USMLE syllabus

Three-step licensing sequence. Step 1 is one day of basic-science items, reported only as pass or fail. Step 2 CK and Step 3 are described here and are not in the practice test.

Step 1 (from 14 May 2026)

Block 1

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 2

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 3

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 4

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 5

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 6

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 7

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 8

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 9

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 10

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 11

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 12

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 13

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Block 14

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer from four or more options, most often five
Patient vignettes that apply foundational science
Some items use a table, a figure, or an audio finding

Step 2 Clinical Knowledge (from 7 May 2026)

Block 1

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 2

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 3

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 4

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 5

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 6

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 7

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 8

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 9

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 10

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 11

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 12

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 13

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 14

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 15

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Block 16

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Single best answer on diagnosis, management, and prevention in clinical settings
Patient vignettes; some items use abstracts, tables, or audio

Step 3 (software from 10 March 2026)

Day 1 block 1

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 2

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 3

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 4

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 5

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 6

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 7

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 8

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 9

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 10

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 11

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 1 block 12

18 to 20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Foundational science applied to care
Biostatistics, epidemiology, and reading a study
Ethics, communication, systems, and patient safety
Some items are based on a scientific abstract or a pharmaceutical advertisement

Day 2 block 1

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Diagnosis and management over time
Prognosis, screening, therapeutics, and medical decision making

Day 2 block 2

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Diagnosis and management over time
Prognosis, screening, therapeutics, and medical decision making

Day 2 block 3

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Diagnosis and management over time
Prognosis, screening, therapeutics, and medical decision making

Day 2 block 4

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Diagnosis and management over time
Prognosis, screening, therapeutics, and medical decision making

Day 2 block 5

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Diagnosis and management over time
Prognosis, screening, therapeutics, and medical decision making

Day 2 block 6

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Diagnosis and management over time
Prognosis, screening, therapeutics, and medical decision making

Day 2 block 7

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Diagnosis and management over time
Prognosis, screening, therapeutics, and medical decision making

Day 2 block 8

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Diagnosis and management over time
Prognosis, screening, therapeutics, and medical decision making

Day 2 block 9

20 questions · 30 minutes

You may review and change answers inside the block. After the block is closed you cannot return to it. An unanswered item is scored as incorrect. There is no penalty beyond that.

Diagnosis and management over time
Prognosis, screening, therapeutics, and medical decision making

Computer-based case simulations

13 to 14 cases · 10 or 20 minutes of real time for each case

Each case is allotted a maximum of 10 or 20 minutes of real time. This site has no item type for a branching case, so the section is labelled ESSAY only as the nearest free-response code. These are not essays, and this site does not include them.

Manage a simulated patient over simulated time: orders, results, and a changing clock