USMLE Step 1 Exam


About USMLE Exam:

What is USMLE Exam?

USMLE test is United States medical licensing examination. It is screening exam for people who want to practice medicine in United States of America. USMLE stands for United Sates Medical Licensing Examination. It is a three-step examination. The USMLE steps are,

  1. USMLE Step 1 exam
  2. USMLE Step 2 CK & Step 2 CS exam
  3. USMLE Step 3 exam

The candidates who are studying in medical school take step 1 and Step 2 examinations, and the candidates who have graduated take Step 3 examination.

Here we are providing all the information about USMLE Step 1 registration, USMLE exam dates, USMLE Step 1 questions, USMLE step 1 fees, and USMLE Results to clear the examination:

USMLE Step 1 Eligibility:

  • For international students who want to apply for USMLE Step 1 exam, should be enrolled / have completed their MBBS from a medical school, which is listed in World Directory of Medical School. Candidates can check if their medical school is listed in World Directory of Medical School or not on WDOMS website.

  • Student should meet eligibility criteria set for ECFMG certificate. (ECMFG: Educational Commission for Foreign Medical Graduates)
  • Student must meet eligibility USMLE eligibility criteria at the time of the application for USMLE step 1 registration.

USMLE Step 1 Subjects & Syllabus:

USMLE Step 1 Syllabus contains mostly the subjects students learn in first two years of medical school. Listed below is the information about the subjects and its weightage range for the respective subject:

USMLE step 1 subjects distribution:



General Principles of Foundational Science

15% - 20%

  1. Multisystem Processes & Disorders

  2. Biostatistics & Epidemiology

  3. Population Health

  4. Social Sciences

15% - 20%

  1.  Immune System

  2. Nervous System & Special Senses

  3. Skin & Subcutaneous Tissue

  4. Respiratory System

  5. Pregnancy, Childbirth, & the Puerperium

  6. Female Reproductive & Breast

  7. Male Reproductive

  8. Endocrine System

  9. Blood & Lymph reticular System

  10. Cardiovascular System

  11. Musculoskeletal System

  12. Behavioural Health

  13. Gastrointestinal System

  14. Renal & Urinary System





Abnormal Processes

55% - 60%

Normal Processes

10% - 15%

Principles of Therapeutics

15% - 20%


10% - 15%

USMLE Step 1 Dates:

  • International students, who are willing to appear for USMLE Step 1 exam, will have to apply for an ECMFG certification. Only after they are eligible for ECMFG certificate, they are eligible to take USMLE Step 1 test. 

  • The candidates will have to choose an eligibility period of three months. After the eligibility period has been chosen, candidates should select the date they want to take the test on during the eligibility period.  According to USMLE the guidelines, students cannot choose first week of January and major holidays as their USMLE dates.

USMLE Step 1 Questions and USMLE Exam Pattern:

  • USMLE Step 1 examination is a one-day exam. The test duration is 8 hours, divided into 7 blocks of one hour each. Each of the blocks will have not more than 40 USMLE questions, and the total number of questions will be 280. The questions will be MCQ type.


Total Questions


No. of Question in each Block

8 Hours




  • USMLE Step 1 exam is an assessment of candidate’s knowledge of science related to medical practice in various disciplines and inter-disciplines of medical science.




Behavioural sciences



Biostatistics and Epidemiology








USMLE Preparation:

How to prepare for USMLE step 1?

To start your USMLE Step 1 Preparation, there is no sanctioned material. The USMLE Step 1 Syllabus mostly contains what candidates have learned in the first two years of their medical school. That is why most of the candidates take USMLE Step 1 exam after the second year of their medical school because the information and the syllabus is quite fresh in their mind and they can perform well. Some candidates will take 2 months to prepare. If a candidate is not a continuous student, it might take 6-12 month to prepare for USMLE step 1. There are many online tutors available with large collection of USMLE sample questions. If a candidate wants to go for self-study, he should refer to those USMLE step 1 Sample Questions online after he has completed the syllabus, to get an idea about USMLE Exam Pattern.

USMLE Step 1 Registration:

International Students willing to appear for USMLE Step 1 will have to apply for an ECFMG certification. ECFMG stands for Educational Commission for Foreign Medical Students. After they have obtained the ECFMG certification, they can choose for a three-month eligibility period, and choose a date during those months to appear for the exam. You should do your USMLE registration accordingly.

Candidates can appear for the USMLE Step 1 exam in their respective countries. Prometric is the testing agency for the USMLE.  To choose a specific test centre for the test, the candidate will have to go on the Prometric USMLE website and register for USMLE Step 1.

USMLE Step 1 Scores:

Test scores for USMLE Step 1 are declared after three to four weeks of the examination. There is no definite minimum score to qualify. They are declared in three-digit format. The latest  Step 1 scores to qualify USMLE Step 1 is 194.

USMLE Step 1 Fees:

Given below is the USMLE Step 1 fees, and additional costs.

For aspirants from USA and Canada:

USMLE Exam Fees

Step 1

Application Fees


Additional Surcharge



For International Students:

ECMFG Certificate



Fee Structure:


USMLE Step 1

Application Fees


Extension of Eligibility Period


Testing Region Change


Score Recheck


ECFMG Exam Chart


ECFMG CSA History Chart


Paper transcript

$70/request (up to 10 transcripts)

USMLE Transcript: ERAS(Electronic Transmission)

$80 per ERAS


Rescheduling Fees:

Days before USMLE Step 1 schedule

Testing Region

Step 1

31+ days before the test date

All testing regions

No Fee

Less than 31 days to more than 5 days before the test date

All testing regions


5 or fewer days before the USMLE Step 1 scheduled test

US and Canada


Africa, Asia (including Hong Kong and Pakistan),

Australia, China, India, Indonesia, Latin America,

Middle East (including Egypt), Thailand


Europe (including Israel), Korea, Taiwan





USMLE Step 1 Test Centres:

  • The table below shows the USMLE Step 1 cost for Test Centers:

Testing Region

USMLE Test Centers for Step 1



Bangladesh, Malaysia, Nepal, Pakistan, People’s Republic of China, Philippines, and Singapore



Australia and New Zealand



Ghana, Uganda, South Africa, and Kenya



People’s Republic of China








Latin America

Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Guatemala, Mexico, Peru, Trinidad and Tobago, and Venezuela


Middle East

Egypt, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, and United Arab Emirates









Croatia, Armenia, Denmark, Germany, France, Greece, Ireland, Israel, Italy, Latvia, Switzerland, Turkey, Netherlands, Portugal, Spain and the UK









USMLE Step 1 Scores:

USMLE Step 1 Results are declared after three to four weeks of the examination. There is no definite minimum score to qualify. They are declared in three-digit format. The latest USMLE Step 1 passing score is 194.

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