USMLE (NBME & FSMB)
USMLE Step 1
United States Medical Licensing Examination, Step 1
The first exam in the US physician licensing sequence, testing whether students can apply foundational science concepts to the practice of medicine. Pass/fail since 2022, it remains a required gateway to clinical rotations and residency.
Blueprint-complete program: 14 decks, 1,546 cards.
What's on the exam
Curriculum decks (2025 USMLE content outline + tier-1 med-school preclinical curricula)
Foundational Sciences (General Principles)
~11%Blood, Lymphoreticular & Immune
~10%Behavioral Health
~5%Nervous System & Special Senses
~7%Musculoskeletal, Skin & Connective Tissue
~8%Cardiovascular
~8%Respiratory
~6%Renal & Urinary
~6%Gastrointestinal
~7%Reproductive
~6%Endocrine
~6%Multisystem, Nutrition & Genetics
~10%Biostatistics, Epidemiology & EBM
~4%Social Sciences, Ethics & Systems-based Practice
~6%Frequently asked questions
How much does the USMLE Step 1 cost?
The USMLE Step 1 costs $695. Approximately $695 registration fee for US/Canadian students; international test-delivery surcharges may apply.
How long is the USMLE Step 1 and how many questions does it have?
Up to 280 items across 14 blocks — Up to 8 hours in one day.
What do you need to pass the USMLE Step 1?
Pass/fail only (since January 2022); no three-digit numeric score is reported.
Can you retake the USMLE Step 1?
Up to four attempts per Step; no more than three attempts within a 12-month period.
What is the best way to study for the USMLE Step 1?
Study the official blueprint, not random material: the exam is weighted by domain (Foundational Sciences (General Principles) ~11%, Blood, Lymphoreticular & Immune ~10%, Behavioral Health ~5%, Nervous System & Special Senses ~7%, Musculoskeletal, Skin & Connective Tissue ~8%, Cardiovascular ~8%, Respiratory ~6%, Renal & Urinary ~6%, Gastrointestinal ~7%, Reproductive ~6%, Endocrine ~6%, Multisystem, Nutrition & Genetics ~10%, Biostatistics, Epidemiology & EBM ~4%, Social Sciences, Ethics & Systems-based Practice ~6%). Spaced-repetition flashcards built domain-by-domain against that blueprint are the most time-efficient way to cover everything the exam tests.
Ready to prepare?
Our USMLE Step 1 program follows this exact blueprint — every domain covered, scheduled by spaced repetition, with a journey from first card to test day.