What resources should I use for Step 1?

For USMLE Step 1, the core resources are UWorld (Qbank), First Aid (high-yield guide), Pathoma (pathology videos), Sketchy Medical (micro/pharm visuals), Anki (flashcards, especially Anking deck), and Boards and Beyond (video lectures) for foundational knowledge. Supplement with NBME Self-Assessments (like the Free 120) for practice exams and AMBOSS for an alternative Qbank or library.

What is the best resource for Step 1?

For USMLE Step 1, the consensus gold standard resources are UWorld (Qbank), First Aid (high-yield overview), Pathoma (pathology videos), Sketchy Medical (visual mnemonics for micro/pharm), and Anki/AnKing (spaced repetition), often used with Boards and Beyond (videos) and NBME Self-Assessments to gauge progress. The key is strategic integration, using UWorld for practice and learning, First Aid as a core reference, and video resources like Pathoma/Sketchy for weak areas, supplemented by Anki. 

What is the best way to study for USMLE Step 1?

One of the most beneficial ways to prepare for your USMLE is to test yourself with practice exam papers. The National Board of Medical Examiners (NBME) offers a range of USMLE Step 1 practice exams.

What books should I read for USMLE Step 1?

If you meant it not literally, I would recommend First Aid, Pathoma and UWorld. If you can understand and memorize them, you'll do fine. First Aid is one of the best curated factbooks for the USMLE Step 1, and represents the crowdsourced wisdom of previous test-takers.

What do I need to bring with me for Step 1?

Government Issued Form of ID

Bring two forms of ID, such as a passport and driver's license. Remember these must be government issued and have your photo and signature.

USMLE STEP 1 Preparation and Resources (If I could start over)

Is 60% enough to pass Step 1?

Yes, around 60% correct is generally considered the approximate pass mark for USMLE Step 1, though the exact percentage varies with each exam form, and the score is reported as Pass/Fail, not a number, so consistently scoring higher (like 65-70%) on practice exams (NBMEs) is recommended for a comfortable pass. The official passing score (around 196 before 2022, now just "Pass") isn't a fixed number of questions, as some are experimental, but aiming for about 60% on practice tests is a good benchmark, with 70%+ being a safer target for a strong pass. 

What is a 75% on Step 1?

A 75% on USMLE Step 1 usually refers to a high performance level, often meaning you scored better than 75% of other test-takers (75th percentile) or got around 75% of questions correct on practice exams, indicating a very high chance of passing, as a ~65% correct on NBMEs often predicts passing. While Step 1 is now pass/fail, historically, a score in the 75th percentile (around 240-250+ on the old scale) was considered strong for residency applications, and 70-75% on practice NBMEs suggests near-certain success on the actual exam.
 

Is 4 months enough for Step 1?

If you are working all day and studying in the evenings, you may need to consider three to four months of studying. If you graduated many years ago and have forgotten much of the basic sciences, you also may need a longer time to study. You may even prefer taking Step 2 first.

What common mistakes to avoid on Step 1?

7 Most Common USMLE Step 1 Study Mistakes Students Make

• Using too many different resources: ...
• Memorizing over understanding: ...
• Over or under-reading rationales: ...
• Ignoring weaknesses: ...
• Not practicing media-based questions: ...
• Not taking full-length practice assessments before the exam: ...
• Not taking care of yourself:

What is the 7 year rule for USMLE?

The USMLE 7-year rule, primarily for International Medical Graduates (IMGs) seeking ECFMG Certification, mandates completing all required USMLE Steps (1, 2 CK/CS, and eventually 3) within seven years of passing the first exam; failure to do so invalidates earlier scores, requiring retakes, though waivers or extensions may be granted for documented issues like PhD programs, severe illness, or certain military service. Most U.S. medical licensing boards also enforce this timeframe for state licensure, starting from the first successful Step pass. 

What month do most people take Step 1?

Most medical students take Step 1 at the end of their second year, typically between February and April. The more prepared you are through spaced repetition early, the earlier you may be able to take the exam and then enjoy a well-deserved break before moving into third year clerkships!

Is UWorld enough for USMLE prep?

UWorld alone is not enough. You should use UWorld along with these tips to effectively prepare for Step 1: Combine UWorld with other resources, such as First Aid and NBME self-assessments. Start with a small question pool at the beginning of each topic to determine which concepts you need to focus on the most.

Is Step 1 the hardest exam ever?

