Step 1 Grand Test

Step 1 changed on 14 May 2026. It is no longer seven hour-long blocks — it is fourteen blocks of thirty minutes, up to twenty items each, across one eight-hour day. Most mocks still rehearse the old paper.

You also get 55 minutes of break for the entire exam, and how you spend it is part of the test. So it is modelled here: take it between blocks, and watch it disappear.

280 items · 14 locked blocks · 30 minutes each · pass/fail

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The current format

Fourteen 30-minute blocks and a 55-minute break budget, verified against usmle.org.

One system vocabulary

5609 items normalised onto the same 15 systems the concept library uses, so feedback means one thing.

Pass/fail, honestly

No invented three-digit score. A provisional call plus performance bands per system, as the real report gives.

Instructions to examinees

280 items · 14 blocks

Fourteen blocks of 30 minutes, up to 20 items each — the format in force since 14 May 2026.
A block ends when its time expires and cannot be reopened. Within a block you may move freely and flag items.
55 minutes of break for the whole day, taken between blocks. Spend it as you like — but when it is gone, it is gone.
Step 1 is pass/fail. There is no three-digit score, so we do not invent one.

This is a full eight-hour day. Nobody feels sharp at block eleven — that is exactly what you are here to practise. Spend the break like it is real, because on the day it is.

Format verified against usmle.org/step-exams/step-1: from 14 May 2026 Step 1 is fourteen 30-minute blocks of no more than 20 items, no more than 280 items in total, in one 8-hour session with a minimum of 55 minutes of break and a 5-minute optional tutorial. Step 1 is reported as pass/fail. Rotation gives 8 forms with no repeated item.

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