USMLE Step-1

Before discussing USMLE Step-1 Exam, let make one thing clear. You can take USMLE Step-1 and Step-2 in any sequence depending on your Basic Sciences knowledge and Clinical Knowledge. If you are going to take USMLE-Exams in your 3rd or 4th year of Med-School, then it is better to go for USMLE Step-2 CK. Because you have a strong grip on your clinical skills, being a 3rd or 4th-year Med-Student, it would be more convenient to go for USMLE Step-2 CK. Following sketch also clears this idea:

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What is USMLE Step-1? A brief overview:

USMLE Step-1 is the first step toward practicing medicines in the USA. Step-1 assesses the understanding and application of basic science knowledge to practice medicine in the USA. It is concerned with the principles and mechanisms which are being applied regarding health, disease, and therapy.

It’s much more than an exam. Step-1 is usually taken by the med-students after their 2nd year of med-school. Thousands of IMGs (International Medical Graduates) and students, who are wishing to practice medicines in the US, also take the step-1 exam. Step-1 emphasizes the knowledge of the basic sciences and evaluation of their concepts.

In the following sections, we will try to cover the basic understanding and a brief overview regarding the USMLE Step-1 exam.

Eligibility Criteria:

A Med-Student can appear in the USMLE Step-1 exam if he/she:

  • Has passed First Year Med-School.
  • Is US and Canadian Med-School Student recognized by Liaison Committee on Medical Education (LCME)
  • Is US and Canadian Med-School Student recognized by American Osteopathic Association
  • Is a student outside US and Canadian Med-Schools recognized by International Medical Education Directory (IMED) and Educational Commission for Foreign Medical Graduates? (ECFMG).

USMLE Step-1 Components:

Step-1 is the hardest part to go through. Once cleared, bingo! Next two are piece of cake. J

What is asked? Application of knowledge of basic sciences to practice medicines.

When to take? Usually after first two years of Medical School.

Time Duration: 8 hours (one day), broken into 7 blocks and 1 hour for each block with 40 MCQ’s in each block.

MCQ questions: Typically, 280

Format: Computer-Based

Test Place: Prometric Sites Internationally

The USMLE Step-1 exam also contains Normal Value Laboratory Tables for reference.


Exam Criteria:

The USMLE Step-1 exam is basically divided into two parts:

  1. General Principles (40%-50%)
  2. Organ System (50%-60%)

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On the basis of the Processes, some other divisions in exam criteria are mentioned below:

Normal Structure 30%-50%
Abnormal Structure 30%-50%
Therapeutics 15%-25%
Behavioral Sciences 10%-20%


Given below is the brief description of General Principles and Organ System:

General Principles (40%-50%) Organ System (50%-60%)
General Biology, Molecular Biology and Biotechnology CNS and PNS
Cell Biology and Genetics Lymphatic System
Embryology Hematopoietic System
Pathology (Tissue Response and Processes) Respiratory system
Pharmacology CVS
Multiple System processes GIT
Microbiology Renal system
Immune system Reproductive system
Biostatics (Hardest part to cover) Musculoskeletal system
Behavioral Sciences Connective Tissue and Skin
  Endocrine System


Questions Type:

In the USMLE Step-1 exam, the pattern of asking questions is ‘Multiple Choice Questions (MCQs)’ to test the basic knowledge of the student. There are further two categories under which questions are being asked. These two categories are elaborated in the below table:

Best Choice Questions (BCQ) Clinical Vignette or Cases
 This type of questions is often confusing as there may be one or two partial right answers but there is only on ‘best answer’. Most of the questions asked in the USMLE Step-1 exam are clinical vignettes. (up to 70%)
Up to 10 responses or choices of one statement are given but, only one is the ‘right answer’ Short paragraphs of information are given, followed by questions with the same strategy as for BCQs.


