What "pass/fail" actually changed
You no longer get a three-digit score on Step 1. You either pass or you do not. The fail rate is still ~5% for US MD students and 25%+ for IMGs — and a fail follows you into every residency interview for years.
Why score-style practice still matters
Step 1 questions test the foundational science Step 2 CK will lean on. Skip the rigour now and your CK score — which IS three-digit and which programs DO use as a filter — will reflect it.
The Wrexa Edge Step 1 simulator
We mirror the Prometric Step 1 UI: 280 questions across seven blocks of 40, 1 hour per block, drug name highlighting, lab values panel, mark/cross/strike on choices. Take a full USMLE Step 1 simulator on the real interface — free.
High-yield topic split for 2026
- Pathology — 44 to 52% of questions.
- Physiology — 25 to 35%.
- Pharmacology — 15 to 22%.
- Biochemistry, microbiology, immunology — the rest.
A realistic 8-week plan
- Weeks 1 to 4 — system-by-system review, 40 question blocks daily.
- Weeks 5 to 6 — full 7-block simulated days twice a week.
- Weeks 7 to 8 — NBME self-assessments + one final Wrexa simulator under real conditions.
Browse the full medical licensing catalog for Step 2 CK, PLAB, NEET-PG, and more.