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The Step 1 exam contains multiple-choice questions that assess your medical skills in the following basic science knowledge areas:

• Anatomy
• Behavioral sciences
• Biochemistry
• Microbiology
• Pathology
• Pharmacology
• Physiology
• Interdisciplinary topics, such as nutrition, genetics, and aging

This is a one-day, 8-hour examination. There are seven blocks. Each block is 1-hour long.

The number of questions per block on a given examination form may vary but will not exceed 40. The total number of items on the overall examination form will not exceed 280.

Typically, most US med school students take this exam at the end of their second year.

International medical school graduates take USMLE Step 1 after becoming licensed doctors in their own countries to work toward being licensed to practice medicine in the United States. These physicians must take the following steps to take the exam:

• Register online with ECFMG (Education Commission for Foreign Medical Graduates)
• Receive an identification number from ECFMG
• Book their exam online on a year-round basis

If you graduated from a medical school outside of the U.S. and Canada, your school must be listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements. Regardless of the type of medical degree you hold, all applicants for the USMLE Step 3 must apply through the Federation of State Medical Boards (FSMB) website.

To be eligible for Step 3, you must have passed Step 1 and Step 2 CK of the Boards during medical school. The USMLE program recommends taking Step 3 after completing (or nearly completing) at least one year of postgraduate training in a U.S.-accredited graduate medical education program that meets state board licensing requirements.

The busiest times for testing are May through July and November through December. Because scheduling is first-come, first-served, try to schedule your test dates early in your eligibility period. This way, you’ll have flexibility if you need to reschedule. You can take the exam at any Prometric® test center in the United States or its territories.

The USMLE Step 3 is a 2-day computerized exam with approximately 500 multiple-choice questions, along with computer-based case simulations (CCS) that evaluate your ability to assess history and physical exam information, order diagnostic tests, select initial therapies, and manage patients.

The exam primarily focuses on patient management (45-55% of questions). Other topics include history and physical exam; lab and diagnostic studies; diagnosis; prognosis; and pathophysiology—each comprising about 8-12% of the exam questions. Additionally, each question falls into one of three clinical encounter frames: initial workup; continued care; and emergency care.

To prepare, review helpful books and complete as many question banks as possible. Consider taking a practice test early to gauge your readiness and become accustomed to the exam's pacing.

For the CCS portion, focus on getting familiar with the software and being efficient and thorough with your virtual patients. While finding study time as a resident can be challenging, persist in your efforts to discover what works best for you in preparing for USMLE success.