found a 2001 research in internal medicine residency. Between 2005 and 2014, Black and Latino candidates were admitted into residency programs at a much lower rate (61 percent) than white applicants in orthopedic surgeon residency training, according to a 2019 research (the profession with the lowest number of minority students) (71 percent ). Disadvantaged and marginalized learners are more likely to choose specialties with lower Step 1 cut-offs including Primary Care, according to further research.

Reducing racial prejudice by modifying Step 1 to pass or fail was approved by the American Academy of Family Physicians and the Association of American Medical Colleges. Step 1 becoming Pass/Fail will mitigate the severity of race-based as well as other biases on residency selection, according to the AAFP. Factors that impact educational experiences with standard testing.  Change in scoring to Pass/Fail was advocated by the American Medical Student Association in an effort to lessen the harmful effects of USMLE achievement in residency selection and the accompanying racial prejudice.

How to maximize your USMLE score?

Test yourself as often as you can

The most important piece of advice I can give you is to constantly question yourself. Truly. Be creative in how you test yourself on new information, for example by covering over a table in First Aid and asking yourself what you believe every row and column should include.

It is more likely that you will remember the information in the table if you ask yourself a question about each element in the table rather than simply reading it as a statement. This method makes it more likely that you will remember the information in the table. It also makes it more likely that you will forget what you learned from the table in subsequent attempts. It’s at this point that the brain pathways that you engaged in quizzing yourself the first time are reactivated and reinforced when you try to remember or study the same knowledge.

Take use of active learning methods

According to adult learning theory, this kind of hands-on learning is essential to enhancing comprehension and memory. What motivates students to engage in active learning? Recalling and integrating knowledge from different disciplines. Instead of passively taking notes, underlining, and hoping facts stick in your mind, forcing yourself to try to fill in the blanks forces your brain to become more active and memorable in identifying what you know and don’t know.

This allows you to create “holes” in your mind frame into which you can incorporate relevant material, increasing the likelihood that it will stick around.

Be realistic about your schedule

A common issue students have is whether or not to postpone their Step 1 examination. Exams may be postponed if students are consistently below their target NBME results. A student with a lot of freedom in their academic pursuits and who may not have prepared properly may be able to justify this. For example, if a student hasn’t had time to review all of the necessary materials, I typically advise them to postpone their test date. Step 1 should not be taken if you have not finished at least one full pass of UWorld. Finishing the question bank and all of the essential materials generally results in considerable increases in students’ NBME scores.

On the other hand, if your NBME results have been below your target after going through the essential resources many times, it may be time to re-evaluate your objective score (see below). A student may not be able to sit for the test if he or she misses the deadline set by his or her institution, and it may even harm the student’s score.

Develop your hobbies in a genuine way

With your hobbies and passions in mind, you may have decided to go into medical school with a certain concentration in mind, or you may still be debating which direction to go in the future. Make the effort. Find out what motivates and inspires you to pursue a career in medicine. If you need to sample and investigate, then focus your recreational activities on this topic. Always plan ahead of time and resist the temptation to try to accomplish it all. A narrower focus may help you achieve your professional objectives while also helping you to stand out from other applicants while submitting to residency training.

It’s important to prioritize your clinical studies so that you can deliver the best possible patient care, according to Lisa Willett, MD, director of the program at the University of Alabama at Birmingham’s Marnix E. Heersink School of Medicine. Then become involved in things outside of school that you’re really interested in. Rather than volunteering in hundreds of lesser activities, it’s best to dedicate time to a few key ones – possibly even working in the management or capabilities of the organization.”

Attend the preclinical training program

Focusing only on Step 1 has caused some medical schools to overlook a number of important characteristics that are not tested on the exam, such as clinical skills and communication. After completing your preclinical education, you’ll be able to devote more time to the other critical aspects of being a physician that residency programs (and patients) are looking for. There is no doubt that programs are looking for pupils who do have the required health skills and knowledge in order to apply it — but they are also looking for students who demonstrate teamwork; are capable of both leadership and follower roles; have high professional identities.

Your tale should be crafted

For me, the most rewarding part of being an academic advising director is trying to get to know each and every kid. As we eliminate the Step 1 score, but as some institutions have now transitioned to pass-fail assessment in preparatory programs as well as the clinical curriculum, properly articulating your narrative to residency programs is increasingly more crucial. What are the best ways to document your own interests and growth?

Important to take stock of your hobbies and activities and look for commonalities. In what ways do you excel? Why might a residency program director be interested in learning more about you? An adviser or mentor may often assist you to shape your tale or perhaps finding themes that may not have been recognized.

USMLE score

During our meeting to discuss Chris’s residence application plan, he remarked, “Well, I’ve done a variety of interesting things and I can’t find a way to connect them.” When we sifted through his extracurricular activities, we found that he was correct: He had accomplished a lot. It was only after working together that we discovered that his ability to recognize and then solve problems in medical systems, clinical services, or community was an underlying theme in his work. He had a knack for coming up with new ideas.

Take care of yourself

Medical student well-being was one of the primary reasons Step 1 was changed to pass/fail grading. When it comes to medical school, several students have regarding their first year as the worst moment in their whole life. Medical students already suffer from emotional exhaustion, anxiety, and stress, so eliminating the test altogether is a welcome relief.

Taking care of yourself, spending time with friends and family, or scheduling appointments with your medical or mental health care providers is a great way to mark the shift. You’ll need to know how to take care of yourself for the remainder of your professional life. If we don’t look after our own needs, how can we look after others?

Change up your study materials for the NBME

Even if you’re doing well with your studies, you might want a different experience from time to time. Reading the same material again and over might lead to a lack of retention, even if the material is high-yield and well-reviewed for the test. Attempt to learn 1-2 new things every hour, and assess your progress at the conclusion of each session. Make a list of these details on a piece of paper or a flashcard.

Your NBME practice exams should be spread out

Practice tests may not be sufficient time apart for you. A significant enhancement, but not a significant one, may be expected in a week’s time. If you take 2 preparation examinations within a week, you may anticipate your results to remain the same (or possibly decrease). To avoid this, attempt to space out your exams as much as possible. However, if this is the case, you may take your exams near each other (just don’t anticipate an improvement from 220 to 260!).

Study for the NBME practice test

Make sure you don’t make the same errors over and over again by properly reviewing your practice exams. To assess your progress and to absorb a lot of useful, testable knowledge, practice examinations are essential. By properly reviewing the test, even if you aren’t satisfied with your results, you may still make progress by analyzing your strengths and flaws. Even if you don’t get the grade you desire on the NBME, you can be certain that you learned a ton in the process.

FAQs about USMLE score

When will I get my test score USMLE?

Every Wednesday, test takers may see their results for Step 1, Step 2 CK, and Step 3. Results for test-takers who took the exam between three and four weeks prior to the release date will typically be included. But there are a number of circumstances that might postpone the delivery of an individual score. Most of these issues will be rectified in the following weekly cycle, and a new score will be published in their place. You will be notified immediately when your result is made public by your registration agency.

NBME or ECFMG for Steps 1 and 2, and FSMB for Step 3 will publish your results on the secure website of your registration body after they have been made public. If eight weeks have passed since your test date and you’ve not received your report card, please get in touch with us so we can check on its progress. Please keep in mind that fresh scores are not published for the week of July 4th or the final week of December, respectively.

Why do the Computer-delivered examinations take 3 to 4 weeks to score?

To ensure that the USMLE tests are processed and scored in a secure and correct manner, a variety of quality control measures must be followed. Monitoring testing facility records for difficulties with the delivery of tests and suspected security breaches as part of these processes. The preponderance of test-takers finishes these procedures within 3-4 weeks.

Is there a current breakdown of the Steps pass rates?

Content-based standards for qualifying indicate that as many as 100 percent of applicants might potentially pass, or as few as 0.01 percent. In this case, the number has not been randomly set. In the same way, the passing percentage might vary from year to year and amongst authorized medical schools in the United States. For each Step, the most recent performance statistics are accessible for first-time participants and repeaters.

What percentage of medical school students have passed the Steps?

In the United States, NBME exclusively reports medical school results to particular schools, and that information is only accessible from those institutions. Graduate practitioners and graduates from overseas medical institutions are evaluated by the ECFMG.

Can I improve my score by retaking a Step that I have passed?

Retaking Steps and Components after passing them is not permitted unless to meet state board criteria that have been previously authorized by USMLE governance. When a medical licensing authority sets a time constraint for the completion of all Steps, or when another authority recognizes the USMLE program for this purpose, you may be able to take back a passed Step.

As long as you’ve passed all of the USMLE steps, including Step 3, and you’re qualified for licensure in this jurisdiction, your medical licensing board should give documentation of your status as a license candidate and your completion of the whole USMLE test series, comprising Step 3. The ECFMG Interactive Web Applications provide information about test retakes authorized to meet their criteria (IWA).

Steps Components that have already been passed may only be retaken whether a medical licensing body has set an expiration date for the test. Exceptions to this rule may be made in the following situations: Your undergraduate medical program has been accredited by either the LCME or AOA; you have earlier completed Step 1 and/or Step 2 but still haven’t completed Step 3; you are 6 or more years away from graduating from the undergraduate medical program; and that you are otherwise qualified to repeat the test.

What is the procedure for obtaining a copy of my USMLE score report?

Please feel free to contact one of several USMLE registering bodies if you need your report or if you want it forwarded to a third party. Depending on the steps you’ve done and the location to which you need your transcription delivered, you’ll need to contact the appropriate institution.

How can I request a transcript of my USMLE scores?

You may request a transcript from the FSMB at any time and it will be transmitted to the appropriate medical licensing body. If you need a transcript delivered to a person besides a medical licensing authority but have not enrolled for or completed Step 3, contact the ECFMG or the NBME, the organization that enrolled you for Steps 1 and 2.  All inquiries for the USMLE transcript should always be made via the FSMB after you have registered for or taken Step 3.

Does anybody else view the score report?

This report is for your private use only. In order to have an official record of your USMLE results sent to a third party (such as residency programs), you must request that your registration body deliver the transcript to them. Medical schools may acquire test results, including grades and pass/fail status, for their students under certain conditions.

Above is all information related to the USMLE score. We hope that this article can help you ace this test.

Let’s get started with our free USMLE practice test to pass your actual exam with a high score on your first attempt.


USMLE Step 1 Test Day Tips You Should Know

USMLE Step 1 test day tips are essential for almost all test-takers during the process of acing this exam. Follow this article to find out beneficial information.

June 10, 2022

Even the most composed medical students might get anxious before taking the USMLE Step 1 exam. The majority of people have two or three years of study behind them before taking tests, yet it is no minor undertaking to sit for the examination. Medical school admissions officers use the results of the USMLE Step 1 test to determine which sorts of specializations and graduate schools you are eligible to apply to.

When studying for the 8-hour exam, it’s critical to be aggressive and examine topics well in advance of the actual test day. The following USMLE Step 1 Test Day Tips can assist you just before you take the USMLE Step 1 examination.

usmle step 1 test day tips

What should you consider before taking the USMLE Step 1?

It is likely that you will frequently hear about this test as you go through your first two years of medical school. Because the amount of knowledge available might be daunting, we’ve broken it down into five fundamental components that you should keep in mind as you begin preparing for Step 1.

