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

The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care. Each of the three Steps of the USMLE complements the others; no Step can stand alone in the assessment of readiness for medical licensure.

Examinations for ECFMG Certification

The USMLE is a three-step examination for medical licensure in the United States. The USMLE provides a common system to evaluate applicants for medical licensure. The USMLE is sponsored by the Federation of State Medical Boards of the United States, Inc. (FSMB) and the National Board of Medical Examiners (NBME). The USMLE is governed by a committee consisting of representatives of FSMB, NBME, ECFMG, and the American public.

Before you can apply for a medical license, you must pass a three-step test called the United States Medical Licensing Examination (USMLE), also known as the board exam.

This test is unusual for two reasons. First, you take each part at a different stage of your medical education. Second, unlike many standardized tests, the USMLE actually assesses your mastery of the material, not how well you take a test. While there are some test–taking strategies that will improve your performance, you won’t pass without comprehensive and detailed knowledge of the sciences, as well as an ability to apply that knowledge in a clinical setting.
The USMLE is divided into three steps:

• Step 1 is a one–day test, usually taken at the end of the second year of med school. It emphasizes knowledge of basic sciences, including anatomy, biochemistry, behavioral sciences, microbiology, immunology, pathology, pharmacology and physiology. Topics such as nutrition, genetics and aging are also covered. All questions are multiple–choice.

• Step 2 is a two–day test, usually taken in the fourth year of med school. It has two components. The first (called Clinical Knowledge, or CK), requires you to answer multiple–choice questions on clinical sciences like surgery, internal medicine, pediatrics and obstetrics and gynecology. The second (called Clinical Skills or CS) requires you to examine and diagnose actors posing as patients. For the Step 2 CS, students must travel to one of five testing centers around the country.
• Step 3 is a two-day test, usually taken after the first year of residency. This is the final assessment of whether or not you’re prepared to practice general medicine in an unsupervised setting. Like Step 2, Step 3 focuses on the diagnosis and treatment of patients. It includes both multiple choice questions and computer simulations of patient care.
The Step 2 CS has no numerical score. You earn a “pass” or a “fail” based on your ability to gather data, communicate with the patient and write an effective report. On all other parts of the test, the number of correct answers you earn is converted into two numerical scores, one on a three–digit scale and the other on a two–digit scale. These are simply two ways of reporting the same result to schools. You must earn a 75 on the two–digit scale to pass.
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. Step 1 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.
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