Enrollment open: 2,000 original Step 1 questions, written to the content specifications USMLE publishes for Step 1. Enroll today and start with the free sample exam.
The United States Medical Licensing Examination (USMLE) is a three-Step examination for medical licensure in the United States, sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). Step 1 tests the sciences basic to the practice of medicine and is reported as pass/fail. Step 2 CK tests clinical knowledge for patient care under supervision and is reported as a three-digit score. Step 3, the final Step, tests readiness for unsupervised practice over two days, including computer-based case simulations. PassProfessor’s Step 1 program — the first program in our USMLE suite to open — prepares you for Step 1 against the same published specifications the real exam is built from, with 2,000 original practice questions. Our full breakdown of the real exams is in the USMLE exam guide.
What’s included
- 2,000 original Step 1 practice questions, written from scratch to the content specifications USMLE publishes for Step 1 — 1,895 clinical vignettes and 105 direct questions.
- Five answer choices on every question (A–E) — the most common format on the real exam. The real Step 1 varies its option count; this program standardizes on five so your practice rhythm is consistent.
- System drills for all 11 systems, plus full practice exams of up to 280 questions drawn fresh at the published system ranges every time you sit one — questions you have not seen come first, and you never sit the same exam twice.
- A free 12-question sample exam — no enrollment required.
- 12 months of access for $129.
What the program will cover
Step 1’s job: the sciences basic to medicine, applied. Step 1 asks whether you understand and can apply the concepts of the sciences basic to the practice of medicine — principles and mechanisms underlying health, disease, and modes of therapy. This program is built for that job alone: every question is a Step 1 question, mapped to the system and process specifications USMLE publishes for Step 1, so your practice data reads the way the real exam is organized.
Step 1 practice in the current block format. Step 1 changed format in 2026, and pacing practice has to change with it. For exams taken on or after May 14, 2026, Step 1 is divided into fourteen 30-minute blocks in one 8-hour testing session, with no more than 20 questions per block and no more than 280 items in total. Practice built for the retired seven-block, 60-minute structure trains the wrong rhythm. The program is being designed around the current 30-minute block structure, with the integrated system-and-process outline USMLE publishes for Step 1.
Timed practice at Step 1’s real length. Step 1 is an 8-hour testing session: fourteen 30-minute blocks of up to 20 questions since the May 2026 format change. Shorter blocks mean more transitions and faster resets. Full-length, timed practice at the real session length is part of the design, so pacing is a practiced skill rather than an exam-day surprise.
A study loop tied to the official specifications. Practice results break down by system and by the published content areas, so you can move from a diagnostic set, to focused drills on the systems and competencies that cost you, to a full timed session.
The real exams at a glance
Current as of October 2026, per the USMLE program’s official pages at usmle.org. Full detail — eligibility, the ECFMG pathway for international medical graduates, registration, retakes, and test day — is in our USMLE exam guide.
| Step 1 | Step 2 CK | Step 3 | |
|---|---|---|---|
| What it assesses | Sciences basic to the practice of medicine | Clinical knowledge for patient care under supervision | Knowledge and skills for independent, unsupervised general medical care |
| Format (current) | One day; fourteen 30-minute blocks; up to 20 questions per block | One day; sixteen 30-minute blocks; up to 20 questions per block | Two days; Day 1 multiple-choice only; Day 2 multiple-choice plus case simulations |
| Items | Up to 280 multiple-choice items | Up to 318 multiple-choice items | Day 1: 232 multiple-choice items. Day 2: 180 multiple-choice items plus 13–14 case simulations |
| Testing session | 8 hours, including a minimum 55 minutes of break time and a 5-minute optional tutorial | 9 hours, including a minimum 55 minutes of break time and a 5-minute optional tutorial | Day 1: about 7 hours, including 55 minutes of break time and a 5-minute optional tutorial. Day 2: about 9 hours, including a minimum 45 minutes of break time |
| Score reporting | Pass/fail only (for exams taken on or after January 26, 2022) | Three-digit score | Three-digit score |
| Minimum passing standard | Reported as pass/fail | 218 (for exams administered on or after July 1, 2025) | 200 (for exams administered on or after January 1, 2024) |
| Application fee (2026 & 2027, per USMLE) | $695 | $695 | $955 |
| Where it is taken | Prometric test centers worldwide | Prometric test centers worldwide | Prometric test centers in the U.S. and its territories only |
- The block formats on this page are the current ones. Step 1 used seven 60-minute blocks for exams taken before May 14, 2026, and Step 2 CK used eight 60-minute blocks for exams taken before May 7, 2026. Those structures are retired for current test-takers. If a study resource still describes them as the live format, it is out of date.
