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The number of questions per block on a given examination form may vary, but will not exceed The total number of items on the overall examination form will not exceed Please visit the USMLE website often to view announcements, regarding changes in the test delivery software, and to access updated practice materials.

Step 1 consists of multiple-choice questions prepared by examination committees composed of faculty members, teachers, investigators, and clinicians with recognized prominence in their respective fields. Committee members are selected to provide broad representation from the academic, practice, and licensing communities across the United States and Canada. The test is designed to measure basic science knowledge. Some questions test the examinee's fund of information per se, but the majority of questions require the examinee to interpret graphic and tabular material, to identify gross and microscopic pathologic and normal specimens, and to solve problems through application of basic science principles.

The content description is not intended as a curriculum development or study guide. It provides a flexible structure for test construction that can readily accommodate new topics, emerging content domains, and shifts in emphasis.

USMLE Step 1: USMLE Step 1

The categorizations and content coverage are subject to change. Broad-based learning that establishes a strong general understanding of concepts and principles in the basic sciences is the best preparation for the examination.

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  7. All USMLE examinations are constructed from an integrated content outline , which organizes content according to general principles and individual organ systems. Test questions are classified in one of 18 major areas, depending on whether they focus on concepts and principles that are important across organ systems or within individual organ systems.

    Content weighting for these topics is provided in Table 1. Sections focusing on individual organ systems are subdivided according to normal and abnormal processes, including principles of therapy. Content weighting for these topics is provided in Table 2.


    In most instances, knowledge of normal processes is evaluated in the context of a disease process or specific pathology. While not all topics listed in the content outline are included in every USMLE examination, overall content coverage is comparable among the various examination forms that will be taken by different examinees for each Step.

    Categories for individual organ systems include test items concerning those normal and abnormal processes that are system-specific. An additional organizing construct for Step 1 design is physician tasks and competencies.

    Pathoma best for Pathology and USMLE step 1 Preparation? - Step 1 - USMLE Press

    Each test item is constructed to assess one of the competencies listed in Table 3. Finally, each Step 1 examination covers content related to traditionally defined disciplines and interdisciplinary areas listed in Table 4. A single patient-centered vignette is associated with one question followed by four or more response options. A portion of the questions involves interpretation of graphic or pictorial materials. You are required to select the best answer to the question.

    This is the traditional, most frequently used multiple-choice question format on the examination.