Recognize the significance of the first step

It’s no surprise that the path to becoming a doctor is a grueling series of tests and examinations. However, medical students will almost always find their lecturers referring to the USMLE Step 1 and Step 2 tests as the most essential set of exams they will ever take in their careers. NRMP recently conducted a survey of program directors for the 2021 academic year, and the results revealed that USMLE grades are some of the most important factors residency directors examine when considering applicants.

In the words of Dr. John Madden, an emergency physician at the St. George’s University (which is popularly known as the SGU for short) School of Medicine, “your achievement on Step 1 will evaluate whether or not you will be interrogated for such a specialized area that you really want to undertake.”

On the USMLE Step 1, you will be evaluated on your understanding and ability to apply major scientific topics that are fundamental to the practice. There is a strong focus on the concepts and processes that underpin health, illness, and therapeutic approaches. A medical student’s chances of passing this test during their first try are significant since it indicates their understanding and application of fundamental scientific ideas, as well as their solution to handle issues via the implementation of those fundamentals.

The test will last approximately eight hours and will consist of multiple-choice questions. A modification to the passing criteria for the USMLE Step 1 exam was implemented in January 2022, with a pass/fail point system replacing the previous pass/fail method. The current average score for the SAT is 196 or above out of a potential 300 points. The USMLE Step 2 test continues to be scored numerically, and it is usually assumed that medical school directors would pay particular attention to this number throughout their application evaluation.

Begin studying as soon as you are accepted into medical school

When it comes to USMLE prep, the last thing you want to do is prepare for the exam the night before. Preparation for the Step 1 test might take a substantial amount of time due to the vast quantity of material covered at this portion of the examination. Consider the fact that you’re preparing for marathons, not a sprint while deciding how to prepare for Step 1. There are so many resources available to you, and so much knowledge to learn, that it might be difficult to cram all this into just a very few weeks of study.

Students normally take the USMLE Step 1 exam towards the conclusion of their 2nd year of med college, but it’s a good idea to start studying for it as soon as possible after graduation. What Dr. Madden tries to convey is that “studying should begin effectively during the first week of medical school,” and that this should continue during the vacation and holiday period.

Getting a head start on your USMLE Step 1 preparation by preparing ahead of time will allow you to have a better understanding of all you will be required to study for the exam. If you have the opportunity to begin allocating time some weeks or months before your designated course of the study, this may be really beneficial for you.

It is important to remember that the USMLE Step 1 will be evaluating you on the content you are supposed to master throughout your first two years of higher education, so having your USMLE Step 1 preparation at the forefront of your mind while you go through those courses might be beneficial. The following is an explanation from Dr. Chirag Shah, an emergency room doctor: “Studying USMLE content while completing the core programs gives an additional perspective that will help you better understand and prepare for the exam months before the real study process has started.”

The process of building a solid foundation of understanding over a predefined time frame might be far more doable than attempting to learn everything in a short amount of time. Consider this: If you begin your USMLE Step 1 prep six months before your designated time, taking a whole cycle of UWorld may be completed in as little as 15 questions per day on average. In comparison to the enormous hours of learning that are necessary during a few-week devoted period, this is far more tolerable for several learners.

Specific resources may differ depending on the student support services provided by your medical school, although some institutions provide students with access to USMLE preparation materials. For illustration, SGU provides its students with access to a variety of prominent USMLE preparation topic banks, some of which are integrated directly into the degree program. Students may use this information to assess which topics they have comprehended and which ones may need further attention.

If you begin early, you may find that you are less worried when you finally reach your designated time period as well. Having finished one cycle of UWorld before beginning my devoted study period, I was able to have a much more enjoyable and reasonable encounter in the few weeks I spent preparing for the USMLE Step 1.

Make use of the materials that are appropriate for your learning style

Throughout your USMLE Step 1 prep, you’ll come across a variety of suggestions for books to read, study plans to follow, and other resources. However, the reality is that there is no “one-size-fits-all” solution that should operate for everyone.

Because every student has a unique learning style, you’ll need to figure out how you’ll effectively assimilate new information in order to succeed. Dr. Madden points out, for instance, that certain individuals get themselves into academic problems when they believe they are better at studying on their own.

It is possible to examine a range of study guides and other materials on your own; however, he recommends joining a peer study group if you feel you work more effectively with some supervision or in the presence of others. You may also enroll in a live reviewing program, which Dr. Madden points out is provided by a variety of vendors on the internet.

usmle step 1 test day tips

Maintain your focus as you prepare for the USMLE Step 1 examination

If you’re not paying attention to the subject, following a strict study plan won’t make much of a difference. So, how then can you know whether you’re keeping up with the Joneses? This may be accomplished most effectively by keeping track of your marks and class standing.

Because the USMLE Step 1 exam covers the topics you’ll be studying in your first couple of years of higher education, your educational success will be a good reflection of your overall understanding of the content. If you discover yourself experiencing academic difficulties at any stage, you’ll want to address the situation as quickly as possible.

As the deadline for your test approaches, plan how you will spend your time. You may be unable to complete any last arrangements if you are distracted by too many things. Doctor Shah recommends that people prepare for the test as they would for a triathlon, by limiting their social engagements in the days coming up to the exam.

Take advantage of the USMLE practice examinations available to you

One of the most successful USMLE preparation recommendations is to complete as many practice examinations as possible before the exam. This is the most accurate method of simulating what the actual procedure will be. Taking the National Board of Medical Examiners (which is also known as NBME for short) practice examinations is highly recommended by several medical students and instructors since they are created to the same requirements as the United States Medical Licensure Examination (USMLE).

It is important to keep in mind, however, that your result on a practice test may be a little higher than it really is. For Step 1 practice tests, Dr. Madden recommends that students remove 15 to 20 points from the results they get while studying in their own homes or apartments. He notes that it is usual for pupils to do worse on the actual exam day as a result of nervousness or other influences.

Common USMLE Step 1 Mistakes

Not sleeping enough

To prevent the first error completely, you may do it while you sleep (bad pun). In the week leading up to your Step 1 test, you should get at least seven hours of sleep. If you want additional study time, it may be helpful to cut down on your nighttime sleep or take more naps throughout the day. Studies, on the other hand, reveal that this is not the case.

Since your circadian clock (which regulates your snooze cycle, hormonal releases, and other biological processes) might take a lot of time to settle into a regular, sleep is essential during your whole studying or working. Make the move to a good sleeping pattern before the examination day.

Prior to the big day, cramming everything in

You’ll get the same reaction from each marathon coach: “you’re insane” if you run a marathon the day before. Training is all about being prepared, not finished. A day before the exam, don’t try to study all you didn’t already know about medicine!

Since you’ve been learning 4 hrs per day, begin to reduce your study time to ten hours a day, and subsequently to 8 hours a day. When you’re cramming for a test, you’re increasing your stress levels, which is more crucial than the amount of time you spend studying. There is evidence to suggest that cramming the night before an exam might negatively impact your long-term memory recall and decision-making abilities because it overloads your short-term memory with unnecessary information.

For illustration, once you study medicine the day before the examination, your brain will automatically gravitate toward diabetes-related responses. Take a whole day off to recharge your mind and avoid cramming!

Making yourself a prisoner in your own home

Even though your future hinges on passing the Step 1 test, this does not imply you should spend all of your free time studying for it. Getaway here! Take a few minutes in the morning to do some gentle exercise. You would not want to overwork yourself, but boosting your pulse rate via aerobic activity is beneficial. Endorphins will be released, which will improve your outlook and give you greater self-assurance. Additionally, it will improve your quality of sleep. Try walking, running, cycling, or hiking as a form of physical activity.

In addition, make an effort to spend more time outdoors while studying. To break the monotony of gazing at your smartphone or computer for days, give your eyes a break! Find a place where you can sit back and enjoy the scenery while allowing your thoughts to wander.

Avoiding all forms of media

You may have previously given up watching television when you were in school as a sign of your perseverance and drive. That’s nearly commendable. Sometimes you just need a little “me” time to recharge your batteries. Don’t deny yourself a treat every now and then if you like watching television on a regular basis. As a pre-test distraction, some students even like watching films.

In contrast, you don’t want to see a film that will leave you thinking too much after you’ve finished it. Avoid watching programs or movies about automobile crashes, soldiers dying in battle, or love triangles that will stick with you the next day. Pick something mindless to watch on TV if you’re going to do it.


Many learners make the error of relying on caffeine and Red Bull to keep them awake during the Step 1 test. Stupidity! Caffeine may be avoided on test days because some students believe it may impair their efficiency. Yet another blunder!

It’s a fact that you should cut down on your caffeine use. In the days preceding up to the test, try to reduce your coffee consumption, or at the very least maintain your current intake. Don’t increase your calorie consumption on the day of the event. Before the test, you shouldn’t be making any major modifications to your nutrition. Avoid coffee after 4 p.m. if you want to get a good night’s rest.

Step 1 may feel like the end of the road, but it isn’t. While it may be tough to look beyond this obstacle, it doesn’t mean you shouldn’t begin making preparations for the period after your test. Having an enjoyable post-exam activity in mind can help you stay motivated. Taking a break from studying might be a welcome change of pace. Plan an enjoyable activity with a network of people to keep the goal in mind.

Using an excessive amount of resources

Students who do not pass Step 1 often make an effort to use all of the resources available for Step 1, but they do not use both of the most important resources to their full potential (namely, First Aid and UWorld). It is possible that becoming distracted by resources with a lower yield will make First Aid and UWorld less useful. First Aid is essential knowledge to have in UWorld, which has a variety of information.

Students need to be aware that reaching this level of knowledge is difficult; if it were easy, everyone would be a physician! in addition to requiring a significant amount of devoted effort and labor. It is essential to make use of flashcards in order to reinforce the information that is difficult to remember; however, it is nearly impossible to navigate through a pre-made deck that contains hundreds of cards. This is typically the reason why students become frustrated with flashcards and fail to use them effectively.

Not keeping track of study progress with NBME practice examinations

Exams given by the NBME are a good indicator of how well one would do on the actual Step 1. Students who did not pass Step 1 often did not make enough use of the NBME assessments to evaluate whether or not they were prepared to take Step 1 of the USMLE. In order to have a sense of where you are at the beginning of the study session, you should take an NBME exam. After that, you should take one about every 1–4 weeks (depending on the length of your dedicated study period of time).


Last but not least, even when it would be in their best interest to push back the date of their Step 1 exam for personal reasons, many students are reluctant to do so. If you need to reschedule the exam because of an unexpected event in your family’s life or because you haven’t been able to dedicate the necessary amount of time to study for any reason, you shouldn’t beat yourself up over it.

Delaying the exam is better than taking it too soon and earning a mark that is just above failing or failing altogether. No matter how busy the rest of your life is, you shouldn’t take the USMLE Step 1 exam “just to get it over with” if you are aware that you haven’t had enough time to thoroughly prepare for the exam and that your NBMEs aren’t where you want them to be. Step 1 is the first step in the process, and although everyone wants to get through it as soon as possible, doing so is not a good idea.

usmle step 1 test day tips

USMLE Step 1 Test Day Tips

Working together 

Preparing for the USMLE Step 1 exam in a group may be challenging. Fortunately, whether you are preparing for the exam during the same period as some other pupils from your institution, you will not be required to do it alone. Having a study group might help you remain motivated while you’re studying. Consider having your study group serve as your ‘accountabilibuddies,’ who will ensure that you do not spend time on your phone or watching Netflix while you’re studying! Then, after a long day of personal effort, you and your pals may unwind with something enjoyable at night to relieve tension.

