USMLE Examination

EXAMINATION

United States Medical Licensing Examination (USMLE)

The United States Medical Licensing Examination (USMLE) is a three-step examination designed to assess a physician’s ability to apply knowledge, concepts, and principles necessary for the effective practice of medicine in the United States. Recognized worldwide, it serves as a gateway for international medical graduates (IMGs) to begin their clinical career in the U.S. The exam ensures that all practicing physicians meet a consistent standard of excellence, patient care, and clinical decision-making.

Exam Format

Step 1 – Basic Sciences

Duration: 8 hours
Total Questions: 280 multiple-choice questions
Format: Divided into 7 blocks, each lasting 60 minutes
Focus Areas:
- Anatomy, Physiology, Biochemistry
- Microbiology, Pathology, Pharmacology
- Behavioral Sciences, Genetics, Nutrition
- Medical Ethics and Patient Safety

Step 2 CK (Clinical Knowledge) – Clinical Sciences

Duration: 9 hours
Total Questions: Approximately 318 multiple-choice questions
Format: Divided into 8 blocks, each lasting 60 minutes
Focus Areas:
- Internal Medicine, Surgery, Pediatrics
- Obstetrics & Gynecology, Psychiatry
- Public Health, Preventive Medicine
- Medical Law & Ethics, Epidemiology

Step 3 – Patient Management

Day 1: Foundations of Independent Practice (FIP)

Duration: 7 hours
Total Questions: 232 multiple-choice questions
Format: 6 blocks of 38-40 questions (60 minutes each)
Focus: Medical knowledge, biostatistics, and patient care principles

Day 2: Advanced Clinical Medicine (ACM)

Duration: 9 hours
Total:
- 180 multiple-choice questions (6 blocks)
- 13 Computer-based Case Simulations (CCS) (10-20 minutes each)
Focus: Clinical decision-making, diagnostics, and treatment strategies in real-life scenarios

Eligibility Criteria

Indian students must be enrolled in or graduated from a medical school listed in the World Directory of Medical Schools and approved by ECFMG. Step 1 requires two years of preclinical study; Step 2 CK follows clinical rotations. Step 3 needs ECFMG certification after clearing Steps 1 and 2 CK.

Documents Required

To apply, students need a valid passport, recent photograph, and Form 186 for verification—either notarized online or through college. Graduates may require official transcripts or diplomas. Additional supporting documents related to school credentials might be requested based on the application. All documents must be submitted via the ECFMG portal accurately.

Syllabus

Step 1 Topics

Anatomy, Physiology, Biochemistry

Pathology, Pharmacology, Microbiology

Behavioral Sciences, Genetics

Medical Ethics and Professionalism

Step 2 CK Topics

Internal Medicine, Surgery, Pediatrics

Obstetrics and Gynecology, Psychiatry

Epidemiology, Biostatistics

Preventive Medicine and Public Health

Step 3 Topics

Patient Management, Diagnosis, Clinical Interventions

Health Maintenance, Disease Prevention

CCS (Clinical Case Simulations)

Application Process

Visit the ECFMG website.
Use the Interactive Web Applications (IWA) portal.
Complete the application for ECFMG Certification.
Upload required identity documents (passport, photograph, etc.).

Must be officially enrolled or a graduate from an ECFMG-recognized medical school.
School details must be listed in the World Directory of Medical Schools.

Choose which exam to register for (Step 1, Step 2 CK, Step 3).
Pay the applicable exam fees during the application process.
Select your 3-month eligibility period (example: Jan–Mar).

Required only once—used to verify your student/graduate status.
Must be signed and submitted electronically via NotaryCam or your medical school.

Once your application is approved, you’ll receive a Scheduling Permit via email.

Visit the Prometric website to choose your test center and date.
Book your slot as early as possible to get your preferred location and time.

Result Declaration

USMLE results are typically released within 3 to 4 weeks after the test date.
Candidates receive an email notification once results are posted on their USMLE/ECFMG account.
The score report includes your 3-digit score, pass/fail status, and performance feedback.

Result Review

If you are unsatisfied with your results, a score recheck request can be submitted (within the permitted time).
Note: Score changes are extremely rare.
Performance breakdown helps you identify strengths and areas needing improvement.

After the Exam – What’s Next?

After passing Step 1 and Step 2 CK, international students must apply for ECFMG certification.
You are then eligible to apply for U.S. residency programs via ERAS.
Matching is done through the National Resident Matching Program (NRMP).
Step 3 is usually taken during or after the first year of residency.

Abroad Medical Registration

International Medical Graduates (IMGs) must obtain ECFMG certification, which includes passing Step 1 and Step 2 CK and completing credential verification.
This certification is mandatory to apply for residency and clinical training in the U.S.
After residency and Step 3, you become eligible for a full license to practice medicine independently.

Fees (Approximate)

Step 1

$1000 USD

Step 2 CK

$1,000

Step 3

$925

ECFMG Certification

$160

Form 186 (Notary/School Verification)

Varies

Prometric Rescheduling Fee

$0–$604 (depends on how early you reschedule)

FAQs

Yes. IMGs from WDOMS-recognized institutions can apply after meeting eligibility requirements.

You can take each step up to 4 times, but no more than once in a 12-month period.

Yes, although now pass/fail, many residency programs still consider Step 2 CK scores and medical school performance crucial.

You must complete a residency program before applying for full medical licensure in the U.S.

Free Counselling

Get started with your MBBS Journey

MBBS Mithram provides personalized counseling to help you choose the right university, understand eligibility, fees, and scholarships, and navigate the admission and visa process smoothly. With expert insights and end-to-end support, we make your MBBS journey hassle-free.