- Step 3’s Day 1 format is also current-form. Day 1 now presents its 232 items in 12 blocks of 18–20 items at 30 minutes per block, and Day 2 presents its 180 items in 9 blocks of 20 items at 30 minutes per block — not the longer blocks older guides describe.
- Fees above are the USMLE application fees, not PassProfessor prices. For Step 1 and Step 2 CK taken outside the U.S. and Canada, USMLE’s Apply page lists an additional region fee — $210 for Step 1 and $235 for Step 2 CK — and notes that this region fee is not a USMLE fee. ECFMG-related fees for international medical graduates are separate and are not stated on this page.
- A passing standard is not a percentage. USMLE reports Step 2 CK and Step 3 results on a three-digit scale and Step 1 as pass/fail. USMLE does not publish a fixed percentage of questions you must answer correctly to pass, so plan to practice comfortably above the line rather than aiming at a converted percentage.
How the practice maps to the real exams
The Step 1 program is built on the content specifications USMLE publishes at usmle.org. Ranges below are USMLE’s published ranges; USMLE states that its percentages are subject to change at any time.
Step 1 — organized by system and process
USMLE constructs Step 1 on an integrated content outline along two dimensions: system and process. Its published system ranges include:
| Step 1 system (published range) | Range |
|---|---|
| Reproductive & Endocrine Systems | 12–16% |
| Respiratory & Renal/Urinary Systems | 11–15% |
| Behavioral Health & Nervous Systems/Special Senses | 10–14% |
| Blood & Lymphoreticular/Immune Systems | 9–13% |
| Musculoskeletal, Skin & Subcutaneous Tissue | 8–12% |
| Multisystem Processes & Disorders | 8–12% |
| Cardiovascular System | 7–11% |
| Gastrointestinal System | 6–10% |
| Social Sciences: Communication and Interpersonal Skills | 6–9% |
| Biostatistics & Epidemiology/Population Health | 4–6% |
| Human Development | 1–3% |
By competency, USMLE’s largest Step 1 range is Medical Knowledge: Applying Foundational Science Concepts at 60–70%, followed by Patient Care: Diagnosis at 20–25%. By discipline, its published ranges are led by Pathology (45–55%) and Physiology (30–40%), with Nutrition, Gross Anatomy & Embryology, Microbiology, and Pharmacology each at 10–20%. Discipline ranges overlap because a single item can assess more than one discipline — read them as emphasis, not as slices of a pie.
How to use it
- Start with the free sample exam, then enroll. Work through the 12-question sample to see the format, then start the program with USMLE’s own published sample items and the Bulletin of Information for Step 1 alongside, so the real formats are familiar early.
- Confirm which Step — and which format — you are preparing for. Steps 1 and 2 CK changed block structure in May 2026. Prepare in 30-minute blocks of up to 20 questions, not in the retired 60-minute blocks.
- Start with a timed diagnostic set. Your breakdown by system and competency is the study plan: it shows where the next weeks of drilling belong.
- Drill by the published specifications, heaviest first. On Step 1, that means foundational-science application inside organ systems.
- Finish with full-length timed sessions at the real length — one 8-hour day for Step 1 — and schedule the real exam through your registration entity and Prometric when your timed practice sits comfortably above your readiness benchmark.
Frequently asked questions
What is the USMLE? The United States Medical Licensing Examination is a three-Step examination for medical licensure in the United States. Per the USMLE program, it is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), and it assesses a physician’s ability to apply knowledge, concepts, and principles and to demonstrate fundamental patient-centered skills.
What is the difference between Step 1, Step 2 CK, and Step 3? Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine. Step 2 CK assesses your ability to apply medical knowledge, skills, and understanding of clinical science to patient care under supervision, with emphasis on health promotion and disease prevention. Step 3, the final Step, assesses physicians who are assuming independent responsibility for providing general medical care, with emphasis on patient management in ambulatory settings.
