Preparing for the Test

Materials Available Through USMLE

The best preparation for the USMLE is a general, thorough review of the examination content and test formats and running the practice test , all of which are available on the USMLE website. Please note: USMLE practice materials are updated periodically. Self-assessment information and materials are also available at

Materials Available Through Third Parties

There are no test preparation courses affiliated with or sanctioned by the USMLE program. Information on such courses is not available from the ECFMG, FSMB, NBME, USMLE Secretariat, or medical licensing authorities.

Test preparation courses and materials are available from individuals and companies not associated with USMLE. It is unlawful for any test preparation service or program to use, disclose, distribute, or otherwise provide access to questions or answers from actual USMLE exams. If you are involved with any enterprise that disseminates USMLE content, you should be aware of the consequences to you, regardless of whether your exposure to USMLE content was advertent or inadvertent: If there is evidence that you enrolled in, participated in, or used any test preparation program or service that distributes, provides access to, or uses USMLE questions or answers, or provides a forum for others to share such information, your registration and/or testing may be canceled, your scores on the USMLE may be withheld or canceled, and you may be subject to further sanctions.

Continue to: Test Lengths and Formats »

Test Lengths and Formats

Sample test materials and further information on test content are available at the USMLE website.

The test descriptions provided here, including test length and number of test items or cases, may be changed at any time. Notice of any changes will be posted on the USMLE website.

The number of test questions on any examination form and on individual blocks may vary to accommodate different test question formats and to meet certain psychometric goals. The number of questions per block is clearly displayed on the computer monitor before each block begins; use this information to pace yourself through each block.

  • Step 1 has approximately 325 multiple-choice test questions, divided into seven 60-minute blocks, administered in one eight-hour testing session. The number of questions per block on a given examination form may vary but will not exceed 46.
  • Step 2 CK has approximately 350 multiplechoice test questions, divided into eight 60- minute blocks, administered in one nine-hour testing session. The number of questions per block on a given examination form will vary but will not exceed 44.
  • Step 2 CS has 12 patient cases, administered in a testing session of approximately eight hours. You will have 15 minutes for each patient encounter and 10 minutes to record each patient note. If you use less than 15 minutes for the patient encounter, the remaining time will be added to the time you have to record the patient note.
  • Step 3 has approximately 470 multiple-choice test questions, divided into 45- and 60 minute blocks, each containing 35 to 50 questions. In addition, there are between 9 and 12 computer-based case simulations. Each simulation is allotted 10 or 20 minutes of maximum real time. Step 3 is administered in two eight-hour testing sessions.

For Step 1, Step 2 CK, and Step 3 multiple-choice sections, during the defined time to complete the items in each block, you may answer the items in any order (with the exception of Sequential Item Sets; see the USMLE website for further information), review your responses, and change answers. After you exit the block, or when time expires, you can no longer review test items or change answers.

Step 2 CS cases and Step 3 case simulations must be taken in the order presented. After you exit the case or session, or when time expires, you can no longer review test items or cases, change answers, or collect additional information.

Continue to: Practicing with the Software »

Practicing with the Software

For Steps 1, 2 CK, and 3, you should acquaint yourself with the test software well before your test date(s). Practice time is not available on the test day, and test center staff are not authorized to provide instruction on use of the software. A brief tutorial on the test day provides a review of the test software, including checking the sound with the audio headphones, navigation tools, and examination format, prior to beginning the test. It does not provide an opportunity to practice. Step 3 examinees should review the Primum CCS materials on the USMLE website and practice with all of the sample cases well in advance of the testing day to have a thorough understanding of how to use the software.

Sample test materials to practice with the software (both multiple-choice questions and Primum CCS cases) are available at the USMLE website.

All examinees taking the Step 2 CS examination are required to type the patient note. Examinees are not permitted to handwrite the note, unless technical difficulties on the test day make the patient note-typing program unavailable. A simulation of the computerized patient note program, which examinees may use to practice typing the patient note, is available on the USMLE website.

Continue to: Practice at Prometric Test Centers »

Practice at the Prometric Test Centers

If you wish to experience some of the conditions of test administration for Step 1, Step 2 CK, or Step 3, you may schedule time to review sample test materials at a Prometric Test Center for a fee. This material is shorter than the actual USMLE examinations. Instructions regarding how to register for a practice session are available on the USMLE website.

If you register for the practice session, you will be issued a separate scheduling permit specifically for the practice session. You must have this permit before you can contact Prometric to schedule the practice session. You should allow seven business days for issuance of your practice session scheduling permit.

Note: Changes to the Step 3 examination will occur beginning in November 2014. During an approximate one-month period (October 2014), it is likely that no Step 3 exams will be administered. Step 3 examinees planning to test in November 2014 or later should check the USMLE website for up-to-date information.