USMLE
United States Medical Licensing Examination
Three-step examination for medical licensure in the United States
Take the exam
Step 1
Step 1 assesses students’ understanding and applicability of important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy.
Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning. Step 1 is constructed according to an integrated content outline that organizes basic science material along two dimensions: system and process.
Step 1 is a one-day examination. The testing day includes 322 multiple-choice items divided into 7 blocks of 46 items; 60 minutes are allotted for completion of each block of test items. On the test day, examinees have a minimum of 45 minutes of break time and a 15- minute optional tutorial. 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.
Step 2
Step 2 assesses whether the candidate can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine.
Step 2 Clinical Knowledge (CK)
Step 2 CK is constructed according to an integrated content outline that organizes clinical science material along two dimensions: physician task and disease category.
Step 2 CK is a one-day examination. The test items are divided into blocks, and test item formats may vary within each block.
The number of items in a block will be displayed at the beginning of each block. This number will vary among blocks, but will not exceed 45 items. The total number of items on the overall examination form will not exceed 355 items. Regardless of the number of items, 60 minutes are allotted for the completion of each block.
Step 2 Clinical Skills (CS)
Step 2 of the USMLE assesses the ability of candidates to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision, and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to the principles of clinical sciences and basic patient- centered skills that provide the foundation for the safe and effective practice of medicine.
Step 2 CS uses standardized patients to test medical students and graduates on their ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues.
Step 3
Step 3 assesses whether the candidate can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. It is the final examination in the USMLE sequence leading to a license to practice medicine without supervision.
The examination material is prepared by examination committees broadly representing the medical profession. The committees comprise recognized experts in their fields, including both academic and non-academic practitioners, as well as members of state medical licensing boards. Step 3 content reflects a data-based model of generalist medical practice in the United States.
The test items and cases reflect the clinical situations that a general, as-yet undifferentiated, physician might encounter within the context of a specific setting. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care.
Step 3 is a two-day examination. You must complete each day of testing within 8 hours.
Day One
The first day of testing includes 336 multiple-choice items divided into 7 blocks of 48 items each. There will be 60 minutes of time allowed for completion of each block of test items. Items with an associated pharmaceutical ad or abstract are included in some of these multiple choice blocks. Those blocks that include these item types will contain 46–47 items per block. The timing will remain the same for all blocks.
There is a maximum of 7 hours of testing on the first day. There is also a minimum of 45 minutes of break time and a 15-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.
Day Two
The second day of testing includes 144 multiple-choice items, divided into 4 blocks of 36 items. These blocks will take 45 minutes. The total time allotted for these blocks is 3 hours. The second day also includes a Primum® Tutorial and instructions for which approximately 15 minutes are allowed. This is followed by 12 case simulations, for which 4 hours are allotted.
A minimum of 45 minutes is available for break time. There is an optional survey at the end of the second day, which can be completed if time allows. The timing and structure of the Step 3 testing days may change without notice.
Step 1 assesses students’ understanding and applicability of important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy.
Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning. Step 1 is constructed according to an integrated content outline that organizes basic science material along two dimensions: system and process.
Step 1 is a one-day examination. The testing day includes 322 multiple-choice items divided into 7 blocks of 46 items; 60 minutes are allotted for completion of each block of test items. On the test day, examinees have a minimum of 45 minutes of break time and a 15- minute optional tutorial. 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.
Step 2
Step 2 assesses whether the candidate can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine.
Step 2 Clinical Knowledge (CK)
Step 2 CK is constructed according to an integrated content outline that organizes clinical science material along two dimensions: physician task and disease category.
Step 2 CK is a one-day examination. The test items are divided into blocks, and test item formats may vary within each block.
The number of items in a block will be displayed at the beginning of each block. This number will vary among blocks, but will not exceed 45 items. The total number of items on the overall examination form will not exceed 355 items. Regardless of the number of items, 60 minutes are allotted for the completion of each block.
Step 2 Clinical Skills (CS)
Step 2 of the USMLE assesses the ability of candidates to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision, and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to the principles of clinical sciences and basic patient- centered skills that provide the foundation for the safe and effective practice of medicine.
Step 2 CS uses standardized patients to test medical students and graduates on their ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues.
Step 3
Step 3 assesses whether the candidate can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. It is the final examination in the USMLE sequence leading to a license to practice medicine without supervision.
The examination material is prepared by examination committees broadly representing the medical profession. The committees comprise recognized experts in their fields, including both academic and non-academic practitioners, as well as members of state medical licensing boards. Step 3 content reflects a data-based model of generalist medical practice in the United States.
The test items and cases reflect the clinical situations that a general, as-yet undifferentiated, physician might encounter within the context of a specific setting. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care.
Step 3 is a two-day examination. You must complete each day of testing within 8 hours.
Day One
The first day of testing includes 336 multiple-choice items divided into 7 blocks of 48 items each. There will be 60 minutes of time allowed for completion of each block of test items. Items with an associated pharmaceutical ad or abstract are included in some of these multiple choice blocks. Those blocks that include these item types will contain 46–47 items per block. The timing will remain the same for all blocks.
There is a maximum of 7 hours of testing on the first day. There is also a minimum of 45 minutes of break time and a 15-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.
Day Two
The second day of testing includes 144 multiple-choice items, divided into 4 blocks of 36 items. These blocks will take 45 minutes. The total time allotted for these blocks is 3 hours. The second day also includes a Primum® Tutorial and instructions for which approximately 15 minutes are allowed. This is followed by 12 case simulations, for which 4 hours are allotted.
A minimum of 45 minutes is available for break time. There is an optional survey at the end of the second day, which can be completed if time allows. The timing and structure of the Step 3 testing days may change without notice.