USMLE Step 1 Basics – Learn what Step 1 is all about


Tests, tests, everywhere there’s tests….a start to a great remake of Signs.

USMLE® Step 1

USMLE® Step 1 is used to assess your understanding and ability to apply the important core concepts of the sciences learned in medical school years 1 and 2. The ability to pass Step 1 ensures the foundation has been laid for safe and competent practice of medicine both now and in the future.


USMLE® Step 1 is a multiple-choice test composed by the examination committee. The test covers the following subjects:

  • Anatomy
  • Physiology
  • Biochemistry
  • Pharmacology
  • Pathology
  • Microbiology
  • Behavioral Sciences
  • Interdisciplinary topics (nutrition, genetics, aging, ethics to name a few)
USMLE® Step 1 is a test that typically requires multiple steps of reasoning/knowledge PER question. The test items will often require you to perform one or MORE of the following tasks:
  • interpret graphic and tabular material
  • identify gross and microscopic pathologic and normal specimens
  • apply basic science knowledge to clinical problems

Content Breakdown

    • 25-35% General Principles
    • 65-75% Individual Organ Systems
      • hematopoietic/lymphoreticularUSMLE Step 1
      • nervous/special senses
      • skin/connective tissue
      • musculoskeletal
      • respiratory
      • cardiovascular
      • gastrointestinal
      • renal/urinary
      • reproductive
      • endocrine
      • immune
    • 20-30% Normal Structure and function
    • 40-50% Abnormal processes
    • 15-25% Principles of therapeutics
    • 10-20% Psychosocial, cultural, occupational, and environmental considerations

Question Formats

USMLE® Step 1 utilizes several different test question formats. These include:

  • Single One Best Answer
    • This test question format is the traditional format used in all tests. There is a question and only one correct answer to choose from
TIP: When reading through the question, try to formulate an answer in your head prior to reading the available answers. Your mind may try to play tricks on you and point you in the wrong direction, even if you feel strongly about one choice.
  • Sequential Item Sets
    • Patient vignettes are the go to test question format for most of your tests here on out. The vignette will give you the story of a patient, followed by one or several questions. Sequential Item Sets are multiple questions following a vignette.


USMLE® Step 1 consists of 322 multiple-choice test questions. These questions are divided into seven 60-minute blocks over an 8 hour day.

Test Location

The USMLE® Step 1 is a computer-based test that is administered by Prometric Services.


There are two pathways to apply for the USMLE® Step 1 exam, depending on if you are a U.S. or Canadian student or not. Check out the USMLE® Application Page

Score Release

The typical score reporting time for the USMLE® Step 1 exam is 4 weeks.

Test Prep

Now we get to the good stuff! Ask 100 medical students how they studied for Step 1, and you’ll get 1 answer (bet you weren’t expecting that). Beyond the obvious expert knowledge that you will have from the first two years of medical school, question banks (qbanks) are the key to rocking Step 1. The majority of medical students use some sort of qbank for their Step 1 test preparation.

Which one? That all depends! Each qbank has pros and cons, and here at MedicalSchoolHQ we will bring you reviews of each. Here is a short list of a few test prep companies:

Bottom Line

The preparation for USMLE® Step 1 begins the first day you step foot on your medical school campus. That doesn’t mean you begin studying for it on day one. Please don’t go out and buy First Aid for the USMLE Step 1.

What I am talking about is a mind set. Understanding that the USMLE® Step 1 is one of the biggest factors in your residency application is very important. Realizing that a solid foundation of core science knowledge will allow better use of the qbanks is a must.

Build good study habits from day one. Don’t get too far behind. Definitely don’t cram – quick in, quick out! There is a reason The Tortoise and the Hare is an everlasting fable in our society.


The information presented on this page is taken from the official USMLE® website Please visit for updated information.


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