But have this in mind: avoid comparing yourself to your peers. While preparing for the USMLE Steps, everyone has their own set of objectives and timetables. Be supportive of one another rather than a source of worry for one another!

Simulating the examination

Simulation of the actual USMLE stages is another excellent method of ensuring success on the USMLE steps. Many pupils discover that they are able to answer 40 questions in a row with no difficulty. The genuine STEP 1 test, on the other hand, comprises 280 questions! Because of this, it may be beneficial to begin developing your issue capacity in the weeks leading up to your planned test day.

There are only a couple of methods to accomplish this: either by completing NBME practice exams (each of which has around 160 questions) or by completing numerous questions. It is possible to reduce anxiety symptoms by gradually boosting your question-taking stamina. This will also assist you in remaining concentrated during the whole 8-hour examination.

Get the sleep you need to achieve your goals

Last-minute prepping always appears to be a smart idea at the time. You must, however, be aware of when it is appropriate to lay down the notes and retire for the night. Staying up all night or sleeping beyond your typical bedtime may lead you to ignore your clock or feel foggy during the USMLE Step 1 test if you don’t get enough sleep. You must be in great physical and mental health in order to perform at your highest level on the USMLE Step 1 examination.

This implies that you should strive to obtain between 6 and 8 hours of sleep each night. The USMLE Step 1 test is organized into many one-hour blocks, each of which is worth one point. Getting adequate sleep guarantees that you are alert and able to answer all of the test questions within the allotted time limit.

Put your morning routine to the test

The ability to improve your morning routine is essential for doing well on tests. Get up at the same time you will on test day 2 – 3 days prior to attempting the USMLE Step 1 exam and stick to that routine all the way through the exam day itself. Being awake and aware of the examination is ensured by setting an alarm for a specified time several days prior to the examination.

In addition, pick a meal that is agreeable to your digestive system. This might be anything as simple as eggs and toast or as complex as a piece of salad and yogurt. Due to the fact that you have been used to these meals for a few days, planning your morning routine might help put your mind at peace.

Maintain consistency in your diet

The day before your USMLE Step 1 test is not the best time to experiment with different approaches. Stay away from trying new meals and consuming excessive amounts of caffeine, in particular. During the USMLE exam preparation process, medical students often consider what healthy meals they should consume. Short answer: well-balanced diets that contain veggies and fruits, as well as healthy carbohydrates and protein, are the best option.

Salty foods and excess carbs should be avoided at all costs since they might cause digestive problems. Prevent jitters and caffeine withdrawal by drinking as much coffee as you normally would in the weeks leading up to and on the day of the exam.

Make a plan for transportation ahead of time

Test out your transportation route in advance of the USMLE Step 1 exam day to ensure a great experience on exam day. Leave your apartment or house at the same time you would on test day in order to observe traffic or public transit trends in your neighborhood. Examine the driving system and determine whether or not you will be required to pay to park in a lot or garage. The timetables for public transit vary depending on where you are. You should double-check that the trains or railways will bring you to the assessment location on time.

Prepare to appear at the test facility at least half an hour prior to the start of your examination. In the event that you intend on driving yourself to the testing site, it is a good idea to look into other routes. This will assist you in coping with unexpected events such as car accidents, road construction, and other scenarios.

Prepare everything you’ll need to bring before the exam

When you arrive for testing, you will need to provide a duplicate of your schedule permission along with government-issued picture identification. Always prepare such products the day before and store them in a convenient location so you will not forget where you placed them once you go out. For example, if you’re driving alone, keeping them next to your keys may be beneficial to you.

Complete a quick review of your work

You may be tempted to continue studying right up to the day of your USMLE Step 1 exam. For this time, you’ve been studying hard for months to be ready, therefore it’s important to keep tutoring sessions short the day before and early morning on the day of the examination. Take advantage of the day before the test to unwind. The ideal situation is to study for the exam with no more than an extended time in the final 24 hours before traveling to the testing site.

When you have so much at stake, it’s understandable to be nervous about the first part of the USMLE. As a result, you now have a clearer sense of how to prepare for Step 1 of the exam. We hope that article can help you to know more about USMLE Step 1 Test Day Tips, which can be beneficial for your process of studying and preparing to ace this exam.


How Much Does The USMLE Cost? Price List You Should Know (2023 Updated)

The USMLE test s a three-part examination for medical licensure in the United States. The overall USMLE cost will be discussed in this section.

June 10, 2022

What is USMLE?

If you have always wanted to practice medicine in another country, especially the United States of America, you must take the USMLE exam. The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners jointly sponsor the United States Medical Licensing Examination (USMLE) (NBME). The USMLE is a three-part test that you must pass if you want to practice medicine in the United States.

The test is designed to examine a medical student’s ability to apply medical information, principles, and concepts. It also assesses the medical practitioner’s ability to display essential and key patient-centered abilities, which are extremely important in the practice of health and illness. These abilities serve as the foundation for providing effective and safe patient care.

usmle cost

The USMLE test was developed in the late 1980s but was initially administered between 1992 and 1994. It superseded two of the most commonly accepted medical licensing examination programs at the time, the NBME Part Examination Program and the Federation Licensing Examination or FLEX program. Continue reading to learn more about the USMLE cost.

What Is USMLE Step 1?

USMLE Step 1 is an eight-hour multiple-choice exam. It is broken into seven 60-minute sections. This phase tests your fundamental grasp of the sciences behind medicine. It includes a wide range of areas like anatomy, biochemistry, behavioral sciences, immunology, and pharmacology. Questions will frequently take the form of outlining a patient’s ailment or circumstance, and multiple choice responses will frequently require you to identify the patient’s disease or suggested evaluation.

What exactly is the USMLE Step 2 (Clinical Knowledge)?

The USMLE Step 2 CK evaluates your ability to use medical knowledge and clinical science in patient care. It’s a one-day multiple-choice exam, similar to Step 1, that lasts nine hours and is divided into eight blocks. Questions address pharmacology, diagnostics, and therapeutic treatments, among other things. Step 2 includes a discussion of illness categories such as the cardiovascular system, the musculoskeletal system, and biostatistics.

What ẻxactly is the USMLE Step 2 (Clinical Skills)?

This is the second section of Step 2; it assesses your abilities to interact with patients and deal with diagnostic issues. The twelve patients you will encounter are professional actors trained to behave as actual patients with clinical difficulties, comparable to the MMI Interview in the UK. Cases and symptoms will vary but may include cardiovascular troubles, musculoskeletal disorders, or women’s health. This stage takes eight hours, with 15 minutes spent on each patient, whom you may visit in person or call. You will have 50 minutes of breaks, however, unlike Step 1 and Step 2 CK, these will be scheduled throughout the day.

What is the USMLE Step 3?

You’re almost there! The USMLE Step 3 exam lasts two days. On the first day, Foundations of Independent Practice is a seven-hour multiple-choice exam comparable to Steps 1 and 2. (CK). It is broken into six 60-minute chunks with a 45-minute break in between. It assesses medical diagnostic knowledge, interpersonal skills, and comprehension of scientific abstracts and pharmaceutical advertisements.

On the second day, Advanced Clinical Medicine will put your understanding of patient care and disease evolution to the test. This consists of 198 multiple-choice questions and 13 computer-based care scenarios lasting 10-20 minutes each. This test lasts nine hours and is broken into six 45-minute halves. This day tests your understanding of diagnosis, care management, and medical decision-making.

USMLE test cost

The USMLE pricing plan for students from the United States or Canada.

To register for the test, medical students from LCME or AOA-approved institutions, or graduates from medical schools in the United States or Canada, must apply through the NBME website.

The pricing schedule for the USMLE Step 1 and Step 2 tests is as follows.

USMLE Fee TypeUSMLE Cost for Step 1USMLE Cost for Step 2 (CK)
Application Fee975975
Rescheduling FeesUp to $604Up to $604
  • The examination price for Step 1 is $880 (about £722). There is additionally an international cost of $185 (about £150) if you take the test outside of the United States.
  • Step 2 examination fees, like Step 1, are $880 (about £722). There is additionally a foreign cost of $210 (about £170) for students taking the test outside of the United States.
  • Step 2 (Clinical Skills) costs £1,535 – or around £1,246. Another consideration is that if you are taking the USMLE from the UK, you will need to fly to the US to a designated CSEC Testing Center. These are in Georgia, Illinois, California, Texas, and Pennsylvania, so plan accordingly!
  • Step 3 costs $830, or £674.

Exam Cost Of USMLE Step 3

Only after passing the Step 1 and Step 2 tests may you apply for the USMLE Step 3 exam. After making an account and checking in, you must submit your applications for the Step 3 test via the FSMB website. You must pay the following fees:

USMLE Fee TypeUSMLE test fees
Application Fee895
Rescheduling FeeN/A (non-refundable and non-transferable)

Applications are made through NBME for AOA or LCME recognized graduates or students in Canada or the United States. The following are the costs:

  • $610 (INR 45,203)- Step 1 Application Costs
  • $610 (INR 45,203)- Step 2 CK Application Costs
  • $1285 (INR 95,223)- Step 2 CS Application Costs 
  • $0-506 (up to INR 37,496)- Step 1 Rescheduling Costs
  • $0-569 (up to INR 42,164)- Step 2 Rescheduling Costs
  • $0-1280 (up to INR 94,853)- Step 3 Rescheduling Costs 

ECFMG accepts applications from graduates and medical students living outside of Canada or the United States (Educational Commission For Foreign Medical Graduates). The costs are as follows:

  • ECFMG Application Charges- $75 (INR 5,558)
  • Application Fees for Step 1- $910 (INR 67,434)
  • Application Fees for Step 2- $910 (INR 67,434)
  • Application Fees for Step 3- $1565 (INR 1,15,972)
  • Extension of Eligibility Tenure for Step 1 or 2 CK- $70 for each Step
  • Step 1 or 2 CK Change in Testing Region- $65 for each Step (INR 4,817) 
  • Rescheduling Charges- $0-569 for Step 1, $0-1285 for Step 2 CK and $0-1280 for Step 2 CS (up to INR 42,164 or INR 94,853)
  • Score Rechecking Fee- $80 for Step 1 and $80 for Step 2 CK (INR 5,928)
  • ECFMG Examination Chart- $50 for Step 1 (INR 3,705)
  • ECFMG CSA History Chart- $50 for Step 1 (INR 3,705)
  • USMLE Transcript Paper- $70 (INR 5,187) for each request (up to 10 transcripts) 
  • USMLE Transcript- Electronic Transmission (ERAS)- $80 (INR 5,928) for each session of ERAS

usmle cost

Step 3 is taken after applicants have passed Steps 1 and 2. The costs are as follows:

  • Application Fees for Step 3- $850 (INR 62,988)
  • Rescheduling Fees for Step 3- $0-114 (up to INR 8,448)

USMLE Exam Total Cost

Application for ecfmg certification and certificate of verification (Form 186)150
Step 1$975 + $180 (Surcharge fee for writing outside the US)
Step 2 CK$975 + $200 (Surcharge fee for writing outside the US)
Extension of eligibility period fee for Step 1 & step 2 CK$90 /exam
Step 1/Step 2 CK Testing Region Change$85 / change
Rescheduling Step 1/ Step 2 CK$0 to $604 (depending upon the exam, testing, region and date of cancellation)
Occupational english test(OET)454 U.S dollars(587 AUD)

Steps For The USMLE

USMLE Test StepExam TypeTotal DurationNumber of QuestionsSkills Assessed
Step 1Computer based1 Day7 blocks of 40 MCQs, 280 in totalBasic Science Concepts + Application to medical practice
Step 2Computer based1 Day316 MCQs across 8 blocksClinical Science Concepts + Application
Step 3Computer based2 Days233+180 MCQs across 6 blocks (Day 1 & 2) +13 computer-based simulationsBiomedical & clinical science concept + applications, patient management, ambulance care etc.

