QUESTION EXPANSION PAUSED
Evidence before volume.
PulseQ is being rebuilt around the official USMLE outline. This report shows what is proven, what is only provisionally mapped, and what still requires medical review.
3/11RELEASE CHECKS PASSED
RELEASE GATE
What must be true before generation resumes
✓Official systems, disciplines, tasks, and source version are recordedPASS
✓Blind question expansion is frozenPASS
○Every official-derived objective is mapped to a reviewed modulePENDING
○Every official-derived objective has reviewed learner content or an approved remediationPENDING
○Every existing anchor is mapped and reviewed at objective levelPENDING
○High-priority objectives have multiple distinct reviewed formsPENDING
○Cross-system disciplines are audited in every relevant systemPENDING
○Official vignette, chart, pictorial, and multimedia formats are represented and reviewedPENDING
○Modules are unique, correctly labeled, and physician-validatedPENDING
○Qualified physician review is signed offPENDING
✓Coverage status and limitations are visible to usersPASS
PRIMARY AUTHORITY
Versioned official sources
2026 USMLE Content Outline ↗Step 1 specifications ↗Physician tasks and competencies ↗Official sample items and formats ↗The USMLE outline gives the canonical content boundary. It is not treated as proof that our current questions cover that boundary.
Format representation is part of coverage
Paragraph vignette, one-best-answer436 present · unreviewed
Structured patient chart, one-best-answer8 present · unreviewed
Graphic or pictorial interpretation1 present · unreviewed
Audio or multimedia findingMISSING
Stratified physician question sample0/44 approved
Reviewed coverage, partials, and gaps
Covered0
Partially covered0
Missing after review0
Duplicated0
Awaiting physician review1,681
Zero objectives are called covered before physician review. Current known gaps include chart-format and audio/multimedia questions, unreviewed cross-system cells, and insufficient distinct forms for most high-priority objectives.
Nothing important is hidden behind a percentage
The official USMLE outline states that its examples are non-exhaustive and that no single examination includes every listed topic.OPEN
All objective-to-module and anchor-to-objective mappings are algorithmic candidates; zero have physician approval.OPEN
Most high-priority objectives lack two independently authored anchors across distinct reasoning axes.OPEN
PulseQ has eight structured chart/table calibration fixtures, but they are unpublished and have not completed medical and style review.OPEN
The official interactive testing experience includes an audio finding; PulseQ has no reviewed audio/multimedia inventory.OPEN
First Aid and Kaplan were not used as coverage authorities and PulseQ has no recorded license to reproduce or claim equivalence to either product.CONTROLLED
USMLE content, competencies, sample formats, and test software can change after the recorded audit date.CONTROLLED
OFFICIAL DOMAIN CROSSWALK
NO COMPLETENESS CLAIM YETCurrent catalog status by USMLE section
Official domainModulesDirect anchorsNeeds reviewStatus
Human Development41655partial
Immune System71699partial
Blood & Lymphoreticular System716121partial
Behavioral Health111677partial
Nervous System & Special Senses182299partial
Skin & Subcutaneous Tissue71677partial
Musculoskeletal System61677partial
Cardiovascular System151677partial
Respiratory System114077partial
Gastrointestinal System122277partial
Renal & Urinary System81677partial
Pregnancy, Childbirth, & the Puerperium7093awaiting review
Female and Transgender Reproductive System & Breast8093awaiting review
Male and Transgender Reproductive System6093awaiting review
Endocrine System92299partial
Multisystem Processes & Disorders1217115partial
Biostatistics, Epidemiology/Population Health, & Interpretation of the Medical Literature91633partial
Social Sciences41633partial
STEP 1 WEIGHTED SYSTEM GROUPS
11 exam-construction groups
Human Development1–3%
Blood & Lymphoreticular/Immune Systems9–13%
Behavioral Health & Nervous Systems/Special Senses10–14%
Musculoskeletal, Skin & Subcutaneous Tissue8–12%
Cardiovascular System7–11%
Respiratory & Renal/Urinary Systems11–15%
Gastrointestinal System6–10%
Reproductive & Endocrine Systems12–16%
Multisystem Processes & Disorders8–12%
Biostatistics & Epidemiology/Population Health4–6%
Social Sciences: Communication and Interpersonal Skills6–9%
CROSS-CUTTING DISCIPLINES
Disciplines are tags, not domains
Pathology45–55%
Physiology30–40%
Nutrition15–20%
Gross Anatomy & Embryology10–20%
Microbiology10–20%
Pharmacology10–20%
Behavioral Sciences10–15%
Biochemistry5–15%
Histology & Cell Biology5–15%
Immunology5–15%
Genetics5–10%
18 official domains · 161 current modules
Module counts follow the official section hierarchy and testable process groupings. All 1,681 derived objectives remain provisional until their mappings and priorities are physician-reviewed.
The catalog is broad but not yet proven complete. The official taxonomy, versioned outline-unit inventory, and generation freeze are in place. Objective mappings are algorithmic candidates—not medical approval—and physician sign-off is still absent. PulseQ will not claim complete USMLE or First Aid-equivalent coverage until every release check passes.