USMLE Step 1 Changes for 2016

Here are some new changes to the step 1 USMLE exam that go into effect May 9, 2016.

>  The total number of items will decrease from 308 to 280.
>  The number of items per block will decrease from 44 to 40.
>  The length of the examination day will remain unchanged.
>  The scores from the old format (308) and new format (280) will be comparable.
>  The passing scores for the exams have not changed and are:

Step 1: 192
Step 2 CK: 209
Step 3: 196


This is not a surprise.... they did the same thing last year.  The exam questions are gradually getting longer and more complex so a decrease in the number of questions allows you more time to handle each question.  With less questions, it means that each question is worth more.  The exam is always getting more difficult. If you could go back 10 years and take the exam it would be a piece of cake. Anyone got a time machine?

Ultimately, it doesn't matter may questions they throw at us... focus on slaying the Dragon!!!    This shouldn't affect your prep.... master the content and do lots of questions.  You got this!

I will be rooting for you as always!



Category: Step 1

Step 1 Advice From a Recent Test Taker [ En Español]


Mis diez mejores consejos para los que van a dar el step 1 proximamente:

Read more: Step 1 Tips from a Recent Test Taker

Category: Step 1

Recent Changes to the Step 1 Exam

"The number of items per block will decrease from 46 to 44. There will be a total of 308 items on each examination. The length of the examination day will remain unchanged. The test day will continue to be divided into seven 60-minute blocks, administered in one seven-hour testing session." -

A lot of students have been asking for my opinons about the recent changes to the step 1 Exam.  So here is my two cents:

The exam is always evolving and getting more difficult.  The length of questions has increased along with more clinical and lab data to sort thru.  In addition, the exam is asking more multistep questions that require you to figure out one fact to answer the question about another fact. This is not new.  This is always happening.  These types of questions require more time so reducing the number of questions must be done from time to time.  This is not the first time that the exam has reduced questions.  The exam used to be 2 days 800 questions and will now be down to one day 308 questions.

The bottom line is that you need to take the exam when and where you are the most ready to get the highest score that you can.  High Scores open doors!  That's all that matters.... so take the time that you need to Rock the Exam!!!

That said... the exam is always getting more difficult so taking it sooner is better then later.  Waiting another year means more "tinib" drugs to learn.  Yikes!   Another reason to take it before the change (May 11th) is that you will have to wait a lot longer for the results which is excrutiating!!!   On the other hand, rushing to get it done and getting a lower score is certainly not the thing to do either!

The much more important issue for you is the addition of quality improvement principles and safety science!  Do you know what a Fishbone Diagram or root cause analysis is all about?!?!?!? 


Wishing you the best!



Category: Step 1

2017 Step 1 Practice Questions

There are 150 Practice questions available to download for Step 1 for free from

These questions are from the guys who write the exam so make sure to do them!!!


Here are some more old Practice questions:


Category: Step 1

Normal Lab Values

It's a great idea to use these normal lab values provided by the boards when your doing Questions.  

Print out the sheet and start using them so when the exam comes your ready to "rock and roll"!

Normal Lab Reference Values



"I had tons of questions that gave me lab values and it takes time to check the table if we don't know them, so learning them would make students more time efficient and have extra time for the tough questions "

- Roberto R. 2016



Barone's Key Lab Values - Organized Version


Download Dr. Barone's Key Lab Values


Related Mnemonic:  Biochemistry: Normal Lab Values

Related Mnemonic: Normal Differential Mnemonic

Category: Step 1

Print it out and tape it to your mirror!


Category: Step 1

New Passing Score for Step 1


The Bar has been raised once again!



The USMLE announced that starting Jan 1 2018, the passing score for Step 1 will increase from 192 to 194.

It doesn't matter for us... cause we are gunners!!!    Passing is not good enough.  In fact forget 240, we are shooting for 260! 


FYI: The last time the USMLE Step 1 score was raised was on Jan 1, 2014 where the passing score increased from 188 to 192.

Category: Step 1

USMLE Step 1 Pass Rates 2008 - 2010

*Note: The minimum passing three-digit score to pass Step 1 was raised from 185 to 188 on January 1, 2010.

Source: website

Category: Step 1

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