How to Register
To apply for USMLE examinations, you must submit an application through the appropriate organization. Appointments at some test centers fill up quickly. Examinees are encouraged to schedule at their preferred test center as soon as they have received their scheduling permit.
Where is the Test Administered?
The Step 1, Step 2 Clinical Knowledge (CK), and Step 3 examinations are computer-based tests that are administered at Prometric Centers. Step 3 is administered only in the US and its territories. Visit the Prometric website to find the test center closest to you. The Step 2 Clinical Skills (CS) examination is administered at six testing centers across the US. More information about CS centers can be found on the Clinical Skills Evaluation Collaboration (CSEC) website.
The USMLE: Purpose, Test Format, and Test Lengths
Probability of IMG Matching to preferred speciality
STEP & PURPOSE | FORMAT | LENGTH (including breaks) | ADDITIONAL INFORMATION |
| STEP 1 assesses the examinee’s understanding of and ability to apply important concepts of the basic sciences to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy | * Approximately 280 multiple-choice questions, divided into seven 60-minute blocks * Computer-based examinations are administered at Prometric Test Centers around the world | * One-day test session – Approximately eight hours | For more information on Step 1, including applications, practice materials, and updates, visit the USMLE website. |
| STEP 2 assesses the examinee’s ability to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision, with an emphasis on health promotion and disease prevention. The clinical skills examination is a separate component of STEP 2 and uses standardized patients to test examinees on their ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues. | Clinical Knowledge (CK) * Approximately 318 multiple-choice questions, divided into eight 60-minute blocks * Computer-based examinations are administered at Prometric Test Centers around the world Clinical Skills (CS) * 12 patient cases: 15 minutes for each patient encounter plus 10 minutes to record each patient note (PN) * Administered at six test centers in the US – Atlanta, Chicago, Houston, Los Angeles, and Philadelphia(2) * Composed of three subcomponents: Communication and Interpersonal Skills (CIS), Integrated Clinical Encounter (ICE), and Spoken English Proficiency (SEP). For more information, see pages 11 and 12 of the Step 2 CS Content Description and General Information Booklet | * One-day test session – Approximately nine hours * One-day test session – Approximately eight hours | For more information on Step 2CK, including applications, practice materials, and updates, visit the USMLE website. For more information on Step 2 CS, including applications, practice materials, and updates, visit the USMLE website. |
| STEP 3 assesses the examinee’s ability to 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. Day 1: FOUNDATIONS OF INDEPENDENT PRACTICE (FIP) assesses the examinee’s knowledge of basic medical and scientific principles essential for effective health care. Day 2: ADVANCED CLINICAL MEDICINE (ACM) assesses the examinee’s ability to apply comprehensive knowledge of health and disease in the context of patient management and the evolving manifestation of disease over time. | Day 1 FIP: * : Approximately 232 multiple- choice test questions, divided into six 60-minute blocks * Computer based, administered at Prometric test centers in the US. Day 2 ACM: * Approximately 180 multiple-choice test questions, divided into six 45-minute blocks * Thirteen computer-based case simulations (CCS). Each simulation is allotted a maximum of 10 or 20 minutes of real time * Computer based, administered at Prometric test centers in the US. | * One-day test session – Approximately seven hours * One-day test session – Approximately nine hours | For more information on Step 3, including applications, practice materials, and updates, visit the USMLE website. |
What are the requirements of USMLE?
- For Step 1, 2 CK and 2 CS:
- Officially enrolled in, or a graduate of, a US or Canadian medical school leading to the MD degree (LCME accredited), OR
- Officially enrolled in, or a graduate of, a US medical school leading to the DO degree(AOA accredited), OR
- Officially enrolled in, or a graduate of, a medical school outside the US and Canada listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements; and meet other ECFMG criteria
- Must meet eligibility requirements at time of application AND on test day
- If you are dismissed or withdraw(n) from medical school, you are not eligible for the USMLE, even if you are appealing the school’s decision or are otherwise contesting your status
Step 3 requirements
- Possess the MD degree (or its equivalent) or the DO degree from an LCME- or AOA-accredited US or Canadian medical school or from a medical school outside the US and Canada listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements, AND
- Pass Step 1, Step 2 CK, and Step 2 CS, AND
- Possess ECFMG Certification if you are a graduate of a medical school outside the US and Canada
- Must meet eligibility requirements prior to submitting your application AND on the day of testing
How many retakes allowed in USMLE?
