StudyDuo
A USMLE study partner for Step 1 is easiest to find among classmates whose dedicated period overlaps yours, then on Student Doctor Network, r/step1 or a live study room. Spend your time together on timed question blocks and the questions you missed, not on teaching each other whole systems.
Step 1 as of November 2026
Step 1 tests whether you can apply the basic sciences to medicine, with an emphasis on the mechanisms behind health, disease and treatment (USMLE). Every exam taken on or after January 26, 2022 is reported as pass or fail. On the old three-digit scale, the passing standard is 196, and results typically arrive within four weeks (USMLE scoring).
The format changed on May 14, 2026. The day is still 8 hours, but it's cut into shorter blocks:
| Before May 14, 2026 | From May 14, 2026 | |
|---|---|---|
| Blocks | Seven, 60 minutes each | Fourteen, 30 minutes each |
| Questions per block | Up to 40 | Up to 20 |
| Break time | At least 45 minutes | At least 55 minutes |
| Optional tutorial | 15 minutes | 5 minutes |
The pace per question hasn't changed: 20 questions in 30 minutes is the same 90 seconds as 40 in 60. For a pair, the new block is a handy unit, since two people can start a 20-question block at the same minute and finish together.
Two more rules shape any plan you make with someone. You can take the same Step no more than three times in 12 months, and four attempts is the limit per Step (USMLE attempt limits). For now, you book your own date at a Prometric center. In January 2029, USMLE plans to switch to designated testing dates, with fewer administrations a year (USMLE).
Where to find a USMLE study partner
Match on the test date first. Someone testing in the same few weeks is in the same phase as you, so your misses overlap and are worth discussing. Then look in this order:
- Your own class. Your classmates share your school's calendar and dedicated period. If your school runs near-peer Step 1 sessions, the people who keep showing up have already proved they're consistent.
- Student Doctor Network and r/step1. Both reach people outside your school, which matters if you're an international graduate or on an unusual schedule. Post your test date, time zone and daily hours, and run one trial session before agreeing to anything longer.
- A live study room. StudyDuo's Find Partners lets you search by country, city and interests, USMLE included. A 1:1 session puts the two of you on video with sound, which suits a review call, and joining one takes a verified photo.
Before the first session, agree on three things:
- how many hours a day each of you studies,
- whether your daily contact is silent co-working, a review call or both,
- which NBME forms you'll take, and when.
For how to ask and what else to settle in the first week, see our guide to finding a study partner.
Step 1 pass rates since pass/fail
Pass rates have slipped since scores went pass/fail. Among first-time takers from US MD schools, 96% passed in 2021 and 91% in 2024 (USMLE performance data). The 2025 figure, 93%, isn't directly comparable: that year USMLE moved examinees from Canadian schools out of the US group.
| Year | US MD schools | US DO schools |
|---|---|---|
| 2020 | ||
| 2021 | ||
| 2022 | ||
| 2023 | ||
| 2024 | ||
| 2025 |
In 2025, 75% of first-time takers from schools outside the US passed, and 71% of repeat attempts by US MD students did. Pass or fail sounds forgiving, but one in fourteen US MD first-takers still failed in 2025, and a fail uses one of your four attempts.
What research says about studying with peers for Step 1
Peer-assisted learning has its best evidence in the clinical years. In 2022, Brierley, Ellis and Reid pooled 21 randomized trials from medical schools (Medical Education). Students taught by peers outscored controls overall, with a standardized mean difference of 0.52. The effect was larger for clinical students (0.63) and practical skills (0.69), not significant for preclinical students (0.39), and near zero for theory (-0.11).
Step 1 is preclinical theory, and a randomized trial aimed at it fits that pattern. New York Medical College randomized second-year students in the 2017-18 and 2018-19 classes to a year-long near-peer Step 1 program or to a control group (Dadafarin and Petersen, 2021). Most participants called the program a good use of their time. Their Step 1 scores were no different from the controls'.
Attendance studies look better, but they can't separate the program from the kind of student who attends. The University of South Carolina School of Medicine Greenville ran 24 weekly near-peer sessions in the second year. Students who came to 16 or more beat those who came to 6 or fewer on Step 1 (p = 0.048) (Khalil, 2022).
