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.
What's on the exam
USMLE Step 1 Content Outline (system-based, approximate weights)
General Principles of Foundational Science
13–15%Biochemistry & molecular biology · Cell biology · Genetics · Pharmacodynamics & pharmacokinetics · Microbiology fundamentals · Pathology mechanisms
Immune System
6–9%Innate & adaptive immunity · Hypersensitivity reactions · Immunodeficiencies · Autoimmunity · Vaccination & immunization
Blood & Lymphoreticular System
7–11%Hematopoiesis · Anemias · Coagulation disorders · Leukemias & lymphomas · Transfusion medicine
Behavioral Health & Nervous System / Special Senses
9–13%Neuroanatomy & pathways · Neurotransmitters & psychopharmacology · Neurodegenerative disease · Behavioral science concepts · Vision & hearing pathology · CNS infections
Musculoskeletal, Skin & Subcutaneous Tissue
6–9%Muscle physiology · Bone & joint pathology · Connective tissue disorders · Dermatologic pathology · Skin infections
Cardiovascular System
7–11%Cardiac physiology & electrophysiology · Atherosclerosis · Heart failure · Cardiac pharmacology · Congenital heart disease
Respiratory System
5–8%Pulmonary physiology & gas exchange · Obstructive & restrictive disease · Respiratory infections · Lung neoplasms · Acid-base regulation
Gastrointestinal System
6–9%GI tract physiology · Hepatobiliary pathology · Malabsorption · GI infections · Nutritional biochemistry
Renal & Urinary System
4–7%Renal physiology & filtration · Acid-base & electrolyte balance · Glomerular & tubular disease · Diuretic pharmacology · Urinary tract pathology
Reproductive & Endocrine Systems
8–12%Hypothalamic-pituitary axis · Thyroid & adrenal disorders · Diabetes & glucose regulation · Reproductive endocrinology · Embryology & development
Multisystem Processes, Biostatistics & Epidemiology
8–12%Study design & statistics · Epidemiology & screening · Aging & metabolism · Nutrition & toxicology · Fluid, electrolyte & multisystem disorders
Program in development
We're building a blueprint-complete program for this exam. Meanwhile, explore live programs across 6 exam.
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