What is the United States Medical Examination ( USMLE ) ?

  • It is a Computer-based exam which has three-steps and is conducted in a standardized format. In order to practise medicine in the USA, international students must clear all three steps of USMLE.

USMLE Step 1

  • Purpose : to evaluate the understanding and ability of an examinee regarding the & application of important basics to practise concepts of sciences of medicine, particularly on principles and mechanisms underlying health, disease, and modes of therapy.

  • Format : Multiple-choice questions (MCQs). 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.

  • Exam duration : Step 1 is a one-day examination. It is divided into seven 60-minute blocks and administered in one 8-hour testing session.

  • Availability : There are Prometric test centres worldwide which allow international medical aspirants to take USMLE step 1 exam even in their home countries.

  • Eligibility: A student needs to fulfil any one of the below requirements at the time of applying AND during the day of examination.

i) A student should be a graduate or an enroller of US or Canadian MD degree that is accredited by The Liaison Committee on Medical Education ( LCME ), OR   

ii) A student should be a graduate or an enroller of US or Canadian DO degree that is accredited by the Commission on Osteopathic College Accreditation (COCA), OR    

iii) The medical school that is outside the US and Canada, of whom a student is a graduate or an enroller, must be listed in the world Directory of Medical Schools to meet eligibility requirements laid by ECFMG, and that meets other eligibility criteria of the ECFMG.   

Fees Centres Subjects Books Study Strategy

In India, the exam fee of the USMLE Step 1 consists of mainly two factors. Firstly, as the actual exam fee which is of $1000 and secondly, $195 fees as an additional surcharge for delivering an international test for candidates taking the test outside the United States and Canada.

Thus, the total fees charged to Indian students is $1,195 for the USMLE Step 1.

However, expenses such as study materials, preparation courses, or travel and accommodation if you need to travel to a different city for the test is not included.

The USMLE Step 1 can be taken at Prometric testing centers in several cities across India, including New Delhi, Kolkata, Chennai, Mumbai, Hyderabad, Ahmedabad, Bangalore, and Allahabad​.

Here are the primary subjects covered in USMLE Step 1:

a) Basic Sciences:

1. Anatomy: Gross Anatomy, Neuroanatomy, Embryology, Histology

2. Behavioral Sciences: Psychiatry, Psychology, Ethics, Biostatistics, Epidemiology

3. Biochemistry: Molecular Biology, Cell Biology, Metabolism, Nutrition

4. Microbiology: Bacteriology, Virology, Mycology, Parasitology, Immunology

5. Pathology: General Pathology, Systemic Pathology

6. Pharmacology: General Principles, Systemic Pharmacology, Mechanisms of Drug Action

7. Physiology: General Principles, Organ Systems Physiology

b) Interdisciplinary Topics: 1. Genetics: Mendelian Genetics, Molecular Genetics, Population Genetics 2. Nutrition: Vitamins and Minerals, Nutritional Diseases 3. Aging: Biological and Clinical Aspects 4. Immunology: Innate and Adaptive Immunity, Immune Response Mechanisms 

1) Comprehensive Review Books: 

  1. First Aid for the USMLE Step 1 by Tao Le and Vikas Bhushan

  2. Pathoma: Fundamentals of Pathology by Dr. Sattar

  3. Boards and Beyond by Dr. Jason Ryan

2) Subject-Specific Books:

  1. BRS Physiology by Linda S. Costanzo

  2. High-Yield Neuroanatomy by James D. Fix

  3. Lippincott's Illustrated Reviews: Biochemistry by Denise Ferrier

  4. Microbiology Made Ridiculously Simple by Mark Gladwin and Bill Trattler

  5. Rapid Review Pathology by Edward Goljan

3) Question Banks:

  1. UWorld

  2. USMLE-Rx

  3. Kaplan Qbank

4) Supplementary Resources:

  1. SketchyMedical

  2. Anki

  3. Picmonic

  1. Integrate Multiple Resources: A blend of comprehensive review books, question banks, and supplementary resources to cover all subjects is ideal.

  2. Create a Study Schedule: An effective study time table that has regular review and practice questions.

  3. Practice Questions: Regularly practise question banks in order to apply your knowledge and enhance your test-taking skills.

  4. Review and Revise: Regularly review high-yield information and concepts using above suggested resources.

USMLE Step 2 : CK (Clinical Knowledge)

  • Purpose : To test the medical knowledge and understanding of clinical science with reference to the patient's care, which includes health promotion and disease prevention.

  • Format : Multiple-choice questions (MCQs). 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.

  • Exam duration : Step 2 CK is a one-day examination. It is divided into eight 60-minute blocks and administered in one 9-hour testing session.

  • Availability : Also available at Prometric test centers globally, so IMGs can take it in their home countries.

