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Indiana University School of Medicine

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/ Education  /   Phase 1 (Years 1 and 2)  /   Step 1 Guide

Step 1 Guide

Updated for the Academic Year 2020-2021

Have you heard? IUSM Students score higher than the national average on USMLE Step 1. The Mentoring and Advising Program at IUSM is here to support you. In 2019, 99% of IUSM students pass Step 1 on their first try. IUSM provides the following resources to assist students in preparing for Step 1 including review sessions and practice exams. Check out the details below in how the School helps support student success…

Class of 2023 Step 1 Deadline

Students must take the exam prior by April 10, 2021.

How to Register


Click first-time user, enter your name, SSN and medical school information.  It is important that you enter your name exactly how it appears on the identification that you will present the day you take the exam. (ie; driver’s license, passport).

The NBME will e-mail you your USMLE ID and a temporary password. This may take up to one business day. Please keep your USMLE ID number as you will need it to register for future exams.

Once you receive this information, you should log in to the menu item: Apply for the USMLE. You will be required to change your password at this time.

You will then be successfully logged on to the NBME Interactive Website. To start a new application, click on “NEW.”

You will be asked to read the application instructions. Then hit “next.” The examination you are applying for is: Step 1.

Follow the instruction and complete the application. The school (Indianapolis campus) and enrollment start date is pre-populated

Regional Campus Students MUST use the drop-down menu to select their campus:

You will need to pay the registration of $645. (via credit card)

Once you have completed your registration, print the Certification of ID and Authorization Form. 

Complete your portion of the forms and add your photo and handwritten signature. 


Scan and send it to the appropriate authorized signer for your campus (listed below).

The appropriate authorized signer will sign your form electronically and send it to the USMLE on your behalf. You will receive an email from the authorized signer confirming that your form has been sent to the USMLE.

After the NBME has completed the processing of the form they will e-mail you with your scheduling permit. This confirms the window in which you can schedule your exam date.

To schedule your examination test location and date, visit the Prometric website (

Due to COVID changes the window for scheduling and the timing of scheduling with Prometric is expected to be different from past years, so please refer to the NBME site and the Prometric site for more information. 



Charles Rudick (


Keith Powers (
Jamie Henderlong (

Fort Wayne

Sharon Roberts (
Gina Bailey (
Carol Craig (


Last names ending in A-B: Amanda Ybarra (
Last names ending in C-G: Kim Sandrick (
Last names ending in H-L: Nancy Mitchell (
Last names ending in M-R: John Keller (
Last names ending in S-Y: Erika Graham (


Ila Verneman (


Dawn Ilgenfritz (

South Bend

Kristina Borger (

Terre Haute

Dr. Peter Duong (
Elizabeth Nesius (
Kristy Nicoson (

West Lafayette

Donna Fulkerson (
Natalie O’Neal (

Step 1 Practice Exams

September:  IUSM centrally provides all Phase 1 Year 2 students a voucher to take a Comprehensive Basic Science Self-Assessment (CBSSA) by the end of October to give them a baseline for their Step 1 preparation. 

January 12th:  IUSM centrally provides the Comprehensive Basic Science Exam (CBSE) that is given as a timed and proctored exam to reflect the effectiveness of our content delivery and to reflect the readiness of individual students for Step 1, well before their dedicated Step 1 study period in March. 

February:  IUSM centrally provides an additional CBSSA voucher for use by students to monitor their progress.

Review Sessions

The Mentoring and Advising Program works with student leaders to provide timely sessions to assist students in preparing for Step 1 throughout Year 2. Sessions topics include information on

Step 1 Resource Canvas Site

Students can self-enroll here. IUSM faculty designed the site to enhance your preparation by providing you with:

  • Step 1 Study tips
  • Practice questions
  • Content summaries/overviews
  • An opportunity to ask questions in the Discussion tab
  • A site that is easy to navigate since it mirrors the organization of First Aid

Lead Advisor Timeline

November – Discuss the CBSSA fall score with the student and suggest study plans prior to the CBSE.

January – Discuss the CBSE score and encourage the student to make adjustments to their study plan as needed.  Discuss the possibility of applying for a delay.

March – Follow up with students’ progress and provide vouchers after the student provides a voucher score.  Discuss the possibility of applying for a delay for those students still not scoring in the passing range.


At no cost, students can work with tutors any time on:

  • Developing study plans
  • Understanding content
  • Improving their strategic approach to questions


Why do I have to take Step 1 before clerkships?

IUSM students are required to take and pass Step 1 as a graduation requirement.  You must take the exam prior to beginning Phase 2.  We have evidence students perform better on clerkship from the intensive study period and will be ready to apply that knowledge to the clinical settings.