You may take the same examination no more than three times within a 12-month period. Your fourth and subsequent attempts must be at least 12 months after your first attempt at that examination and at least six months after your most recent attempt at that examination. If you have passed an examination, you are not permitted to retake a Step or Step Component, except to comply with certain requirements as approved by the USMLE governance committee
2018 USMLE Scores
How many attempts allowed to take USMLE?
You are ineligible to retake a Step or Step Component if you have made six or more prior attempts to pass that Step or Step Component, including incomplete attempts, regardless of when the examinations were taken. Many state medical boards require that all Steps of the USMLE be successfully completed within a certain time frame. Information regarding specific state requirements can be obtained on the FSMB website.
USMLE Checklist
To make the application and testing process as easy as possible, here’s a list of key things to do and remember:
Registering and Preparing for Your Examination
- Review the USMLE Bulletin of Information.
- Ensure that you are eligible to register to take USMLE.
- Log in to the registration website of the appropriate organization (dependent on your medical school and the Step for which you are applying).
- Ensure that the name you enter on your application matches your government-issued, unexpired photo identification exactly.
- Choose an eligibility period (only for Steps 1, 2 CK, and 3; for Step 2 CS your eligibility period will be assigned to you).
- Indicate on your application if you plan to apply for accommodations under the Americans with Disabilities Act (ADA).
- Submit your application and other required forms.
- After your application is processed, you’ll receive your Scheduling Permit and schedule your test date. If it turns out you are unable to test during your eligibility period, contact the organization that registered you to request an eligibility period extension (fees and restrictions may apply).
- Prepare for the USMLE by using the free practice materials that are available on the USMLE website. For Steps 1, 2 CK, and 3 you can take a practice test at a Prometric test center or purchase an NBME Self-Assessment.
- Contact Prometric (for Steps 1, 2 CK, and 3) or CSEC (for Step 2 CS) if you need to reschedule your test date.
Test day
- Before you go to the testing center, make yourself aware of the Rules of Conduct and learn what behaviors violate the rules. This also includes understanding what items you may and may not access during your exam.
- Report to the test center at least 30 minutes prior to your scheduled testing appointment (for Step 2 CS, arrive at the time given on your confirmation notice). Bring a paper or electronic copy of your scheduling permit to the test center.
- Bring an acceptable form of government-issued, unexpired photo identification.
- Expect to undergo security measures when entering the test center and throughout the test day.
- Report any issue or suspicious behavior you encounter on test day.
- Consider rescheduling your examination if you do not feel well or otherwise feel unprepared to test.
How Long Does it Take to Get USMLE Results?
Results for computer-based examinations (Steps 1, 2 CK, and 3) are typically available within three to four weeks after your test date. However, delays are possible for various reasons. In selecting your test date and inquiring about results, you should allow at least eight weeks to receive notification that your score report is available. For more specific information about potential scoring delays, please visit the Announcements section of the USMLE website.
After testing, the examination data are delivered electronically to the NBME
Examinee responses are converted into a raw score (the sum of the points earned from correct responses)
The raw score is converted into a three-digit score
Analyses are performed to detect aberrant examinee response behavior. Candidates who are identified by these analyses as having an aberrant score pattern may be asked to provide an explanation for their testing behaviors
Final quality assurance procedures are performed to verify the accuracy of the scores
Score reports are then posted to the secure website of the organization that registered you for your examination (NBME, ECFMG, or FSMB) and made available to examinees
What to do on USMLE test day?
- Review the USMLE Rules of Conduct prior to taking your examination
- Follow all test center staff instructions on the day of your examination
- Remember to bring a copy of your scheduling permit (electronic or paper) and required identification (see below); you will not be permitted to test without them
- Arrive 30 minutes prior to your testing appointment (computer‐based examinations); for Step 2 CS, arrive at the time listed on your confirmation notice
- Confirm that your headphones are working, either before the examination begins or during the tutorial (computer‐based examinations)
- Use personal items only when on an authorized break; you are not permitted to access your locker during unauthorized breaks (computer‐ based examinations)
- Ensure you’ve completed all sections of the examination
Non-US IMG USMLE Scores