  • Eligibility: A student needs to fulfil any one of the below requirements at the time of applying AND during the day of examination.

i) A student should be a graduate or an enroller of US or Canadian MD degree that is accredited by The Liaison Committee on Medical Education ( LCME ), OR    

ii) A student should be a graduate or an enroller of US or Canadian DO degree that is accredited by the Commission on Osteopathic College Accreditation (COCA), OR    

iii) The medical school that is outside the US and Canada, of whom a student is a graduate or an enroller, must be listed in the world Directory of Medical Schools to meet eligibility requirements laid by ECFMG, and that meets other eligibility criteria of the ECFMG.

Fees Subjects Books Study Strategy

In India, the exam fee of the USMLE Step 1 consists of mainly two factors. Firstly, as the actual exam fee which is of $1000 and secondly, $195 fees as an additional surcharge for delivering an international test for candidates taking the test outside the United States and Canada. Thus, the total fees charged to Indian students is $1,195 for the USMLE Step 1.

However, expenses such as study materials, preparation courses, or travel and accommodation if you need to travel to a different city for the test is not included.

1. Comprehensive Review Books:

  1. First Aid for the USMLE Step 2 CK

  2. Master the Boards USMLE Step 2 CK

  3. Step-Up to Medicine

  4. Kaplan Medical USMLE Step 2 CK Lecture Notes

  5. Blueprints Series (e.g., Blueprints Medicine, Blueprints Pediatrics)

2. Question Banks:

  1. UWorld

  2. Kaplan Qbank

  3. AMBOSS

3. Additional Resources:

  1. OnlineMedEd

  2. USMLE Rx

  3. Case Files Series (e.g., Case Files Internal Medicine, Case Files Pediatrics)

1) Comprehensive Review Books: 

  1. First Aid for the USMLE Step 1 by Tao Le and Vikas Bhushan

  2. Pathoma: Fundamentals of Pathology by Dr. Sattar

  3. Boards and Beyond by Dr. Jason Ryan

2) Subject-Specific Books:

  1. BRS Physiology by Linda S. Costanzo

  2. High-Yield Neuroanatomy by James D. Fix

  3. Lippincott's Illustrated Reviews: Biochemistry by Denise Ferrier

  4. Microbiology Made Ridiculously Simple by Mark Gladwin and Bill Trattler

  5. Rapid Review Pathology by Edward Goljan

3) Question Banks:

  1. UWorld

  2. USMLE-Rx

  3. Kaplan Qbank

4) Supplementary Resources:

  1. SketchyMedical

  2. Anki

  3. Picmonic

  1. Review Comprehensive Resources: Usage of textbooks as well as online resources that cover the above subjects in depth.

  2. Practice Questions: Consistently solve MCQs from reliable sources to get accustomed to the format and style of the questions.

  3. Clinical Guidelines: Stay updated with the latest clinical guidelines and treatment protocols.

  4. Time Management: Try to ace time management during your preparation and while taking practice exams to ensure you can complete the exam within the allotted time.

By focusing on these subjects and utilizing effective study strategies, candidates can enhance their readiness for USMLE Step 2 CK.

 

USMLE Step 3

  • Purpose : This step assesses whether the examinee can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine. It evaluates the examinee's ability to manage patient care and handle evolving situations over extended periods.

  • Format : Multiple-choice questions (MCQs) and computer-based case simulations.

  • Availability : Unlike Steps 1 and 2 CK, Step 3 must be taken in the United States. It is not offered internationally and is typically taken at Prometric test centers across various states in the USA.

  • Time : Step 3 is a two-day examination. The first day of testing includes 232 multiple-choice items divided into 6 blocks of 38-39 items; 60 minutes are allotted for completion of each block of test items. There are approximately 7 hours in the test session on the first day, including 45 minutes of break time and a 5-minute optional tutorial. Note that 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.
Eligibility Fees Subjects Books Study Strategy

i) Passing scores on Step 1 and Step 2 CK, AND

ii) An MD degree or the DO degree from an LCME- or COCA-accredited US or Canadian medical school, OR the equivalent of the MD degree from a medical school outside the US and Canada that is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements and obtain ECFMG Certification, AND

iii) Meet all other eligibility criteria as listed in the USMLE Bulletin of Information

The USMLE program recommends that, for Step 3 eligibility, applicants should have completed, or be near completion of, at least one postgraduate training year in an accredited US graduate medical education program that meets state board licensing requirements.

USMLE step 3 application Fee is $925.

The subjects covered in USMLE Step 3 include:

    Foundations of Independent Practice (FIP): Patient history and physical examination, Diagnosis and management, Diagnostic studies interpretation, Preventive medicine and health maintenance

    Advanced Clinical Medicine (ACM): Diagnosis and management of acute and chronic conditions across various specialties such as internal medicine, surgery, pediatrics, obstetrics/gynecology, psychiatry, and preventive medicine;Principles of patient safety and quality improvement

    Biostatistics and Epidemiology/Public Health (BE/EPI): Interpretation of medical literature and studies, Application of epidemiologic methods,Understanding of public health principles and their application to patient care

    Social Sciences (SS): Communication and interpersonal skills, Medical ethics and professionalism, Systems-based practice, including health care delivery and financing

Patient Safety and Quality Improvement (PSQI): Identification and reduction of medical errors,Implementation of strategies to improve patient care and safety

Comprehensive Review Books:

    First Aid for the USMLE Step 3

    Master the Boards USMLE Step 3 by Conrad Fischer 

Internal Medicine and Subspecialty Books:

    Step-Up to Medicine by Steven Agabegi and Elizabeth Agabegi

    Pocket Medicine by Marc S. Sabatine: A compact reference that can be useful for quick reviews and clinical scenarios.

