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Step 1 of the USMLE (United States Medical Licensing Examination) is the first part of the United States Medical Licensing Examination. It is open to medical school student and graduates to assess their ability to apply important concepts fundamental to the practice of medicine. While American medical students usually take USMLE Step 1 at the end of the second year of medical school, all graduates of foreign medical schools must take this exam is they intend to practice medicine in the United States.

USMLE Step 2 is open to all medical students and graduates who have successfully passed the USMLE Step 1. The Step 2 exam assesses the candidates' medical knowledge, skills, and understanding of clinical science essential for patient treatment and care, health promotion and disease prevention.

USMLE Step 2 is a one-day (8 hours) exam. Similar to the Step 1, the test items are divided into blocks, and test item formats vary within each block, with the total number of exam questions equaling to 355.

Reference: http://www.usmle.org/step-1/#question-formats

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