The United States Medical Licensure Exam (USMLE) Step 1, commonly called “the Boards,” is a standardized test that assesses a med student’s ability to apply basic science fundamentals to the practice of medicine. The entire exam has three steps, but this article applies only to Step 1. Students generally take Step 1 following their second year of medical school. The test is administered by the Natiol Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB).
Below are answers to some of the most common questions about Step 1.
1. What is the Step 1 exam format?
The Step 1 exam is a computer-based test taken in a single day over an eight hour period. It’s a multiple choice question test that includes seven sections of 46 questions each for a total of 322 questions. One hour is allotted for each of the seven sections. That’s an average of one minute and 18 seconds per question.
Test takers are allowed 45 total minutes during the test for personal breaks. If you finish any section before the allotted hour is up, you can add that time to your personal break total. Six breaks total are allowed. There is an optional 15 minute tutorial period at the beginning of the exam. If you choose to skip the tutorial you can add the 15 minutes to your total break time.
During the test, you are only allowed to bring soft foam earplugs into the examination room. Nothing else is allowed – no bags, electronics, phones, or even jackets are allowed. Be sure to check with the exam monitor prior to entering the test room for complete details.
2. How do I apply for Step 1?
Student or graduates of a medical school in the United States and Canada must apply for the USMLE Step 1 exam with the NBME. Students or graduates of medical schools outside of the U.S. or Canada register with the Educational Commission for Foreign Medical Graduates (ECFMG). Tests are administered by appointment year round.
3. How much does the test cost?
As of 2015, Step 1 costs $590.
4. What is covered on the exam?
Step 1 mainly covers basic scientific principles including anatomy, behavioral sciences, biochemistry, microbiology, pathology, pharmacology, and physiology. Interdisciplinary topics covered include genetics, aging, nutrition, immunology, molecular and cell biology, epidemiology, and medical ethics.
Some questions test your understanding of basic facts and definitions. But the majority deal with your ability to solve problems using basic scientific principles. For example, you’ll be asked to interpret graphs, identify gross and microscopic pathology and normal specimens, and apply concepts and principles relevant to individual organ systems.
5. When should I take the test?
Most people take the test between their second and third years in medical school, after finishing basic science courses and before a clinical clerkship. Many have success taking it within two months of finishing basic courses because material is still fresh in their minds, combined with an extra month or two of studying.
6. What is needed to pass?
A score of 192 is needed to pass the Step 1 exam. The average score in 2013 was 228 with a standard deviation of 21.
7. When do I get my USMLE test results?
Scores for Step 1 are released each Wednesday. It usually takes three to four weeks for scores to be released. You will receive an email from the entity you registered with (NBME or ECFMG) when your score is available. It will also be posted to that entity’s website. If you don’t receive an email within two months, it’s recommended that you contact the registration entity directly. The current pass rate is about 85%.
8. I passed Step 1 but am not thrilled with my score. Can I retake it to raise my score?
Unfortunately, the answer to this is no.
9. I didn’t pass the first time. Can I retake the exam?
Yes. You may take the USMLE Step 1 exam a maximum of three times within a 12-month period. Your fourth attempt must be at least 12 months after your first attempt, and at least six months after your most recent attempt.
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