USMLE Free 120 – A complete guide

Tyler York
USMLE free 120 a complete guide

Curious about the USMLE Free 120? First, let’s talk about the exam. The USMLE (United States Medical Licensing Examination) is a centralized program created to certify the medical licensing qualifications of an individual in the United States. It is owned by two non-profit organizations: the FSMB (the Federation of State Medical Boards) and the NBME (the National Board of Medical Examiners). The USMLE Step 1 is the first exam in this series and is often considered the most important.

USMLE Step 1 results are forwarded to the state medical boards (licensing authorities) of each jurisdiction that permits the individual medical candidate with the license to practice medicine. These results are also used heavily by program directors to evaluate applicants for their medical programs, with 94% of program directors calling them the ‘most important’ evaluation metric.

Goals of the USMLE exams include:

  • Meaningful assessment of candidates’ skills, knowledge, values, and attitude for effective patient care
  • Fair, equal, and highly professional assessment standards
  • Involve educators, authorities, clinicians in the design and development of assessments

Let’s jump in and find out why the USMLE Free 120 is such an important part of this process.

Otolaryngology doctor examines a patient's throat
Photo by H Shaw on Unsplash

USMLE Step 1 Significance

The USMLE Step 1 examination evaluates the medical candidates’ in the way they understand and apply the basic medical concepts and mechanisms that they learned. This leads to a strong foundation for safe patient care and also lays a deeper root to pursue or take up specialized residency programs of their interest. 

The basic principles and concepts of the USMLE Step 1 examination comprise anatomy, physiology, biochemistry, microbiology, pathology, genetics, immunology, behavioral science, pharmacology, nutrition, and more.

The USMLE Step 1 is a one-day computer-based multiple-choice examination held throughout the year. Medical students mostly attempt this examination at the end of their 2nd year in medical education. The examination is conducted in an uninterrupted single 8-hour session that is divided into seven blocks, with each block lasting to 60-minutes. Each block can have a maximum of 40 questions, which means the Step 1 examination can have up to 280 questions in total.

Need for practicing USMLE Step 1

Preparing for the USMLE is like running a race. Many hours of practice, advice, and other learning may not help if you are not able to tune-up in the last 2 weeks before the final examination. You have to smartly assess your strengths and weaknesses, and use that information to guide your preparation.

This is where the USMLE Free 120 is so important – it’s a free diagnostic test provided by the makers of the exam itself. Because of this, you can trust that it’s highly representative of the real USMLE Step 1 questions.

What is the USMLE Free 120

The USMLE Free 120 is a set of model questions in 3 different blocks, with 120 total questions. Each question is presented as a practical clinical examination or evaluation with a patient with particular symptoms, illness, or medical history. The test taker will then answer a number of questions about that examination or patient, with some multiple choice questions having as many as twenty possible answers. 

With the help of these questions, a candidate can become clearer in the way they interpret the medical conditions, diagnostic tools and results, and infer the possible diseases. This is essential for preparing for the actual USMLE Step 1. But perhaps most importantly, these questions can help you diagnose yourself and which sections of the USMLE Step 1 you need more practice with.

The only factor that cannot be tackled with the free 120 test is the test center influence, which the candidates have to experience by undertaking the CBT (computer based testing) session at the respective test centers.

Additional resources authenticated by USMLE

  1. Take the free tutorial test (this is the “USMLE Free 120”):
  1. For general information and content description booklets, candidates can use this link (from the USMLE site): 
  1. Sample PDF#1 (direct link) with 117 questions with correct answers given at the end of the document:
  2. Sample PDF#2 (direct link) with 99 questions (no correct answers given at end):
computer based test
Photo by Marcus Loke on Unsplash

USMLE’s Practice CBT (Computer Based Test)

Registered examinees get an opportunity to practice a sample test at the Prometric test center, which is highly recommended for individuals with test anxiety or someone looking to understand the full test experience before the crucial day. This makes the candidates familiar with the test center, facilities, and other environmental factors that could influence their score in the exam.

However, unlike the USMLE Free 120, the practice CBT costs money. Step 1 and 2 Practice Testing fee for candidates within the US and Canada is $75, and for international candidates, it is $155. The only eligibility requirement for a Prometric practice test is the successful registration for USMLE’s Step 1 or 2 examinations. It’s important that you save this practice test for when it will be most valuable: only one practice test session per exam registration is allowed.

Link to registering for the CBT practice test at the Prometric test center:

Once the test is completed, the candidates are allowed to download their scores immediately. The session lasts for up to 3.5 hours, with 3 blocks of 60 minutes each.

How to use the results

Once you have completed your USMLE Free 120 questions, write down your performance by section and make a note of the questions you got wrong. If you have time, go through the questions you got wrong in detail and write down common mistakes or themes. 

A passing grade for the USMLE Step 1 is 194, but the goal is not just to pass (at least not yet – the USMLE Step 1 will become pass/fail in 2022). You want to research the USMLE score you need for your target program or residency and see where you’re falling short. We hope that this helps you determine what USMLE score you need to reach your target program. Having a target score and holding yourself accountable to that target is one of the best things you can do to stay motivated during the months of studying to come.

This philosophy is at the heart of the new USMLE Step 1 course that we developed at Achievable, based on the official USMLE Content Outline. Achievable USMLE Step 1 combines our author’s stellar experience in preparing US and international medical students for their USMLE exams with Achievable’s time-saving product approach. Our adaptive algorithm takes this a step further by scheduling your review flashcards for optimal memory retention, helping keep the large amount of material that is in the USMLE in your head with minimal study time.

Peek inside to view Chapter 1 of Achievable USMLE Step 1 for free to see it for yourself.

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