There will be up to 280 questions split among 7 blocks, no more than 40 questions a block and no more than 280 questions total.
The standard exam time without accommodations is 8 hours total, 60 minutes per block, plus 45 minutes of break time and a fifteen minute optional tutorial. You may do the tutorial prior to your test day through the USMLE's Step 1 Orientation page (opens page>>).
To learn more about exam time with accommodations, please visit our accommodations page (opens page>>).
While there's no way to know what exactly will be covered in the Step 1 exam from year to year, the National Board of Medical Examiners (NBME) does provide insight to the content weighting for each system, discipline, and physician task/competency that will be covered in the exam, which you can find on the USMLE website (link below).
Check out the official content outline and specifications tables below or by visiting the official USMLE site (opens page) >>
Link to infographic mentioned in image above (opens PDF>>)
The NBME has not given an exact score or percentage needed to pass Step 1 since the change to a pass/fail context. However, data and guidance from the NBME's Comprehensive Basic Science Self-Assessment (CBSSA) practice exams, along with your q-bank data, can be used to estimate your readiness prior to sitting.
To help students interpret their CBSSA results, the NBME has provided a guidance document (opens online pdf>>). Below, we'll try to simplify the main points of the guidance document:
Your score on the CBSSA should be interpreted as a "likely score range," with your test day performance predicted to be within four points of the given score*. E.x.: scoring a 62% gives you a likely score range of 59-67%.
The score report will show you a graph to represent your likely score range in relation to the "low pass range," which is described as follows: "The Step 1 low-pass range represents performance that is above but near the passing standard, or performance that is sufficient to pass Step 1, but only by a small margin."
The low pass range is 61-70%. Scoring below 61% would be considered performance that is insufficient to pass Step 1, and scoring above 70% would be considered significantly above the minimum passing standard.
Therefore, if you scored a 63%, with a likely score range of 59-67%, your predicted performance falls within and below the low-pass range.
Students whose likely score range falls below the low-pass range (below 61%) run a serious risk of not passing Step 1 if they sit without significant additional readiness work.
Students whose likely score range falls only within the low-pass range may also need additional readiness work.
Students whose likely score range extends beyond the low-pass range (beyond 70%) have likely completed sufficient readiness work. E.x.: A student who scores a 68% has a likely score range of 64-71%, and has surpassed the low-pass range.
However, it's best to use multiple data points to gauge your readiness to sit! Multiple self-assessments that confirm your likely score range, along with strong q-bank trending and good overall well-being are all important components in determining your readiness. Your Learning Specialist can help you put this data together to understand your current readiness at any time.
Note that the likely score range / performance prediction is assuming you sit within a week of taking the CBSSA without gaining or losing any knowledge.
Most students receive their score after two weeks. However, some times of year have a higher volume of exams being scored, and students may need to wait longer for their scores.
Step 1 can be taken at various Prometric sites around the United States. There are several Prometric sites in Phoenix, as well as in Tucson and other cities near central Arizona. Some students with family out of state choose sites near where their families live instead.
Unfortunately, there's no way to look up locations outside of the official scheduling process with the NBME and Prometric, as not all exams are offered at all Prometric sites at all times.
Registration is done online through the MyUSMLE.org site (opens log-in page>>). If you have not yet created an account with MyUSMLE, you will need to do that first. You can create an account using a button provided on the log-in page.
Registration is done separately from and prior to scheduling your actual exam date and location, which will be done through the Prometric site after you have registered through MyUSMLE.
During the online registration process, you will be asked to select a three month eligibility window within which you plan to sit for Step 1. Students who plan to sit during the Dedicated period may want to choose January-March, but students who plan to sit prior to the Dedicated period should select an eligibility window starting with the month you plan to sit for the exam. There is a $70 fee to extend your eligibility period if needed.
You will also be required to pay the registration fee at the time of your online registration. The current exam registration fee is $695. You can confirm via the NBME's website (opens page>>).
The NBME warns that "if you submit a payment for registration and/or examinee records services that is uncollectible and returned to the NBME, you will be charged a $25 fee. No further services will be provided until payment is received."
After you register, the NBME will authorize your permit to schedule your exam and Prometric will send you an email with instructions to select your date and location. There may be a delay between the NBME authorizing your permit and Prometric granting you access to schedule your test.
Canceling or rescheduling your exam can be done through the Prometric site (opens page>>). Fees for canceling or rescheduling your exam can be found below or in a table on the bottom of the USMLE's rescheduling information page (opens page>>).
46 or more days before (but not including) the scheduled test date—All testing regions: No Fee
31-45 days before (but not including) the scheduled test date—All testing regions: $35
6-30 days before (but not including) the scheduled test date—All testing regions: $100
5 or fewer days before (but not including) the scheduled test date—US and Canada: $140
5 or fewer days before (but not including) the scheduled test date—Outside the US and Canada: $358
If you need to extend your eligibility window, there is a $70 fee.
Please see our Accommodations page (opens page>>) for thorough information on the NBME's process and requirements.
Breastfeeding parents can request to bring their pump via a Personal Item Request form and will be given an appropriate space to express milk if the testing site is notified ahead of time.
Additional break time with standard testing time can be requested for this purpose as well, and your request to bring a pump can be added to the Additional Break Time Only request form instead of filling out a separate Personal Item Request form.
The downloadable forms can be found on the USMLE's webpage (opens page and subsection>>).
The NBME has an extensive list of pre-approved medical items, communication and mobility aids, and other personal items which can be found on the USMLE Accommodations page (opens page>>).
Additional information about personal item procedures can be found on the Personal Belongings page (opens page>>).
This page last updated 10/22/2025.