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USMLE Step 1 / PREPARATION ON MYNDAQ

Connect the science. Understand the presentation.USMLE Step 1 preparation online

Prepare for USMLE Step 1 by connecting mechanisms across the basic sciences. Practise explaining how a process produces the finding in the question before choosing the answer.

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One free mock for one eligible exam per account · Sign-in required · No card

Baseline source review · ↗
Conceptual USMLE Step 1 preparation illustration: biomedical molecular sculpture combining anatomy-inspired abstract forms and lavender glass, midnight blue academic laboratory desk
USMLE Step 1Myndaq · AI illustration
19 chapters47 modules2,115 practice itemsYOUR RESOURCE LIBRARY ↗

EXAM ESSENTIALS

Understand the exam before you plan.

01Eligibility
Students or graduates of LCME-accredited MD schools, COCA-accredited DO schools, or international schools listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements
02Format (from 14 May 2026)
One 8-hour session; fourteen 30-minute blocks with no more than 20 questions each; 5-minute optional tutorial; at least 55 minutes of break
Before 14 May 2026: seven 60-minute blocks of up to 40 questions; total still no more than 280 items
03Question type
Single-best-answer multiple choice applying basic science to clinical vignettes
04Fee (2026 and 2027)
US$695 application fee · +US$210 region fee for testing outside the US and Canada · +18% GST for tests taken in India
Baseline source review · 2026-09-05 ↗

YOUR PREPARATION PRIORITIES

Give each session a purpose.

Illustration of two adult medical students, an Indian woman and a Black man, comparing a small heart anatomy model with a notebook and microscope in a sunlit medical-school study room.
PUT YOUR LEARNING IN CONTEXTConnect the mechanism to the case.AI-generated illustration
01

Follow the mechanism

Trace physiology, pathology and pharmacology from cause to effect. Use the clinical findings to test whether the mechanism fits.

02

Integrate across subjects

A vignette can connect several disciplines. Identify the underlying concept rather than treating every clue as a separate fact to memorise.

03

Review the distractors

Explain the condition under which an alternative would be correct. That comparison often exposes the missing distinction in your knowledge.

INSIDE MYNDAQ

Understand the question. Build the method.

Read the explanation, ask the AI tutor for help and revisit the concept behind the mistake. Course counts below come from the live catalogue.

Biochemistry & Molecular BiologyMicrobiology & ImmunologyPathology & PharmacologyPhysiology by organ systemBehavioral Science
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USMLE Step 1

Practice → Review → Apply

Trace physiology, pathology and pharmacology from cause to effect. Use the clinical findings to test whether the mechanism fits.

Find the guide you need next. ↗

YOUR PRACTICE ROUTINE

Turn the next step into a habit.

  1. 01

    Establish your starting point

    Start with a mixed vignette set to identify a weak mechanism. Rebuild the chain from a basic-science process to the finding described in the stem.

  2. 02

    Practise the difficult distinction

    Link related disciplines around one clinical presentation. Explain the mechanism before looking at the options and identify what finding would distinguish an alternative.

  3. 03

    Review before repeating

    Review your errors by mechanism and reasoning step. Apply the corrected model to a new vignette so you test understanding rather than recognition.

YOUR RESOURCE LIBRARY

Find the guide you need next.

01 / USMLE Step 1

USMLE Step 1 Syllabus and Content Outline - Systems, Competencies and Disciplines

Read the guide →02 / USMLE Step 1

USMLE Step 1 Fees and Registration - Cost, Eligibility and Attempt Limits

Read the guide →03 / USMLE Step 1

USMLE Step 1 Practice Questions with Worked Answers - Pattern and Method

Read the guide →04 / USMLE Step 1

USMLE Step 1 Preparation Guide for the Current Exam

Read the guide →

YOUR NEXT STEP

Start with a clear purpose.

Build a preparation routine for USMLE Step 1. Use focused practice, explanations and the AI tutor to understand what needs your attention next.