The USMLE is broken into three steps: Step 1, Step 2 CK (Clinical Knowledge), and Step 3. Up to 2020, Step 2 also contained a CS (Clinical Skills) component. However, the NBME and FSME declared that Step 2 CS will be permanently canceled in March 2021. While you can do Steps 1 and 2 in any order, you must pass the first two tests before taking Step 3.

ItemsUSMLE Step-1USMLE Step-2 (CK)USMLE  Step-3
Total Duration (including break time)8 hours9 hours8 hours on Day 1
9 hours on Day 2
Format280 MCQs divided into 7 sixty-minute blocks each with 40 MCQs.About 316 MCQs divided into 8 sixty minute blocks.Day 1:
About 233 MCQs divided into 6 sixty minute blocks.
90 seconds for each question.91 seconds for each question.Day 2:
About 180 MCQs divided into 6 forty five minute blocks.
13 computer-based case simulations (CCS).
10-20 minutes for each simulation.

USMLE Step 1

The USMLE Step 1 tests your understanding of fundamental science principles such as anatomy, biochemistry, behavioral science, microbiology, pharmacology, pathology, and physiology. Step 1 also assesses your understanding of multidisciplinary topics such as genetics, nutrition, and immunology.

USMLE Step 2

Step 2 CK evaluates your ability to use medical knowledge and skills, as well as grasp clinical science, which are crucial to patient care, under supervision. It emphasizes illness prevention and health promotion even more. The exam includes a 45-minute break and a 15-minute instruction.

USMLE Step 3

Step 3 is a two-day test that assesses your ability to use your medical knowledge and comprehension of clinical and biological science in an unsupervised setting. It focuses on patient management in ambulatory settings and examines your ability to perform primary medical care independently. On the first day of Step 3, you must complete 232 multiple-choice questions distributed among six blocks of 38-39 questions. You get 60 minutes to finish each block throughout a 7-hour exam period, including a 45-minute break and a 5-minute optional lesson.

The second day consists of a 9-hour exam session, which contains a 5-minute optional lesson, followed by 180 multiple-choice items distributed across six blocks of 30 items, with a 45-minute break. Each block must be completed within 45 minutes. You must also complete a 7-minute CCS lesson, followed by 13 case simulations lasting 10-20 minutes each.

Eligibility Criteria for the USMLE

Eligibility for the USMLE Step 1 and Step 2 Exams

To be eligible for the USMEL Step 1 and Step 2 tests, you must fulfill one of the following criteria:

  • You must be enrolled in or have graduated from a medical school in the United States or Canada that leads to the MD degree. The medical school in the United States or Canada should be accredited by the Liaison Committee on Medical Education, the accrediting organization for MD programs in both countries, and recognized by the United States Department of Education.
  • You must be enrolled in or have graduated from a medical school in the United States that leads to the DO degree. The American Osteopathic Association (AOA) Commission on Osteopathic College Accreditation (COCA), the accrediting authority for osteopathic educational institutions in the United States, as recognized by the US Department of Education, should approve such a school.
  • You must be enrolled in or have graduated from a medical school outside of the United States and Canada that is listed in the World Directory of Medical Schools, or WDOMS. Such a school should fulfill the qualifying standards and criteria of the Educational Commission for Foreign Medical Graduates (ECFMG).

Eligibility for the USMLE Step 3

To take the USMLE Step 3, you must fulfill ALL of the qualifying criteria listed below:

  • You must have an MD (or an equivalent degree, such as MBBS) from an LCME-certified medical school in the United States or Canada.
  • You must have a DO degree from an AOA-certified medical school in the United States OR an MD (or equivalent, MBBS) degree from a WDOMS listed medical school outside of the United States and Canada, as well as the ECFMG Certification.
  • You should have passed the USMLE Step 1 and Step 2 tests.

International Students Can Register For The USMLE

If you want to register for USMLE but are not a medical student from the United States or Canada, you must do so through the ECFMG website. To apply for the ECFMG certification, you must spend $150.

Additional fees for the USMLE Step 1 and Step 2 tests

USMLE Fee typeUSMLE Price for Step 1USMLE Price for Step 2 (CK)
Fee to Extend Eligibility Period7070
Fee to Change Testing Region8585
Fee to recheck scores8080
Fee for ECFMG Exam Chart$50 per request form (up to three copies)N/A
Fee for ECFMG CSA History Chart$50 per request form (up to three copies)N/A
FEE for USMLE Transcript paper$70 per request (up to 10 transcripts)$70 per request (up to 10 transcripts)
USMLE Transcript – Electronic  Transmission for ERAS$80 per ERAS session$80 per ERAS session

Steps to register for USMLE Exam

You apply to take the USMLE from the UK by enrolling with the Educational Commission for Foreign Medical Graduates (ECFMG).

Then you’ll need to take the USMLE Step 1 (Basic Medical) and Step 2 (Clinical Knowledge) exams, which you may do while studying for your Medicine degree. Following that, you can take USMLE Step 2. (Clinical Skills). After passing all three tests, you will be awarded a Standard ECFMG certificate.

Graduates must have complete ECFMG certification in order to apply to Graduate Entry Medicine (GEM) programs in the United States, and one to three years of GEM is necessary to practice medicine. After the first year of GEM, the last stage, USMLE Step 3, is commonly taken. Following your graduate entrance program, you can apply for a license in the US state where you want to practice medicine.

usmle cost

Step 1: Register for an account on the ECFMG website

Visit the website, then click on the ‘I Want to Apply for ECFMG Certification’ link to get a USMLE/ECFMG identification number. You will be routed to another window with a new form where you can fill up your information and submit it. You will receive your ECFMG ID and password in about two weeks (which you may change).

Step 2: Fill out the ECFMG website’s USMLE step 1 application

Log in to your ECFMG account and click the start new application button. Fill out the form, input all of your information correctly, and pay the USMLE exam price. Also, choose your qualifying term carefully. You should be aware that you have a three-month window in which to schedule your exam.

Step 3: Fill out Form 183

After paying the USMLE exam price, a link to Form 183 appears in the same window. Fill out the form and get it signed and stamped by the Dean of your medical school. Check that the Dean’s signature matches the signature on the ECFMG records. Remember to emphasize this to the office personnel at your medical school because your form will not be approved if the signatures do not match.

Step 4: Form 183 should be mailed to Philadelphia

After completing Form 183, please submit it to the following address:



3624 Market Street

Philadelphia, PA 19104-2685


Make sure the envelope you mail the form in is from your Dean’s official stationery and bears the Dean’s stamp. This is something that your medical school should be familiar with.

Step 5: Wait for the scheduling permit to arrive

ECFMG will send you an email with your scheduling permission within 2-3 weeks of receiving Form 183. This is a critical document that you must have with you on exam day. Examine the permission to check the information is correct.

Step 6: Schedule your appointment at a Prometric Center

You may now access the website of Prometric, the official testing provider in charge of all USMLE tests. Within your qualifying period, you must pick USMLE, your testing site, and your chosen exam date. Finish the booking procedure by referring to and inputting the information from the schedule permits.

Top 5 USMLE Tips

  • Become used to working with breaks – Personal breaks totaling 45 or 50 minutes are allowed for Steps 1, 2 (CK), and 3. You can take them whenever you want, but never more than six at a time. There’s also an optional lesson at the start of each test, so if you skip it, you may make up the time in your breaks. When you first start taking practice tests, it’s a good idea to repeat a broken structure to get acclimated to functioning under these conditions.
  • Answer all of the questions — you can’t re-open a block of questions after you’ve closed it, so be sure you’ve answered everything! If you are unclear about a question in Step 1, 2 (CK), or 3, it is advisable to guess. An unmarked response is automatically read as incorrect, while an informed guess may be correct!
  • Get a decent night’s sleep — you won’t be able to take a test for eight or nine hours if you’ve been up all night cramming! To perform at your best, try to obtain at least eight hours of sleep every night and eat a nutritious meal.
  • Practice as much as you can — practice questions (many of them!) are the way to go for Steps 1, 2 (CK), and 3. Step 2 (CS): Practice your spelling and typing so that your patient notes are as accurate as possible, and run through patient situations with your pals in 15-minute increments. When exam day arrives, you’ll feel completely prepared.
  • Check the prerequisites – double-check USMLE’s Examination Day and Testing page for instructions on what you need to bring with you on the day, as well as what you may bring inside the testing room – and when you need to arrive!


Earning a degree in a medical discipline from a reputable institution overseas can put you on the route to your desired job. Because US degrees are recognized internationally, you will be able to practice in any part of the world. The USMLE is not an easy exam to pass, as seen by the multiple levels and syllabus necessary. The good news is that you may access all of the necessary study materials and take our free USMLE practice tests to acquire a feel for the exam. Hopefully, our test can provide suitable information that you need to know about USMLE cost. We wish you the best of success in passing these tests with flying colors.

Frequently Asked Questions – USMLE exam cost

Can I take the USMLE again?

Yes, you are allowed to retake the USMLE. You may take the same examination (or stage) up to three times in a 12-month period. Any subsequent efforts should be made at least one year after the first try and at least six months after your most recent attempt at that stage.

How to prepare for the USMLE?

You can prepare for the USMLE by using the practice resources offered on the test website. You may also use the NBME website to get self-assessment information and study materials. Furthermore, registered examinees who want to familiarize themselves with the setting at a Prometric test center can do so by paying a fee and registering for a practice session.

Is the USMLE difficult?

The USMLE Step 1 is widely recognized as one of the most difficult medical exams in the world. The results of this exam will provide the groundwork for a successful residency program in the future. Above all, the USMLE is a lengthy process that challenges a candidate’s patience. Furthermore, the exam is quite competitive.

When are the USMLE exams given?

With the exception of the first week of January and other public holidays, the USMLE Step 1 can be taken at any time of year. The specifics of the USMLE test are not released by the organizational authority. Following registration and receipt of the eligibility period, the candidate must reserve a test date for a certain stage.

Which countries recognize the USMLE?

The USMLE is a well-known medical license exam. Because of its hardness and competitiveness, it is difficult to break. The USMLE program is accepted by medical licensing bodies in the United States, Israel, New Zealand, the United Arab Emirates, and Qatar. These nations accept USMLE results and exempt candidates from additional qualifying requirements.


USMLE Step 1 Registration [2023 Comprehensive Guide]

Although the USMLE is a very difficult exam, registering for it should not be. Here's all you need to know about USMLE Step 1 registration and eligibility.

June 6, 2022

If you want to register for the USMLE STEP 1, this post will walk you through the process step by step. Although the USMLE is a difficult exam, registering for it should be not. Here’s all you need to know about USMLE registration and eligibility.

Let’s get started with our free USMLE practice test to pass your actual exam with a high score on your first attempt.

Who is Eligible to take the USMLE Exam?

