Before you can apply for a medical license to work in the United States as a medical doctor, you must pass a three-step test called the United States Medical Licensing Examination (USMLE), also known as the board exam.
This test assesses your mastery of medical knowledge and your ability to apply it in a clinical setting.
Overview of USMLE
This test is divided into three steps.
Step 1
This is a one-day test.
It emphasizes knowledge of basic sciences including anatomy, biochemistry, behavioural sciences, microbiology, pathology, immunology, pharmacology, and physiology.
Topics such as genetics, nutrition, and ageing are also covered.
All questions are multiple-choice.
Step 2
This is a two-day test.
It has two components.
The first, clinical knowledge or CK, requires you to answer multiple-choice questions on clinical sciences like internal medicine, surgery, paediatrics and obstetrics and gynaecology.
The second, clinical skills or CS, requires you to examine and diagnose actors posing as patients.
For CS, you must travel to any of the testing centres as directed during registration.
Step 3
This is a two-day test.
It is the final assessment of whether or not you are prepared to practice general medicine in an unsupervised setting in the US.
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.
USMLE Scores
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 pen an effective report.
On all the 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.
You must earn a 75 on the two-digit scale to pass.
While your medical school education may give you many of the skills and much of the knowledge necessary to pass the USMLE, you are still likely to log a substantial amount of time reviewing and preparing for each stage of the test.
