Although USMLE Step 1 is now pass/fail, it is still a monumental exam that will put your study strategies, test taking skills, and endurance to the test. At half an hour longer than the MCAT, the USMLE Step 1 length alone is enough to cause even the strongest medical student to quake in their boots.
It is vital to your future medical education and career that you pass Step 1, and the key to your success is knowing precisely what you will face. In this post, we break down the length of Step 1, including how the exam is formatted and how long it will take you to study and prepare.
When you’re finished here, check out our comprehensive USMLE Step 1 Guide, which covers what resources to use, study strategies, and frequently asked questions.
What Is USMLE Step 1?
The United States Medical Licensing Exam (USMLE) is a 3-part test designed to assess a student’s medical knowledge as well as their ability to apply that knowledge to patient care. There’s Step 1, Step 2 CK, and Step 3.
Students usually take USMLE Step 1 at the end of second year (MS2), USMLE Step 2 CK at the end of third year (MS3) or during fourth year (MS4), and Step 3 during the first year of residency.
Learn more about Step 2 with our USMLE Step 2 CK Guide.
Step 1 arranges basic science material along two dimensions: systems and processes. The primary focus of the test is on the principles and mechanisms underlying health, disease, and modes of therapy.
Step 1 used to be regarded as one of the most important and difficult tests medical students faced. This is because it used to have major implications for residency. If you scored poorly on Step 1, you could largely kiss your chances of joining a competitive specialty goodbye.
However, as of January 26, 2022, Step 1 became pass/fail. This change eases the heavy burden on medical students during their first two years of medical school.
Making Step 1 pass/fail frees students to focus more on their studies and extracurriculars; it also reduces stress and boosts group cohesion, as students can focus on building friendships rather than competing with their fellow classmates.
While the pass/fail change does lessen some of the stress on students, Step 1 should not be taken lightly, as even just passing the test is quite a challenge. Step 1 is packed with content, so passing will still require a tremendous effort and weeks upon weeks of dedicated studying.
How Long Is the Step 1 Exam?
Step 1 is a one-day exam that’s divided into seven 60-minute blocks and administered in one 8-hour testing session.
This includes an optional 15-minute tutorial and 45 minutes of break time. So, if you were to skip the tutorial and the breaks, which we do not recommend, the test would take you 7 hours.
The number of questions per block may vary but will not exceed 40. The total number of questions in Step 1 will be no more than 280. The current minimum USMLE Step 1 score to pass is 196, and the maximum possible score is 300.
Step 1 Length Compared to Other Exams
At 8 hours, Step 1 is a significantly long test. Including breaks, Step 1 surpasses even the MCAT by a half hour. However, Step 1 is actually the shortest USMLE exam.
Length of major medical school and residency exams:
MCAT: 7.5 hours
Step 1: 8 hours
Step 2 CK: 9 hours
Step 3: 16 hours (Step 3 is a two-day exam. Day 1 is 7 hours, and Day 2 is 9 hours.)
The tests medical students face are no joke. This is why it is imperative you use evidence-based learning strategies early on in your medical education. Despite Step 1 being pass/fail, you absolutely need to be building your studying and test taking skills throughout your time in medical school.
How Long Should You Study for Step 1?
Passing Step 1 requires a great deal of studying—so much that it is broken down into two phases: the pre-dedicated period and the dedicated period. The pre-dedicated period comprises the months leading up to Step 1, and the dedicated period comprises the 4-8 weeks before your exam.
The resources you choose to use are also important. When it comes to Step 1, the gold standard is known by the acronym UFAPS, which stands for UWorld, First Aid, Anki, Pathoma, and Sketchy.
You may choose to supplement these resources with AMBOSS or Boards and Beyond, and it’s also important to make use of NBME Practice Tests and UWorld Self-Assessments.
Pre-Dedicated Period
Use the pre-dedicated period to build a foundation of knowledge during the several months leading up to your exam. Since you also have your coursework and lectures to focus on, it’s vital you balance studying for Step 1 with your regular responsibilities. After all, you still need to maintain high grades.
Use about a quarter to a third of your day on coursework and lectures. Spend the rest of the day working through UFAPS. In the days leading up to your school’s block exams, switch to near 100% focus on your coursework so that you can ensure you perform optimally.
Ensure you take a pass through First Aid and Pathoma before you reach your dedicated period. Watch video lectures while reading along in First Aid and taking notes, then add in Anki decks for review to dial in the information.
Maximize your study time by watching Sketchy medical videos while you’re eating instead of watching Netflix. This is a low-stress form of studying you can do if you need a break from video lectures and practice questions.
Take a first path through either the UWorld or AMBOSS question bank, but don’t use both. Determine and abide by a daily question quota so that you can complete all of the question bank before your dedicated period starts.
Maintaining this pace throughout your preclinical years will help you build a rock-solid foundation of medical knowledge before diving into the dedicated period.
Dedicated Period
Depending on your school’s schedule and policies, your dedicated period will vary between 4-8 weeks.
Choose your resources carefully, then decide how you will organize your days.
For example, you could divide each day into three 4-hour blocks of studying that would occur in the morning, afternoon, and evening. Take a 5 to 10 minute break once per hour during each session to keep your mind sharp. Depending on how you like to study or your other responsibilities, you can follow this schedule five to six days a week.
Do not aim to study like this every day of the week. You must intentionally schedule downtime, as you can easily burn out trying to maintain this study rhythm. You also have the regular requirements of life to consider, like buying groceries and washing your clothes. You can block off Friday nights to relax or visit friends, and use Saturday morning to shop, do laundry, meal prep, and run any other errands.
Go through First Aid and UWorld (or AMBOSS) at least once during this time, and watch Sketchy micro and pharm videos during your breaks. Choose whatever form of spaced repetition, such as Anki cards, you like best to help you remember any concepts you struggle with.
Take a practice test early on to determine your strengths and weaknesses so you can focus your study efforts on any problem areas. Review your answers thoroughly to understand where you went wrong.
It will be an extremely busy time, which is why it’s crucial to create a schedule you can stick to.
For more information on how to effectively study for Step 1, read our comprehensive guides: Leading up to the Dedicated Period and Dedicated Study Period Schedule.
Conquer Your Exam With a USMLE Step 1 Tutor
Passing Step 1 is a monumental challenge for any med student, but the good news is you don’t have to do it alone.
Ensure a passing score by utilizing our customizable USMLE Step 1 Tutoring. Each of our Med School Insiders tutors aced the USMLE Step 1 exam by employing the Med School Insiders methodology. This means you’ll be learning from the best.
At Med School Insiders, we believe no two students are the same. This is why we focus on one-on-one mentorship and relationship building with your tutor and a diagnostic process to assess where you can make the greatest improvements based on your strengths, weaknesses, and personal habits.
Matching into one of your top residency programs is no mean feat, which is why we offer a number of Residency Admissions Consulting Services tailored to your needs, including personal statement editing, interview prep and mock interviews, and overall application editing. Med School Insiders can help you put together a stand out residency application that will guarantee a match at one of your top programs.
For more advice from students who have been exactly where you are right now, read:
What I Wish I Knew Before Taking USMLE Step 1 and Don’t Make the Top 4 Mistakes I Made Studying for Step 1.
