USMLE
Overview
The USMLE (United States Medical Licensing Examination) is a three-step exam series (Step 1, Step 2 CK, Step 3) that assesses a physician’s ability to apply medical knowledge, concepts, and patient-centered skills for U.S. licensure, covering basic sciences (Step 1), clinical knowledge (Step 2 CK), and independent patient management (Step 3) at different stages of medical training. It ensures doctors possess the foundational and practical skills needed for safe and effective patient care, moving from foundational science to independent practice.
USMLE Step 1
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.
The examination also includes a minimum allotment of 45 minutes of break time and a 15-minute optional tutorial. The amount of time available for breaks may be increased by finishing a block of test items or the optional tutorial before the allotted time expires.
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.
USMLE Step 1: Foundations of Medicine.
- Focus: Basic sciences (anatomy, physiology, biochemistry, pharmacology, pathology, microbiology, behavioral sciences, etc.).
- Timing: Taken after pre-clinical years.
Format: Computer-based, multiple-choice questions (MCQs). - Scoring: Pass/Fail.
USMLE Step 2 CK
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.
USMLE Step 2 CK (Clinical Knowledge): Clinical Science Application
- Focus: Clinical knowledge and skills for patient care, including health promotion and disease prevention.
- Timing: Generally taken after completing clinical rotations.
Format: Computer-based, multiple-choice questions (MCQs). - Scoring: Scored on a 3-digit scale.
USMLE Step 3
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.
USMLE Step 3: Independent Practice
- Focus: Patient management, clinical decision-making, and unsupervised practice in ambulatory settings.
- Timing: Typically taken during the first year of residency.
Format: A two-day exam with MCQs and Clinical Case Simulations (CCS). - Scoring: Scored on a 3-digit scale.
Purpose of the USMLE
- To license physicians in the U.S..
- To ensure competence across the continuum of medical education and practice.
- To facilitate entry into U.S. residency programs and, ultimately, independent practice.
USMLE Exam Eligibility
USMLE eligibility requires being a student or graduate of an accredited US/Canadian medical school (LCME/COCA) or an international medical school listed in the World Directory of Medical Schools (WDOMS) and meeting ECFMG certification requirements, especially for international graduates, which often involves passing Steps 1 and 2 CK before taking Step 3. Key criteria include enrollment/graduation status, medical school accreditation, ECFMG certification (for IMGs), and passing all prior steps for Step 3.
USMLE Exam Eligibility
USMLE eligibility requires being a student or graduate of an accredited US/Canadian medical school (LCME/COCA) or an international medical school listed in the World Directory of Medical Schools (WDOMS) and meeting ECFMG certification requirements, especially for international graduates, which often involves passing Steps 1 and 2 CK before taking Step 3. Key criteria include enrollment/graduation status, medical school accreditation, ECFMG certification (for IMGs), and passing all prior steps for Step 3.
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