Everything You Need to know About the USMLE Step 1

United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. The exam is sponsored by the Federation of State Medical Boards and the National Board of Medical Examiners. USMLE is taken by persons who intend to practice medicine in the United States or might be taken to assess the possibility of practicing medicine in the Unites States. As common with United States exams, all steps of the USMLE require a lot of hard work and studies to be successful. All three steps of the USMLE exam must be passed before a physician with an M.D. degree is eligible to apply for an unrestricted license to practice medicine in the United States. 

Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning. Step 1 is constructed according to an integrated content outline that organizes basic science material along two dimensions: system and process.
Step 1 is a one-day examination. It is divided into seven 60-minute blocks and administered in one 8-hour testing session The number of questions per block on a given examination form will vary, but will not exceed 40. The total number of items on the overall examination form will not exceed 280.

The USMLE Content Outline provides a common organization of content across all USMLE examinations. In addition, the USMLE Physician Tasks/Competencies, outline lists tasks and competencies assessed throughout the sequence of USMLE.
The USMLE Content Outline organizes content according to general principles and individual organ systems. Test questions are classified in one of 18 major areas, depending on whether they focus on concepts and principles that are important across organ systems or within individual organ systems.
Sections focusing on individual organ systems are subdivided according to normal and abnormal processes, including principles of therapy. Each Step 1 examination covers content related to the following traditionally defined disciplines:

behavioral sciences
biostatistics and epidemiology
The Step 1 examination also covers content related to the following interdisciplinary areas:
molecular and cell biology

Currently, students receive a three-digit score following sitting for the Step 1 examination. In 1999, the USMLE phased out the use of a percentile-based system in favor of a three-digit and two-digit scaled scoring system. In October 2011, two-digit scaled scores were no longer reported to any parties besides the examinees. In April 2013, the two-digit score was eliminated completely from the score report.

While the USMLE program does not disclose how the three-digit score is calculated, Step 1 scores theoretically range from 1 to 300, most examinees score in the range of 140 to 260, the passing score is 194 and the national mean and standard deviation are approximately 229 and 20, respectively.[9][10] Rise in the national mean Step 1 score has been observed with time, as shown in the table below.[11] According to the National Resident Matching Program, the mean score for U.S. allopathic seniors who matched to residency programs in 2016 was 233.2

The USMLE score is one of many factors considered by residency programs in selecting applicants. However, at present, this test is the only standardized measure of all applicants. The median USMLE Step 1 scores for graduates of U.S. Medical Schools for various residencies are charted in Chart 6 on page 9 of “Charting Outcomes in the Match” available through NRMP Website

Many residency programs use a “cutoff” score for Step 1, below which applicants are unlikely to be considered, although in some cases individuals with significantly higher Step 2 CK scores may still receive further consideration. The NRMP Residency Program Director survey contains more information, both overall and by specialty, regarding “cutoff” scores (i.e., scores below which programs generally do not grant interviews).[16]

The eligibility to write USMLE steps are different for Step 1& 2 and Step 3. (Click here to read our comprehensive summary sheet on USMLE steps and requirements)

Step One & Two: For Nigerians, any medical student officially enrolled in, or a graduate of a medical school that is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements, and that meets other eligibility criteria of the ECFMG.

To be eligible:

  • You must be enrolled as a medical student in Nigeria.
  • The medical school must be listed in the World Directory of Medical Schools (as a school which has met the ECFMG eligibility)
  • The medical school must meet other eligibility criteria of ECFMG


The good news therefore is that most of the medical students in Nigeria can write Step One of the USMLE.



Currently (as at August 2018) on World Directory of Medical Schools, students of 37 Nigerian medical schools can write USMLE. The list is below:

Medical School Name                                                                                                                                   City Name

Abia State University Faculty of Medicine                                                                                                        Uturu

Afe Babalola University College of Medicine and Health Sciences                                   Ado Ekiti

Ahmadu Bello University Faculty of Medicine                                                                            Zaria

Ambrose Alli University College of Medicine                                                                                Ekpoma

Bayero University Faculty of Medicine                                                                                            Kano

Benjamin S. Carson School of Medicine, Babcock University                                             Ilishan Remo

Benue State University College of Health Sciences                                                                                      Makurdi

Bingham University College of Health Sciences                                                                          Karu

Bowen University College of Health Sciences                                                                              Iwo

Chukwuemeka Odumegwu Ojukwu University College of Medical Sciences           Uli

Delta State University College of Health Sciences                                                                                        Abraka

Ebonyi State University College of Health Sciences                                                                  Abakaliki

Ekiti State University College of Medicine                                                                                                        Ado Ekiti

Enugu State University of Science and Technology College of Medicine                     Enugu

Gombe State University College of Medical Sciences                                                               Gombe

Imo State University College of Medicine                                                                                                          Owerri

Kaduna State University Faculty of Medicine                                                                               Kaduna

Ladoke Akintola University of Technology (LAUTECH)                                                                        Osogbo

Lagos State University College of Medicine                                                                                    Ikeja

Madonna University College of Medicine                                                                                                          Elele

Niger Delta University College of Medical Sciences                                                                   Amassoma

Nnamdi Azikiwe University College of Health Sciences                                                        Nnewi

Oba Okunade Sijuade College of Health Sciences, Igbinedion University  Benin

Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University           Ago Iwoye

Obafemi Awolowo University College of Health Sciences                                                                      Ile-Ife

University of Abuja College of Health Sciences                                                                            Abuja

University of Benin School of Medicine                                                                                            Benin

University of Calabar College of Medical Sciences                                                                                        Calabar

University of Ibadan College of Medicine                                                                                                           Ibadan

University of Ilorin College of Health Sciences                                                                             Ilorin

University of Jos Faculty of Medical Sciences                                                                               Jos

University of Lagos College of Medicine                                                                                           Idi-Araba

University of Maiduguri College of Medical Sciences                                                               Maiduguri

University of Nigeria Faculty of Medicine                                                                                                         Enugu

University of Port Harcourt College of Health Sciences                                                         Port Harcourt   

University of Uyo College of Health Sciences                                                                                Uyo

Usmanu Danfodiyo University College of Health Sciences                                                   Sokoto

The USMLE Step 1 and Step 2 CK exams are taken at Prometric test centers worldwide. Prometric is the testing agency for USMLE.  In Africa, the Prometric test centers are in Ghana, Kenya, South Africa, and Uganda. A test center used to be available in Nigeria but was discontinued due to the high level of irregularities. The closest test center for Nigerian applicants is currently Ghana.

The Step 2 CS and the Step 3 can only be taken in the United States. There is no fee for taking the test in the United States and in Canada. (Click here to read our comprehensive summary sheet on USMLE guidelines and requirements)

This Post Has One Comment

  1. Genolyn Onyebueke

    Is there a place you can apply for the USMLE in Nigeria ? I know you have to take the test in Ghana but I heard you can apply at a facility in Nigeria ? If there is a facility what is the address or contact number ? Thanks

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