The United States Medical Licensing Examination (USMLE) is a three-step exam required for medical licensure in the United States. It evaluates a physician’s ability to apply medical knowledge, use clinical concepts, and demonstrate essential skills needed for patient care.
This guide offers a step-by-step overview of each part of the USMLE from step one to till residency match for helping Bangladeshi students, so that they can prepare effectively. It includes important details on exam timing, registration procedures, and associated fees.
USMLE Step 1
Overview:
→ Covers core subjects in basic medical sciences such as Anatomy, Physiology, Biochemistry, Genetics, Pharmacology, Pathology, Microbiology, Biostatistics and Behavioral sciences.
→ Focuses on understanding key concepts and applying them to clinical situations.
→ Learning the basic knowledge and applying that knowledge during solving questions is the strategy of success.
Exam Timing:
● Preparing for USMLE Step 1 typically requires at least one year of dedicated study, although this may vary depending on individual study habits and time availability.
● It is recommended to schedule the exam 3 to 6 months in advance, based on your NBME practice exam scores and readiness.
Exam Fees (for Bangladeshi Students):
- Registration Fee: $1,020 (subject to annual changes)
- International Test Delivery Surcharge: $205 (applies to test centers outside the U.S.)
- Form 186 Notarization (via NotaryCam): $160
Study Strategy
- Understand the Exam Structure:
Begin by reviewing the USMLE content outline to understand what topics are covered. Be strategic—this is a long and challenging journey. Focus on mastering both the basic medical concepts and the exam-specific material. Avoid making your study plan too broad, or using many resources, as it may prevent you from completing revisions before the test, which can negatively affect your performance. - Use High-Yield Resources:
Rely on trusted, high-yield study materials that are widely recommended by successful USMLE candidates:
- First Aid for the USMLE Step 1
- UWorld Question Bank
- Pursuit of USMLE courses by Dr. Shanta Afrin
- Sketchy Microbiology
- Pathoma (Chapters 1–3 recommended at minimum)
- USMLE Free 120 practice questions
- First Aid for the USMLE Step 1
- Practice Questions Daily:
Aim to solve at least 40 practice questions each day. Carefully review the explanations to understand the reasoning behind each answer, especially your mistakes. - Simulate the Exam:
Take full-length NBME practice exams to evaluate your progress and determine if you’re ready for the actual test. - Time Management:
Plan your preparation timeline based on your academic background. Most students require 3 to 8 months of focused study to be adequately prepared.
📅 USMLE Step 1 – 12-Month Study Plan (Personalized by Shanta Afrin, MD)
🔹 Months 1–3: Light Foundation Building (12 weeks)
Goal: Ease into study while reinforcing basic sciences with minimal daily pressure.
- Hours/day: 8–10 (5 days/week)
- Resources:
- First Aid for USMLE Step 1
- Pathoma (Ch. 1–3)
- Sketchy Micro & Pharm
- Pursuit of USMLE courses by Shanta Afrin (My classes and lectures)
- First Aid for USMLE Step 1
Schedule:
- Weekdays: 1 system/topic from First Aid + Sketchy/Pathoma
- Weekends: Review full week topics then break
- UWorld: Begin with understanding (~15–25 questions/day)
🔹 Months 4–6: Deep Subject Review + Integrated Understanding (12 weeks)
Goal: Strengthen knowledge and integrate concepts using high-yield tools.
- Hours/day: 10–12
- Focus:
- Complete First Aid once
- Cover full Pathoma and Sketchy
- Begin full UWorld (40–50 Qs/day, tutor mode)
- Complete First Aid once
- Pursuit of USMLE courses by Shanta Afrin (My classes and lectures)
Additional:
- Annotate First Aid with UWorld explanations
- Revise Pursuit of USMLE lectures note you made during my class
- Begin spaced repetition (e.g., Anki) for facts
🔹 Month 7: Midpoint Assessment + Targeted Review
Goal: Evaluate progress, identify weaknesses.
- Analyze results to build a targeted review list
- Increase UWorld to 50 questions/day (timed, mixed)
- Continue focused review in weak systems
- Begin second pass of First Aid
🔹 Months 8–10: Full-Length Integration and Simulation
Goal: Simulate test behavior and reinforce knowledge.
- UWorld: Finish first pass by Month 10, start second pass
- By the end of 10 months, you will have successfully completed the Pursuit of USMLE courses—congratulations! You now possess a solid foundation in the core concepts and have developed the ability to apply your knowledge effectively during question solving
- Take a baseline NBME or UWSA 1
- Daily Tasks:
- 1–2 UWorld blocks/day
- Timed mode with self-assessment
- Review each question thoroughly
- 1–2 UWorld blocks/day
- Take one NBME/UWSA every 3–4 weeks
- Reinforce weak subjects with Pathoma or Sketchy where needed
- Practice time and break management
🔹 Month 11: Final Review & Practice Exam Phase
Goal: Sharpen test readiness and confidence.
- Review marked UWorld questions
- Revisit First Aid + Sketchy summaries
- Take Free 120 + UWSA 2
- Build stamina with full-length practice days
- Study 15–16 hours/day, 6 days/week
🔹 Month 12: Polishing & Rest (Exam Month)
Goal: Peak performance without burnout.
- Final week: Light review only (notes, flashcards, First Aid diagrams)
- 2 days before exam: Rest, relax, sleep well
- Day before: Revise your weak area, Revise Pharma, Micro throughly
- Exam Day: Follow your test center plan
🛠️ Tracking Tools
- Calendar or Notion: Plan your weekly goals
- UWorld Dashboard: Track correct % by system/topic
- NBME/UWSA Scores: Gauge readiness every 1–2 months
- Study Log: Record hours, subjects, and confidence levels
Step 1 Content Specifications:
| System | Range, % |
| Human Development | 1-3 |
| Blood & Lymphoreticular/Immune Systems | 9-13 |
| Behavioral Health & Nervous Systems/Special Senses | 10–14 |
| Musculoskeletal, Skin & Subcutaneous Tissue | 8-12 |
| Cardiovascular System | 7-11 |
| Respiratory & Renal/Urinary Systems | 11-15 |
| Gastrointestinal System | 6-10 |
| Reproductive & Endocrine Systems | 12–16 |
| Multisystem Processes & Disorders | 8-12 |
| Biostatistics & Epidemiology/Population Health | 4–6 |
| Social Sciences: Communication and Interpersonal Skills | 6–9 |