What Is The USMLE

Published on 19/02/2021 in
What is the USMLE

USMLE is an abbreviation of United States Medical Licensing Examination. It is a three-step exam that every doctor-to-be needs to take before getting a medical license in the US. The exam assesses your ability to apply your fundamental medical skills and knowledge, to ensure that you are fit to become a doctor and be entrusted with someone’s life. 

You will need to pass each step one by one. Step 1 verifies your basic medical knowledge. After Step 1, you will be able to sit an exam in Step 2 - Clinical Knowledge. Once you pass these tests and your clinical knowledge is verified, you can take the Step 2 Clinical Skills exam. To complete Step 2 Clinical Skills exam, you will need to travel to the US and pass the test in one of the designated CSEC Testing Centres. 

It is similar to the UKMLA exam in the UK, but with some differences.

Also, if you intend to take USMLE outside the US, then make sure that your medical university is listed on the World Directory of Medical Schools. At Medlink students, all of the medical schools we work with are listed there.

Step 1

Step 1 aims to ensure that you understand the basic scientific principles and can apply them. Besides ensuring that you can safely and competently practice medicine, the test also assesses your life-long learning potential, which is necessary for any doctor.

All this might sound complicated, but remember, the test is meant for 2nd-year students. It basically assesses your understanding of anatomy, biochemistry, behavioural sciences, microbiology, immunology, pathology, pharmacology and physiology. Additional topics such as nutrition, genetics and ageing are also covered. 

All questions are multiple-choice. And the passing score is 194 points out of 300 points.

The examination fee for Step 1 is $975 (roughly £703 or €810). If you are taking the test outside of the US, then you have to pay an additional international fee of $185 (roughly £150 or €153).

Step 2

All participants must pass Step 1 before continuing to Step 2.

Step 2 takes two days and is divided into two parts - Clinical Knowledge and Clinical Skills. Both tests mainly evaluate your knowledge in general medicine and particularly in diseases. You can move on to the “Clinical Skills” part of the exam only after you pass the “Clinical Knowledge” exam.

The Clinical Knowledge part is like the test from Step 1. The entire test is divided into eight 1-hour blocks and the passing score is 209 out of 300 points. In total, the test takes 9 hours including 45 minutes that you have for breaks.

The examination fee for Step 2 Clinical Knowledge is $975 (roughly €810). If you are taking the test outside of the US, then you have to pay an additional international fee of $210 (roughly £170 or €174).

After you pass this part, you can move on to part 2 where your Clinical Skills are going to be tested. Here, you are judged based on your communication skills with your patient, your analytical skills to understand the problem, and lastly how you are going to fix the problem, which tests your general medical knowledge. This part of the exam has no score, you can only pass or fail.

The examination fee for Step 2 Clinical Skills is $1535 (roughly £1,246 or €1272). If you are taking the test outside of the US, then you have to pay an additional international fee of $210 (roughly £170 or €174).

Important detail: The Clinical Skills part must be taken in the US! If you are studying in the UK or abroad, you will have to travel to one of the designated CSEC Testing Centres. These are in Georgia, Illinois, California, Texas and Pennsylvania – so be prepared for the flight cost!

Step 3

USMLE Step 3 just like Step 2 is a two-day exam. It is the final exam that will determine whether you are ready to practice medicine in an unsupervised setting.

During the first day of the exam, you will sit an exam which consists of six 60-minute blocks. In total, the exam on day 1 will last for 7 hours including a 45-minute break. The purpose of this test will be to assess your diagnosis and patient-treatment skills.

The examination fee for Step 3 Clinical Knowledge is $830 (roughly £674 or €687).

The minimum passing score is 198 out of 300.

On day 2 you will be presented with 198 questions, segmented into six 45-minute block tests, and 13 computer-based simulations, each lasting approximately 15 minutes. In total, the test is going to last 9 hours. On day 2 your interpersonal skills, your ability to make an accurate diagnosis and decision making are all going to be tested. 

When is the best time to take USMLE?

  1. If you are an international graduate, you can do USMLE whenever you want. Step 1 is administered all year long except holidays (Refer to the United States Medical Licensing Examination). You can reschedule it one time by paying a fee depending on certain criteria.
  1. As a medical student in a US medical school, you can do USMLE only after your second year as per the mandate.


This depends if you study outside of the US and Canada, or not. 

If you don’t, then you should apply through NBME on NLES (NBME Licensing Examination Services).

However, if you study abroad you should use ECFMG on IWA (Interactive Web Applications).

To know more, you can check out the official USMLE website here.

When should you start preparing for USMLE?

If you are an American or Canadian student, then we recommend you start studying in January of your second year. This way you will start refreshing your knowledge and it will be fresh in your mind before you take the test. You will have approximately 3 months for studying, which should be enough for you to get high scores.

But if you are an international student, then we recommend you to do everything after your graduation.

If you want to learn how to study effectively, check out our article. It will help you motivate yourself and organise your studying routines so that your studying would be as efficient as possible.

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Article written by Medlink Students
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