USMLE Step 1
Updated on Jun 6, 2018 - 9:45 a.m. IST by Shivani Bhatt

USMLE Step 1 – United States Medical Licensing Exam (USMLE) Step 1 is the first step of the three-step examination for medical licensure in the United States. The USMLE Step 1 attempts to test the candidate’s knowledge on foundational concepts of medicine and its medical practice. USMLE step 1 evaluates the aspirants understanding and ability to apply essential concept of sciences to medicine practice. The step also tests the understanding of principles and mechanisms which are responsible for health, diseases and therapy modes. USMLE is governed by an 80-member board that which includes members from the Federation of State Medical Boards (FSMB), National Board of Medical Examiners (NBME) and the Educational Commission for Foreign Medical Graduates (ECFMG) as well as representatives from different organizations. International USMLE 2018 aspirants have to apply to the ECFMG to take their USMLE Step 1.


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According to the USMLE eligibility criterion, international candidates aspiring to take the USMLE 2018 Step 1 should be either pursuing or have completed their MBBS from a medical college listed in the World Directory of Medical Schools. The other important criteria are listed below.


USMLE Step 1 Eligibility Criteria 2018

  • The aspirant should be either pursuing or be a graduate of a medical school outside of the US and Canada, which is listed in the World Directory of Medical Schools.

  • Meets ECFMG certification eligibility criteria.

  • Must meet eligibility requirements at time of application.

USMLE Step 1 Dates

Before deciding on a test date for USMLE 2018 Step 1, aspirants have to choose an eligibility period. Once the eligibility period is selected, the candidates then have to select their USMLE step 1 test date. The USMLE step 1 has to be taken within the eligibility period chosen. The USMLE step 1 eligibility period is three months. However, according to USMLE guidelines, eligibility period for first week of January or major holidays will not be available.

USMLE Step 1 Application Form

International candidates aspiring to apply for the USMLE step 1 have to apply for an ECFMG certification. Educational Commission for Foreign Medical Graduates (ECFMG) evaluates the international medical graduates aspiring to pursue a residency programme in the USA. After the candidate has applied for ECFMG certification, they can initiate the USMLE registration process through the Interactive Web Applications (IWA).


The international medical graduates planning to take the USMLE 2018 Step 1 are required to choose a three-month eligibility period. They can take the USMLE step 1 within the chosen eligibility period. The aspirants have to take care that the eligibility period chosen should not be between the first fortnight of January and or on major holidays.


Prometric is the testing partner for USMLE 2018. Aspirants can select their country of choice for USMLE 2018 Step 1. To choose and book a specific test centre for USMLE 2018 step 1, international aspirants have to visit the Prometric website.


The application fee for USMLE step 1 2018 is $910. An additional surcharge depending on the country of examination of $0-$365 has to be paid. Additionally, international medical graduates have to pay $65 for ECFMG certification.


USMLE 2018 Step 1 Exam Pattern

The single-day exam, USMLE Step 1 has multiple-choice question. The exam is divided into seven 60-minute blocks is of 8 hours duration. Each block will have a minimum of 40 questions and the total seven blocks should not have more than 280 questions.


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USMLE Step 1 Pattern




Step 1

Computer-based test covering 280 MCQ questions.

8 hours

The qualifying marks required in USMLE 2018 Step 1 is 194.


The USMLE Step 1 questions can be grouped into 18 prime areas. They focus on basic concepts and principles important across organ-systems or within individual organ-systems. The examination covers topics related to the traditionally defined disciplines such as: These are as follows:

  • Anatomy

  • Behavioral Sciences

  • Biochemistry

  • Biostatistics and Epidemiology

  • Microbiology

  • Pathology

  • Pharmacology

  • Physiology

The following interdisciplinary areas are also covered in the USMLE 2018 step 1:

  • Genetics

  • Aging

  • Immunology

  • Nutrition

  • Molecular and Cell Biology

The table below showcases the Step 1 test items. The test items are grouped in two parts; system and process. Specific weightage is given to the covered areas under these two divisions. The table below reflects the weight given to each of these subject areas:


USMLE Step 1 Syllabus



General Principles of Foundational Science

15% – 20%

1. Immune System

2. Blood & Lymphoreticular System

3. Behavioral Health

4. Nervous System & Special Senses

5. Skin & Subcutaneous Tissue

6. Musculoskeletal System

7. Cardiovascular System

8. Respiratory System

9. Gastrointestinal System

10. Renal & Urinary System

11. Pregnancy, Childbirth, & the Puerperium

12. Female Reproductive & Breast

13. Male Reproductive

14. Endocrine System

60% – 70%

1. Multisystem Processes & Disorders

2. Biostatistics & Epidemiology

3. Population Health

4. Social Sciences

15%– 20%



Normal Processes

10% – 15%

Abnormal Processes

55% – 60%

Principles of Therapeutics

15% – 20%


10% – 15%

USMLE Step 1 Physician Competencies



Medical Knowledge/Scientific Concepts

55% – 65%

Patient Care: Diagnosis


History/Physical Examination


Laboratory/Diagnostic Studies






20% – 30%


Patient Care: Management***


Health Maintenance/Disease Prevention










Practice-based Learning and Improvement


USMLE Step 1 Scores

USMLE Step 1 test results are declared 3 – 4 weeks after the exam date. Though the exam does not have any exact total score, the examinees have to score a minimum marks to qualify. The minimum score required in USMLE is 194.


USMLE Step 1 number of attempts and sequence

An aspirant can take the exam only three-times within a 12-months. In case the aspirant wants to take more than four attempts, there has to be 12-month gap between the first and next attempt and an at least six-months gap between the previous attempt.  Aspirants who have passed a USMLE step are not allowed to retake the examination. Candidates are not eligible to retake a Step or Step Component if they already taken the six or more prior attempts for Step or Step Component. This includes incomplete attempts. The US state medical records require that the aspirants complete all the steps within a period of seven years.


Aspirants who meet the eligibility can take the USMLE Step 1, Step 2 CK and CS in any sequence. However, Step 3 can only be taken once the candidates clear the USMLE step 1, step 2 CS and CK.


Also, read:

USMLE Step 2

USMLE Step 3

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Questions related to USMLE

Showing 71 out of 71 Questions

I am studying MBBS in China in Guangxi University Of Chinese medicine .This is my 3rd year .I am from India .I want to give USMLE and rest of the exams like MCI .How to apply what should I do now ..I need some suggestions

Animesh Vats Student Expert 18th Feb, 2020


Well I would like to tell you that after MBBS you can give USMLE exam in order to qualify for residency program in USA and for India you will have to give fmge qualifying exam and then you can practice medicine here. Either way the path is going to be difficult cause both the exams are difficult and USMLE happens in three levels.

I hope my answer helps.

All the best.


I have completed my MBBS in China in Xiamen university in 2011. In 2013 I got married. In 2014 I cleared fmge and did internship in osmania hospital. After that I went to Qatar with my husband for 2 years. I got degree on Sept 2017. Next month Im flying to US withm eligible for applying usmle

Animesh Vats Student Expert 17th Feb, 2020


Well I would like to tell you that after MBBS program ends a doctor can apply for USMLE exam . In USA once you are done with your studies, you are required to give USMLE exam which is organised in three levels and once you qualify all the three levels then you are allowed to get into residency program but finding one is really difficult. USMLE can not guarantee you residency rather it will only help you in allowing you to go search for residency in US hospitals. Same goes for international students as well but the level of difficulty is a lot and getting residency is the most difficult thing to do.

I hope my answer helps.

All the best.


what is the process of usmle for pg course! l want all information regarding usmle please

Sourandhi Saha Student Expert 17th Feb, 2020

You can appear for USMLE or United States Medical Licensing Examination in order to do medical pg courses from USA. It's same as All India PG Entrance exam where you study up all your MBBS Subjects and write the exam. USMLE is a three step process where you have to score a very high percentage. Based on your marks you will be given a stream to get your MD in. USMLE 1 and 2 can be given in India after getting an appointment but for Step 3 you have to go USA and sit for interview. You can check the detailed eligibility criteria here-


Why GATEIIT considered as the best Coaching centre for USMLE Licence exam preparation in India? How to join GATEIIT?

saad ali 29th Jan, 2020


GATEIIT is best in this domain for USMLE license preparation.

Well it is good because of the following reasons:

1) They are quite experienced in this field

2)Test series provided is very much similar to USMLE exam.

3) You are provided with several mock tests to give a brief idea about the exam.

To get admission in GATEIIT,you just have to pass 10+2 level of education.

Hope it helps!!


I am from India and I complete my MBBS degree from china but not clearing my FMGE exam..Can I eligible for USMLE EXAM?

Srijika Bhattacharyya 30th Jan, 2020
The USMLE exam has three steps- step 1, step 2cs and step 2ck.
The main eligibility criteria for USMLE is that you must have completed (in case of step 2) or must be pursuing(in case of step 1) mbbs in a medical college listed in the World directory of Medical colleges. If your college is listed in this directory you are eligible for the USMLE exam.
You can refer to this link for more details.
Hope this helps.

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