USMLE Step 1 Study Schedule

A good Step 1 schedule starts with facts about you, not a template: your test date, your practice exam scores, your question bank percentages and how you use Anki. Below is how we turn those numbers into a dedicated Step 1 calendar, using the exam format USMLE publishes. Our lead tutor, Dr. Shauhin “Sean” Moazezi, DO, is a board-certified internist who teaches Step 1 students full time. We build customized Step 1 study plans one-on-one, online by live video (Zoom or Google Meet).

By Dr. Sahith Valluru. For The Boards Professor, founded by Dr. Sean Moazezi, DO. Updated October 28, 2026.

Know the exam you are scheduling for

Step 1 has been scored pass/fail since January 26, 2022 (USMLE announcement).

Since May 14, 2026 the exam is one 8-hour day split into fourteen 30-minute blocks of up to 20 questions, which is why the sample below drills 20-question, 30-minute blocks. Check for changes on the official USMLE Step 1 page.

Exam facts the schedule is built on

Checked October 28, 2026. Rules change; the linked page is the authority.

Topic	Official rule	Source
Length	One 8-hour testing session. From May 14, 2026: fourteen 30-minute blocks, with at least 55 minutes of break time.	USMLE: Step 1
Questions	No more than 20 per block from May 14, 2026; about 280 in total.	USMLE: Step 1
Scoring	Pass/fail only since January 26, 2022. The passing standard was set at 196 on the three-digit scale, which is no longer reported.	USMLE: results and scoring
Official practice exams	NBME Comprehensive Basic Science Self-Assessment (CBSSA): seven forms, from $62 each, four sections of 50 questions, with an estimated probability of passing.	NBME: CBSSA
First-time pass rate, 2025	93% of 23,028 takers from US MD schools; 89% of 4,623 from US DO schools; 75% of 22,066 from non-US schools.	USMLE performance data
Results	Typically within four weeks of the test date; USMLE advises allowing at least eight weeks.	USMLE: results and scoring

Build your Step 1 plan in five steps

1. Count the weeks to your Step 1 date. The number of dedicated weeks decides how many systems share a week and how many NBME forms fit.
2. Measure where you are. Sit a CBSSA or the free USMLE sample questions cold, and note your question bank average by system. A tutor needs exactly these two numbers at the first meeting.
3. List your weak spots. Order the Step 1 systems by your practice-exam results, not by which preclinical course felt hardest. The bottom three systems get the most dedicated days.
4. Block your weekly time. Decide how many hours a day you can sustain for the whole period, and put them in a calendar rather than a to-do list.
5. Re-test and adjust. After each practice form, compare its weakest systems with next week’s plan and move days to match.

A sample 6-week dedicated Step 1 schedule

Sample schedule

Sample schedule for illustration only. Not a real student, not real data. Your tutor builds your actual plan around your practice-exam results and the time you have.

Sample 6-week dedicated Step 1 schedule: 6 weeks, about 10 hours a day, 6 days a week. One full day off each week (day 7).

A typical day

Block	Hours	What
Anki review	1.5	Clear all due reviews first (portal target: 70%+ recall)
Question bank	4	Timed random blocks of 20 questions in 30 minutes (the 14-block format from May 14, 2026), then review every question
Content review	3	Re-learn the systems your missed questions point to
Other	1	Tutor session or missed-concept list review

Week by week

Week	Focus	Practice exam
Before week 1	Baseline	NBME CBSSA Form 26
Week 1	Cardiovascular; Respiratory; Neurology
Week 2	Psych / Behavioral; GI; Renal / Urinary	NBME CBSSA Form 27
Week 3	Endocrine; Reproductive / OB-GYN; Musculoskeletal	NBME CBSSA Form 28
Week 4	Heme / Onc; Dermatology; Immune / ID	UWorld UWSA 1
Week 5	Weakest 3 systems from practice exams; Biostats / Ethics	NBME CBSSA Form 29
Week 6	Mixed review; Rest the day before the exam	UWorld UWSA 2

Download this sample schedule (CSV) to open in Excel, Numbers or Google Sheets and replace the systems with your own weakest areas. The file carries the same sample label.

