The USMLE Step 1 is, by all means, a gateway exam. It is a portal that allows access to a procedure upon successful completion of which, you reach the pinnacle of the medical career.

Every Step in the USMLE has a purpose. In the case of USMLE Step 1, the purpose is to confirm whether you have the requisite comprehension of the mechanisms and principles of medical science. This includes advanced ideas of disease and therapy. It checks your caliber to continue the process of learning beyond USMLE & your medical PG, however ahead you may be in your career.


Firstly, the USMLE Step 1 requirements for a US/Canadian medical graduate are different. For an International Medical Graduate, the mandatory eligibility to appear in the USMLE Steps 1 & 2 is that she must have an official enrollment in a medical college or university listed in the WDOMS. To directly check the list of Indian Medical Colleges enlisted in WDOMS.  Secondly, you need to meet other ECFMG criteria as well. Click here to know what other eligibility criteria you need to meet.

How do I apply for Step 1?

How to apply for USMLE Step 1? For the US/Canada Medical University students, the application portal is the NBME login portal at the NBME Website. This is where you do your USMLE registration. However, if you are an IMG, for USMLE step 1 registration and USMLE Step 2 registration, you will have to go through the ECFMG Official Website. The entire process is simple and direct. Finally, you will have to visit the website of Prometric USMLE to lock your Prometric USMLE Step 1 & 2 test date.


The current USMLE Step 1 cost is $985 (around 74k INR) while the USMLE Step 2 CK price is also the same. The fees for the test gets reviewed annualy and current fees can be found on click here

Prometric Test Center

Like all the USMLE Steps, Step 1 takes place in Prometric USMLE Step 1 centers. You do not have to be physically present in USA for this. There are 110 such Prometric centers outside of the US/Canada. We have centers all across India in major metro cities.

What are the dates for Step 1 2022? 

The USMLE Step 1 testing dates are available for most of the year except major holidays.

Exam Pattern

Only the Step 1 scoring has changed. The Exam pattern remains the same.

There are no USMLE Step 1 question types other than MCQs. How many questions on USMLE Step 1? In total, there will be not more than 280 questions.These 280 questions appear in 7 blocks.

How long is USMLE Step 1? Well, you get a maximum of 60 minutes for attempting the test items in each block. The number of test items in each block does not exceed 40. You have the provision of minimum 45 minutes of break time. So, the total time that you get is 8 hours.

The Step 1 is a one day examination that will continue for 8 hours. There is a 15 minutes tutorial and 45 minutes break. Therefore, there are 7 blocks of 60 min duration each. Each block may have a maximum of 40 questions.

So, in total, there are 280 questions. Before January 26, 2022, the Step 1 was a scoring test. The minimum USMLE Step 1 passing score was 194. Now, it is a pass/fail exam.If you manage to finish your blocks in less than the stipulated 60 minutes, you may use the saved time as break time.

Sample Questions 2022 

To get the feel of the Step 1 challenge and to check out the nature of questions asked, download USMLE Step 1 question bank pdf – PDF.
Download PDF

What are the subjects in Step 1?

There is no separate USMLE Step 1 subjects list or topic list. The entire USMLE Exam is based upon a content outline. This content outline is designed in such a way that test items from these topics serve the purpose of the USMLE.

The purpose of the USMLE Exam is to gauge whether you have had a ‘broad-based’ learning. It tests whether you have the ‘general understanding of concepts and principles in the basic sciences…’ as per the official website.

For your convenience, we provide you the same course outline that you may download for reference – USMLE Step 1 syllabus PDF

A section of the Step 1 content outline deals with the various organ systems. The test items may be limited to 1 organ system or they may span across different systems. There is a weightage assigned to each of the 18 major sections in this integrated content outline. We present the same in a tabular format below.

System Percentage(%)
General Principles 12–16
Behavioral Health & Nervous Systems/Special Senses 9–13
Blood & Lymphoreticular/Immune Systems 7–11
Cardiovascular System 5–9
Musculoskeletal, Skin & Subcutaneous Tissue 6–10
Gastrointestinal System 5-9
Respiratory & Renal/Urinary Systems 9-13
Reproductive & Endocrine Systems 9-13
Gastrointestinal System 5-9
Multisystem Processes & Disorders 6-10
Social Sciences: Communication and Interpersonal Skills 6-9
Biostatistics & Epidemiology/Population Health 4-6

There is another section of the exam that deals with the Physician Competencies and Tasks. These are broadly in 6 sections – fundamental scientific concepts, diagnosis & patient history, interactive skills, and learning & improvement based on practice.

The following Table gives a rough outline of the weightage of these sections.

Physician Task Average(%)
Medical Knowledge: Applying Foundational Science Concepts 65
Patient Care: Diagnosis 23
History/Physical Examination  
Communication and Interpersonal Skills 7
Practice–based Learning & Improvement 5

How to study for Step 1?

There is no doubt that there is no shortcut to doing well in the USMLE. The tips and tricks that are doing the rounds on the internet are at the most ‘slightly helpful’. There is no way that you can expect to bluff your way through this one.

However, for those aspirants who are serious and who are ready to work hard, we have some advice –

Start early 

We come across students who contact our experts begging to get short-term (6 months / 3 months) study schedules. This is not the way to perform in USMLE. We urge you to start preparing as early in your MBBS as you can. Start preparing from the day you decide you want to do USMLE.


Time management is crucial in the USMLE Step 1, both when you attempt practice questions and when, in the real test, you struggle to attempt the 40 test items in 60 minutes. So, with less than 2 minutes per question, you have to read, understand, analyze, and reach the most logical conclusion. Now, typically, almost all the test items have a lot of content to read. You will find detailed history and diagnostic processes.

Here are some USMLE Step 1 test day tips.

Skip to the bottom part of the question and ascertain the area of focus of the question. This will give you a perspective and when you start reading the history, you will already know which pieces of information are relevant.

Eliminating wrong options 

Another strategy that is always ideal for attempting MCQs is the elimination of absurdly wrong options. A powerful weapon that the USMLE uses against you is the large number of options that it gives. The purpose is to check the depth of your knowledge and the confidence you have in it.

Now, to attempt these questions better, you should begin by eliminating the wrong choices. This will narrow down your scope and save your time and energy.

For more USMLE test-taking strategies, click here.

Step 1 Scores

On January 26, 2022, the USMLE Step 1 has become a pass/fail exam. There will be no reporting of digital scores, so, there is no longer any passing score for Step 1.

Can you retake Step 1 if you pass? The answer that would have been correct before January 26, 2022, would be ‘No’. Now, all we need to say is – you don’t need to because passing is all you require.


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