USMLE Step-1 Comprehensive Study:

When it comes to the comprehensive study for USMLE Step-1, following subjects are to be focused:

  • Anatomy
  • Physiology
  • Biochemistry
  • Microbiology and Immunology
  • Pathology
  • Pharmacology
  • Behavioral Sciences
  • Embryology
  • Genetics
  • Aging
  • Nutrition
  • Molecular Biology

USMLE Step-1 Study Material or Content:

Now, this is the most important part which you have to focus on. When it comes to preparing the USMLE Step-1 exam, many students get confused about the study material. In this section I will be explaining in details which books to follow for the USMLE Step-1 exam:

  1. Kaplan Videos + Lectures ( go through again and again)

Most of the students who are preparing for Step-1, watch Kaplan series videos again and again. Some of the students also study Kaplan series lecture books thoroughly as well. It is considered high yield by many of the students.

Kaplan - What is UMSLE Step 1? | What is on The USMLE Step 1?


  1. First Aid

First Aid is considered to be the best book for taking the USMLE Step1 exam. Many students keep First Aid with them from the beginning of their med-school as a reference book but, some of the students also start preparing for step1 following this book.

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  1. U-World (Online Question Bank)

U-World or USMLE World is considered to be the most authentic and very high yield study source for taking USMLE Step-1. U-World contains an ‘Online and Offline question bank’ which is very accurate to get the high score in step-1. U-World is a learning tool as it gives you the explanation of all right and wrong statements.

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  1. NBME (National Board of Medical Exams)

Taking NMBE online tests is one of the best criterions to judge your USMLE Step1 knowledge. If you are scoring 250 or 260 in your NBME tests then surely you are going to score these much of high scores in your actual exam. NBME is an actual test tool to test knowledge.

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  1. Pathoma for Pathology

Many of the students who have scored high in USMLE Step-1 suggest Pathoma for Pathology.

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Table below gives an overview of above-discussed sources for USMLE Step-1;

Study Source Importance

·       Online Question Bank

·       Learning Tool

·       Layout is Actual

·       2000+ questions

Very High Yield
First Aid High Yield
Kaplan Videos + Lectures High Yield
NBME High Yield


Study Strategy for USMLE Step-1:

Scoring high in USMLE Step-1 is the dream of every med-student, interested in practicing medicines in the USA. Follow a routine and stick to it for 4-6 months, if you want to clear your Step-1 with high scores. Some o the strategies you can adopt are described below:

  • How much do you have to study every day?                                                      Many of the people make it hard for themselves by taking 8-10 hours study routine daily. You do not have to follow a very tight schedule every day. If you study actively for only 6 hours then it would be enough to clear the step-1 exam.
  • What do you have to study every day?                                                                This is where you have to decide what do you want to every day? To score high in USMLE Step-1, try to ‘Master’ one concept daily. By mastering only one concept daily, you will be having a very strong grip at the end of your preparation.
  • How to use resources?                                                                                       Use your resources in a constructive way. Don’t waste time looking for lengthy and hard books. Just follow what has been shared in the upper paragraphs.

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Registration and Fee Structure:

To know about the registration procedure and fee structure please read the below-mentioned article;

USMLE [A General Study Guide To All USMLE Steps]


Exam Day:

No matter how smart or intelligent you are, on the exam day, you will be nervous or even may be jittery, shaking. But, after 20-30 minutes you will feel normal. Keep in mind:

  • To go to bed early (10 Pm – 6 AM)
  • Take your breakfast
  • Take your lunch with you
  • Use your break time wisely ( You will be having a break of total time 45 minutes and 15 minutes extra if you don’t attend tutorial. Split this break times into 3-4 parts of 10-15 minutes)
  • Read the statement carefully, take your time. Do not hurry!
  • Don’t indulge yourself in meaningless activities



Follow the following tips to save your precious time:

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  • Learn Vocabulary
  • Study in groups
  • Take active notes from videos
  • Pause video when necessary
  • Memorize Basics again and again
  • Revise basic biology
  • Make flashcards
  • Look for patterns
  • Connect all the information
  • Do ask for help from others
  • Highlight the important topics
  • Attach paper tags


A word from Author:

Kindly, remember one thing, scoring high in USMLE Step-1 will not guarantee your residency in the US. You will have to follow up with the procedure implemented by US Government.

If you find this article beneficial, kindly give us feedback and if you want any topic in specific also mention it in the comments section. Feel free to drop an email at


Disclaimer: All contents of this article are for informational purposes only and not a substitute for professional advice, diagnosis, or treatment. Reliance on any information is solely at your own risk,




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