USMLE Step 1
Offered by NBME / Federation of State Medical Boards (USMLE)
USMLE Step 1 is the first exam in the United States Medical Licensing Examination sequence. It assesses whether you can apply basic-science concepts (anatomy, biochemistry, microbiology, pathology, pharmacology, physiology, and related disciplines) to medicine.
EXAM AT A GLANCE
Questions
20
Sections
3
Delivery
Prometric test center
Passing score
Pass/fail
Cost
$695 USD (2026–2027); additional regional surcharge if testing outside the U.S. and Canada
Your USMLE Step 1 Community
Connect with other people preparing for the USMLE Step 1.
What the exam covers
Systems (cardiovascular, respiratory, renal, GI, neuro, musculoskeletal, etc.)
Physician tasks (diagnosis, management, mechanisms)
Disciplines (pathology, physiology, pharmacology, microbiology, biochemistry, anatomy, behavioral)
About the USMLE Step 1 exam
Results for exams taken on or after January 26, 2022 are reported as pass/fail only. Updated test-delivery software with shorter 30-minute blocks rolled out for Step 1 on May 14, 2026; total questions and exam length did not change.
Who it’s for
Medical students (typically after pre-clerkship coursework) and graduates seeking U.S. medical licensure.
- Testing time
- One-day, 8-hour testing session (includes a 45-minute break allotment)
- Validity
- A passing Step 1 result remains valid for completing the USMLE sequence subject to USMLE attempt and time-limit rules; state boards set licensure recency rules.
- Prerequisites
- Enrollment in or graduation from a medical school listed in the World Directory of Medical Schools that meets USMLE eligibility; application via NBME (U.S./Canadian) or ECFMG (IMGs)
Official exam page· Details verified August 2026
Exam details can change. Always confirm current requirements, fees, and exam policies with the certification provider before registering.
How to prepare
01
Map your school's pre-clerkship curriculum to the official Step 1 content outline.
02
Use a dedicated question bank and review every explanation, not just the letter answer.
03
Build a systems-based review (cardio, renal, neuro) rather than isolated fact lists.
04
Sit timed NBME self-assessments; Step 1 is pass/fail, but you still need a comfortable margin.
05
Practice the 30-minute block pacing introduced with the 2026 software.
Related resources
FAQ
Is Step 1 still scored numerically?
No. Since January 26, 2022, Step 1 is pass/fail only. Step 2 CK is now the primary numerical USMLE score for residency applications.
Did the 2026 software change the content?
No. Block length became 30 minutes, but the 280-question cap, overall day length, and question format stayed the same.
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