USMLE Test Delivery Software Updates Coming in 2026

Posted February 5, 2026

In the first half of 2026, the United States Medical Licensing Examination® (USMLE®) program will transition to an updated test delivery software for the Step exams.  This transition will be in place for those who sit for the first day of Step 3 exams on or after March 10.  It will begin in the second quarter of 2026 for Step 1 and Step 2 Clinical Knowledge (CK) exams.    

The new test delivery software will offer improvements to the Step exam interface, including an updated design and improved keyboard navigation. It will also offer some brand-new additions, including a settings menu and the ability to adjust the contrast on each image.

The total number of items and overall length of the test will remain unchanged.  However, each exam day will have more blocks, and the blocks will be shorter in length.  As with the current test delivery software, examinees can only review items within the current block and are unable to return to previous blocks once closed.

Current Software New Software
Step 3 Day 1 Total number of multiple choice questions 232 items No change
Number of test blocks 6 blocks 12 blocks
Items per block 38-39 items 18-20 items
Minutes per block 60 minutes 30 minutes
Exam day length Approx 7 hours No change
Step 3 Day 2 Total number of multiple-choice questions 180 items No change
Number of MCQ test blocks 6 blocks 9 blocks
Items per MCQ block 30 items 20 items
Minutes per MCQ block 45 minutes 30 minutes
Number of case simulations 13-14 cases No change
Maximum allotted minutes per case 10 or 20 minutes No change
Exam day length 9 hours No change

The test delivery software update is in response to changing needs and examinee feedback, as well as the program’s continuous efforts to look for tools to deliver the Step exams in the most efficient, reliable, and adaptable manner while also protecting the integrity of the assessments.

The test delivery software updates will provide examinees with a more consistent and familiar experience throughout their USMLE journey, as USMLE co-sponsor NBME’s self-assessments and other practice materials are already delivered with this software.

FAQs:  

  • When will Step 3 exams be delivered using the new software?  

    The new testing software will be in place for Step 3 exams whose first day of testing is on or after March 10.

  • My Step 3 appointments are scheduled within 1 week of March 10.  Will my testing appointment need to be rescheduled?

    Transition to the new software may require rescheduling a limited number of appointments. If your appointment needs to be moved, you will be contacted directly. Every effort is being made to minimize the number of examinees impacted by this transition.

  • What is the reason for this change?  

    This change is part of the USMLE program’s efforts to deliver the Step exams in the most efficient, reliable, and adaptable manner while also protecting the integrity of the assessments. The updated test delivery software will provide a more consistent and familiar experience, as USMLE co-sponsor NBME’s self-assessments and other practice materials are already delivered with this software.  

  • How will this change influence my preparation for the Step exams?  

    The update should not change how you study for the exams. Examinees should prepare using the tutorial that corresponds to the test delivery software their exam will use. If your Step 3 exam begins before March 10, you should continue using the current Step 3 tutorial. Examinees whose exams begin on or after March 10 should practice with the new Step 3 testing experience tool and tutorial (available soon) to become familiar with the new 30-minutes blocks and the updated functionality. 

  • Will different parts of my Step 3 exam be delivered using different software versions?

    No. The test delivery software used for Step 3 is determined by the first day of testing and will be the same throughout your entire exam administration.

  • Will the test delivery software updates affect when I receive my score report?  

    Exam results are typically available two to four weeks after your test date. However, various factors may impact score reporting timelines. As always, when selecting your test date and inquiring about results, you should allow at least eight weeks to receive notification that your score report is available.  

  • When will the test delivery software updates take place for Step 1 and Step 2 CK?  

    The test delivery software updates for Step 1 and Step 2 CK will be released in the second quarter of 2026. The USMLE program will announce the exact timing in the coming months.  

  • Who should I contact if I have questions about the test delivery software updates?  

    If you have questions, please reach out to NBME at webmail@nbme.org or +1 (215) 590-9700.