Everything you need to know about the USMLE Step 1 Exam

If you’re an aspiring physician, you will have heard about the USMLE Step 1 Exam - the first of three licensing exams required to practice medicine in the USA. This exam is taken at the midpoint of medical school and passing successfully is a requirement for continuing your medical school studies. The exam is extremely comprehensive and challenging. Residency programs favor students that have both passed the USMLE Step 1 on their first try and have also scored well on the exam.Here are some of the most frequently asked questions about the USMLE Step 1 Exam.

What is the USMLE Step 1 Exam?
The United States Medical Licensing Examination Step 1 (or Stage 1) is the first of the 3 stages of licensing exams required for practicing in the USA. The USMLE Step 1 assesses the ability of students to provide safe and effective patient care.To pass, you should have a significant understanding of basic clinical sciences like physiology and epidemiology and learn how to apply them in different clinical scenarios.

Exam format
The Step 1 exam is a computer-based test administered in a single day over 8 hours. It comprises multiple choice questions that are divided into 7 sections. Each section may have up to 40 questions, and the total paper may have up to 280 questions. You have 1 hour for each section and can take 45 minutes for personal breaks between sections. If you finish a section before the allotted time, you can add that to your break time too. The exam also consists of an optional 15-minute tutorial period before the first section.
How can I apply for the exam?
If you are a medical student from the USA or Canada, you should apply for the exam with the National Board of Medical Examiners (NBME). You can go to their website to obtain a valid USMLE ID by filling out the form.
If you are an international student, you have to register with the Educational Commission for Foreign Medical Graduates (ECFMG) and your school authorities can help you register for USMLE Step 1. Your test can be taken at any point of the year.

How much does the exam cost? With the NBME, the Stage 1 exam costs $645 (2020).

What topics does the exam cover?
The NBME website states that the test covers the fundamental scientific principles of the following USMLE Step 1 subjects:

  • Anatomy
  • Biochemistry
  • Biostatistics and Epidemiology
  • Microbiology
  • Pathology
  • Pharmacology
  • Physiology
  • Behavioral Sciences
  • Nutrition
  • Immunology
  • Genetics
  • Molecular Biology
  • Medical Ethics

Most USMLE Step 1 questions are application-based - for instance, you might have to identify the pictures of pathological specimens, interpret statistical data or graphs or justify your actions in fictional scenarios.

When can I take the exam?
Most medical schools arrange for students to take the test after they have finished their second year and have mastered the basic sciences. This is an appropriate strategy as the second-year syllabus is still fresh in students’ minds.

The NBME has several test centers worldwide for the USMLE Step 1 Exam so you can take the exam at a location that’s convenient for you.

What score do I need to pass?
The passing score is 194 out of 280.

Can I retake the exam?
You can retake the exam up to 6 times if you need to. Although the USMLE exam can seem overwhelming, it’s important to pass it on your first attempt. You just need to work hard and apply the knowledge gained in your medical school curriculum. Many medical schools integrate a special emphasis on USMLE Step 1 preparation into their basic sciences curriculum.

The Medical University of the Americas (MUA), situated on the island of Nevis in the Caribbean, is the ideal place to start your medical career. MUA had a 95% USMLE Step 1 first time pass rate between 2015 - 2019. MUA utilizes significant resources to make sure its students are well prepared for the USMLE Step 1.


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