Longer or shorter than six weeks

The sample assumes a full-time dedicated period. With eight weeks, keep the same order, give each system week an extra day or two, and add one more practice form. With four weeks, collapse weeks 1 to 4 into two weeks of mixed random blocks and keep the last two weeks unchanged, because the late practice exams are what tell you whether to sit on your date.

Over three months or more, usually alongside classes or rotations, the day shrinks rather than the structure: fewer hours, the same questions-first order, and one practice exam every two to three weeks until the final month.

The week Sean sets with his students

In dedicated Step 1 study, Dr. Moazezi gives his students a fixed daily rhythm. The volume changes with your date and scores; the order of the day does not.

• 80 to 100 Step 1 questions a day. Question blocks come first each morning, and content review follows from what they expose.
• Same-day review of every miss. Label it as missing knowledge or a test-taking slip, then answer two prompts: what did I already know, and what will I do differently on the next similar stem?
• Each miss leaves a trace. Unsuspend or write one Anki card for it, or add it to an organ-system list of misconceptions you reread before each practice form.
• A ceiling on Anki. Due reviews get a fixed slot, as in the typical day above, so they never push the question blocks out.
• A practice form every one to two weeks, reviewed in full that same day. NBME offers seven CBSSA forms for Step 1; see NBME practice exams for the format and how to buy them.
• Two or three tutor sessions each week, with a daily question you can text in between.

Studying during rotations or work

Before a dedicated study period, when clinical rotations or a job take most of the day, Sean scales the plan down rather than dropping it. In his words: “the questions say 30 questions a day, half random and half focused on the systems that you’re struggling with the most. Now, of course, we can bump that up to 60… in the days where we have a little bit more time.”

• About 30 questions a day, half random and half on your weakest systems, and up to 60 on lighter days.
• One practice exam a week, even when it feels too early. As Sean put it to a student who wanted to wait: “Once a week is the move.”
• A weekly session to go over the major concepts you missed that week.

Where Anki fits

Anki is part of many schedules. We rebuild your deck around evidence-based spaced repetition, with no thousand-cards-a-day grind, so reviews fit inside your schedule instead of taking it over.

Step 1 resources and where each fits in the schedule

Most students use some version of the same short list. What matters is the job each one does in the day, so nothing gets studied twice and nothing important gets skipped.

Resource	What it is for	When it goes in the schedule
UWorld or another question bank	Timed, mixed questions with explanations; the core of the day	Every study day, first, in timed blocks
First Aid for the USMLE Step 1	A condensed review book used as a reference and annotation base	After question review, to look up and note what you missed
Anki (AnKing deck or your own)	Spaced-repetition flashcards for facts that keep slipping	Capped daily reviews; new cards from your misses
NBME CBSSA forms	Official practice exams with an estimated probability of passing	Baseline before week 1, then every one to two weeks
USMLE free sample questions	Free official questions in the real exam format	Late in dedicated, under timed conditions

For First Aid in particular: it works best as the place you file what questions teach you, not as a book to read cover to cover before you start questions. We see students lose the first two weeks of dedicated to a straight read-through; the sample above puts questions first from day one. USMLE lists its free practice materials on USMLE: prepare for your exam, and our guide to NBME order covers which CBSSA forms to save for the end. For deck choices, see the best Anki decks for the USMLE.

What to bring to your first Step 1 planning session

• Your test date
• Your latest CBSSA or other practice-exam reports
• Your UWorld (or other bank) percentage, overall and by system
• The Step 1 calendar you are using now, working or not

After test day

USMLE says results are typically available two to four weeks after your test date (USMLE scoring and score reporting). Leave room for that wait if a later deadline depends on your result.

Because Step 1 is pass/fail, there is no numeric score. USMLE says examinees who fail will receive information about how far they were from passing, along with content-based feedback for the next attempt (USMLE). If that has happened to you, read what happens after a failed Step 1.

Why the Step 1 date matters: attempt limits

USMLE caps Step 1 at three attempts in any 12 months; a fourth must wait 12 months from the first and six from the latest; four unsuccessful attempts, incomplete ones included, end eligibility for every Step; and a passed Step cannot be retaken except to meet a licensing time limit (USMLE eligibility requirements). In practice, book the date your practice scores support rather than the date your class picked. Our attempt-limit guide compares the USMLE and COMLEX rules.