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You may take the USMLE Step 1 exam a maximum of three times within a 12-month period. Your fourth attempt must be at least 12 months after your first attempt, and at least six months after your most recent attempt.
After the second year in medical school, medical students take an exam called USMLE Step 1, which covers all basic sciences material that is taught in the first two years of medical school. After passing USMLE Step 1 you enter the second half of medical school.