Completing Step 1 prior to starting clerkships also allows students to put this stressful exam behind them before starting this new and exciting next phase of their training.

For AY 2020-2021 all students must take their exam no later than April 10th.  For students who anticipate taking a vacation month for their first clerkship, this deadline still applies.

How do I delay Step 1?

In 2018, IU School of Medicine’s mean Step 1 score was 234 while the national mean was 230. In 2019, the school’s mean score was again 232 and the national mean was 231. We hope that this gives you confidence that your Phase 1 curriculum has prepared you well for Step 1. However, some students may not feel ready to take Step 1 by the deadline on April 10, 2021. There are three reasons students can request a delay for Step 1:

There are three reasons students can request a delay for Step 1:

  1. Remediation of P1Y2 course. Students who are remediating a course from the second year are required to delay Step 1. Students who are required to delay for this reason will have a vacation month placed on their schedule in the first rotation and will need to take Step 1 by the last day of R1.
  2. Leave of absence. Students who are planning to take a leave of absence to improve their mental health or well-being will need to complete a LOA form, which requires the approval of the Lead Advisor and the senior associate dean or a designate. View the full policy here.
  3. Failing scores on practice exams. Students who are not passing Comprehensive Basic Science Self-Assessments (CBSSAs) can request a delay of Step 1 from the Ad Hoc committee. The committee will review the student’s scores and may provide recommendations such as attendance at a structured Step 1 prep program. Students should submit this request to Abigail Klemsz, MD, no later than April 1st.

Students who delay Step 1 will use their vacation month for their delay, which will likely change the rest of their third year schedule. They will also be required to work with their Lead Advisor and the Learning Strategist to create a study plan to ensure progress in their exam preparation. The deadline for students who delay will be the last day of R1.

All students who are granted a delay for Step 1 must complete all parts of the Orientation to Phase 2 including Transitions 2 and any other curricular requirements.

A delay of greater than one month must be approved by the Student Promotions Committee and will result in a delay of graduation by one year.  Longer delays can have a financial impact if the student does not complete a rotation in either June or July.  Without clerkships in one of those two rotations, the student’s university enrollment will be dropped which will cancel the financial aid received.  Dr. Marti Reeser ( or 317-274-2208) is available to talk more about impacts of enrollment delays.

What happens if I fail?

IUSM students are very well prepared to take Step 1. We are proud that our school Step 1 average has been above the national average for many years and last year we had only a very small number of students who did not pass the 1st time that they sat for the exam. However, in anticipation that there may be a few students who fail, we have developed the following procedure. We would like to share this information with you not to create additional anxiety, but to be fully transparent and reassure you that we have a well thought out plan to assist you in case of this rare eventuality.

We anticipate receiving the majority of Step 1 scores prior to the start of the first clerkship, so in the event that a student did not pass Step 1, they would not be allowed to start that clerkship.   Students whose scores are received after the start of the first clerkship will have the option to remain in their clerkship or withdraw from the clerkship.   

IUSM requires that students retake and pass the Step 1 exam prior to returning to their clerkships. 

Students will be enrolled for fall 2021 once a passing score is received.  If the student is already enrolled, their enrollment will be cancelled.  Retroactive enrollment might occur based on when the passing score is received.  We need to inform you that without enrollment, students are not eligible for financial aid or malpractice insurance and are no longer on the School’s Health Insurance plan (if applicable) as of August 1, 2021.

What should I do if I feel overwhelmed?

The student affairs team is here to support you! We believe in you! But we also know that this is a very stressful time, so we have worked to make a lot of different resources available to help you. Dr. Dana Lasek, Stephanie Cunningham, Dr. Brian Nichelson, Mr. Michael Trexler and Dr. Samia Hasan are available to work with students on issues such as test anxiety that might prevent them from performing well on exams. All of their services are confidential. You can contact the program coordinator at 317-278-2383 to set up a time to meet with any of them.

What do I do if I have more questions?

Please do not hesitate to reach out to anyone on our team at any time with questions or concerns that you have. Your success and wellness are our priority!

Specific questions about Step 1 preparation may be directed to:

Kristin Richey
Learning Strategist
Medical Student Education
Indiana University School of Medicine
1130 W. Michigan St., FH 115B
Indianapolis, IN 46202

Abigail F. Klemsz, MD, PhD
Assistant Dean, Academic Advising
Associate Professor of Clinical Pediatrics
Medical Student Education
Indiana University School of Medicine
1120 W. Michigan St., GH 550
Indianapolis, IN 46202