What is USMLE?

The United States Medical Licensing Examination or Usmle is a medical licensure exam that is applicable to all allopathic physicians wanting to practice medicine in the US. It is sponsored by the FSMB or Federation of State Medical Boards and the NBME or National Board of Medical Examiners.

The Exam consists of three steps to assess a candidate’s ability to apply knowledge, concepts, principles, and determine fundamental patient-centered skills that are the basis of safe and effective patient care.

Most importantly, it aims to assure both fairness and equity to all physicians through the establishment of the highest professional testing standards. This is accomplished through examination committees.

Stages of the Exam and Applicability

A basic outline of the stages of the USMLE Exam and its applicability is provided in the paragraphs that follow.

USMLE Step 1: The Exam assesses whether candidates understand and apply important concepts of basic sciences to the practice of medicine. Special emphasis is placed on principles and mechanisms underlying health, disease, and modes of therapy.

It is a one-day exam, divided into seven blocks of 60 minutes each. The duration is eight hours and it consists of approximately 280 multiple-choice questions. It is computer-based and administered at Prometric Test Centers around the world.

USMLE Step 2 Clinical Knowledge (CK) Exam: This assesses whether examinees can apply medical knowledge, skills, and understanding of clinical science considered essential for the provision of patient care under supervision. Special emphasis is placed on health promotion and disease prevention.

It is a one-day exam, divided into eight blocks of 60 minutes each. The duration is nine hours. It consists of approximately 318 multiple-choice questions and is a computer-based exam administered at Prometric Test Centers around the world.

USMLE Step 2 Knowledge Skills (CS) Exam: This uses standardized patients to test the examinees’ ability to gather information from patients, perform physical examinations and communicate their findings to patients and colleagues.

It is a one-day exam and the duration is eight hours. It includes 12 patient cases and is administered at six test centers located in the US.

USMLE Step 3: In this final step, the ability to apply medical knowledge and an understanding of biomedical and clinical science considered essential for the unsupervised practice of medicine, come under assessment. Special emphasis is placed on patient management in ambulatory settings. It is a two-day exam.

Day 1 is Foundations of Independent Practice (FIP). It specifically assesses knowledge of basic medical and scientific principles that are essential for effective health care. The duration is seven hours, divided into six blocks of 60 minutes each. It contains approximately 235 multiple-choice questions and administered at Prometric Test Centers the US.

Day 2 is Advanced Clinical Medicine (ACM). In the context of patient management and evolving manifestation of disease over time, the exam assesses the ability to apply comprehensive knowledge of health and disease. The duration is nine hours, divided into six blocks of 45 minutes each. It consists of about 180 multiple-choice questions. In addition, 13 computer-based case simulations (CCS) are administered, with each being allotted 10 or 20 minutes of real time. The whole exam is a computer-based exam and administered at Prometric Test Centers in the US.

Applicability:
The USMLE Exam is applicable in the following ways:

1. To students and graduates of medical school programs in the U.S. or Canada. These must be accredited by either the LCME leading to M.D. degree or AOA that leading to D.O. degree. These candidates register for USMLE Steps 1 and 2 with the NBME.
2. Both students and graduates from medical schools not in the U.S. or Canada but listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements. These candidates register for USMLE Steps 1 and 2 with the ECFMG.
3. To graduates of medical schools in and outside the U.S. and Canada. These candidates register for USMLE Step 3 with either FSMB or a medical licensing authority in the US

The Secret of a Successful USMLE Exam

Before starting preparation, it is important to decide the category of test taker you are. In the USMLE Exam, it has been found that these are two types:

(a) Candidates who want to only pass the examination

(b) Candidates who want “crush” the examination

This determines the appropriate study method:

1. Combination of a First Aid Book and question bank, with a couple of revisions
2. Combination of a First Aid Book and question bank, with several

The key to success is repetition. The more the repetitions, the greater the amount you are likely to remember and recall, and therefore the better you are likely to ultimately perform and score.

Regarding comprehension, the best method of improving it is through practice questions. It gives an indication of areas needing improvement by exposing the weaknesses in your knowledge. The next step is to thoroughly and continuously practice, as many of the practice questions as possible and at the same time understand their explanations.

Through the above process, you will also build your confidence, which is extremely important. An additional way is to start the practice questions as early as possible and doing them in a random manner. An earlier start ensures an opportunity to steadily improve, by correcting mistakes or weaknesses that surface as you continue to practice. Doing random practice questions prepares and conditions the mind, as on the exam day the questions will not come in any order. In addition, you will be able to handle unknown questions better.

Last but not the least, it is vital to remember that this is a national exam and part of a lifelong journey. Through high yield review books and practice questions with detailed explanations, you must expose yourself to as much of the material as possible. This material has then got to be practiced multiple times. This is the method and always ensures for you a high confidence and knowledge level and the best outcome.