Sample questions

Try 5 real USMLE Step 1 questions

Taken from the 2,115-item USMLE Step 1 bank on Myndaq. Work them here; sign in (Google or email link, no card) to check each answer and have the AI tutor explain why the other options are wrong.

  1. Question 1 · medium · Macronutrient Micronutrient Deficiency · Environmental Nutritional Disease

    A 45-year-old woman with chronic alcohol use is admitted with confusion and receives intravenous dextrose before any vitamin supplementation. She acutely develops nystagmus, ophthalmoplegia, and gait ataxia. The deficient cofactor is required by transketolase, pyruvate dehydrogenase, and alpha-ketoglutarate dehydrogenase. Administering the glucose load before this vitamin worsened her state primarily by which mechanism?

    • Direct glucose toxicity to peripheral nerve myelin
    • Stimulation of insulin causing intracellular potassium depletion
    • Increased demand for the cofactor as glucose is funneled into pyruvate/citric acid cycle metabolism
    • Accumulation of methylmalonic acid from impaired odd-chain fatty acid metabolism
    • Osmotic shift of water into neurons causing cerebral edema
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  2. Question 2 · medium · Hormonal Physiology Of Pregnancy And The Placenta

    A 30-year-old woman at 8 weeks' gestation has a rising serum human chorionic gonadotropin (hCG). Her physician notes hCG maintains progesterone secretion at this stage. Through which receptor does hCG act to sustain the corpus luteum?

    • The follicle-stimulating hormone receptor
    • The luteinizing hormone/choriogonadotropin receptor
    • The estrogen receptor alpha
    • The thyroid-stimulating hormone receptor
    • The progesterone nuclear receptor
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  3. Question 3 · medium · Gram Positive Cocci · Bacterial Toxins

    A 5-year-old boy develops a rapidly spreading skin infection with honey-colored crusts. A gram-positive coccus in clusters is isolated. Some strains of this organism cause a widespread blistering disease in which the superficial epidermis separates at the granular layer. The toxin responsible cleaves which of the following host structures?

    • Type VII collagen anchoring fibrils
    • The GTPase Rho by glucosylation
    • Desmoglein 1 in desmosomes
    • Elongation factor 2 by ADP-ribosylation
    • Hemidesmosomal integrin adhesion
    Check your answer with the AI tutor →
  4. Question 4 · easy · Biliary Secretion · Gi Hormones

    A 34-year-old woman is studied after eating a fatty meal. Investigators observe that her gallbladder contracts vigorously and the sphincter of Oddi relaxes, delivering bile into the duodenum. This response is triggered by a hormone released from duodenal I cells in response to fatty acids and amino acids in chyme. Which hormone is chiefly responsible for gallbladder contraction in this scenario?

    • Somatostatin
    • Secretin
    • Motilin
    • Gastrin
    • Cholecystokinin
    Check your answer with the AI tutor →
  5. Question 5 · hard · Pathology Of Pregnancy And Gestational Disease

    A 27-year-old woman presents with amenorrhea and a positive pregnancy test. Ultrasound shows no intrauterine gestational sac but an adnexal mass with a tubal ring, and serum beta-hCG is lower than expected for gestational age with an abnormally slow rise. She has a history of chlamydial pelvic inflammatory disease. Which pathophysiologic factor most directly predisposed her to this condition?

    • Failure of trophoblastic invasion of spiral arteries
    • Excessive corpus luteum progesterone secretion
    • Premature rupture of the amniotic membranes
    • Increased endometrial receptivity to trophoblast
    • Scarring and impaired ciliary transport within the fallopian tube
    Check your answer with the AI tutor →

THE NEXT STEP IN YOUR PREPARATION

Your USMLE Step 1 resource hub.

Practical tools, detailed guides and related courses — find what you need for your next session.

CONSIDERING YOUR OPTIONS?

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THE FACTS BEHIND THE TEST

Official details, clearly explained.

USMLE Step 1 is the first of the United States Medical Licensing Examination steps, open to students and graduates of US MD and DO schools and of international medical schools listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements. From 14 May 2026 it runs as fourteen 30-minute blocks at Prometric centres.

