Free USMLE Step 1 Preparation 2026
INTERNATIONAL
Free USMLE Step 1 preparation with solved past papers and unlimited chapter-wise MCQs, every answer explained. No fee and no account needed to start. USMLE Step 1 is conducted by NBME / FSMB (ECFMG for international graduates).
First step of the United States Medical Licensing Examination, pass/fail since 2022, examining the basic medical sciences as applied to clinical vignettes. Required for ECFMG certification and US residency.
USMLE Step 1 MCQs with answers and explanations
Free USMLE Step 1 MCQs for every subject on the paper: Pathology, Physiology, Pharmacology, Microbiology, Biochemistry and General Anatomy. Each question is chapter-wise, taken from the NBME / FSMB (ECFMG for international graduates) syllabus, and carries a written explanation of why the correct option is correct, so a wrong attempt teaches you the fact you were missing instead of just marking you down. Unlimited attempts, no fee and no account needed. Pick the subject you are weakest in and start there.
Sample USMLE Step 1 MCQs by subject
A few questions from across each subject on the USMLE Step 1 paper. Open one for the correct answer and its explanation.
USMLE Step 1 Pathology sample MCQs
- The most common site of metastases of osteosarcoma is_____________?
- NK cells are effective against viral infected cells only if the cell with infection___________?
- Daily loss of iron per day in a healthy adult male is_______________?
- Which of the following procedures is used as a routine technique in karyotyping using light microscopy ?
- The dominant histologic feature of infarction is__________________?
- Enzymes responsible for suppuration are derived chiefly from_____________?
USMLE Step 1 Physiology sample MCQs
- Distribution of blood flow is mainly regulated by the________________?
- In cases of hypercapnia there is_______________?
- All the following causes the secretion of gastric juice during cephalic phase EXCEPT______________?
- All are seen in Cushing 's syndrome except_______________?
- Ovulation is associated with sudden rise in______________?
- Decreased basal metabolic rate is seen in_______________?
USMLE Step 1 Pharmacology sample MCQs
- For Arsenic poisoning Antidote is_____________?
- A child has phocomelia, this impliments his mother had taken which of the following medication during…
- This drug reduces blood pressure by acting on vasomotor centers in the CNS:
- Folic acid deficiency occurs in______________?
- When allergic manifestations occur pursuant to use of antimicrobial agents, what of the following is…
- Tetracycline when given to pregnant woman can cause_______________?
USMLE Step 1 Microbiology sample MCQs
- Chemotactic cytokine is_________________?
- The component that sensitizes bacteria and virus to UV irradiation_______________?
- The term animalcules to oral microorganisms is given by__________________?
- The cell wall deficient bacteria_______________?
- Herpes virus_____________?
- Candida albicans causes all of the following except______________?
USMLE Step 1 Biochemistry sample MCQs
- The precursor of steroid is_______________?
- The most abundant protein present in body is_____________?
- Enzymes help by____________?
- Increase in pyruvate and lactate is seen in which of the following deficiency ?
- The sigma subunit of prokaryotic RNA polymerase_______________?
- Enzymes stored in muscle is________________?
USMLE Step 1 General Anatomy sample MCQs
- All of the following are composite muscles except ____________?
- The inferior surface of the heart is formed by_________________?
- Liver is divided into______________?
- The cranial nerves which are part of parasympathetic card via_____________?
- Glossopharyngeal nerve supplies posterior part of tongue because it develops from_____________?
- Holocrine secretion is seen in_____________?
USMLE Step 1 paper at a glance
USMLE Step 1 is 100 MCQs in 480 minutes, with no negative marking, so never leave a question unanswered.
100
MCQs
480
Minutes
No
Negative marking
USMLE Step 1 subject weightage
How many MCQs each subject contributes to the USMLE Step 1 paper, and how many free MCQs we hold for it. Study in this order: the heaviest subject is where a weak topic costs you the most marks.
| Subject | MCQs on paper | Share | Free MCQs here |
|---|---|---|---|
| USMLE Step 1 Pathology MCQs | 25 | 25% | 289 |
| USMLE Step 1 Physiology MCQs | 20 | 20% | 437 |
| USMLE Step 1 Pharmacology MCQs | 17 | 17% | 476 |
| USMLE Step 1 Microbiology MCQs | 13 | 13% | 452 |
| USMLE Step 1 Biochemistry MCQs | 13 | 13% | 393 |
| USMLE Step 1 General Anatomy MCQs | 12 | 12% | 452 |
Full USMLE Step 1 paper pattern 2026: the marking scheme, the time each subject is worth, and the subject weightage charted.