Step 1 and Step 2 Clinical Knowledge

To be eligible to take the exam, you must be in one of the following categories at the time you apply and on the day of your examination:

  • A medical student officially enrolled in, or a graduate of, a Candian or United States medical school program leading to the MD degree that’s accredited by the Liaison Committee on Medical Education (LCME).
  • A medical student officially enrolled in, or a graduate of, a United States medical school leading to the DO degree accredited by the American Osteopathic Association. Or,
  • A medical student officially enrolled in, or a graduate of, a medical school that is outside the United States and Canada that is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements and meets other ECFMG eligibility criteria.

You will not be eligible for the USMLE exam if you are dismissed or withdraw(n) from medical school, even if you are appealing the school’s decision or are otherwise contesting your status. Please check with the organization that registered you for your examination before submitting your application; if you have already registered, please check before testing. Failure to notify the institution that registered you for the USMLE exam of your new status may result in an irregular behavior finding and a permanent annotation on your score reports and transcripts.

Step 3

Step 3 eligibility requirements are as follows:

  • You need to pass Step 1 and Step 2 Clinical Knowledge, and
  • An MD or DO degree from a COCA or LCME-accredited US or Canadian medical school, or the equivalent of an MD degree from a medical school outside the US or Canada that is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements and obtaining ECFMG Certification, and
  • Meet all additional requirements as listed in the USMLE Bulletin of Information.

According to the USMLE program, applicants for Step 3 eligibility must have completed, or be on their way to completing, at least one postgraduate training year in a recognized United States graduate medical education program meeting state board licensing requirements.

If you have passed a Step four times or more, including incomplete attempts, you are ineligible to apply for any Step in the USMLE exam sequence. The time limit includes previous attempts at Step 2 Clinical Skills.


Change in Eligibility Status

You must promptly notify the organization that registered you for your examination if your eligibility for a Step changes after you submit your application but before your scheduled test date(s). If you do not notify the organization that registered you for the exam of your change in status, you may be charged with participating in irregular behavior. If you take a Step for which you are not qualified, the results of that examination may not be reported or, if previously reported, may be canceled at the USMLE program’s discretion.

Graduates From Unaccredited Medical Schools in the United States or Canada

If you graduated from an unaccredited medical school in the United States or Canada and are eligible for initial physician licensure by a US medical licensing authority, you may only take the USMLE if that physician licensing authority specifically requests it. In advance of your application for each Step, the physician licensing authority should make a request to sponsor you to the USMLE Secretariat.

Sequence of Steps

You may take Step 1 and Step 2 Clinical Knowledge in any sequence if you meet the eligibility requirements. Only after passing Step 1 Clinical Knowledge may you take Step 3.

Number of Attempts and Time Limits

You are ineligible to apply for any Step in the USMLE exam sequence if you have missed a Step four times or more, including partial attempts. The limit includes attempts at the previously administered Step 2 Clinical Skills.

Regardless of when the examinations were taken, all attempts at a Step count towards to the limit.

Many state medical boards require that all steps of the USMLE exam be completed within a certain amount of time.

USMLE Step 1 Registration

This part will show you how to register for step 1.

Step 1: Apply for your USMLE/ECFMG identification number

Go to The ECFMG website and select “Online Services” then choose IWA – Interactive Web Applications as below:

usmle step 1 registration

If you have never obtained an ECFMG/USMLE Identification Number, select the appropriate option as mentioned above.  Following that, you’ll see an important page of instructions for the ECFMG Online Authentication Process, which you should read carefully. Both the box confirming that you “read the above information and instructions” and the box certifying that you “read, understood, and agree to the ECFMG Privacy Notice” must be marked. The next page asks if you have ever applied for ECFMG Certification or an ECFMG exam. After you’ve confirmed your answer, you’ll be taken to the request form.

There are warnings in the instructions about making incomplete or inaccurate entries. You should also be aware of any special circumstances that may apply to you. If you followed the instructions correctly, you should receive an email confirmation with your ID number in five business days. If you do not follow the instructions correctly, your request may not be processed, and you’ll never be notified. If this happens, you must apply for a USMLE/ECFMG Identification Number after a minimum of five business days has passed. Next, as before, click on “IWA – Interactive Web Applications,” which will take you to the following page:

usmle step 1 registration

Among the other details, keep in mind that you must spell your name exactly as it appears on your current, valid passport, or you may be required to fill out extra documentation for a name change. The information you provided while getting your USMLE/ECFMG Identification Number will become part of your permanent ECFMG record.

Your Identification Number will be sent to you along with a password for your online services, which you can change.

Step 2: Establish your account

To establish an account, return to the IWA login page and click “here,” as shown below:

usmle step 1 registration

Step 3: Complete the Application for the ECFMG Certification

Before you begin an exam application, you must first complete the Application for ECFMG Certification. The first step is to log in to the IWA as you did before. Follow the provided instructions to access, complete, and submit the online portion of the application. After that, pay the $150 as directed.

Step 4: Complete & notarize the Certification of Identification Form 186

The Certification of Identification Form 186 must be completed and notarized as part of the ECFMG Certification application. Since the pandemic, this has been done online with NotaryCam, where you can confirm your identity and sign the needed affidavit via virtual video calls. Before you can apply to ECFMG for examination, ECFMG must accept the Application for ECFMG Certification and the notarized Form 186. ECFMG’s Online Applicant Status and Information System (OASIS) or the MyECFMG mobile app could be used to verify the status of your Application for ECFMG Certification.

Step 5: Fill out the USMLE Step 1 application and pay the fees

Return to the IWA login page and log in using your USMLE/ECFMG Identification Number and password as follows:

usmle step 1 registration

You’ll be sent to a new window where you click “Begin New Application.” Fill out the application form carefully, making sure that all of the information is correct.

You’ll be asked to choose a period of eligibility, which is usually three months. Due to the pandemic, the eligibility period is greater than three months from January to March 2021, during which you can arrange your test. Make sure the eligibility period you choose is appropriate for your needs and situation.

At the end of the form, you must pay the $975 USMLE Step 1 examination fee. You will be charged an additional $180 international test delivery surcharge for USMLE Step 1 when you choose a testing region other than the United States or Canada. For testing regions in the United States and Canada, there is no international cost.

Step 6: Verify your medical school status online or on paper with the Certification Statement Form 183

After you’ve completed the payment process, you’ll see a link to request verification of your status as a current student or direct graduate from your medical school. Before you can register for the USMLE exam, ECFMG must receive this verification. ECFMG will submit the request in one of two ways: electronically through the ECFMG Medical School Web Portal (EMSWP) Status Verification program, or on paper via the Certification Statement Form 183.

You will be notified at the end of the online application process if your medical school completes status verification requests electronically. You will be given Form 183 at the end of the online USMLE application process in ECFMG’s Interactive Web Applications if your medical school completes status verification requests on paper (IWA). The form also includes detailed instructions on how to fill it out and submit it.

If your program requires a paper form, fill out Form 183 as follows:

usmle step 1 registration

Form 183 USMLE- Before an applicant can register for the USMLE, ECFMG must require verification of the applicant’s status as a current student or a grad student of his or her medical school.

The ECFMG Medical School Web Portal (EMSWP) Status Verification program or a paper form, the Certification Statement, would be used to request status verification from your medical school (Form 183).

You will be given Form 183 at the end of the online USMLE application process in ECFMG’s Interactive Web Applications if your medical school completes status verification requests on paper (IWA).

Access IWA if you’ve already completed the online part of an IWA exam application and need to download/reprint your Certification Statement (Form 183).

The instructions explain how to print, sign, and date paper Form 183 in detail. You must mail it to your medical school to have it certified by an authorized official, who must then transmit it directly from their office to the ECFMG for acceptance.

Step 7: Submit all other necessary documentation to the ECFMG as follows:

  • Graduates must submit a copy of their medical diploma (if it has not been submitted previously) as well as an official English translation if the diploma is not in English.
  • Send a copy of an official transcript that was issued by any school or institution from which you transferred credits to the medical school that awarded or will award your medical degree (if it’s not already submitted); and include the official English translation of the transcript (if the transcript is not in English). The ECFMG Information Booklet contains information on transfer credits and medical education credentials.
  • Any other documents are required to complete your application, as stated in the instructions.

Any additional documents should be sent to ECFMG at the address listed below, or submitted to the MyECFMG mobile app.



3624 Market Street, 4th Floor

Philadelphia, PA 19104-2685


To process your application, ECFMG must receive the online part of your application, the Certification Statement Form 183, and any needed documents.

Step 8: Wait to receive your Scheduling Permit

Exam applications are typically processed within two weeks after receiving the online part, certification of your medical school status, and any other required documents. After their application has been completed, eligible applicants are registered for the USMLE.

Make sure everything is accurate when you receive the permit through email. On Exam Day, you will be required to bring the scheduling permit with you. Although this is the last step in your USMLE Step 1 application, there is still work to be done on finishing the enrollment process.

Step 9: Schedule a test date at the Prometric website

You must make an appointment with Prometric, the testing service that conducts all USMLE tests, to schedule your USMLE Step 1 Exam. Go to Prometric and enter USMLE in the Search box, or go directly to Prometric.

  • Click “Step 1” under USMLE Step 1 on the following page.
  • Select your selected location to take the Exam on the Prometric website.
  • Select the section “Schedule an Appointment” on the following page.

After accepting Prometric’s disclaimers, you’ll be taken to a screen in which you can schedule your appointment. You’ll need your Permit’s Scheduling Number and the first four characters of your last name. Click “Send.” After your eligibility has been confirmed, you will have the opportunity to choose your test during your eligibility window. To the test center, bring a copy of your USMLE ID number and scheduling permit.

FAQs – USMLE Step 1 Registration

When do you have to register for USMLE Step 1?

How far in advance do you need to schedule your Step 1 exam? You can schedule your Step 1 exam up to six months in advance on the Prometric website.

Is Step 1 offered every day?

Step 1 is a one-day exam. It is separated into seven 60-minute blocks and given in one 8-hour session. A specific examination form’s number of questions per block may vary, but it’ll never exceed 40.

Does ECFMG expire?

The ECFMG Certificate will no longer be subject to expiration once the applicant has successfully completed the first year of training in a US GME training program accredited by the Accreditation Council for Graduate Medical Education (ACGME).

What is the eligibility period in USMLE?

Fill out the application once logging into your account. You must choose a three-month eligibility period to take the exam. A scheduling permit will be provided once ECFMG has confirmed your eligibility. You can then schedule an appointment for your testing.

In which countries is USMLE valid?

Through its leadership in the development, delivery, and continual improvement of high-quality exams across the continuum of physicians’ preparation for practice, the USMLE program serves medical licensing authorities in the United States. It’s valid in New Zealand, UAE, Qatar, Israel, and Dubai Health City.

Is USMLE easy to pass?

When compared to Indian PG Entrance Examinations, the USMLE can be considered easier (not easy, but easier).

Which country has the highest passing rate of USMLE?

According to the list, China had the most graduates (11,825) with a pass percentage of 18.9%, followed by Russia (5,950) with a pass percentage of 18.4%, Ukraine (3,520) with a pass percentage of 19.1%, and Nepal (3,163) with a pass percentage of 21.2 percent.


We hope this article helps you in your USMLE Sep 1 registration. This is an exciting time in your medical career. Please share this post with your friends and colleagues if you find it useful.


USMLE Step 2: The Most Comprehensive Guide in 2023

Before applying for a medical license, you will need to pass the USMLE exam. Read on to find out the most comprehensive USMLE Step 2 Clinical Knowledge guide.

