Since May 2026, USMLE Step 1 and Step 2 CK are delivered in shorter blocks. The exam is still one day and the session is the same length, but each block is now 30 minutes with no more than 20 questions. This guide sets out exactly what changed according to the official USMLE exam pages, what the numbers mean for your pace, and how to practice for the new structure.
What changed, according to USMLE
| Element | Step 1 | Step 2 CK |
|---|---|---|
| Applies to exams taken | On or after May 14, 2026 | On or after May 7, 2026 |
| Blocks (new) | Fourteen 30-minute blocks | Sixteen 30-minute blocks |
| Blocks (before) | Seven 60-minute blocks | Eight 60-minute blocks |
| Questions per block (new) | Does not exceed 20 | Does not exceed 20 |
| Questions per block (before) | Did not exceed 40 | Did not exceed 40 |
| Testing session | One 8-hour session | One 9-hour session |
USMLE says the number of questions per block can vary from one exam form to another, so do not assume every block has exactly 20 questions.
What the new blocks mean for your pace
With at most 20 questions in 30 minutes, a full block allows at least 90 seconds per question. The old format gave the same figure: at most 40 questions in 60 minutes. The time per question did not shrink. What changed is how often the clock restarts. A mistake in pacing now costs you at most one 30-minute block before you get a fresh start, instead of an hour.
Pacing strategies for 30-minute blocks
These are study-skills suggestions, not official USMLE guidance.
- Use the half-block checkpoint. By about 15 minutes you should be near question 10 of a 20-question block. Glance at the timer at that point rather than after every question.
- Decide quickly, then flag. If a question is taking far more than 90 seconds, choose your best answer, flag it, and move on. With shorter blocks there is less spare time to rescue a slow start.
- Treat every block as a new start. A slow block does not carry into the next one. Use the end of each block to reset your breathing and posture.
- Finish blocks early when you can. USMLE states that break time can be increased by finishing a block or the optional tutorial before the allotted time expires. See our break time and test-day timeline guide for how to plan that time.
Practice in the same structure
- Do timed practice in 20-question, 30-minute sets, in runs of several blocks, rather than 40-question hour-long sets.
- Build up to a full-day run of 14 blocks for Step 1 or 16 for Step 2 CK, so that stamina on the real day is not a surprise.
- Review your timing, not only your score: note which blocks you finished with time to spare and which you rushed.
- Try the official interactive testing experience on usmle.org so the interface is familiar before test day.
What USMLE does not say on these pages
The official Step 1 and Step 2 CK pages describe the block structure, session length and break allowance. They do not announce changes to exam content or scoring, and they do not give a total question count for the new format. Check usmle.org before you rely on any number that is not in the table above, including claims on prep-company blogs.
Where to go next
- USMLE Step 1 guide: eligibility, scoring and a study plan.
- USMLE Step 2 CK guide: format, passing score and study plan.
- USMLE results, rechecks and transcripts.