How Long Is the USMLE Step 1 Exam? What You Need to Know Before You Take It

Are you preparing for the USMLE Step 1 exam? It’s completely natural to have questions about what the test day will look like—and knowing exactly how much time you’ll spend in the exam room can help you plan better and ease some of that pre-test stress.

Here’s a detailed look at the length and structure of the USMLE Step 1 exam to help you feel confident and ready!

Total Time You’ll Spend on Exam Day

The USMLE Step 1 exam is an 8-hour test divided into several blocks, each with a specific time limit. Though eight hours may seem long, knowing how this time is split up can help you tackle it with less anxiety and more control.

Here’s how the time is typically structured:

  1. Testing Time: Approximately 7 hours
  2. Break Time: 45 minutes (can be managed as needed throughout the day)
  3. Tutorial: Optional, 15 minutes (can add this time to your break if you skip the tutorial)

Exam Structure and Time per Block

The USMLE Step 1 consists of up to seven blocks of questions. Each block has a time limit of 60 minutes and may contain up to 40 questions. The total number of questions across all blocks is 280, but it may vary slightly depending on the test version.

Each block tests a range of medical knowledge, including foundational science and clinical concepts. Here’s a rough breakdown:

  • 7 blocks
  • 60 minutes per block
  • Up to 40 questions per block

How Breaks Work

The Step 1 exam provides 45 minutes of break time, but you can actually extend this time. If you skip the 15-minute tutorial at the beginning of the exam, those extra minutes are added to your break time, giving you a total of 60 minutes. You can use this break time however you like between the blocks—some test-takers take short breaks after each block, while others save it up for longer rest periods.



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