Step 1 is the first part of the United States Medical Licensing Exam (or USMLE), which tests a medical student’s ability to apply basic science knowledge. Medical students typically take the USMLE Step 1 after completing basic science courses at the end of their second year. Below we explain the structure of the exam and list the distribution range for content areas tested on Step 1.

Structure of the USMLE Step 1

Step 1 is divided into 7 blocks of multiple choice questions. Each multiple choice question will have at least 4 answer choices. One and only one answer choice is correct. For examples, see the USMLE Step 1’s Sample Questions. You have the option to take a 15-minute tutorial prior to taking the exam. Break time may exceed 45 minutes if you finish early on one or more blocks.

Total Testing Time 7 hours and 45 minutes
Time per Block 60 minutes
Break Time Allotted 45 minutes
Total Multiple Choice Questions No more than 280
Questions per Block No more than 40

Content Areas

Test questions are divided among two dimensions: systems and processes.

Area Range
General principles 15%-20%
Organ systems 60%-70%
Skin/connective tissue
Multi systems 15%-20%
Multisystem Processes and Disorders
Biostatistics, Epidemiology and Interpretation of Medical Literature
Social Sciences

For a breakdown of specific topics tested under each organ system, see the USMLE’s official Content Outline.

Process Range
Normal structure and function 10%-15%
Abnormal processes 55%-60%
Principles of therapeutics 15-20%
Biostatistics, Social Sciences and General Principles 10-15%

Preparing for Step 1

Cram Fighter maintains a list of the most popular Step 1 textbooks, lecture series, question banks, and flashcards. For information on NBME Step 1 self-assessments, see Below we answer frequently asked question regarding Step 1 test preparation.

How long do most students study for Step 1?

According to Cram Fighter’s statistics, most students study for 100 days.

When are the most popular months to take Step 1?

The most popular period among Cram Fighter users for taking Step 1 is May-June. For a complete list, visit our page on the most popular months for taking Step 1.

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