USMLE Step 1 guides: the questions candidates ask in sentences
Format, scoring, what each stage requires and how to prepare, written to be read rather than practised.
Which exams do doctors need to work abroad?
The licensing exams internationally trained doctors take to work abroad, country by country: USMLE for the US, PLAB for the UK, AMC for Australia, MCCQE for Canada, PRES for Ireland, NZREX for New Zealand, and the Gulf authorities' licensing exams. What each involves and what else it needs.
USMLE, PLAB, AMC or FCPS: which route should a Pakistani medical graduate take?
The four routes a Pakistani MBBS graduate chooses between, compared on what each exam tests, how long the route takes, what it costs in broad terms, the English test each needs, what happens after the exam, and which suits a graduate by specialty, budget and timeline.
How does the USMLE route work for a Pakistani MBBS graduate?
The United States route for a Pakistani medical graduate from start to residency: ECFMG registration and degree verification, Step 1 since it became pass/fail, Step 2 CK and why its score now matters most, the English requirement, US clinical experience, and what the residency match actually rewards. With a realistic timeline and budget.
Premium
Ready for Ustad Mode?
Full-length mocks and progress tracking, on top of everything free on this page.
Rs. 999Rs. 9,999a year
Where would you rank this week?
This week's top performers on USMLE Step 1 tests. With Premium, your subject-wise accuracy sits next to theirs.
0 students active today
100 tests completed today · 890 total students
Follow TestUstad on WhatsApp
Today's Daily 20 and puzzles, exam news and results, every day. Nobody sees your number.
USMLE Step 1 preparation: frequently asked questions
What is the USMLE Step 1 paper pattern?
USMLE Step 1 is 100 MCQs in 480 minutes, about 288 seconds a question. There is no negative marking. The marks are split across 6 subjects, led by Pathology at 25 MCQs.
Which subjects are in the USMLE Step 1 paper?
Pathology (25 MCQs), Physiology (20 MCQs), Pharmacology (17 MCQs), Microbiology (13 MCQs), Biochemistry (13 MCQs) and General Anatomy (12 MCQs), 100 in total. Start with Pathology: a weak chapter there costs more marks than a weak chapter anywhere else on the USMLE Step 1 paper.
Is USMLE Step 1 preparation on TestUstad really free?
Yes. All 2,499 USMLE Step 1 MCQs here, across Pathology, Physiology and Pharmacology and the rest of the paper, can be practised at no cost with the answer and explanation shown. Paid USMLE Step 1 access only adds full-length USMLE Step 1 mocks on the 100-MCQ pattern and a saved record of your scores.
How many free USMLE Step 1 MCQs are there?
2,499 across the USMLE Step 1 syllabus: 289 Pathology MCQs, 437 Physiology MCQs, 476 Pharmacology MCQs, 452 Microbiology MCQs, 393 Biochemistry MCQs and 452 General Anatomy MCQs. Each one carries the correct answer and a written explanation, and attempts are unlimited.
How should I prepare for USMLE Step 1?
The USMLE Step 1 syllabus here runs to 48 chapters across 6 subjects. Work through them in weightage order, Pathology (25), Physiology (20) and Pharmacology (17) first, and stay on each chapter until you score above 80 percent. USMLE Step 1 has no negative marking, so practise answering every question, including the ones you have to guess. In the final weeks, sit timed mixed tests at the real pace of about 288 seconds a question.
Does TestUstad have USMLE Step 1 past papers?
Not as solved papers yet. Until one is added, the 2,499 USMLE Step 1 MCQs here cover the same Pathology, Physiology and Pharmacology syllabus, and any USMLE Step 1 paper that is added appears on the USMLE Step 1 past papers page with every answer explained.
Who conducts the USMLE Step 1 exam?
USMLE Step 1 is conducted by NBME / FSMB (ECFMG for international graduates). Dates, eligibility and the fee change every cycle, so confirm them on the NBME / FSMB (ECFMG for international graduates) advertisement before you apply.
Exams similar to USMLE Step 1
Other tests prepared for on TestUstad. The question bank is shared by subject rather than split by exam, so any subject one of these has in common with USMLE Step 1 is the same bank you are already practising, and the work carries across.
Free MO preparation
Public Service Commissions
Free NLE preparation
Pakistan Medical and Dental Council
Free FCPS Part 1 preparation
College of Physicians and Surgeons Pakistan
Free PLAB 1 preparation
General Medical Council (UK)
Free AMC MCQ preparation
Australian Medical Council
Free Dental Surgeon Test preparation
Public Service Commissions
Free Prometric Nursing preparation
Gulf health authorities, delivered by Prometric
Free NCLEX-RN preparation
NCSBN (National Council of State Boards of Nursing)