While USMLE Step 1 is notoriously difficult, often considered the hardest among medical licensing exams due to its vast knowledge base and high stakes, calling it the absolute "hardest in the world" is subjective; exams like China's Gaokao are also cited for extreme pressure, but Step 1's challenge lies in consolidating foundational medical science before clinical focus in later steps. Many students find it uniquely stressful as a major hurdle in becoming a doctor, testing broad concepts and clinical reasoning.
 

How many hours a day to study for Step 1?

Most students preparing for USMLE Step 1 study between 6 to 10 hours per day, depending on how far they are from test day and their familiarity with the material.

How long is free 120 Step 1?

The Free 120 simulates the exact format of the USMLE Step 1 question style and user interface (i.e, how the screen looks, how break time looks, etc). It's three blocks of 40 questions timed exactly like the USMLE Step 1, gives you the exact same tutorial, and allows you to check your answers once you've finished.

What is the best prep course for USMLE Step 1?

6 Best USMLE Prep Courses & Classes (2025)

1. Kaplan. A veteran in the test prep world, Kaplan is a go-to for many medical students. ...
2. PASS Program. The PASS Program offers a unique, immersive approach to USMLE test prep. ...
3. Achievable USMLE. ...
4. Lecturio. ...
5. BoardVitals. ...
6. SmashUSMLE.

What is a 90% chance of passing Step 1?

A 90% chance of passing USMLE Step 1, often from an NBME practice test, means that for every 100 people with that score, 90 pass, but 10 still fail, so it's a strong indicator but not a guarantee, highlighting the need to focus on weak areas identified in the report, especially for Step 1's new pass/fail format where recent pass rates hover around 90-92%.
 

What is the top 3 toughest exam in the world?

The three toughest exams globally often cited for their extreme difficulty, low pass rates, and high stakes are China's Gaokao (National College Entrance Exam) for its sheer scale and competitiveness, India's UPSC Civil Services Exam for its life-altering potential and minuscule selection, and India's IIT-JEE Advanced (Joint Entrance Exam) for its rigorous engineering entrance criteria, alongside prestigious UK fellowships like the All Souls Prize Exam, with difficulty varying by individual and goals. 

How common is failing Step 1?

While most people pass USMLE Step 1, failure rates have increased, especially since the scoring change to pass/fail in 2022, with overall pass rates for first-time test-takers dropping, and international medical graduates (IMGs) and repeat test-takers facing significantly lower odds, though the exact number varies yearly, with thousands failing in recent years (e.g., over 11,000 in 2023). For MD students, first-time pass rates were around 90-93% in 2022-2023, compared to 82-83% for DO students and ~72% for IMGs in 2023, with repeaters seeing even lower success.
 

Is Step 1 harder than the mcat?

Most sources suggest the USMLE Step 1 is generally considered harder than the MCAT due to its immense content depth in basic sciences and higher stakes (though its scoring changed), while the MCAT is often seen as a broader critical thinking/reading test; however, opinions vary, with some finding the MCAT's abstract, interdisciplinary nature more challenging than Step 1's deep science focus. Step 1 covers a vast amount of medical science (physiology, pharmacology, etc.) after two years of med school, whereas the MCAT tests foundational sciences and reasoning for med school entry, often seen as tricky or abstract, per Reddit users and this YouTube video. 

How much does USMLE Step 1 cost?

The total cost of taking USMLE Step 1 ranges from $695–$3,507 for U.S. students and $1,760–$4,577 for IMGs, including Step 1 registration fees, ECFMG certification cost for IMGs, Step 1 question banks and common study resources.

How to ace USMLE Step 1?

Tips for Effective USMLE Step 1 Preparation

1. Start early. Begin integrating Step 1 review materials into coursework during the first year of medical school.
2. Use active recall. ...
3. Take full-length practice exams. ...
4. Review every mistake. ...
5. Prioritize self-care.

Is UWorld enough for Step 1?

Based on internal and independent data, there's a notable correlation between completing UWorld Step 1 questions and improving your Step 1 score. While finishing our QBank once is enough to pass Step 1 for many students, we suggest reviewing it twice for the best results.

When did Step 1 Go Pass fail?

On January 26, 2022, the United States Medical Licensing Examination (USMLE) Step 1 exam transitioned to a pass-fail grading system instead of the conventional three-digit score.

What is a low pass on Step 1?

The Step 1 low-pass range represents performance that is above but near the passing standard. In other words, performance that is sufficient to pass Step 1, but only by a small margin. Any overlap between your likely score range and the Step 1 low-pass range should warrant extra caution.