USMLE Step 1 Exam

Basic Medical Sciencies

Minimum score to pass	185/75
# of questions	350 multiple-choice questions on computer
Duration	8 hours
Additional information	Step1, Step 2CK and Step 2CS can be taken in any order. Score is valid for 7 years.

The USMLE Step 1 is the first in the series of three USMLE exams that candidates must pass in order to qualify for medical licensure in the United States. It is a one-day computer exam taken by medical students at the end of completed second year of medical school.

The Step 1 emphasizes basic science principles, specifically in anatomy, behavioral science, biochemistry, microbiology, pathology, pharmacology, and physiology. Interdisciplinary areas such as genetics, immunology, and nutrition are also tested.

The Step 1 exam contains 350 questions and spans 8 hours of testing (including an hour of break time). It is administered as 7 one-hour "blocks" of 50 questions each. You will be able to skip back and forth among test questions, but only within a particular block. Once you leave a block (or time expires for that block), you will not be able to return to the questions of that block.

Step 1 questions are NOT grouped by subject within a block. For example, you won't find a section devoted to biochemistry. This random ordering of items presents you with a unique challenge. You must switch from thinking about one subject, such as pathology, to another, such as behavioral science, without skipping a beat.

In total, you will have 45-60 minutes of "break" time depending on whether you choose to complete the 15 minute tutorial at the start. You can "add" to your break time by finishing a block early. Please note, however, that finishing blocks early does not add to your total "test time" which remains constant at 7 hours. That means that you can't add time to one block by finishing another block ahead of time. You should only take breaks BETWEEN blocks; leaving the testing area DURING a block will be noted as a testing irregularity.

Question Formats

The only question format currently on the USMLE Step 1 is one best answer (matching questions as well as negatively phrased questions were eliminated a few years ago). Some of the Step 1 items test your fund of knowledge directly; however, the majority require application of basic science principles to clinically-relevant situations. You will also be asked to identify microscopic and gross specimens, interpret graphic or tabular information, and solve simple clinical problems. In an effort to make the Step 1 exam more medically relevant, the USMLE items often assess basic medical science concepts in a clinical context. While some points are asked in a fairly traditional, straightforward manner, you will also be presented with many clinical vignettes. This style typically involves fairly long lead-in scenarios followed by relatively brief response options.

Scoring

With the new computer exam, you should receive your score back within 3 weeks of your test date. The USMLE Step 1 is scored and reported on two-digit and three-digit scales. Your score report will also include a pass/fail designation as well as a graphic depiction of your performance by discipline and organ system. The defined scale is based on the performance of a criterion group. This group represents a previous group of second year US med students who took the exam for the first time at the end of their second year of medical school.
The minimum passing score on the three-digit scale is 185, while the passing score on the two-digit scale remains 75 (75 does NOT mean 75%). To achieve a passing score, you typically need to answer between 55-65% correct (it can vary based on the calculated difficulty of the exam you took as each candidate takes a different version of the exam).