The United States Medical Licensing Examination is divided into three parts, or steps. Step 1 of the USMLE measures the candidate's ability to comprehend and apply essential scientific concepts to the practice of medicine. This exam focuses especially on the principles and mechanisms that underlie disease, health, and methods of treatment. The successful candidate will be able to demonstrate not only the ability to use scientific information to successfully treat patients using current methods, but also the base knowledge required to keep abreast of developments in methodology.

The test is composed of approximately 350 multiple-choice questions; it is administered during seven-hour long periods in a single day. The test items on the Step 1 USMLE will be drawn from the following eight content areas: anatomy; behavioral sciences; biochemistry; microbiology; pathology; pharmacology; physiology; and assorted interdisciplinary topics, as for instance nutrition, aging, and genetics. Although all of the questions will be in the multiple-choice format, candidates will be required to identify graphical representations of gross and microscopic pathologic and normal specimens, to apply core scientific knowledge to hypothetical clinical situations, and to interpret the information contained in a graph or table.

The content of the USMLE Step 1 can be considered from two different perspectives, system and process. In terms of the systems of the body, 40-50% of the exam will focus on general principles, while 50-60% of the exam will focus on the individual organ systems. The individual organ systems covered by the examination are the endocrine; reproductive; renal/urinary; gastrointestinal; cardiovascular; respiratory; musculoskeletal; skin/connective tissue; nervous/special senses; and hematopoietic/lymphoreticular systems. In terms of the processes of the body, 30-50% of the exam will focus on normal structure and function; 30-50% will focus on abnormal processes; 15-25% will focus on the principles of therapeutics; and 10-20% will focus on the psychosocial, cultural, occupational, and environmental considerations relating to body processes.

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