June 6, 2022

The United States Medical Licensing Examination (USMLE) is a set of exams for medical graduates who want to practice unsupervised medicine in the United States. It’s a three-part exam, with the three USMLE steps, including

  • USMLE Step 1
  • USMLE Step 2 Clinical Knowledge, & Step 2 Clinical Skills
  • USMLE Step 3

The USMLE Step 2 exam is the next step after passing the USMLE Step 1 exam. In this article, we provide the most comprehensive USMLE Step 2 Clinical Knowledge guide for 2022. 

Let’s get started with our free USMLE practice test to pass your actual exam with a high score on your first attempt.

usmle step 2

What is the USMLE Step 2?

The USMLE Step 2 exam is split into 2 parts: USMLE Step 2 Clinical Knowledge and USMLE Step 2 Clinical Skills. The latter has been permanently canceled.

Step 2 Clinical Knowledge evaluates a candidate’s ability to apply medical knowledge, skills, and understanding of clinical science to provide patient care under supervision, with an emphasis on health promotion and disease prevention. Step 2 Clinical Knowledge ensures that the foundation for the safe and competent practice of medicine under supervision is established by principles of clinical sciences and basic patient-centered skills.

USMLE Step 2 Clinical Knowledge exam format

USMLE Step 2 Clinical Knowledge is a one-day examination.  It’s broken down into eight 60-minute blocks and given in one 9-hour session. On a given examination, the number of questions per block will vary but will not exceed 40. There will be no more than 318 questions on the overall examination.

A minimum of 45 minutes of break time is included in the exam and a 15-minute optional tutorial. Finishing a block of test items or the optional tutorial before the time limit expires can increase the amount of time available for breaks.

USMLE Step 2 Clinical Knowledge question formats

Single-Item questions

A vignette and question are followed by three to twenty-six responses grouped in alphabetical or logical order in this traditional, most commonly used multiple-choice question format. You have to choose the best answer to the question from a list of lettered responses (A, B, C, D, etc.). Remember that while other answers may be partially correct, there is only one correct answer. This means that before selecting an answer, you must thoroughly study the vignette, the questions, and all of the response options.

Sequential item sets

This question format gives you a single patient-centered vignette followed by two or three questions on the patient’s problem. Each question is related to the vignette but tests a different aspect of the patient’s problem. You must select the most appropriate answer to each question.

It’s crucial to remember that after answering the first question, you must click “proceed to next item” to see the vignette’s following question. Even though the patient’s problem remains the same, you will not be allowed to change the response to the previous question once the next question shows on the screen.

Pay attention to what you’re being asked and the answers you select because the questions are structured to be answered in order. The format and purpose of single-item questions and sequential item sets are similar in that you must choose the proper answer to questions that are presented to you.

Keep in mind, however, that sequential item sets require more concentration and time since you must pay attention to each question separately, as well as how each question relates to previous question items and the patient’s problem. While a single item type only requires you to answer one question about the patient’s problem, sequential item sets are longer and more involved.

Abstract format

The abstract format questions ask about a summary of an experiment or clinical investigation given in a way that physicians are familiar with, for as an abstract that comes with a research report in a medical journal. Examinees must interpret the abstract in order to answer questions on a variety of subjects, including

  • Decisions about care for an individual patient
  • Biostatistics/epidemiology
  • Pharmacology/therapeutics
  • Use of diagnostic studies

USMLE Step 2 Clinical Knowledge content

System-based practice, patient safety, legal/ethical issues, and professionalism are all evaluated in this section of the USMLE Step 2 exam. The integrated content outline is used to design all USMLE tests, so make sure you read it before you begin studying.

The exam’s content is arranged according to general principles and individual organ systems, as shown in the outline. Clinical Knowledge questions are classified into one of 18 major groups based on whether they address concepts and principles that apply across organ systems or only to specific organ systems.

A table outlining content weighting can be found below. Individual organ system sections are further divided into normal and abnormal processes, as well as therapy principles. The majority of the time, knowledge of normal processes are assessed in the context of a disease or pathology.

While not all of the topics in the content outline will be included in every USMLE examination form, content coverage is generally comparable across exam forms. Moreover, while the tables below provide an estimate of each content area’s weighting, the percentages are subject to change at any time.

Step 2 Clinical Knowledge System Specifications

General Principles of Foundational Science2–4%
Immune System3–5%
Blood & Lymphoreticular System4–6%
Behavioral Health6–8%
Nervous System & Special Senses6–8%
Musculoskeletal System/Skin & Subcutaneous Tissue6–10%
Cardiovascular System8–10%
Respiratory System7–9%
Gastrointestinal System7–9%
Renal & Urinary System & Male Reproductive4–6%
Pregnancy, Childbirth & the Puerperium4–6%
Female Reproductive System & Breast4–6%
Endocrine System4–6%
Multisystem Processes & Disorders4–6%
Population Health/Biostatistics & Epidemiology/Interpretation of Medical Literature3–5%
Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety10–15%

Step 2 Clinical Knowledge Discipline Specification

Each Step 2 Clinical Knowledge exam form will include content from the fields listed below. Another reminder: based on the exam form, the amount of content from each discipline varies:

Obstetrics & Gynecology10–20%

Step 2 Clinical Knowledge Physician Task/Competencies Specifications

Step 2 Clinical Knowledge assesses your physician competencies and practical knowledge in addition to your theoretical clinical knowledge. Each test question is  designed to evaluate one of the following skills:

Medical Knowledge: Applying Foundational Science Concepts0
Patient Care: History and Physical Exam0
Patient Care: Laboratory/Diagnostic Studies13–17%
Patient Care: Diagnosis16–20%
Patient Care: Prognosis/Outcome5–9%
Patient Care: Health Maintenance/Disease Prevention8–12%
Patient Care: Pharmacotherapy8–12%
Patient Care: Clinical Interventions6–10%
Patient Care: Mixed Management12–16%
Practice-based Learning & Improvement3–5%
Systems-based Practice & Patient Safety5–7%

USMLE Step 2 Fees Test Centers

USMLE Test Center Fees & Surcharges

USMLE Test RegionPrometric Testing Centres LocationSurcharge
AsiaBangladesh, Philippines, Malaysia, Singapore, Pakistan, People’s Republic of China, Nepal170
AustraliaAustralia and New Zealand170
AfricaKenya, Ghana, South Africa, and Uganda170
ChinaPeople’s Republic of China170
Latin AmericaBrazil, Trinidad and Tobago, Guatemala, Argentina, Venezuela, Chile, Dominican Republic, Colombia, Peru, Mexico, Costa Rica, Bolivia 170
Middle EastOman, Jordan, Egypt, Saudi Arabia, Lebanon, Kuwait, Qatar, and United Arab Emirates170
EuropeUK, Denmark, Spain, Greece, Latvia, Ireland, Armenia, Israel, Turkey, Switzerland, Portugal, Netherlands, Italy, Germany, France, Croatia210

USMLE Step 2 Fees

Given below is the USMLE Step 2 CK fees, and additional costs.

usmle step 2

For aspirants from USA and Canada:

USMLE FeesStep 2 CK
Application Fees610
Additional Surcharge0

For International Students:

USMLE FeesStep 2 CK
Application Fees910
Extension of Eligibility Period70
Testing Region Change65
Rescheduling Fees$0-$1285
Score Recheck80
Paper transcript$70/request (up to 10 transcripts)
USMLE Transcript: ERAS (Electronic Transmission)$80 per ERAS

Rescheduling Fees:

Days before scheduled testTesting RegionStep 2 CK
31+ days before the test dateAll testing regionsNo Fee
Less than 31 days to more than 5 days before the date of testAll testing regions50
5 days or fewer days before the scheduled testUS and Canada128
Africa, Asia (including Pakistan and Hong Kong),311
India, Australia, Latin America, China, Indonesia,
Thailand, Middle East (including Egypt)
Europe (including Israel), Korea, Taiwan353

USMLE Step 2 exam dates

The rules for Step 2 Clinical Knowledge are the same as for the USMLE Step 1 exam. Students must choose a three-month eligibility period and take the USMLE exam during that time period. According to USMLE regulations, students cannot take the USMLE during the first fortnight of January or during major public holidays.

The USMLE Step 2 Clinical Skills examination has a 12-month eligibility period since students need to travel to the United States to take it.

USMLE scores for Step 2

The results of the USMLE Step 2 Clinical Skills exam are either Pass or Fail. There are no USMLE Step 2 Clinical Skills scores provided. Step 2 Clinical Knowledge, like Step 1, is scored in 3 digits. There is no minimum qualifying score for candidates, but the most current USMLE Step 2 Clinical Knowledge qualifying score is 209.

How to prepare for USMLE Step 2 Clinical Knowledge

An exam committee consisting of faculty members, investigators, teachers, and clinicians develops a series of multiple-choice questions (MCQs) for USMLE Step 2 Clinical Knowledge. All members of the committee are recognized professionals in their fields.

As previously stated, the test evaluates your ability to recognize and apply clinical science principles that are essential for practicing medicine as a supervised medical professional in postgraduate study.

The content outline I offer in the section above is not meant to be used as a curriculum or a study guide, but rather to represent the breadth of issues that will be faced in actual medical practice. The outline provides a flexible framework for creating exams that may easily handle new topics, developing content domains, and emphasis shifts. Keep in mind that the categories and content coverage may change.

Focus on broad-based learning that builds a firm understanding of concepts and principles in the basic and clinical sciences to prepare for USMLE Step 2 Clinical Knowledge. Here are some research methods you should use:

Do Well on Your Subject Exams

After each major rotation, medical students have to take a SHELF exam, which assesses their knowledge of the material covered in that rotation. These comprehensive exams include the same material as the USMLE Step 1 and Step 2 Clinical Knowledge exams. They will assist you in identifying your strengths and weaknesses before to taking the exam. When a student regularly does well on each SHELF exam, they will be well prepared for Step 2 Clinical Knowledge.

If IMG students do not take the shelf exams, they should spend enough time reviewing the information from each of these core rotations (as specific questions may come up). While the SHELF and USMLE exams may have similar content, the USMLE examinations and scoring process are independent of the SHELF exams.

Start Your Review Early

You should keep your USMLE Steps in mind as you start medical school. A good score will not be obtained by cramming for any of your USMLE exams a few weeks before the exam date.

Form good study habits to retain new knowledge and engage yourself in your studies starting your first year of medical school to ensure success in Step 2 Clinical Knowledge. As soon as you begin your medical school rotations, get in the practice of studying the content of Step 2 Clinical Knowledge — set aside a few hours each week to review what you learned in clerkships.

A weekly review of your materials will strengthen your knowledge base. Instead of cramming for your exam a few months before the exam date, if you follow this advice, you will simply review your notes and study materials, rather than learning new content or trying to recall content studied one or two years ago.

Focus on Clerkships

After you pass the USMLE Step 1, a lot of the clinical knowledge you’ll want to retain and apply will be covered in your program’s clerkship rotations. Clerkship years are difficult because, in addition to the demanding workload and studying, students have less free time to relax, eat, or even sleep.

Furthermore, many students begin to be worried about the residency match, potential career options, and performing well on Step 2. While these concerns are reasonable, we highly advise you to concentrate on the content material you will be presented during each rotation – this will be the key to your success on USMLE Step 2, both Clinical Knowledge and Clinical Skills.

