Content Description

Step 1 consists of multiple-choice questions (MCQs), also known as items, created by USMLE committees composed of faculty members, 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.

Step 1 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. 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.

Important

• The term item is used to describe a test question in any format.
• You must run the Step 1 interactive testing experience to become familiar with the test software prior to your test date.
• The tutorial provided at the beginning of the Step 1 examination has fewer screens and less detailed information than the tutorial in the Step 1 interactive testing experience.
• The Step 1 interactive testing experience includes items with associated audio findings. Become familiar with how these types of test items function before your test day.

Content Outline

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.

Step 1 content weighting for these topics is provided in Table 1 below. Sections focusing on individual organ systems are subdivided according to normal and abnormal processes, including mechanisms of pharmacotherapy. 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 each USMLE Step examination, overall content coverage is comparable among the various examination forms that will be taken by different examinees for each Step.

Physician Tasks/Competencies

An additional organizing construct for Step 1 design is physician tasks and competencies. Each test question is constructed to assess one of the competencies listed in Table 2. Click here for detailed information about the physician tasks and competencies outline.

Discipline

Each Step 1 examination covers content related to traditionally defined disciplines and interdisciplinary areas as listed in Table 3.

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Content Outline

Physician Tasks/Competencies