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The Ultimate Guide to USMLE® Step 1 Exam

usmle step 1 exam

What is the USMLE Step 1 Exam?

USMLE stands for US Medical Licensing Examination. It consists of USMLE 3 Steps, USMLE Step 1, USMLE Step 2 CS, USMLE Step 2 CK and USMLE Step 3. It is a license examination for practice, residency, and fellowships in the USA. It’s not easy to be a doctor! There’s a lot of challenges and hurdles coming up if you’re looking to become a doctor. The biggest challenge is that the practicing doctors face on their educational path is- THEY MUST PASS THE USMLE.
USMLE is a famously challenging 3-step USMLE exam series that is required for anyone who wants to practice medicine in the United States. The first two steps of the series are usually taken while a student is still in medical school, while the third step takes place after graduation.

USMLE Step 1 is a multiple-choice examination conducted by the FSMB (Federation of State Medical Boards) and NMBE (National Board of Medical Examiners). The main objective of this review is to test your basic medical knowledge and the application of basic ethical practice. It covers most of the first and second years of the MBBS syllabus.

Importance of USMLE

The examinations are sponsored by two organizations: the Federation of State Medical Boards (FSMB) and the National Medical Examiners Board (NBME). The USMLE exams, especially Step 1, are often referred to colloquially as “The Boards.”

Most U.S. medical schools require students to graduate from USMLE Step 1 — and some also require students to pass USMLE Step 2 / Clinical Knowledge (CK) and Step 2 / Clinical Skills (CS) to graduate.

The scores from the first two steps (Step 1, Step 2 CK, and Step 2 CS) play an important role in the assessment of residency training positions for medical students in the US.

Passing the last step (Step 3) is necessary in order to be admitted to U.S. specialty boards, such as the American Board of Internal Medicine, but state medical boards are also required to allow physicians to practice in their specialty. (Boards are governing bodies at the state level which certify doctors as well as more than 150 specialties).

Syllabus of USMLE Step 1

Step 1 examination focuses on basic medical knowledge, including anatomy, biochemistry, microbiology, pathology, pharmacology, physiology, and also behavioral sciences, biostatistics, and epidemiology. Initials 6 topics are covered in the first and second year of MBBS, while in the third year, you will be expected to read psychiatry and preventive and social medicine, which are MBBS topics for the third year.

USMLE Step 1 Exam Pattern

The one-day USMLE Step-1 exam contains seven 60-minute blocks to be completed in one 8-hour testing session. The number of questions per block may vary but there will be no more than 40. The total number of questions in the exam won’t exceed 280.

The whole USMLE Step 1 exam takes about 8 hours, broken down as follows:

  • Tutorial: 15 minutes (optional—more on that later)
  • Breaks: 45 minutes
  • 7 Testing Blocks: 60 minutes per block (~1.5 minutes per question)

USMLE Step 1 Eligibility Criteria

  • U.S. or Canadian allopathic medical school accredited by the Liaison Committee on Medical Education (LCME), leading to an M.D. degree.
  • U.S. or Canadian osteopathic medical school accredited by the American Osteopathic Association (AOA), leading to a D.O. degree.
  • Medical schools outside the U.S. or Canada that are listed in the International Medical Education Directory (IMED) and that meet Educational Commission for Foreign Medical Graduates (ECFMG) criteria.
  • U.S. or Canadian allopathic medical school accredited by the Liaison Committee on Medical Education (LCME), leading to an M.D. degree.
  • U.S. or Canadian osteopathic medical school accredited by the American Osteopathic Association (AOA), leading to a D.O. degree.
  • Medical schools outside the U.S. or Canada that are listed in the International Medical Education Directory (IMED) and that meet Educational Commission for Foreign Medical Graduates (ECFMG) criteria.

What is the passing score for USMLE Step 1?

Your USMLE Step 1 result is reported as a binary pass/fail, along with a 3-digit score ranging from 1 to 300. The passing score is 194, slightly up from 192 in 2017. Despite the reputation of the USMLE Step 1 as one of the most difficult exams in the world, the U.S. and Canadian candidates achieved a 94% pass rate in 2018.

Is the USMLE Step 1 Score Changing to a Pass/Fail Result?

On 12 February 2020, co-sponsors of the USMLE Program, the FSBM, and NBME® announced a number of important policy changes regarding USMLE eligibility and score reporting.

The most notable of these changes is that the USMLE Step 1 exam will no longer be scored as a 3-digit numeric score. This change will be implemented by January 2022 at the latest.

What is a good Step 1 score?

In 2018, the U.S. and Canadian candidates achieved a mean score of 230, with a standard deviation of 19. That means that about two-thirds of these candidates scored between 211 and 249. You can read more about how scores are calculated in the USMLE Examination Score Interpretation Guidelines.

USMLE Step 1 scores can later have a direct effect on your residency choices. Some residency programs, such as dermatology, plastic surgery, otolaryngology, orthopedic surgery, and neurosurgery, can be highly competitive. Fellowship programs are also inclined to use a resident’s Step 1 score as a primary indicator of past performance, in particular more competitive fellowships such as gastroenterology, oncology, cardiology, and surgical fellowships. For example, the average score for candidates who matched in Orthopedic Surgery in 2018 was 248 according to the National Resident Matching Program.

How long does it take to get your Step 1 score after the exam?

Typically, results are available within three to four weeks of your test date. It’s not unheard, however, of missing test results by up to eight weeks. In most situations, if there is any national holiday in the US, expect a weekly break. Once your score is available, you’ll be provided with email instructions to access your one-year USMLE score chart. You will only be able to access your scores through an official USMLE transcript after that year, which is available at a fee. It is advisable to save a pdf version of this report as this will be required for residency applications (ERAS) in the future.

Subjects Covered in USMLE Step 1

  • Anatomy
  • Biochemistry
  • Behavioral Sciences
  • Biostatistics and Epidemiology
  • Pathology
  • Microbiology
  • Physiology
  • Nutrition
  • Pharmacology
  • Genetics
  • Aging
  • Molecular and Cell Biology
  • Immunology

How much does The USMLE Step 1 cost?

There is a registration fee of $630 ($645 for 2020 registrations) for students and graduates of LCME- or AOA-accredited medical programs in the US or Canada. The Eligibility Period Extension fee is $70.

Prometric also charges a $50 fee for examinees to change their testing appointment-if you change your appointment five days or less before the test date, a higher fee will apply.

If you’re a Foreign Medical Graduate (IMG), taking the USMLE Phase 1 with a minimum of $160 surcharge would cost $940 if you’re taking the exam outside the USA. Additional fees – some quite high – are also applicable for changing the date or location of your exam, as well as translation fees if translated

Check the latest fees from HERE

USMLE Step 1 Preparation Tips

1. Find Your Starting Point – Before calculating your study needs and setting a USMLE study schedule, you must know where you stand. Instead of relying on unstandardized grades from the medical school, sign up for NBME self-assessments or other tests to better understand your baseline score, strengths, and weak points.

2. Set a goal – define what you want to achieve when your USMLE preparation is finished. You ‘re aiming for a score above 240 for example, or just looking to pass the exam? Take career goals into account but be practical, as it will take more time or energy to leap from a baseline score of 140 to over 260 than to target for 200!

3.USMLE Step 1 Questions and Answers

Download Free USMLE Step 1 Q & A from HERE