Expert Guidance for USMLE
Want to practice Medicine in the US? Find out how to take the USMLE and what each stage of the exam involves.
What is the USMLE?
The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. The USMLE assesses a physician's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care.
If you are applying to take the USMLE outside of the US, your Medical School must be listed on the World Directory of Medical Schools.
How Do I apply for USMLE?
For American or Canadian students, applications are done through the National Board of Medical Examiners (NBME).
For UK and other international students, applications to take the USMLE are done by registering with the Educational Commission for Foreign Medical Graduates (ECFMG).
In order to take Steps 1 and 2, students must be enrolled in or be a graduate of an LCME accredited medical degree (for US or Canadian students) or an WDMS listed international medical degree (for foreign students).
To take Step 3, students must have passed Steps 1 & 2 and have attained their accredited medical degree as outlined above. It is worth noting that you do not need to have taken Step 3 in order to start your residency and many students choose to take the test later.
In summary, Steps 1 & 2 are taken during Medical School whereas Step 3 is taken after you have completed Medical School.
Need Help With Application?
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Frequently Asked Questions
What is USMLE Step 1?
USMLE Step 1 is an eight-hour multiple choice examination divided into seven 60-minute blocks, each containing up to 40 questions. The exam includes a minimum amount of 45 minutes of break time and an optional 15 minute tutorial. Break time can be increased by finishing blocks early.
Step 1 primarily assesses pre-med subjects such as anatomy, biochemistry, behavioural sciences, immunology and pharmacology. Questions are usually formatted with a stem describing a patients illness or scenario and a following multiple choice question.
What is USMLE Step 2?
USMLE Step 2 used to comprise of two tests – Clinical Skills (CS) and Clinical Knowledge (CK). However, due to Covid, the CS component was cancelled and has since been permanently cancelled. Therefore, when you take Step 2, it will only consist of the Clinical Knowledge component.
USMLE Step 2 CK is similar to Step 1 in that it is a one day multiple choice exam. However, it is nine hours long and divided into eight blocks, with the same 45 minute break time and 15 minute optional tutorial. Questions here are focused on topics such as pharmacotherapy, diagnostics and clinical interventions in addition to disease categories such as the cardiovascular or musculoskeletal systems.
What is USMLE Step 3?
USMLE Step 3 is a two-day examination. Day one, Foundations of Independent Practice, is a seven-hour multiple choice test similar to Steps 1 & 2. It is divided into six 60-minute blocks with 45 minutes of break time. Day two, Advanced Clinical Medicine, tests your knowledge of patient management and how diseases evolve over time. The format of this exam is slightly different. The first part comprises of 180 multiple choice questions divided into six blocks, each lasting 45 minutes. This is followed by 13 Computer Case Simulations (CCS), each lasting 10-20 minutes. Day two takes nine hours in total and aims to assess your knowledge of diagnosis, care management and medical decision making.
How Is The USMLE Scored?
Scores for each step of the USMLE are on a three digit scale from 1 to 300. As of 2022, Step 1 is reported as pass or fail only. The current minimum passing scores for Step 2 and Step 3 are 214 and 198 respectively. Total marks are calculated based on correct answers only, and there is no negative marking – so make sure you give an answer for every question even if it is just a guess! Generally, scores between 230-245 are considered good, scores between 245-255 as very good and scores over 255 as excellent. Higher scores for Steps 1 & 2 will make you a more competitive candidate for residency applications.