Step 1 Guide


Updated for the Academic Year 2019-2020

Have you heard? IUSM Students score higher than the national average on USMLE Step 1. The Student Affairs Mentoring and Advising Program at IUSM is here to support you. To date, 99% of 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.

2020 Step 1 Deadline

Students must take the exam prior by April 6, 2020.

Step 1 Practice Exams

September: IUSM 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. The expanded feedback will help you identify areas of opportunity for improvement and highlight areas of competence.

January: IUSM provides the Comprehensive Basic Science Exam (CBSE) that is given as a timed and proctored exam in order to best simulate the real exam and to help students assess their readiness for Step 1, well before their dedicated Step 1 study period in March.

February: IUSM provides an additional CBSSA voucher to each student to monitor their progress. This can be used at any point during the dedicated study period.

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.

  • Creating a study plan
  • Addressing Q-Bank questions and clinical vignettes (ongoing)
  • Managing self-care
  • Using practice exam results to improve performance
    January 7, 2020 from 10:00 a.m. to Noon EST (9:00 to 11:00 a.m. CST) in MS B26 Zoom meeting room – Join from PC, Mac, Linux, iOS or Android:
  • Q-Bank Practice Question Strategies
    January 7, 2020 from 1:00 p.m. to 3:00 p.m. EST (12:00 to 2:00 a.m. CST) in MS B26 Zoom meeting room – Join from PC, Mac, Linux, iOS or Android:
  • Managing and garnering support for your study time (specifically for non-traditional students)
    January 7, 2020 from 3:00 p.m. to 5:00 p.m. EST (2:00 to 4:00 p.m. CST) in MS B26 Zoom meeting room – Join from PC, Mac, Linux, iOS or Android:
  • Managing dedicated study time
    February 25, 2020 (date may change if snow days are used) 10:00 a.m. to Noon EST/9:00 to 11:00 a.m. CST in MS B26 Zoom meeting room – Join from PC, Mac, Linux, iOS or Android:

Step 1 Resource Canvas Site

Students can self-enroll in the canvas site. The site was designed by IU School of Medicine faculty 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

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 adjust their study plan as needed. Discuss the possibility of applying for a delay.

March: Check in on preparation progress and provide extra vouchers as needed. Students must share their scores prior to receiving a new voucher In order to guide discussions about the possibility of applying for a delay.


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?

IU School of Medicine students are required to take and pass Step 1 as a graduation requirement prior to beginning Phase 2.  We have evidence students perform better on clerkships 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 students who anticipate taking a vacation month for their first clerkship, the deadline still applies. 

In order to keep students on track to complete all of their requirements to graduate on time, we allow students to begin their clerkships after they have taken Step 1 for the first time, even and before their score is received. 

How do I delay Step 1?

In 2018, IU School of Medicine’s mean Step 1 score was 233 while the national mean was 230. In 2019, the school’s mean score to date is 230 and the national average won’t be officially known until February 2020. We hope that this gives you confidence that your IUSM 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 Monday, April 6, 2020.

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 automatically granted a delay of Step 1. Students who delay for this reason will take a vacation in their first month and will need to take Step 1 by May 30th.
  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 1.

Students who delay Step 1 will have a vacation in their first month of third year.This will likely change the rest of their third year schedule to accommodate this delay. 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 to take Step 1 for students who delay will be May 30th. Students who delay for one month are required to sign the agreement for one month Step 1 delay. This form can be found below:

All students who are granted a delay for Step 1 are still required to attend IPE/OTC/Transitions 2 and Intersessions April 7 – April 29, 2020.

Students wishing to delay for more than a month are required to submit an Study Plan for Extended Step 1 Delay to the Student Promotions Committee.  Students delaying more than one month will have a Step 1 deadline of Saturday, August 22, 2020 and will begin clerkships with Rotation 5.  They will be moved to the Class of 2023. Students who delay for an extended period are required to sign the agreement for Application for SPC Approval of Extended Step 1 Delay. This form can be found below:

Delaying past one month will mean that students will not be enrolled until they start their clerkships in August and will not have access to financial aid, health insurance or malpractice until they return to clerkships. 

What happens if I fail?

IU School of Medicine 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 first time that they took 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 situation.

We anticipate receiving Step 1 scores on April 29, 2020 or May 6, 2020. Since this is prior to the start of the first clerkship or on the third day of the clerkship, students will need to postpone starting their clerkships in the event they do not pass Step 1. Due to the postponement, the clerkship director and coordinator will be notified of that student’s schedule change when the score is received. Students whose scores are received on May 6, 2020 will have the option to remain in their clerkship or withdraw from the clerkship.   

IUSM policy requires that students retake and pass Step 1 prior to returning to clerkships. Any student who fails will work with the Lead Advisor and Student Affairs to develop a remediation plan.

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. Student Affairs will be sponsoring Wellness events during dedicated study to help students focus on all aspects of wellness.

What do I do if I have more questions?

Please do not hesitate to reach out to anyone on the MAP 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