The USMLE Step 1 exam is an 8-hour exam. The exam allocates 7 hours for questions and 1 hour for break time that can be used between question blocks.
The exam consists of 280 questions divided into seven blocks. Each block is allocated 60 minutes to complete. Once the 60 minutes finish, the block is automatically submitted and the student can no longer return to that block of questions. However, if the block is submitted early, any remaining time will be added to your break time.
The 60 minutes of break can be divided in any way between the question blocks. It is completely up to the test-taker to decide how to divide up their break time. However, an important note is that breaks can only be taken between blocks; breaks cannot be taken during a block.
The exam begins with an optional 15-minute tutorial that is deducted from your break time. If you have done the tutorial before, you can skip it to save some break time. It is recommended to try the tutorial prior to your actual exam.
Every student develops their own pace for this exam. Most students have never taken an 8-hour exam, so it takes a lot of practice to develop endurance for this exam. Before the exam, it is recommended that students complete multiple full-length practice tests in order to develop a proper pace.