Approach each clerkship rotation as if you’re considering pursuing this specialty as a career. Learn, understand, and memorize all of the fundamentals required to work in that profession of medicine.

Not only will you be able to improve your clinical skills, but you will also be able to honestly assess your fit for each specialty because you contributed everything that you have to each rotation. Rotations are designed to help you prepare for exams, but they also allow you to try out new specialties and develop the theoretical and practical knowledge necessary to work as a supervised practitioner.

Tip: The main six clerkships including Psychiatry, Family Medicine, Pediatrics, Internal Medicine, Surgery, and OB/GYN account for approximately all of the content on the Step 2 Clinical Knowledge exam.

FAQs – USMLE Step 2

How to Apply for Usmle Step 2 Clinical Knowledge?

Students and graduates of AOA or LCME accredited programs should apply for USMLE Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills by following the instructions on the NBME website

International medical graduates should apply for USMLE Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills by following the instructions on the ECFMG website.

How Much Does Usmle Step 2 Clinical Knowledge Cost?

The fee for medical school graduates in Canada and the United States is $645. This fee for international medical graduates is $965.

When Should I Take Usmle Step 2 Clinical Knowledge?

In their fourth year of medical school, students typically take the USMLE Step 2 Clinical Knowledge and Clinical Skills exam.

What Does Usmle Step 2 Clinical Knowledge Assess?

This exam evaluates your ability to apply medical knowledge, skills, and understanding of clinical science, and it qualifies you for regulated medical practice. Even though the question is focused on diagnosis or management, most of the basic science concepts will be examined in Step 1. Foundational science knowledge will often be required to answer questions in Step 2 Clinical Knowledge. Foundational science knowledge will be covered in all USMLE examinations since it is required for both licensure examinations and lifetime learning beyond assessments and tests.

When Will I Get My Score?

Every Wednesday, the scores of Step 2 Clinical Knowledge are released. The score usually takes three to four weeks to be released after the test date. Many factors, however, can lead an individual score to be delayed. Usually, problems are handled quickly, and the score is released in the following weekly cycle. When your score becomes available, your registration entity will send an email to you. Your scores will be posted on the secure website of your registration entity, either NBME or ECFMG, once they are released.

What Is The Passing Score For Step 2 Clinical Knowledge?

209 is the current minimum passing score.

Can I Retake A Step To Raise My Score?

You cannot retake a Step or Step Component if you pass it the first time.

How Much of Each Content Area on The Exam?

The amount of content in each area changes depending on the test. The percentages here give you an idea of how much content is on the exam in each classification:

  • Medicine 50-60%
  • Surgery 25-30%
  • Pediatrics 20-25%
  • Obstetrics & Gynecology 10-20%
  • Psychiatry 10-15%

What to Do If I Fail My Step 2 Clinical Knowledge Exam?

Don’t be worried. You will have the opportunity to retake the USMLE Step 2 exam. Make sure you thoroughly review the exam content before arranging a new test date. The Step tests are very integrative, therefore you should prepare to cover all subjects. When deciding which areas to review, consider both the topic area’s representation on the exam (based on the percent of items per exam next to the content area label) and your relative performance in that content area. For failing examinees, remediation strategies that focus primarily on relatively weak areas of performance are unlikely to be the most effective. In most cases, failing scores can be improved by paying close attention to all content areas.

This article will aid you in better understanding the USMLE Step 1 so that you can prepare for the exam. Don’t forget to take our free USMLE practice test to get familiarized with the format as well as the questions of the actual exam to strengthen your knowledge and skills, as a result, enhancing your chance to pass the USMLE exam with a flying score on your first attempt. Good luck to you!


USMLE Step 1: Everything You Need To Know in 2023

The USMLE Step 1 is a one-day computer exam that you’ll most likely take after your second year of medical school. It tests your understanding of and ability to apply key scientific concepts that are fundamental to practicing medicine. What is USMLE Step 1? The USMLE Step 1 is an eight-hour computerized exam that evaluates […]

June 3, 2022

The USMLE Step 1 is a one-day computer exam that you’ll most likely take after your second year of medical school. It tests your understanding of and ability to apply key scientific concepts that are fundamental to practicing medicine.

usmle step 1

What is USMLE Step 1?

The USMLE Step 1 is an eight-hour computerized exam that evaluates whether you comprehend and can apply key concepts in the sciences fundamental to medical practice, with a focus on the principles and mechanisms underlying disease, health, and modes of therapy. Step 1 ensures you understand the science in clinical contexts then you may practice medicine safely and competently under supervision.

USMLE Step 1 details:

Test Type: Computer-based assessment

Examination Duration: Seven 60-minute “blocks” administered in one eight-hour testing session; computer tutorial: 15 minutes; breaks: 45 minutes, self-scheduled

Number of Questions: About 280; maximum of 40 questions per block

Question Type: Multiple-choice test items with a single best answer

Average Time per Question: About 90 seconds

The USMLE Step 1 is unlike any other exam you’ve ever taken in medical school, and it’s broader, more difficult, and more comprehensive in many ways. As a consequence, it necessitates a different approach to study than other medical school exams.

The USMLE exams take more time, effort, and money to prepare for than any other exam you’ve taken. Exam items are not just questions to be answered; they’re also problems to be solved. Good USMLE questions assess students’ ability to think critically about the important medical knowledge and apply them to particular situations. The USMLE evaluates students’ ability to apply their knowledge in practical situations rather than just recalling facts. Good fundamental knowledge is essential but is not sufficient. Students must be able to apply as they know.

What’s on The USMLE Step 1?

All USMLE exams are designed around an integrated content outline that organizes information into general principles and individual organ systems. Test questions are divided into 18 major areas that are based on whether they focus on concepts and principles that apply across organ systems or within particular organ systems.

Table 1 shows the content weighting for these topics in the Step 1 USMLE exam. Individual organ systems are separated into sections based on normal and abnormal processes, as well as pharmacotherapy mechanisms. The majority of the time, knowledge of normal processes is evaluated in the context of a disease or pathology.

While each USMLE Step exam does not cover all of the topics listed in the content outline, overall content coverage is comparable throughout the various examination forms that will be taken by different examinees for each Step.

SystemRange, %
General Principles**12–16
Blood & Lymphoreticular/Immune Systems7–11
Behavioral Health & Nervous Systems/Special Senses9–13
Musculoskeletal, Skin & Subcutaneous Tissue6–10
Cardiovascular System5–9
Respiratory & Renal/Urinary Systems9–13
Gastrointestinal System5–9
Reproductive & Endocrine Systems9–13
Multisystem Processes & Disorders6–10
Biostatistics & Epidemiology/Population Health4–6
Social Sciences: Communication and Interpersonal Skills6–9

Table 1: Step 1 Test Content Specifications*

*Percentages are subject to be changed at any time.

**Normal and abnormal processes that are not limited to specific organ systems are included in the Step 1 General Principles category.

Physician tasks and competencies are another organizing construct for Step 1 design. Each test question is designed to evaluate one of the skills outlined in Table 2.

CompetencyRange, %*
Medical Knowledge: Applying Foundational Science Concepts60–70
Patient Care: Diagnosis20–25
 History/Physical Examination
Communication and Interpersonal Skills6–9
Practice–based Learning & Improvement4–6

Table 2: Step 1 Physician Tasks/Competencies Specifications*

*Percentages are subject to be changed at any time.

usmle step 1

As shown in Table 3, each Step 1 examination covers content from traditionally defined disciplines and interdisciplinary areas.

DisciplineRange, %
Biochemistry & Nutrition14–24
Gross Anatomy & Embryology11–15
Histology & Cell Biology8–13
Behavioral Sciences8–13

Table 3: Step 1 Discipline Specifications*

*Percentages are subject to be changed at any time.

Who takes the USMLE Step 1?

To take the exam, you must fall into one of the following categories when you apply for Step 1 and on the day of testing:

  • A medical student officially enrolled in, or a graduate of, a Candian or United States medical school program leading to the MD degree that’s accredited by the Liaison Committee on Medical Education (LCME).
  • A medical student officially enrolled in, or a graduate of, a United States medical school leading to the DO degree that’s accredited by the American Osteopathic Association (AOA).

When should I take the USMLE Step 1?

Step 1 is accessible by appointment throughout the year. While the majority of students take Step 1 of the Boards at the end of their second year, you should wait until you’re certain you’ll pass. By April, you should have finished the USMLE Step 1.

Step 1 has two unique features:

  • It evaluates your ability to apply your skills, values, and attitudes to real-life, patient-centered scenarios.
  • Many residency program directors consider it the most essential factor in selecting graduating medical students for their programs.

Where will I take the Step 1 exam?

The USMLE Step 1 exam is available at Prometric® test centers around the world. You must bring your scheduling permit on paper or online, as well as the relevant identification, to the test. You would not be able to test without them. Arrive 30 minutes before your planned testing time.

Test center staff supervises Step 1 exam sessions both in person and by audio and visual recording. They are not allowed to address inquiries about registration, testing software, examination content or format, scoring, or retesting.

How to pass the USMLE Step 1 exam?

Step 1 test preparation can take a number of forms, including watching videos, using question banks, reading review books, and doing review programs.  It’s essential to remember that you don’t have to know everything as you begin your focused USMLE Step 1 preparation. This exam just tests the general principles of the basic medical sciences.

Although this does not make the exam any simpler, it should help you put things into perspective: USMLE Step 1 can be conquered with strong discipline, the right attitude, and solid prep support.  Doing your best requires a plan and preparation. This preparation must take place on different levels.

  • You should be familiar with the types of questions you’ll be requested as well as the exam’s overall structure.
  • To get the most out of your study time, you must organize it effectively.
  • Not only must you be able to recognize the content being assessed, but you must also be able to use it. You must be able to use it in a number of situations.
  • You must prepare yourself physically and mentally for the task at hand.

In short, you need to know about the exam, master the material tested, and be prepared to handle yourself during this stressful time. USMLE prep is where we come in. Take the first step towards your dream future by taking our free USMLE Step 1 with Medtutor. Let’s get started with our free USMLE  practice questions to get familiarized yourself with the format, questions, and knowledge of the actual USMLE exam, from that get your highest score and pass the exam on the first attempt.


What Is USMLE? The Most Comprehensive Guide in 2023

Before applying for a medical license, you must pass the USMLE exam. But what is USMLE exam? Read on to figure out everything related to the USMLE exam.

June 3, 2022

You must pass the United States Medical Licensing Examination (USMLE), also known as the board exam, before you may apply for a medical license. But what is the USMLE exam? This page will walk you through the three steps of the USMLE, like how to register for the exam and how to prepare for the exam.

Let’s get started with our free MCAT practice test to pass the actual exam with a high score on your first attempt.

what is usmle

What is the USMLE test?

The United States Medical Licensing Examination (USMLE) is a three-part exam that is required of anyone who wants to practice medicine in the United States. It is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) (NBME).

Physicians need to pass this examination during med school and after receiving an M.D. degree in order to be licensed and practice medicine in the United States. The USMLE’s three steps all work together to examine a physician’s skills and competencies, therefore a step can not stand alone to determine readiness for medical licensure.

How do I apply to the USMLE?

You apply to take the USMLE from the Uk by registering with the Educational Commission for Foreign Medical Graduates.

After that, you’ll need to take the USMLE Step 1 (Basic Medical) and USMLE Step 2 (Clinical Knowledge) tests, which you can do while studying for your Medicine degree. After that, you can take the USMLE Step 2 test (Clinical Skills). You’ll earn a Standard ECFMG certificate when you’ve completed all three stages.

