USMLE
The United States Medical Licensing Examination (USMLE) program supports medical licensing authorities in the United States through its leadership in the development, delivery, and continual improvement of high-quality assessments across the continuum of physicians’ preparation for practice.
It has 3 components
- Step 1
- Step 2
- Step 3
Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. It ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning. Step 1 is constructed according to an integrated content outline that organizes basic science material along two dimensions: system and process.
Step 1 is a one-day examination. It is divided into seven 60-minute blocks and administered in one 8-hour testing session. The number of questions per block on a given examination form may vary, but will not exceed 40. The total number of items on the overall examination form will not exceed 280.
Step 2 CK assesses an examinee’s ability to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. Step 2 CK ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine under supervision.
Step 2 CK is a one-day examination. It is divided into eight 60-minute blocks and administered in one 9-hour testing session. The number of questions per block on a given examination will vary but will not exceed 40. The total number of items on the overall examination will not exceed 318.
Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. It is the final examination in the USMLE sequence leading to a license to practice medicine without supervision.
The examination material is prepared by examination committees broadly representing the medical profession. The committees comprise recognized experts in their fields, including both academic and non-academic practitioners, as well as members of state medical licensing boards. Step 3 content reflects a data-based model of generalist medical practice in the United States. The test items and cases reflect the clinical situations that a general, as-yet undifferentiated, physician might encounter within the context of a specific setting.
Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care.
For more information
https://www.usmle.org/prepare-your-exam/step-1-materials/step-1-content-outline-and-specifications
Step and purpose | Format | Length |
STEP 1 Evaluates applicant’s understanding of and ability to apply important concepts of the basic sciences to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy | Around 280 MCQs, divided into seven 60-minute blocks Computer-based test administered at Prometric test centers across the world | Single day test Approximately eight hours |
STEP 2 Tests examinee’s ability to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision, with an emphasis on health promotion and disease Prevention | Clinical Knowledge (CK) Around 318 MCQs, divided into eight 60-minute blocks Computer-based test administered at Prometric test centers. | One-day test Session -Approximately nine hours |
The Clinical Skills examination is a separate and the second component of STEP 2. It tests the examinee’s ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues by using standardized patients. | Clinical Skills (CS) 12 patient cases: 15 minutes for each patient encounter plus 10 minutes to record each patient Administered at six test centers in the US: Atlanta, Chicago, Houston, Los Angeles, and Philadelphia (2) Has three subcomponents: Communication and Interpersonal Skills (CIS), Integrated Clinical Encounter (ICE), and Spoken English Proficiency (SEP). | One-day test Session -Approximately eight hours |
STEP 3 Assesses the ability of the examinee to apply medical knowledge and understanding of biomedical and clinical science essential to carry out unsupervised practice of medicine, while emphasising on patient management in ambulatory settings. Day 1: FOUNDATIONS OF INDEPENDENT PRACTICE (FIP) assesses the examinee’s knowledge of basic medical and scientific principles essential for effective health care Day 2: ADVANCED CLINICAL MEDICINE (ACM) assesses the examinee’s ability to apply comprehensive knowledge of health and disease in the context of patient management and the evolving manifestation of disease over time | Day 1 FIP: Approximately 232 MCQs, divided into six 60-minute blocks. Computer based test administered at Prometric test centers in the US Day 2 ACM: Approximately 180 MCQs, divided into six 45-minute blocks Thirteen computer-based case simulations (CCS). Each simulation is allotted a maximum of 10 or 20 minutes of real time Computer based test, administered at Prometric test centers in the US |
USMLE is a three-step test, with each step having its own eligibility criteria. So, if you are appearing in USMLE Step 1 2021 , you need to meet the eligibility criteria of USMLE 2021 as elucidated in the table below.
Who can take USMLE Step 1 2021?
Step | Eligibility Criteria |
Step 1 | The candidate must be enrolled in, or a graduate of, a medical school that is located outside the US or Canada and is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements; In addition, the candidate must also meet any other ECFMG criteria as may be mandated. Other details:
|
USMLE Step 1 Registration Entity 2021
Student category | How to apply |
For students / graduates of LCME-or AOA-accredited medical programs in the US or Canada: | Apply through NBME on NLES (NBME Licensing Examination Services) |
For students / graduates of medical schools located OUTSIDE the US and Canada: | Apply through ECFMG on IWA (Interactive Web Applications) |
Questions that are asked in USMLE Step 1 can be grouped into 18 core areas. These areas cover basic concepts and principles of the organ-systems or within individual organ-systems. The Step 1 of the USMLE covers topics related to traditionally defined disciplines as described in the table below:
Disciplines covered in USMLE Step 1
Anatomy | Pathology |
Behavioral Sciences | Pharmacology |
Biochemistry | Physiology |
Biostatistics and Epidemiology | Microbiology |
USMLE Step 1 Syllabus
System | Range |
General Principles of Foundational Science | 15% – 20% |
1. Immune System 2. Blood & Lymphoreticular System 3. Behavioral Health 4. Nervous System & Special Senses 5. Skin & Subcutaneous Tissue 6. Musculoskeletal System 7. Cardiovascular System 8. Respiratory System 9. Gastrointestinal System 10. Renal & Urinary System 11. Pregnancy, Childbirth, & the Puerperium 12. Female Reproductive & Breast 13. Male Reproductive 14. Endocrine System | 60% – 70% |
1. Multisystem Processes & Disorders 2. Biostatistics & Epidemiology 3. Population Health 4. Social Sciences | 15%– 20% |
Process | Range |
Normal Processes | 10% – 15% |
Abnormal Processes | 55% – 60% |
Principles of Therapeutics | 15% – 20% |
Other | 10% – 15% |
NBME will declare the result of USMLE 2021 Step 1 and also issue score cards. Once Step 1, reports are available, ECFMG will send an e-mail notification to international medical students/graduates notifying them about availability of the result.
USMLE Step 1 2021 Score Reporting
- Examination data is sent electronically to NBME
- The points accumulated after scoring correct responses is converted into a raw score
- The raw score is then converted to a 3-digit score
- Candidates behavior is examined, with those with aberrant behavior asked to give an explanation
- Final quality assurance done to ensure accuracy
- The score report is shared with organisations like NBME, ECFMG, or FSMB, with whom you registered for the exam, who send the report to you.
USMLE 2020 cut-off scores for Step 1, 2 CK and 3
Step | Cutoff score |
Step 1 | 194 |
Step 2 CK | 209 |
Step 3 | 196 |
Note: USMLE 2021 result for Step 2 CS is reported simply as pass or fail.