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Ultimate Guide To USMLE (United States Medical Licensing Examination)

What is USMLE?

 

USMLE stands for the United States Medical Licensing Examination. USMLE is a three-step examination for medical licensure in the United States. USMLE is conducted by the Federation of State Medical Boards of the United States (FSMB) and the National Board of Medical Examiners (NBME).

 

USMLE is governed by a committee that is formed of members from FSMB, NBME, and ECFMG (Educational Commission for Foreign Medical Graduates).

 

The content of the USMLE is developed by the members of USMLE test committees which include medical professionals from various medical fields including medical educators, biomedical scientists, and clinicians from every region of the United States (US). USMLE Examination Committee is responsible for the creation of USMLE Examination materials.

 

To get the license to practice medicine in the US, MD degree holders needs to qualify USMLE. In USMLE Program’s own terms, “USMLE assesses an examinee's ability to apply knowledge, concepts, and principles and to demonstrate fundamental patient-centered skills.” To put it even simpler, USMLE is the gateway for medical licensure in the US.

 

USMLE Steps

 

USMLE is composed of a total of three steps: USMLE Step 1, USMLE Step 2 [Consisting of two parts: Clinical Skills (CS) and Clinical Knowledge (CK)], and USMLE Step 3. A detailed overview of each USMLE Step is tabulated as under:

 

Particulars

USMLE Step-1

USMLE Step-2

USMLE  Step-3

Clinical Knowledge

Clinical Skills

Test-Type

Computer-based

Computer-based

Held at test centers in the US (Atlanta, Chicago, Houston, Los Angeles, and Philadelphia)

Computer-based

Duration (including break time)

8 hours

9 hours

8 hours

- 8 hours on the first day

- 9 hours on the second day

Format

280 MCQs divided into 7 sixty minute blocks each with 40 MCQs. For each question, a student has 90 seconds.

About 316 MCQs divided into 8 sixty minute blocks. For each question, a student has ~91 seconds.

Student’s encounter with 12 patient cases and record findings on each patient. 15 minutes allocated for each patient encounter & 10 minutes to note each patient information & findings.

Day 1:

About 233 MCQs divided into 6 sixty minute blocks.

 

Day 2:

- About 180 MCQs divided into 6 forty five minute blocks.

- 13 computer-based case simulations (CCS). 10-20 minutes allowed for each simulation.

Purpose

Test student’s understanding of basic sciences & its application to the practice of medicine.

Test student’s understanding of clinical science and its application.

Test the ability to examine patients, gather information, and communicate the findings.

Test student’s knowledge & understanding of biomedical & clinical sciences and its application in practice of medicine & patient management in an ambulance.

 

 

USMLE Eligibility

 

Eligibility for USMLE Step 1 and USMLE Step 2

 

A student is eligible to apply for USMLE Step 1 as well as USMLE Step 2 if s/he meets any one of the following requirements:

 

A.

Student is officially enrolled in, or a graduate of, a US or Canadian medical school leading to the MD (Doctor of Medicine) degree.

 

Such US or Canadian medical school should be accredited by the Liaison Committee on Medical Education (LCME) which is an accrediting body for MD programs in the US & Canada and recognized by US Department of Education. [LCME Accredited US or Canadian medical schools]

OR

B.

Student is officially enrolled in, or a graduate of, a US medical school leading to the DO (Doctor of Osteopathic Medicine) degree.

 

Such US medical school should be accredited by American Osteopathic Association (AOA) Commission on Osteopathic College Accreditation (COCA) which is an accrediting body for osteopathic schools, colleges & universities in the US and recognized by US Department of Education. [AOA Accredited US medical schools]

OR

C.

