USMLE 2026 changes: new software and 30-minute blocks
The Step exams moved to new test software in 2026, with shorter blocks. Here is what changed, what did not, and how to adjust your practice.
The rollout dates
| Exam | New software from |
|---|---|
| Step 3 | 10 March 2026 |
| Step 2 CK | 7 May 2026 |
| Step 1 | 14 May 2026 |
Source: usmle.org, checked October 2026.
The new block structure
| Exam | Before | Now | Test day |
|---|---|---|---|
| Step 1 | 7 blocks of 60 minutes (up to 40 questions each) | 14 blocks of 30 minutes (up to 20 each) | 8 hours |
| Step 2 CK | 8 blocks of 60 minutes | 16 blocks of 30 minutes (up to 20 each) | 9 hours |
| Step 3, Day 1 | 6 blocks | 12 blocks of 30 minutes | About 7 hours |
| Step 3, Day 2 | 6 multiple-choice blocks, plus 13 to 14 case simulations | 9 multiple-choice blocks of 30 minutes, plus 13 to 14 case simulations | 9 hours |
Content, the total number of questions and the length of the exam day did not change. Once you finish a block you cannot return to it.
Other changes to know
What did not change
The exam content, the total number of questions and the length of the exam day stayed the same. Only the block structure and the screen changed.
Registration for IMGs
USMLE services for international medical graduates are now handled by FSMB. ECFMG still handles certification and the Pathways.
Higher surcharge from January 2026
The international test delivery surcharge rose to US$ 210 for Step 1 and US$ 235 for Step 2 CK, on top of the exam fee.
Fewer exam dates later
USMLE says it will reduce the number of Step exam administrations each year from January 2029, so plan your dates early.
Past papers and syllabus
Changed software does not change the syllabus: the official content outline still describes what is tested. USMLE publishes no past papers, so practise with original questions written to that outline.
2026 change questions answered
Do I need to practise on the new interface?
Did the new blocks make the exam shorter?
Which questions are best for the new format?
Practise in the new format
MedMasters USMLE Qbank timed blocks use 20 questions in 30 minutes, matching the new structure.