To apply for Graduate Entry Medicine (GEM) programs in the United States, graduates would have to have full ECFMG certification, and one to three years of GEM is required to practice medicine. After the first year of GEM, the final stage, USMLE Step 3 test, is commonly taken. You can apply for a license in the United States state where you want to practice medicine after completing your graduate-entry program.

USMLE Step 1 exam

What is USMLE Step 1?

The USMLE Step 1 exam is an eight-hour multiple-choice exam. It is split into seven 60-minute sections. This step tests your basic knowledge of the sciences behind medicine. It covers a range of topics including biochemistry, anatomy, behavioral sciences, pharmacology and immunology. Frequently, questions will detail a patient’s illness or scenario, with multiple-choice answers requesting you to identify the patient’s illness or recommended examination.

How much does USMLE Step 1 cost?

USMLE Step 1 has an exam price of $880 (roughly £722). There is also an international fee of $185 (roughly £150) if you are taking the test outside of the United States.

USMLE Step 2

USMLE Step 2 (Clinical Knowledge)

What is USMLE Step 2 Clinical Knowledge?

The USMLE Step 2 Clinical Knowledge evaluates your ability to apply medical and clinical science to patient care. It’s a one-day multiple-choice exam, similar to USMLE Step 1, that lasts nine hours and is divided into eight blocks. Questions cover physician tasks, such as diagnostics, pharmacotherapy, and clinical interventions. Step 2 additionally includes disease categories such as the musculoskeletal system, the cardiovascular system, and biostatistics.

How much does USMLE Step 2 (Clinical Knowledge) cost?

USMLE Step 2, like Step 1, has an examination fee of $880 (roughly £722). There is also a $210 (roughly £170) international fee for students taking the test outside of the United States.

USMLE Step 2 (Clinical Skills)

What is USMLE Step 2 (Clinical Skills)?

This is the second part of USMLE Step 2; it assesses your ability to deal with patients and diagnose problems. Professional actors trained to act as real patients with clinical problems will play the twelve patients you will see, comparable to the MMI Interview in the UK. Cardiovascular issues, musculoskeletal issues, and women’s health are some of the causes and symptoms you may encounter. This step takes eight hours, with 15 minutes spent with each patient you meet in person or over the phone. You will have 50 minutes of breaks, but they will be scheduled during the day, unlike Step 1 and Step 2 Clinical Knowledge.

How much does Step 2 (Clinical Skills) cost?

USMLE Step 2 (Clinical Skills) costs £1,535 (roughly £1,246). Another thing to keep in mind is that if you’re taking the USMLE from the UK, you’ll need to travel to a designated CSEC Testing Center in the United States. These are in California, Illinois, Georgia, Pennsylvania, and Texas so be sure to consider the cost of travel!

USMLE Step 3

What is USMLE Step 3?

You’re almost finished! The USMLE Step 3 exam lasts two days. Foundations of Independent Practice, the first day, is a seven-hour multiple-choice test comparable to USMLE Steps 1 and 2 (Clinical Knowledge). It is split into six 60-minute blocks with a 45-minute break in between. It evaluates medical diagnosis knowledge, interpersonal skills, and comprehension of scientific abstracts and pharmaceutical adverts.

On the second day, Advanced Clinical Medicine evaluates your knowledge of patient management and how diseases evolve over time. This is broken down into 198 multiple-choice questions and 13 computer-based care simulations each lasting 10-20 minutes. This exam lasts nine hours and is divided into six 45-minute blocks. This day tests your knowledge of care management, diagnosis, and medical decision-making.

How much does Step 3 cost?

USMLE Step 3 costs $830, which is £674.

USMLE examination requirements

There are several USMLE requirements for international students that you should keep in mind:

  • Applicants will get an email notification of scheduling permit availability after completing the application procedure.
  • To schedule the exam, they must go to the Prometric official site.
  • Applicants should keep their exam scheduling permits safe.

Aspirants should read the test’s Rules of Conduct thoroughly and follow all instructions at the testing center, as well as provide copies of their schedule permits and proof of identity. They are not permitted to bring any additional family members or friends to the testing location.

Soft-foam earplugs are permitted, but they should avoid unauthorized accessories. USMLE  Step 2 Clinical Skills allows only the use of a stethoscope and a white laboratory coat. Before going to the CIN (Candidate Identification Number) and starting the session, they should never write on laminated note boards.

Steps 1 and 2 Clinical Knowledge can be attempted in any sequence, but Step 3 can only be attempted after the first two steps have been completed.

USMLE exam details: Time limits, Number of attempts & retakes

Retakes, Time Limits, and Number of Attempts on the USMLE Exam

Applicants for the USMLE can take a Step or section of a Step up to three times in 12 months. The fourth attempt should take place at least 12 months following your first attempt. It should also be at least six months after the last take at the exam.

Aspirants can take the same exam Step or part of the exam as many times as they like, including incomplete exams. Regardless of the examination time, all attempts contribute to calculating the limit. There are no retakes if the applicant passes the Step or Step Component, except to meet the time limit set by the authority for US physician licensing. This means that all Steps must be completed by the deadline.

what is usmle

USMLE exam centers

Candidates may check examination center lists on the official Prometric website. The testing regions like Japan, India, Europe, and the Middle East are grouped, and applicants should choose the examination center at the time of registration. Note that centers may change without any advance notice. Here is a list for your perusal (USMLE Steps 1 and 2 only): 

Area of TestingSpecific Areas
The United States and CanadaGuam, Puerto Rico, Nova Scotia, Ontario, British Columbia, Alberta, Manitoba, Saskatchewan, Labrador and Newfoundland, Quebec, and the Virgin Islands
AfricaGhana, Kenya, Uganda, and South Africa
AsiaBangladesh, Malaysia, Taiwan, India, Indonesia, Thailand, Singapore, Japan, Nepal, the Philippines, and People’s Republic of China
OceaniaNew Zealand and Australia
EuropeArmenia, Croatia, Latvia, Switzerland, Israel, Denmark, Italy, Portugal, Spain, Ireland, France, Turkey, Netherlands, and the United Kingdom
Latin AmericaGuatemala, Argentina, Colombia, Brazil, Costa Rica, Mexico, Bolivia, Peru, Chile, Venezuela, Dominican Republic, and Trinidad and Tobago
Middle EastEgypt, Saudi Arabia, Kuwait, Jordan, Qatar, UAE (United Arab Emirates), Lebanon, and Oman

Step 3 is only possible in the United States and its territories.

USMLE scoring system

The USMLE releases results online, and administrators distribute scorecards with candidates’ results. The authorities also inform all applicants about the availability of their results. When Step 3 results are announced, FSMB officials send out notifications.

Score reports are generated using electronic formats, and results are revealed three to four weeks after the exam. At least 194 in Step 1 and 209 in Step 2 (Clinical Knowledge) are required. In Step 3, they should get at least 196. Step 2 (Clinical Skills) will only have a Pass/Fail result.

USMLE registration entity

There are three steps to the examination. Every step in the digital mode has its own application form. To complete Step 3, candidates must have passed USMLE Steps 1, 2 Clinical Skills, and 2 Clinical Knowledge. Candidates have to submit application forms to their respective entities for registration. They must schedule examination dates after applying.

The following is a guide for you:

USMLE Steps 1, 2 Clinical Knowledge and 2 Clinical SkillsUSMLE Steps 1, 2 Clinical Knowledge and 2 Clinical SkillsUSMLE Step 3
For graduates or students of LCME or AOA accredited medical courses in Canada or the United States.For graduates or students of medical schools outside the USA and Canada.All medical school graduates who have passed Steps 1, 2 Clinical Knowledge, and 2 Clinical Skills.
Applications are available on the NBME official website.Applications on IWA via ECFMG.Application through FSM.

Top 5 tips to pass the USMLE exam

  1. Get used to working with breaks

Personal breaks of 45 or 50 minutes are allowed for USMLE Steps 1, 2 (Clinical Knowledge), and 3. You can take these whenever you want, but no more than six are allowed. If you choose to skip the optional tutorial at the beginning of each exam, you can add the time to your breaks. It’s a good idea to repeat a break structure once you’ve begun taking practice tests so you can get used to working under these conditions.

  1. Answer all of the questions

You can’t reopen a block of questions once it has been closed, so make sure you’ve answered everything! If you’re unsure about a question in USMLE Steps 1, 2, or 3 (Clinical Knowledge), the best idea is to guess. An unmarked answer will be automatically read as wrong, whereas an educated guess may be correct!

  1. Get a good night’s sleep

If you were up trying to cram the night before, you won’t be able to sit an exam for eight or nine hours! To ensure you perform at your best, get at least eight hours of sleep and have a good breakfast in the morning.

  1. Practice as much as you can

Practice questions (lots of them!) are the way to go for Steps 1, 2 (Clinical Knowledge), and 3. For Step 2 (Clinical Skills), practice your typing and spelling so that your patient notes are written to the best of your ability, and practice patient scenarios with your friends in 15-minute slots. When exam day comes, you will be completely prepared.

  1. Check the requirements

Check USMLE’s Examination Day and Testing page for details on what to bring on exam day, as well as what you can bring into the testing room – and when you need to arrive!

FAQs – USMLE exam

Is USMLE Valid in India?

Technically, US residency degrees are recognized in India. However, the residency should be recognized by the ACGME (Accreditation Council for Graduate Medical Education). All residency program degree holders (accreditation from ACGME) will be eligible for MD degrees in India. In India, one doesn’t need to give any other entrance to the practice.

How to Apply for USMLE for Indian Students?

The application procedure involves obtaining USMLE/ECFMG identification numbers, creating accounts, and filling out applications. It also involves filling out and notarizing Form 183, Certificate of Identification. This form will be sent to Philly, and you will receive an email with a scheduling permit in two to three weeks. The final step is to book an appointment with Prometric.

Is USMLE Hard?

The USMLE Step 1 is considered one of the most challenging medical exams in the world. The results of this test will lay the foundation for a successful residency program. The USMLE is a long process that puts a candidate’s patience to the test. Furthermore, the exam is highly competitive.

When is USMLE Exams Held?

The USMLE Step 1 examination is available all year, with the exception of the first week of January and major public holidays. The USMLE exam details are kept secret by the conducting bodies. Following registration and receipt of the eligibility period, the candidate must arrange an exam for a specific step.

Which Countries Accept USMLE?

One of the most well-known medical licensing exams is the USMLE. Because of its toughness and competition, it is hard to crack. The USMLE program is accepted by medical licensing authorities in the United States, New Zealand, Israel, the United Arab Emirates, and Qatar. These counties accept USMLE scores and waive other eligibility requirements for candidates.

Who Can Give the USMLE Exam from India?

To take the USMLE exam, Indian doctors need to pass their equivalent exam with a score of at least 230. To qualify for a residency in the United States, students must take the USMLE Step 2 Clinical Knowledge exams. They can apply for work visas in the United States once their residency has been confirmed.


With so much relying on your success in the USMLE, it’s possible to feel nervous as the first section of the exam series approaches. However, now that you’ve received some expert advice, you have the answer to the question “what is the USMLE test” and also a better understanding of everything related to the exam.

Let’s get started with our free USMLE practice questions to get familiarized yourself with the format, questions, and knowledge of the actual USMLE exam, from that get your highest score and pass the exam on the first attempt.