United States Medical Licensing Examination Step 1
Administered by National Board of Medical Examiners (NBME) and FSMB
Tests your understanding of foundational biomedical sciences and their application to clinical practice. Since January 2022, Step 1 is scored pass/fail, removing it as a competitive differentiator for residency applications.
Quick Facts
Format
280 multiple-choice questions across 7 blocks of 40 questions each
Duration
1 day (8 hours of testing time with breaks)
Passing Score
Pass/fail (since January 2022)
Valid For
No expiry, but all 3 Steps should ideally be completed within 7 years
Cost
USD 645 (plus ECFMG certification fees)
Cost in Naira
Approximately N1,000,000
Test Centres in Nigeria
- Prometric Test Centre Lagos (Victoria Island)
What is Tested
Anatomy and Embryology
Gross anatomy, histology, embryology, and neuroanatomy with clinical correlations.
Biochemistry and Molecular Biology
Metabolic pathways, enzyme deficiencies, molecular biology, and genetics.
Pharmacology
Drug mechanisms, side effects, interactions, and clinical therapeutics.
Physiology
Organ system physiology with emphasis on pathophysiological mechanisms.
Pathology
General and systemic pathology, including laboratory findings and disease mechanisms.
Microbiology and Immunology
Bacteriology, virology, parasitology, mycology, and immune system function.
Behavioural Sciences and Biostatistics
Epidemiology, biostatistics, ethics, patient communication, and health systems.
How to Register
- 1
Apply for ECFMG certification at ecfmg.org (requires medical school verification).
- 2
Complete the ECFMG application and document verification process.
- 3
Once approved, receive your USMLE/ECFMG Identification Number.
- 4
Apply for Step 1 through the ECFMG and pay the USD 645 exam fee.
- 5
Receive your scheduling permit via email.
- 6
Schedule your exam date at Prometric Lagos through prometric.com.
- 7
Sit the exam at the Prometric centre in Lagos.
Tips for Nigerian Candidates
The Prometric centre in Lagos is the only test centre in Nigeria. Book well in advance.
ECFMG verification of your Nigerian medical degree can take 2 to 6 months. Start early.
Your medical school must respond to ECFMG's verification request. Follow up with your university registrar.
The scheduling permit has a 3-month eligibility window. Plan your study timeline accordingly.
Many Nigerian doctors form study groups. Check the 'USMLE Nigeria' groups on Telegram.
The exam starts early. Stay close to Victoria Island the night before to avoid Lagos traffic delays.
Budget for ECFMG certification fees (approximately USD 160) in addition to the Step 1 fee.
Preparation Tips
Even though Step 1 is now pass/fail, do not underestimate the difficulty. A solid foundation here helps with Step 2 CK.
Use First Aid for the USMLE Step 1 as your primary review book.
Watch Pathoma videos for pathology and Sketchy for microbiology and pharmacology.
Do all of UWorld Step 1 question bank at least once (ideally twice).
Supplement with Boards and Beyond video lectures.
Use Anki flashcard decks (AnKing is the most popular) for daily review.
Plan for 3 to 8 months of dedicated study depending on your base knowledge.
Recommended Resources
Cost Breakdown
Exam Fee
USD 645 (plus ECFMG certification fees)
In Naira
Approximately N1,000,000
Who Needs This Exam
Medical graduates who want to practise medicine in the United States
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