Student is officially enrolled in, or a graduate of, a medical school outside the US and Canada listed in the World Directory of Medical Schools (WDOMS) which meets ECFMG eligibility requirements & criteria. [WDOMS listed medical schools outside US & Canada & meeting ECFMG criteria]

 

Note: LAU students are eligible for USMLE Step 1 as well as USMLE Step 2

 

Lincoln American University, School of Medicine (LAU) is listed in the World Directory of Medical Schools (WDOMS) and also fulfills the eligibility requirements & criteria of ECFMG. Therefore, LAU students are eligible for USMLE Step 1 as well as USMLE Step 2.

 

Eligibility for USMLE Step 3

 

A student is eligible to apply for USMLE Step 3 if s/he meets all of the following requirements:

 

- Student holds MD (or its equivalent; like MBBS) degree from LCME Accredited US or Canadian medical school OR;

- Student holds DO degree from AOA Accredited US medical school OR;

- Student holds MD (or its equivalent; like MBBS) degree from WDOMS listed medical school outside the US & Canada & possess ECFMG Certification.

 

AND

Student has passed USMLE Step 1 and USMLE Step 2 [Clinical Skills (CS) as well as Clinical Knowledge (CK)]

 

 

Note: LAU medical graduates are eligible for USMLE Step 3

 

Lincoln American University, School of Medicine (LAU) meets all the requirements established by ECFMG and is listed in the World Directory of Medical Schools (WDOMS). Further, while students pursue their medical education at the University, LAU provides its students with USMLE coaching & guidance from USMLE qualified professionals to help them clear USMLE Step 1 and USMLE Step 2 during the LAU MD Program itself. By the time LAU students complete their medical graduation, they can have the first 2 steps of USMLE already qualified. Then, after completing their MD Program, LAU students can apply for ECFMG certification and then apply for USMLE Step 3.

 

Time Limit for Completing USMLE

 

USMLE Bulletin of Information (USMLE BoI) doesn’t specify any limit regarding time frame within which a student shall complete USMLE. However, it does mention that “Many state medical boards require that all Steps of the USMLE be successfully completed within a certain time frame, usually seven years.

 

Therefore, 7 years can be considered as the standard time limit to complete the USMLE. It implies that a student shall complete all the USMLE Steps within a period of 7 years.

 

USMLE Retake & Number of Attempts Limit

 

Within a period of 12 months, a student can give maximum 3 attempts for the same USMLE exam. To take the 4th attempt, a student must wait for a period of 12 months after the first attempt and a period of 6 months after the third attempt. It means that in the first 12-month period, there can’t be more than 3 takes (including retakes) and to try for the 4th & subsequent time, students are required to wait for 6 months from the date of their last attempt.

 

Further, USMLE BoI states that “An examinee may not take the same Step or Step Component more than six times, including incomplete attempts.” So, the maximum number of total attempts allowed to qualify each USMLE Step is 6. It means that students need to qualify each USMLE step in maximum 6 attempts.

 

Note on State Specific Requirements on USMLE Retake & Number of Attempts Limit

 

The maximum number of total attempts allowed to qualify USMLE Steps also varies depending on the US State in which a student wants to practice. Different states impose different limits on the number of attempts allowed to qualify USMLE.

 

State Specific Requirements (SSR) regarding USMLE time & attempts limit can be found on the website of Federation of State Medical Boards.

 

USMLE Application - USMLE Exam Fees | How to Apply for USMLE

 

If a student is eligible to apply for USMLE, s/he can apply online for USMLE Steps depending on his/her medical school as under:

 

Student’s Medical School Category

USMLE Steps

USMLE Exam Fees 

USMLE Application – How To Apply

How To Schedule Test Date

Advance Scheduling

LCME Accredited US or Canadian medical school OR AOA Accredited US medical school

USMLE Step 1

$630

Apply on NBME Application Website

Schedule on Prometric Website

Student can schedule test date up to 6 months in advance.

USMLE Step 2 (Clinical Knowledge)

$630

USMLE Step 2 (Clinical Skills)

$1290

Schedule on  USMLE Website

Post application, student is allotted a 12-month eligibility period. USMLE BoI advice students to schedule test date at least 6 months in advance.

