USMLE EXAM

What is USMLE exam?

USMLE test or USMLE exam refers to the United States Medical Licensing Exam. It is a screening exam for medical students who want to obtain a medical license in the USA. It is sponsored by 2 regulatory bodies in the USA, the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). It is a 3-step examination. It evaluates a physician’s ability to apply knowledge, principles and concepts to demonstrate fundamental patient-centred skills.


Three steps in USMLE Exam

USMLE includes a 3-step examination. Which are

  1. Step 1 exam
  2. Step 2 CK (Clinical Knowledge)
  3. Step 3

Step 1 and Step 2 examinations should appear while the student is in medical school. Step 3 is taken after he or she has graduated.


USMLE STEP -1

Step 1 evaluates whether a candidate understands and can apply important concepts of the sciences basic to the practice of medicine. Especially with emphasis on principles and mechanisms underlying health, disease, and modes of therapy.

  • International students who want to apply for the USMLE Step 1 exam, should be enrolled or have completed their MBBS from a medical school. The school must be in the list of World Directory of Medical Schools.
  • Step 1 is a one-day examination. It is divided into seven 60-minute blocks and conducted in one 8-hour testing session.
  • The number of questions per block on a given examination form may vary, but will not cross 40. The total number of items on the overall examination form will not be more than 280.
  • USMLE Step 1 Syllabus contains mostly the subjects you have learnt in the first two years of your medical school.

USMLE Step 2 CK (Clinical Knowledge)

Step 2 CK (Clinical Knowledge) evaluates student’s ability to apply medical knowledge, skills, and understanding of clinical science important for the provision of patient care but under supervision. This includes emphasis on health promotion and disease prevention.

  • Step 2 CK (Clinical Knowledge) is a one-day examination. It is split into eight 60-minute blocks and conducted in one 9-hour testing session.
  • The number of questions per block on a given examination will vary but will not be more than 40. The total number of items on the overall examination will not cross 318.

USMLE Step-3

USMLE Step 3 evaluates the knowledge and skills of an examinee who is assuming independent responsibility for providing general medical care to patients. This emphasis on patient management in ambulatory settings. Applicants should clear USMLE Steps 1, 2 CS, and 2 CK for completing Step 3. It is the final examination in the USMLE sequence resulting in a license to practice medicine without any supervision.


  • The test items reflect the clinical situations. These are general, as-yet undifferentiated, physicians might come across within the context of a specific setting.
  • Step 3 is a two-day examination. On the first day of the USMLE STEP-3 is referred to as Foundations of Independent Practice (FIP), and on the second-day USMLE STEP-3 is referred to as Advanced Clinical Medicine (ACM).
  • The first day of testing consists of 232 multiple-choice items. It is divided into 6 blocks of 38-39 items. 60 minutes is given for the completion of each block of test items. There are around 7 hours in the test session on the first day, including 45 minutes of break time and a 5-minute optional tutorial.
  • There are around 9 hours in the test session on the second day. It includes a 5-minute optional tutorial followed by 180 multiple-choice items. This is divided into 6 blocks of 30 items. 45 minutes is given for the completion of each block of test items. It includes a 7-minute CCS tutorial. This is followed by 13 case simulations, each of which is given a maximum of 10 or 20 minutes of real-time. A minimum of 45 minutes is given for break time. There is an optional survey at the end of the second day, if time allows.

USMLE Registration

As we have already mentioned, the USMLE covers three steps. Separate application forms exist for every step. They have to apply to respective entities for registration. After applying, they have to schedule examination dates. Here is a guide for you:

USMLE Steps 1, 2 CK USMLE Steps 1, 2 CK USMLE Step 3
For graduates or students of AOA or LCME accredited medical courses in United States of America or Canada. For graduates or students of medical schools outside United States of America and Canada. All graduates of medical school who have successfully cleared Step 1 and step 2 CK
Should apply at the official NBME website. Should apply to IWA through ECFMG. Should apply through FSM.

Important information about USMLE

  • Retakes - USMLE applicants can take a USMLE Steps or part of a Step more than 3 times within a year.
  • Time Limits - The 4th attempt should be at least 12 months after your first attempt of the exam. It should also be at least 6 months after the last examination attempt.
  • Number of Attempts- Applicants can sit for the same exam Step or part of the Step more than 6 times, including incomplete test attempts.

USMLE Score/ results:

Results are declared online by the USMLE, and officials release scorecards with candidates’ marks. Authorities also intimate all candidates about result availability. FSMB officials issue notifications when Step 3 results are updated. Electronic formats generate score reports, with results declared 3-4 weeks post exam completion.