Conducting body
FSMB and NBME; delivered at Prometric test centres
OFFICIAL SOURCE USMLE — Step 1
Eligibility
Students or graduates of LCME-accredited MD schools, COCA-accredited DO schools, or international schools listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements
OFFICIAL SOURCE USMLE — Bulletin of Information: eligibility
Format (from 14 May 2026)
One 8-hour session; fourteen 30-minute blocks with no more than 20 questions each; 5-minute optional tutorial; at least 55 minutes of break

Before 14 May 2026: seven 60-minute blocks of up to 40 questions; total still no more than 280 items

OFFICIAL SOURCE USMLE — Step 1
Question type
Single-best-answer multiple choice applying basic science to clinical vignettes
OFFICIAL SOURCE USMLE — Step 1
Fee (2026 and 2027)
US$695 application fee · +US$210 region fee for testing outside the US and Canada · +18% GST for tests taken in India
OFFICIAL SOURCE USMLE — Apply for exams (fees)
Registration route
US MD/DO students via NBME (MyUSMLE); international graduates via the FSMB USMLE portal since 12 January 2026
OFFICIAL SOURCE USMLE — Service transition launching January 2026
ECFMG certification application
US$580
OFFICIAL SOURCE ECFMG — Fees

Dates and fees can change. Later source checks are dated beside the relevant fact; other facts retain the baseline review date. Confirm current details on the linked official page. Myndaq is not affiliated with the exam body.

INSIDE YOUR MYNDAQ COURSE
  • 2,115 practice items
  • 47 modules
  • 19 chapters
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USMLE Step 1: common questions

What is the USMLE Step 1 format from 14 May 2026?

Step 1 is now fourteen 30-minute blocks in one eight-hour day, with no more than 20 questions per block, a five-minute optional tutorial and at least 55 minutes of break time. Before 14 May 2026 it was seven 60-minute blocks of up to 40 questions. The total item count still does not exceed 280.

How much does Step 1 cost for an Indian MBBS graduate?

The 2026 and 2027 application fee is US$695. Testing outside the United States and Canada adds a US$210 region fee, and tests taken in India attract 18 per cent GST on top. Budget roughly US$1,070 for the exam before ECFMG certification costs, whose application fee is US$580.

Where do international graduates register for Step 1 now?

Since 12 January 2026 all USMLE Step exam services for international medical graduates are handled by FSMB through its USMLE portal rather than ECFMG's MyIntealth. US MD and DO students continue through NBME's MyUSMLE. ECFMG certification itself is still required for the Match and for Step 3.

Who is eligible to sit Step 1?

Students or graduates of LCME-accredited US MD schools, COCA-accredited DO schools, or any medical school outside the United States listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements. Indian MBBS students from listed colleges can therefore apply while still enrolled.

How many questions are on Step 1 and how much time per question?

Up to 280 single-best-answer questions. With no more than 20 questions in each 30-minute block you have about 90 seconds per item, the same pace as the old format but with twice as many block boundaries, so time lost at transitions matters more than it used to.

Where is Step 1 held?

At Prometric test centres worldwide, including centres in India. You choose a three-month eligibility period during application and then schedule a specific date with Prometric within that period; dates are available year-round rather than in fixed windows.

Is there a free full-length Step 1 practice test in the 14-block format?

Yes. Myndaq's free mock gives 280 questions across fourteen timed 30-minute sections on a server-controlled clock, mirroring the post-May-2026 structure, one attempt per account and no card. Results come back as a per-section breakdown with an AI tutor explanation for every vignette. See free mock tests →

What does the Myndaq USMLE Step 1 course include?

Practice across Biochemistry & Molecular Biology, Microbiology & Immunology, Pathology & Pharmacology, Physiology by organ system, Behavioral Science with an AI tutor that explains every answer, plus progress analytics.

Is there a free USMLE Step 1 mock test?

Myndaq runs a free mock test programme. Availability varies by exam and publication status — check the free mock tests page. One attempt per account, for one eligible exam; sign in with Google or an email link, no payment card required. See free mock tests →