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The USMLE stands for United States Medical Licensing Examination which is a three-step examination for medical licensure in the United States. The Three Steps of the USMLE.

The United States Medical Licensing Examination (USMLE) is a three-step exam that is required for medical licensure in the United States. The USMLE assesses the ability of a medical graduate to apply medical knowledge and understanding of biomedical and clinical science concepts to the practice of medicine.

Step 1 is typically taken by medical students after their second year of medical school and assesses their understanding of the basic sciences, such as anatomy, physiology, and biochemistry. Step 2 used to consist of two parts: Clinical Knowledge (CK) and Clinical Skills (CS). Step 2 CK is taken by medical students after their third year of medical school and assesses their knowledge of the clinical sciences, such as internal medicine, pediatrics, and surgery. Step 2 CS is a hands-on exam that tests the examinee's clinical skills, such as taking a patient history and performing a physical examination. Please note that the step 2 CS has been scrapped after the start of COVID-19 pandemic and no longer required.

Step 3 is taken by medical students or graduates who have completed their medical education and are seeking to obtain a license to practice medicine in the United States. It is the final step in the USMLE sequence and must be passed before a medical graduate can be licensed to practice medicine. Step 3 consists of a series of multiple-choice questions and computer-based case simulations that test the examinee's knowledge and skills in a variety of medical disciplines.

The USMLE is administered by the National Board of Medical Examiners (NBME) and is a required part of the licensure process in all 50 states and the District of Columbia. It is an important exam that is designed to ensure that medical graduates have the knowledge and skills necessary to practice medicine safely and effectively.

Step 1

USMLE Step 1 assesses whether medical school students or graduates understand and can apply important concepts of the sciences basic to the practice of medicine. It covers the following subjects: Anatomy, Physiology, Biochemistry, Genetics, Behavioral Medicine, Statistics, Microbiology (including Parasitology), Ethics, Pathology, Pharmacology, Histology, Immunology, Molecular Biology, and Epidemiology. US medical students usually take Step 1 at the end of the second year of medical school. It is an eight-hour computer-based exam consisting of 350 multiple-choice questions (MCQs) divided into seven blocks each consisting of 50 questions. Each block must be finished within an hour. The remaining hour is break time. An optional tutorial about how to use the computer program of the exam is offered at the beginning of the exam and takes 15 minutes. This time is deducted from the hour of alloted break time.

The scores are reported with a three digit score and a two digit score. A score of 182 is required to pass the exam, which corresponds to a two digit score of 75. A three digit score of 200 corresponds to a two digit score of 82. If the student passes the exam, he or she may not repeat the exam to achieve a higher score.

While not recommended by the creators of the USMLE, the Step 1 score is frequently used in medical residency applications as a measure of a candidate's likelihood to succeed in that particular residency (and on that specialty's board exams). More competitive residency programs usually accept applications with higher Step 1 scores. The Step 1 exam is arguably the hardest and most important examination a medical student will take during his/her career.

Step 2

USMLE Step 2 is designed to assess whether medical school students or graduates can apply medical knowledge, skills and understanding of clinical science essential for provision of patient care under supervision. US medical students typically take Step 2 during the fourth year of medical school. Step 2 is further divided into two separate exams.

Step 2-CK

USMLE Step 2-CK is designed to assess clinical knowledge through a traditional, multiple-choice examination. It is a 9 hour exam consisting of 8 blocks of 46 or 47 questions each.

Step 2-CS

No longer required.

Step 3

USMLE Step 3 is designed to assess whether a medical school graduate can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine. Graduates of US medical schools typically take this exam at the end of the first year of residency. Foreign medical graduates can take Step 3 before starting residency in about ten U.S. states.

Step 3 is a two-day examination. Each day of testing must be completed within eight hours. The first day of testing includes 336 multiple-choice items divided into blocks, each consisting of 48 items. Examinees must complete each block within sixty minutes.

The second day of testing includes 144 multiple-choice items, divided into blocks of 36 items. Examinees are required to complete each block within forty-five minutes. Approximately 3 hours are allowed for these multiple-choice item blocks. Also on the second day are nine Clinical Case Simulations, where the examinees are required to 'manage' patients in real-time case simulations. Examinees enter orders for medications and/or investigations into the simulation software, and the condition of the patient changes accordingly. Each case must be managed in a maximum of 25 minutes of actual time.

Approximately forty-five minutes to one hour is available for break time on each of the two days of testing.

Similar exams

• The "Comprehensive Osteopathic Medical Licensing Examination" (COMLEX-USA), is required for osteopathic physicians in the United States of America
• Professional and Linguistic Assessment Board test (similar exam used in United Kingdom)
• NCLEX-RN and NCLEX-PN (used for nurses in the United States)

External links

• USMLE official website
• ECFMG official website
• NBME official website

See also

• List of Cases