Step One of the United States Medical Licensing Examination measures the candidate’s ability to apply scientific knowledge to the practice of medicine. This examination is sponsored by the Federation of State Medical Boards and the National Board of Medical Examiners. Questions are created by committees of experts in each of the content areas. These content areas are anatomy; behavioral sciences; biochemistry; microbiology; pathology; pharmacology; physiology; and other topics including genetics, nutrition, and aging. Between 40 and 50% of the exam covers general principles in these content areas; the remaining 50 to 60% focuses on the following individual organ systems: hematopoietic/lymphoreticular; nervous/special senses; skin/connective tissue; musculoskeletal; respiratory; cardiovascular; gastrointestinal; renal/urinary; reproductive; and endocrine. The exam will focus on the following themes with respect to the above content areas: normal structure and function (30 to 50% of the exam); abnormal processes (30 to 50%); principles of therapeutics (15 to 25%); and psychosocial, cultural, occupational, and environmental considerations (10 to 20%). Candidates will often have to incorporate information from charts, tables, graphs, and gross and microscopic specimens.
The questions on the USMLE Step 1 are in a multiple-choice, best-answer format. There are 280 questions on the exam. The number of questions answered correctly will be used to calculate the score on a three-digit scale. Individuals who do not begin every block of the test will not receive a score. In order to pass the USMLE Step 1, individuals must receive a minimum score of 192. The exam takes 8 hours and is administered in 7 one-hour blocks over the course of a day. The USMLE Step 1 is administered year-round by Thomson Prometric; those who wish to take this exam should register for test date and location at the Prometric website.