How many questions are on Step 1? For exams taken on or after May 14, 2026, Step 1 presents up to 280 multiple-choice items in fourteen 30-minute blocks of up to 20 questions each, in one 8-hour testing session, per USMLE. Step 1 taken before May 14, 2026 used seven 60-minute blocks; that structure no longer applies to current test-takers.
How many questions are on Step 2 CK? For exams taken on or after May 7, 2026, Step 2 CK presents up to 318 multiple-choice items in sixteen 30-minute blocks of up to 20 questions each, in one 9-hour testing session, per USMLE. Step 2 CK taken before May 7, 2026 used eight 60-minute blocks.
How is Step 3 structured? Step 3 is a two-day examination, per USMLE. Day 1 (Foundations of Independent Practice) presents 232 multiple-choice items in 12 blocks of 18–20 items at 30 minutes per block, in a session of about 7 hours. Day 2 (Advanced Clinical Medicine) presents 180 multiple-choice items in 9 blocks of 20 items at 30 minutes per block, plus 13 to 14 computer-based case simulations allotted a maximum of 10 or 20 minutes of real time each, in a session of about 9 hours.
What score do I need to pass each Step? Step 1 is reported as pass/fail only for exams taken on or after January 26, 2022. The current minimum passing score for Step 2 CK is 218, for exams administered on or after July 1, 2025. The current minimum passing score for Step 3 is 200, for exams administered on or after January 1, 2024. All three figures are as published by the USMLE program on its Examination Results and Scoring page, current as of October 2026.
Who is eligible to take the USMLE Steps? For Step 1 and Step 2 CK, USMLE’s Bulletin of Information eligibility page requires you, both when you apply and on the day of the exam, to be a medical student officially enrolled in, or a graduate of, an LCME-accredited U.S. MD program, a COCA-accredited U.S. DO program, or a medical school outside the U.S. that is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements and that meets ECFMG’s other eligibility criteria. Step 3 adds further requirements — see the next answer and our exam guide.
What does Step 3 require before I can take it? Per USMLE’s eligibility page, Step 3 requires passing scores on Step 1 and Step 2 CK, plus an MD or DO degree from an LCME- or COCA-accredited U.S. medical school — or, for graduates of medical schools outside the U.S., the equivalent of the MD degree from a school listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements, together with ECFMG Certification and a valid, unexpired ECFMG Certificate. USMLE also recommends that Step 3 applicants have completed, or be near completion of, at least one postgraduate training year in an accredited U.S. graduate medical education program that meets state board licensing requirements.
How much do the real USMLE exams cost? USMLE’s Apply for Exams page lists the 2026 and 2027 application fees as $695 for Step 1, $695 for Step 2 CK, and $955 for Step 3, current as of October 2026. For Step 1 and Step 2 CK taken outside the U.S. and Canada, that page lists an additional region fee of $210 for Step 1 and $235 for Step 2 CK, and states that the region fee is not a USMLE fee. These are the real exams’ fees, paid through your registration entity — they are not PassProfessor prices.
Are these the actual USMLE questions? No. PassProfessor practice questions are written independently, from scratch, to the content specifications the USMLE program publishes. We never use actual USMLE items, recalled items, or another provider’s material.
When will the PassProfessor USMLE program be available? The Step 1 program is open now — enroll on this page and start with the free sample exam. Step 2 CK and Step 3 are separate programs in the PassProfessor catalog; enrollment for each opens as the catalog expands.
Disclaimer
PassProfessor is an independent exam-preparation provider and is not affiliated with, sponsored by, or endorsed by the Federation of State Medical Boards (FSMB), the National Board of Medical Examiners (NBME), or the Educational Commission for Foreign Medical Graduates (ECFMG). USMLE® is a joint program of the FSMB and NBME. This program is exam preparation only and provides no medical degree, certification, or license; medical licensure is granted solely by U.S. state medical boards to candidates who meet their requirements, including passing the USMLE Steps. Exam details on this page are general information current as of October 2026 — the USMLE program’s official publications govern if anything here differs from them.