The USMLE Step 1 (United States Medical Licensing Examination Step 1) is the first major milestone in your medical licensing journey. It evaluates whether you understand and can apply the important concepts of the basic sciences, particularly as they relate to the practice of medicine.
Step 1 is now graded pass/fail, but it’s still a critical milestone. A strong foundation here will make Step 2 easier and prepare you for residency. The right preparation strategy—paired with the right study tools—can make all the difference.
When Do I Have to Take the USMLE Step 1?
Most students take Step 1 at the end of their second year of medical school, after completing the preclinical curriculum. This timing gives you the chance to study while the material is still fresh, but also allows for a dedicated preparation period.
The exact timing depends on your medical school’s requirements. Some schools mandate a passing Step 1 score before starting clinical rotations, while others allow more flexibility. Always confirm your program’s expectations early so you can plan your study schedule accordingly.
How Long Is the USMLE Step 1?
The Step 1 exam is an eight-hour test, divided into seven one-hour blocks.
- Questions: Up to 280 multiple-choice questions in total.
- Format: Case-based questions requiring application of knowledge to clinical scenarios.
- Breaks: 45 minutes of total break time (plus 15 minutes for the tutorial, which you can add to your break if you skip it).
Because of its length and intensity, it’s important to practice with exam-like question banks and simulate the testing environment in advance.
How to Study for the USMLE Step
Many students struggle with:
- Cramming too close to the exam date instead of consistent review.
- Ignoring weaker subjects like biostatistics or anatomy.
- Focusing on passive review (e.g., re-reading notes) instead of active recall.
But the most successful Step 1 study strategies include:
- A long-term schedule – many students begin structured review six months to a year in advance, with an intensive “dedicated period” closer to exam day.
- Active learning methods – such as flashcards, practice questions, and self-testing.
- Targeted review – spending more time on weak areas rather than re-studying what you already know.
- Focusing on high-yield topics – studying topics that are likely to make up most of the exam questions.
Resources like Med School Bootcamp can help by breaking content into short videos, quizzes, and board-style practice questions, making it easier to stay consistent and reinforce learning over time.
Practice Questions and Explanations
A key part of Step 1 preparation is getting used to how questions are asked. The exam tests your reasoning, not just memorization.
Good practice resources should provide:
- Representative questions that match the exam’s difficulty and style.
- Explanations for both right and wrong answers so you understand the reasoning.
- Illustrations or diagrams for visual concepts, like anatomy or physiology.
Med School Bootcamp, for example, provides 2,500+ practice questions based on student feedback, along with step-by-step explanations and diagrams that mirror the real test format.
Anatomy and Other Challenging Subjects
Certain Step 1 topics—like anatomy, neuroanatomy, and biostatistics—are consistently cited by students as the hardest to prepare for. These subjects require both memorization and applied understanding.
Anatomy review is especially important since questions often use cadaveric images or require identification of structures in clinical scenarios. To prepare effectively, look for resources that include:
- Cadaveric images to build real-world recognition.
- Practice exams to simulate lab-style testing.
- Video breakdowns for complex regions and systems.
Med School Bootcamp integrates all three, with over 500 cadaver images and structured modules to guide anatomy study.
Study Schedules and Tracking Progress
A Step 1 study schedule is essential to keep you consistent and avoid burnout. While everyone’s timeline looks different, most schedules include:
- Daily video review or reading for content learning.
- Regular practice blocks with questions.
- Time set aside for weak areas to close gaps.
Using a resource that provides an adaptive study schedule can take the guesswork out of planning. Bootcamp, for example, allows you to create a schedule in seconds, track your progress, and adjust as needed if your timeline changes.
Tracking performance over time is also key—knowing whether you’re improving gives you confidence and shows you where to focus.
How do I register for the USMLE Step 1?
Registration is handled through the NBME website. Once approved, you can schedule your exam with Prometric.
How much does the USMLE Step 1 cost?
As of 2025, registration fees are $670 for U.S. students. International test-takers may face additional charges.
What is the passing score for the USMLE Step 1?
The exam is pass/fail. You only need a passing score to move forward, though strong preparation will help with Step 2 and clinical training.
Where can I start studying for the USMLE Step 1?
There are several popular resources:
- UWorld – known for its extensive question bank.
- Boards & Beyond – lecture-style content review.
- Med School Bootcamp – combines short videos, Anki decks, quizzes, practice questions, anatomy modules, a question tagging system to help track questions you have a hard time with, and adaptive study schedules in one platform. Available as a mobile app for iOS and Android.
The USMLE Step 1 is a challenging exam, but with early planning, active study methods, and consistent practice, you can pass with confidence. The key is to use resources that fit your learning style, keep you engaged, and provide feedback as you improve.
Whether you prefer lecture-style reviews, question banks, or structured video modules, make sure your study plan includes a balance of content review, practice, and self-assessment. That balance will not only help you pass Step 1 but will also set you up for success in Step 2 and beyond.
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