USMLE Step 1 Board Review Questions and Practice Tests

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“Our medical school curriculum committee met, and student members expressed their like of the product, including that they really liked the video clips and also felt the questions were more like actual USMLE questions than those in UWorld."”

Rachel R. Walden
MLIS, Associate Dean/Associate Professor

USMLE Step 1 Questions and Answers

Most programs will give you 2 months (no classes) before the Step 1 exam so that you have time to prepare. It’s a difficult exam and the national average score on the Step 1 exam is 229. The minimum required score (as of 2014) is 192. While there are no widely published studies on the pass rates for 2014, top tier programs that we interviewed had a pass rate of 95%+ and mid-tier programs had a pass rate of 90%. Some schools, such as Ross, publish their scores each year (with an average of over 96%). Scores on the MCAT do have a correlation with performance on the Step 1 exam, though the correlation is weak. Most importantly, the USMLE step 1 is known to have a significant influence on residency match and is therefore known to be a high-pressure exam as those with the highest scores on this exam are thought to have the most options in terms of residency specialties and locations.

Additional resources: We strongly suggest using First Aid as a study companion. We also suggest Rapid Review Pathology by Goljan.

USMLE Step 1 Exam Content

The following categories are found on the Step 1 exam:

  • Biochemistry
  • Molecular biology
  • Biology of cells
  • Human development and genetics
  • Biology of tissue response to disease
  • Gender/ethnic, and behavioral considerations affecting disease treatment and prevention
  • Pharmacokinetics and pharmacodynamics
  • Microbial biology and infection
  • Quantitative and statistics
  • Heme and Lymph
  • Cardiovascular
  • Renal
  • Respiratory
  • Gastrointestinal
  • Reproductive
  • Endocrine
  • CNS and PNS
  • Skin and Connective tissue
  • Musculoskeletal
  • Immune system

Information about the USMLE Step 1 Exam

Step 1 is a one-day examination. It is divided into seven 60-minute blocks and administered in one 8-hour testing session The number of questions per block on a given examination form will vary, but will not exceed 40. The total number of items on the overall examination form will not exceed 280.

Generally, time is not a problem, but we strongly suggest that you practice the timing on the questions. We provide a timer for both the individual questions, as well as your overall practice exam. This should help give you a feel for the pace of the questions. Our USMLE board review questions are specifically written to simulate the complexity and time of the real questions on the exam. The real exam lets you move backwards and forwards from question to question, as well as correct old answers. Our system is modeled after this behavior as well.

Other advice for the Step 1 exam - choose a faculty advisor, and make friends with other MS2 and MS3 students. If you need help with shelf exams, visit our shelf exam prep section. And when you’re ready, check out our Step 2 question bank or Step 3 question bank.

Understand that no matter how well you prepare, there will be tough questions. Make sure to stay in touch with friends, and keep a steady schedule. Taking a practice exam each and every week is a great way to know how well you’re doing, and also to understand which categories you need to focus on (Our system individually suggests categories individualized to each person.) Make sure to use this to your advantage so that you’re optimizing your study time instead of going back to categories that you already know.

If you need any help, feel free to reach out to us.