What did predict scores was practice. Deng, Gluckstein and Larsen surveyed 72 students at Washington University in 2015 (Perspectives on Medical Education). After accounting for MCAT score, grades and test anxiety, each extra 445 board-style questions went with about one more Step 1 point. So did each extra 1,700 unique Anki cards, and anxiety itself predicted lower scores.
The most valuable partner, then, is the one who keeps you both doing questions every day. Explain things to each other only where one of you missed.
How to split the systems
Split the review, not the studying. You both still do questions in every system. But with a USMLE study partner, each of you owns half of the systems for the review calls. You collect both partners' misses in your systems, look for the pattern and lead that part of the call. USMLE publishes each system's share of the exam, which lets you split the weight evenly (Step 1 content):
| Partner A leads | Share of Step 1 | Partner B leads | Share of Step 1 |
|---|---|---|---|
| Behavioral health, nervous system, special senses | 10 to 14% | Reproductive and endocrine | 12 to 16% |
| Blood, lymphoreticular and immune | 9 to 13% | Respiratory and renal/urinary | 11 to 15% |
| Musculoskeletal, skin and subcutaneous tissue | 8 to 12% | Multisystem processes and disorders | 8 to 12% |
| Cardiovascular | 7 to 11% | Gastrointestinal | 6 to 10% |
| Biostatistics, epidemiology, population health | 4 to 6% | Communication and interpersonal skills | 6 to 9% |
| Human development | 1 to 3% |
Disciplines cut across every system. Pathology makes up 45 to 55% of the exam and physiology 30 to 40%, so a renal miss is often really a pathology or physiology miss. Tag each miss in a shared log with its system and its discipline, and by the second week the log shows where both of you lose points.
A dedicated week for two
| When | What | Alone or together |
|---|---|---|
| Morning | Timed, random 20-question blocks of 30 minutes | Alone, or side by side on silent video |
| After each block | Read every explanation; log each miss: the fact tested, why the right answer is right, why yours wasn't | Alone |
| Late afternoon | Review call: each brings the misses from their own systems that most need explaining | Together, with sound |
| Evening | Flashcards made from the day's misses | Alone |
| Once a week | The same NBME self-assessment form, started at the same time | Side by side, then a review call |
NBME's Comprehensive Basic Science Self-Assessment has four sections of 50 questions, 75 minutes each at standard pace: again 90 seconds a question (NBME). It reports an estimated chance of passing Step 1 and a performance profile by content area, and NBME lists seven forms. Review your own report first, then compare profiles: a weak area you share goes on the call, and a weak area only one of you has is homework.
USMLE also posts more than 100 sample Step 1 questions, as a PDF and in the interactive testing software (USMLE sample questions). Do them together in the last weeks, in the new interactive testing experience USMLE built for the 30-minute blocks.
When to stop studying together
- Your dates drift apart. If one of you postpones by a month, you're in different phases. Keep the silent hours and drop the review call.
- Practice scores turn into a contest. Test anxiety predicted lower scores in Deng's survey. If comparing NBME results makes either of you anxious, share weak areas, not numbers.
- One of you is far ahead. A big gap turns the review call into tutoring, and tutoring didn't move Step 1 scores in the New York trial.
- The call starts replacing questions. If you skip blocks to prepare for it, shorten it.
If two of these happen, end it kindly and look for a new USMLE study partner closer to your date. Methods for working with one person, from quizzing to arguing before you check the key, are in How to Study With a Partner. Before medical school, the MCAT has its own partner routine: CARS debates and full-length reviews.
For the UK's clinical exam, see a PLAB 2 study partner; for rooms with other medical students, online study rooms for medical students.
FAQ
Can my study partner be at another medical school?
Yes. Everyone sits the same Step 1, and NBME forms and USMLE's sample questions give you items in common even if your curricula differ. Check that your test dates are close before anything else.
Is it a problem if we use different question banks?
No. Log misses by system and discipline whatever bank they come from, and make the NBME self-assessments the set you both take.
Is a group better than one partner for Step 1?
A pair is easier to keep in step: each extra person adds another test date and another daily schedule to match. If you like a group, keep the daily review call to two people and meet as a group once a week.
Does the same approach work for Step 2 CK?
Mostly. Step 2 CK still reports a three-digit score, and its content is clinical. A partner on the same rotation schedule can review misses by discipline instead of by organ system.
