USMLE Step 1 Communication and Ethics Practice Questions
6–9% of Step 1 · 26 practice questions with a note on every option
280 questions in 14 timed 30-minute blocks, with your score in communication and ethics and every other content area.
Free communication and ethics drillA 32-year-old man comes to the physician because of 3 days of rhinorrhea, sore throat, and cough. He has no fever, and examination shows clear nasal discharge, mild pharyngeal erythema without exudate, and clear lungs. The physician explains that he most likely has a viral upper respiratory infection. The patient says, “I have a big presentation on Monday. Antibiotics always work for me, so I just need a prescription.” Which of the following is the most appropriate response by the physician?
Social Sciences: Communication and Interpersonal Skills on Step 1
Social Sciences: Communication and Interpersonal Skills is 6–9% of Step 1. Each question puts you in a conversation with a patient or family and asks for the best thing to say or do next.
- Share of Step 1
- 6–9% of the exam, per the USMLE content outline
- On our mock exam
- 21 of 280 questions, with your score for this system in the result
- Our drill
- 10 questions from 26 communication and ethics questions, untimed, a note on every option; one free attempt, unlimited with a pass
What Step 1 communication and ethics questions test
- Breaking bad news and responding to emotion
- Informed consent, decision-making capacity and surrogate decision makers
- Confidentiality and when it can be broken
- Minors, adolescents and parental involvement
- Advance directives and end-of-life conversations
- Disclosing medical errors, interpreters, and conflicts with patients or colleagues
Sit all 280 questions in timed blocks
280 questions in 14 timed 30-minute blocks, with your score in communication and ethics and every other content area.
Free communication and ethics drillHow to study it
- Pick the answer that is honest, respects the patient’s autonomy and keeps the conversation open.
- Prefer open-ended questions and acknowledging emotion over reassurance or lecturing.
- Learn the few situations where the physician must act without consent: emergencies, and specific legal reporting duties.
Common questions
Is ethics on Step 1 or Step 2 CK?
Both. Step 1 tests communication and interpersonal skills at 6–9%; Step 2 CK tests legal and ethical issues, professionalism and patient safety at 10–15%.
How do I choose between two reasonable answers?
Choose the one that asks or listens first, addresses the patient directly and does not shut the conversation down. Answers that reassure falsely, refer away or defer to family over a capable patient are usually wrong.
280 questions in 14 timed 30-minute blocks, with your score in communication and ethics and every other content area.
Free communication and ethics drillThe other Step 1 systems
Sources
- USMLE: Step 1 (blocks, items, testing day, break time)
- USMLE: Step 2 CK (blocks, items, testing day, break time)
- USMLE: Test delivery software updates for Step 2 CK and Step 1 (May 2026)
- USMLE: Step 1 content outline and specifications
- USMLE: Step 2 CK content outline and specifications
- USMLE: Examination results and scoring (minimum passing scores)
- USMLE Bulletin: Scoring and score reporting (about 60% correct to pass; result timing)
- USMLE Bulletin: Eligibility (attempt limits)
- USMLE: Apply for exams (2026 and 2027 fees, FSMB registration, region fees)
- USMLE: Performance data (pass rates)
- Intealth ECFMG: Fees overview (ECFMG Certification)
Original practice questions written to the USMLE content outlines and current standard references. USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and NBME. Independent practice, not affiliated with or endorsed by the FSMB, NBME or Intealth (ECFMG). Follow current guidelines in clinical practice.