USMLE Step 3

$875

Apply on FSMB Website

Schedule on  Prometric Website

Student can schedule test date up to 6 months in advance.

WDOMS listed medical schools outside US & Canada & meeting ECFMG criteria

USMLE Step 1

$940

Apply on ECFMG Application Website

Schedule on  Prometric Website

Student can schedule test date up to 6 months in advance

USMLE Step 2 (Clinical Knowledge)

$940

USMLE Step 2 (Clinical Skills)

$1580

Schedule on  USMLE Website

Post application, student is allotted a 12-month eligibility period. USMLE BoI advice students to schedule test date at least 6 months in advance.

USMLE Step 3

$875

Apply on FSMB Website

Schedule on  Prometric Website

Student can schedule test date up to 6 months in advance.

 

 

Prepare for USMLE

 

USMLE program has not sanctioned any test preparation courses for the USMLE preparation. However, USMLE Practice Materials & Self-Assessment Services are available on the website of USMLE & NBME respectively. Apart from the education & knowledge imparted at medical schools, experience gained in clinical rotations while pursuing medical programs, USMLE aspirants can complement their USMLE preparation with the help of USMLE Practice Materials & availing Self-Assessments Facility for each USMLE Step available on the USMLE & NBME website.

 

Further, LAU students get help from the University to better prepare themselves for the USMLE examinations. LAU’s MD Program is strictly based on the medical curriculum of the US and also covers the USMLE syllabus. Further, LAU’s USMLE coaching and counseling from USMLE qualified faculties also help LAU students in better USMLE preparation.

 

USMLE Results: USMLE Minimum Passing Scores, USMLE Score Reporting Schedule

 

USMLE program provides separate results (in terms of “pass” or “fail”) for each USMLE step. Scores are also reported for Step 1, Step 2 (CK) & Step 3. No scores are reported for Step 2 (Clinical Skills). Current Minimum Passing Scores required to qualify USMLE are:

 

USMLE Steps

Minimum Passing Scores

USMLE Step 1

194

USMLE Step 2

Clinical Knowledge (CK)

209

Clinical Skills (CS)

Scores not reported for Step 2: Step 2 results are declared only as Pass/ Fail outcome

USMLE Step 3

196

 

The recommended minimum passing score of USMLE is reviewed periodically (approximately once in every 4 years) and is subject to change. As per the latest USMLE BoI, students must answer 60-70% of MCQs correctly to achieve a passing score. In the case of USMLE Step 3, student’s performance in computer-based case simulations (CCS) is also considered in the determination of the scores.

 

Once the USMLE score is out, students get an email notification from the organization with which they registered for USMLE Steps. USMLE score report remains available online for 120 days from the date of USMLE results.

 

USMLE Step1, USMLE Step 2 (Clinical Knowledge) & USMLE Step 3 are computer-based exams and their results are posted online on the website of NBME, ECFMG, and FSMB. Usually, USMLE score report for Step1, Step 2 (Clinical Knowledge) and Step 3 are available within 3-4 weeks after the test date. However, USMLE BoI suggests that students should wait for up to 8 weeks for the results. USMLE students can check the result on NBME or ECFMG or FSMB website depending on the category of their medical school & with which organization they applied for the USMLE Steps.

 

For results of USMLE Step-2 (Clinical Skills), there is a reporting period of 4-5 weeks after the test. Results for the majority of the students (about 98-99% of students) are reported by the third Wednesday of the reporting period. For other 1-2% of students, results are declared by the end of the reporting period.

 

USMLE Results Recheck

 

If for any reason, a student is not satisfied with his/ her USMLE score, he/ she can apply for USMLE score recheck within 90 days from the declaration of USMLE results. Till date, score recheck of any student has not resulted in a score change or change in the pass/ fail status.

 

Should you need to know more about USMLE? Do contact us.  For admission inquiries regarding LAU MD Program in Guyana & Study MBBS in Caribbean, contact LAU Intake Team.

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