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    Everything You Need to Know for USMLE Step 1 Exam Day

    Key points:

    1. Visit the test center beforehand so you can go into your exam day feeling confident and prepared! 
    2. Take a practice exam at a testing center or take advantage of the Step 1 interactive testing experience. 
    3. Bring your scheduling permit and government issued ID or you won't be admitted to take your exam. 
    4. The exam is a one-day (8 hour) exam and is divided into a short tutorial section and then seven one-hour blocks with 40 questions.

    Gearing up for your USMLE Step 1 exam? Read up on what you need to know about the day of your exam so you can stop stressing about exam logistics and focus more time on your studies. 

    What to do before your USMLE Step 1 day of exam 

    1. Understand the Step 1 USMLE Exam Content Outline and have study with MedStudy's Medical Student Study Strong System to ace your exam. 
    2. Read the rules of conduct from the USMLE. TL;DR: don't cheat and don't tell others what's on the exam.
    3. If you will need accommodations (assistance with keyboard tasks, audio rendition, extended time for your test, or additional break time) on your test day, make sure that you request them ahead of time and complete the required form. 
    4. Visit the test center. In our recent blog Best USMLE Step 1 Advice from Reddit - R/Step1, u/Gubernaculum mentions that it's a good idea to visit the testing center before your exam day. That way you'll know the route you'll take on the day of, you'll know where to park, where the bathrooms are, etc. They recommend that you make it to the testing center at least 30 minutes before you're scheduled to take the examination. All of this travel prep will take some of the anxiety out of test day. If you're taking public transportation, make sure to figure out your route and times beforehand. 
    5. Another thing to do before your exam day is to take advantage of the Step 1 interactive testing experience. This will get you comfortable with the format of the test. Then on the day of your USMLE Step 1 exam, you won't have to waste any time trying to figure out the features, and you can focus on the questions.
    6. You can also set up a full USMLE Computer-based Testing Practice Session. Setting up a practice test allows you to become comfortable with the testing environment and the exam format. There is a fee of $75 to do the practice test. It is a maximum of three and a half hours, and is divided into a tutorial section and three 60-minute blocks of about 40 exam-style questions. When you're done with the practice exam you'll get your percentage correct score, though this won't tell you exactly how you'll do on your actual exam, it can help you focus your studying! It's not required to do this before setting up your actual exam, but it's a good idea nevertheless. 
    7. Get everything ready to take with you before the morning of the exam. 
    8. DON'T take any study material with you. Use your breaks to give your brain a rest, and don't stress about looking up material in between exam blocks.

    What to bring with you on exam day 

    Make sure that you have all of these items prepared before the morning of the exam.

    1. Paper or electronic copy of your scheduling permit
    2. Government-issued photo ID (check right now and make sure it's not expired!) This can be a Passport, Driver's License, or National ID card.   
    3. Ear plugs. As far as personal items go, ear plugs are the only thing that you're allowed to bring into the exam with you. They need to be cordless soft-foam earplugs, with no strings attached. Everything else you bring with you to the test center can be stored in a locker that will be assigned to you. Keep in mind that anything you take with you to the test center is subject to inspection.
      a) Be prepared for a security check. They'll ask you to open your pockets, take your fingerprints, and even examine your glasses. 
    4. Pack snacks for your break times and a healthy lunch! It's a good idea to also pack plenty of water bottles and coffee if you're a coffee drinker. 
      a) ProTip! Take some healthy snacks to eat during break times to keep you alert and focused!

    Understand the exam day schedule 

    This is a one-day (8 hour) exam and is divided into a short tutorial section and then seven one-hour blocks. The number of questions that you'll answer during each block varies depending on how much time you take to answer the questions, but won't be more than 40. And the full exam won't be more than 280 questions.

    During the exam, there is an allotment of a minimum of 45 minutes for break time, and 15 minutes for an optional tutorial at the beginning. Again, we recommend doing the Step 1 interactive testing experience ahead of time, or doing a full practice test at the testing facility.

    You gain more time for your breaks if you finish a block of questions before the allotted time expires and if you finish the tutorial early. With that all being said, don't rush through any of the question or tutorial. Take your time! Keep in mind that each time you leave the exam and come back in, they will take your fingerprint. 

    Sample exam overview from the Step 1 interactive testing experience

    Understand the timers 

    There are 2 different timers on your exam to be aware of. To access the timers during your exam, you can click on the bottom toolbar and click Block Time Remaining to open the Timer Panel.

    The first is the Block Time Information timer which will show you which block you are on out of 7 blocks, the time remaining on the block, time elapsed, and the length of the block. You'll also see the Day Time Information timer, which shows the time remaining on the full exam (not just the block you're on), time elapsed of the day, and the total time (which is 8 hours). 

    It will also show you how much break time you have remaining. 

    Exam timer example from the Step 1 interactive testing experience

    Looking for a better way to study for your Step 2 exam? Check out the Medical Student Study Strong System—Start a free trial now and get the full Musculoskeletal section for 30 days. 

    gif of scrolling through the core

    An inside look at the Musculoskeletal section as part of the Medical Student Study Strong System

    You got this! 

    Related content:  

    How to Study For the Step 1 USMLE Exam

    How to Study for Step 1 Biochemistry

    Best USMLE Step 1 Advice from Reddit -  R/Step1

    Everything You Need to Know About The USMLE Step 1 Pass Fail Update


    The United States Medical Licensing Examination (USMLE®) is a joint program of the Federation of State Medical Boards (FSMB®) and National Board of Medical Examiners (NBME®). None of the trademark holders are affiliated with MedStudy.

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