CCS (Computer-based Case Simulations):

    USMLE Step 3 CCS Cases by John Barone

Biostatistics and Epidemiology:

    Clinical Biostatistics and Epidemiology Made Ridiculously Simple by Ann Weaver and Stephen Goldberg

Ethics and Professionalism:

    The Medical Ethics Manual by the World Medical Association: 

Online Resources: 

    UWorld Step 3 QBank

    MedQuest Step 3 High-Yield Videos

    Review Comprehensive Resources: Usage of textbooks as well as online resources that cover the above subjects in depth.

    Practice Questions: Consistently solve MCQs from reliable sources to get accustomed to the format and style of the questions.

    Clinical Guidelines: Stay updated with the latest clinical guidelines and treatment protocols.

    Time Management: Try to ace time management during your preparation and while taking practice exams to ensure you can complete the exam within the allotted time.

By focusing on these subjects and utilizing effective study strategies, candidates can enhance their readiness for USMLE Step 2 CK.

Additional Tips

  • Practice CCS ( Computer - based Case Simulations ): Get familiar with the software and learn to practise the cases under a timed frame.
  • Stay Updated: Check USMLE official website and forums for staying updated with exam content and format changes.
  • Plan Your Study Schedule: Intelligently divide time for each subject area. Moreover, prioritise practice questions and CCS cases.

Remember to integrate them with your clinical experience and critical thinking skills to perform well on the exam.

Benefits of USMLE

Practicing medicine in the USA after passing the USMLE (United States Medical Licensing Examination) offers numerous benefits, making it an attractive option for medical professionals. Here are several key advantages:

1. Lucrative salary:

The physicians of the USA are few among those who have the privilege to earn the highest salaries in the world because the average annual salary for doctors is around $309,775. The one who is serving as a specialist in the USA earns an even higher amount based on their field and experience.

2. State-of-art Medical Technology:

The USA is the leading country in medical technology and research. Hence, practising in the USA provides access to the latest medical equipment, cutting-edge treatments, and advanced research opportunities.

3. Professional Development:

Continuous Medical Education (CME) in the USA ensures that doctors stay updated with the latest advancements in medical science and practice,which contributes to ongoing professional development and expertise of physicians.

4. Pool of Career Opportunities:

Practising medicine in the USA means access to a wide range of career paths like clinical practice, research, academia, and administration. Physicians can work in hospitals, private clinics, research institutions, and universities.

5. Global Recognition:

Obtaining a Medical qualification from the USA is highly regarded worldwide. Practising medicine in the USA enhances a doctor’s professional reputation and opens the doors to international opportunities.

6. Better Quality of Life:

Apparently, physicians of the USA have a higher standard of living as they earn high salaries. Also, the diverse work environments and advanced healthcare infrastructure enhances the quality of life.

7. Job Security and Demand:

The demand for healthcare professionals in the USA is quite high due to the ageing population and increasing chronic diseases. This need ensures job security and numerous employment opportunities across the country.

8. Comprehensive Healthcare System:

The healthcare system of the USA is complex as well as comprehensive. As a result, it offers many specialties and subspecialties, which allows physicians to pursue specific areas of interest and expertise.

9. Patient Diversity:

The USA has a diverse patient population, which comprises distinct cultural, socioeconomic, and demographic backgrounds. Owing to this diversity the learning experience and clinical skills of physicians enhance remarkably.

10. Research and Innovation:

Because the USA is a global leader in medical research and innovation, physicians have great opportunities to be part of groundbreaking research, clinical trials, and innovative treatments. Thus, the USA offers a chance in contributing to the advancement of medical science.

These advantages make practising medicine in the USA a highly desirable goal for many medical professionals around the world.

FAQ

Yes, when applying for Step 1 or Step 2 CK, select an eligibility period as per your preference to take the exam. The allocated eligibility period will be listed on the scheduling permit. The exam takers have to book their exam from the eligibility period assigned to them. 

Unfortunately, if exam takers are unable to appear for Step 1/Step 2 CK during the allotted eligibility period, requesting for a one-time contiguous eligibility period extension is possible. 

However, if a candidate stays absent for Step 1/Step 2 CK during the original or extended eligibility period or extending the eligibility period is not possible, reapplication has to be done with a new application and fee(s), if wishing to take the exam.

Step 1 and Step 2 CK are delivered at Prometric test centres which are located across the world. Test takers can select any test center that offers a slot to book the seat for the date chosen. However, changing the test center or test region once booked for USMLE Step 1 and Step 2 CK is subject to rescheduling.

Yes, it is available for Step 1/Step 2 CK. If interested in rechecking, which is a chargeable process, the request must be done within the 90 days of the result declared.

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