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Free USMLE practice questions

Here are 20 free, original USMLE-style questions: short clinical vignettes in the style of Step 1 and Step 2 CK, on core topics like pharmacology, murmurs, anemia, stroke and biostatistics. Each one has five answer choices and a plain-English explanation of why the answer is right and the others are wrong. We use 70% (14 right) as a practice target, which is our own goal, not a USMLE rule. The real Steps have about 280 to 412 questions, so treat this as a warm-up and use the official sample questions too.

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Updated October 2026 · Written from official sources, listed at the bottom of this page

Question 1 of 20

A 6-month-old girl born overseas, who had no newborn screening, is brought in for developmental delay. She has eczema, unusually light skin and hair, and her urine has a musty smell. A deficiency of which enzyme is the most likely cause?

Sample of the exam: same format, 20 questions.

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OverviewUSMLEQuestions and passingHow many questions are on the USMLE, and what’s the passing score?ScoringHow USMLE scoring worksBookingHow to sign up for and schedule the USMLECostHow much does the USMLE cost?What to bringWhat to bring to the USMLEOnline examCan you take the USMLE online?Step 1USMLE Step 1: pass/fail, format and lengthStep 2 CKUSMLE Step 2 CK scores, percentiles and formatStep 3USMLE Step 3: applying, the two days, CCS and scoresResults and transcriptsWhen do USMLE results come out?Free 120 and self-assessmentsFree official USMLE practice: sample questions and NBME self-assessmentsInternational graduatesThe USMLE for international medical graduatesIf you failFailed a USMLE Step? How retakes workContent outline and booksUSMLE study guide: the official content outlineWhere to learnWhere to study for the USMLEStudy plannerUSMLE study planner
Sources: USMLE and 4 more. Checked October 2026.

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