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USMLE Step 1: Pathology & Pharmacology

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Essential concepts for USMLE Step 1 covering pathology, pharmacology, and foundational medical sciences

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What does USMLE stand for?

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  1. 1What does USMLE stand for?
    United States Medical Licensing Examination
  2. 2What are the three steps of the USMLE?
    Step 1 (foundational sciences), Step 2 CK (clinical knowledge), and Step 3 (patient management)
  3. 3Which organizations sponsor the USMLE?
    Federation of State Medical Boards (FSMB) and National Board of Medical Examiners (NBME)
  4. 4When was the USMLE created?
    Early 1990s (1992)
  5. 5How long is the USMLE Step 1 exam?
    8 hours
  6. 6How many questions are on USMLE Step 1?
    280 multiple-choice questions
  7. 7How are Step 1 questions organized?
    Seven 40-question blocks
  8. 8What is the current scoring system for USMLE Step 1 (as of 2022)?
    Pass/Fail
  9. 9What was the previous scoring range for Step 1 before 2022?
    1 to 300 (most scores 140-260)
  10. 10What was the passing score for Step 1 under the numeric system?
    196
  11. 11What subject areas does Step 1 test?
    Anatomy, behavioral sciences, biochemistry, microbiology, pathology, pharmacology, physiology, genetics, aging, immunology, nutrition, molecular and cell biology
  12. 12When did USMLE Step 1 transition to pass/fail?
    January 2022
  13. 13Why was Step 1 changed to pass/fail?
    To reduce overemphasis on scores in residency selection, alleviate student stress, and decrease racial bias
  14. 14What is the fee for USMLE Step 1?
    $680.00
  15. 15What is the fee for USMLE Step 2 CK?
    $680.00
  16. 16What is the fee for USMLE Step 3?
    $935.00
  17. 17How long is the USMLE Step 2 CK exam?
    9 hours
  18. 18What is the passing score for Step 2 CK (as of July 2025)?
    218
  19. 19What is the score range for Step 2 CK?
    1-300
  20. 20How long is USMLE Step 3?
    Two days: Day 1 is 7 hours, Day 2 is 9 hours
  21. 21What is the passing score for Step 3?
    200
  22. 22When was Step 2 CS discontinued?
    January 2021
  23. 23Why was Step 2 CS suspended and then discontinued?
    Initially due to COVID-19 pandemic, then permanently discontinued citing evolving medical education and alternative assessments
  24. 24What does Step 1 assess?
    Application of foundational medical science concepts to clinical medicine
  25. 25What does Step 2 CK assess?
    Application of medical knowledge and clinical science for supervised patient care
  26. 26What does Step 3 assess?
    Application of medical knowledge for unsupervised practice of medicine
  27. 27Who must take the USMLE for medical licensure?
    All MD degree holders; DO degree holders may take USMLE or COMLEX-USA
  28. 28What was the mean Step 1 score for first-time US/Canadian test-takers in 2021?
    231 (standard deviation 19)
  29. 29What company administers USMLE exams?
    Prometric
  30. 30Can Step 1 and Step 2 CK be taken outside the US?
    Yes, at Prometric centers worldwide

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