What Is the USMLE? Gain Key Insights and Tips
Explore our overview of the USMLE tests, exam formats and the significance of these critical stages in the medical education journey.
The USMLE stands for the United States Medical Licensing Examination. It is an examination divided into three steps that every individual needs to pass if they wish to practice medicine in the United States. The USMLE is sponsored by the National Board of Medical Examiners and the Federation of State Medical Boards.
All three steps of the USMLE series of exams complement each other and are designed to assess the skills and abilities of future physicians. It means that one step alone cannot truly determine the readiness of a doctor to gain their medical license.
Generally, the first two steps are taken by students during medical school, while the third step is taken after graduation, during residency.
This is the case at Saba University School of Medicine (SUSOM), where successful MD program students take the USMLE Step 1 after the Basic Sciences program (semesters 1-5), and the USMLE Step 2 CK after their Clinical Medicine rotations (semesters 6-10).
Who Takes the USMLE Exam?
Any physician who wants to earn a license to practice medicine in the U.S. needs to take the USMLE exam.
At SUSOM, the USMLE Step 1 and 2 CK are an essential part of the MD program, and all participants must take and pass the exams in order to progress and ultimately earn their degree. Even those who do not wish to immediately practice in the U.S. must complete these stages.
Given their importance, USMLE preparation is an essential part of both our academic curriculum and the student services we offer. Explore the Student Support Services at SUSOM in order to learn how we can help you succeed!
What Is the USMLE Exam Format?
Discover what each stage of the USMLE looks like and requires of participants.
USMLE Step 1: Overview and Format
The Step 1 exam tests the basic knowledge of a candidate in the medical sciences. Step 1 is an eight-hour exam, divided into seven blocks constituting 60 minutes each. USMLE Step 1 has around 280 questions in total, not exceeding 40 questions per block. Most of the material covered in Step 1 evaluates the understanding of the student in subjects they have studied in the first and second year of their MD program.
USMLE Step 2: Clinical Knowledge
Step 2 CK, which stands for clinical knowledge, has a similar structure to Step 1. It is a one-day exam administered in eight blocks, each for 60 minutes. It aims to test the diagnostic ability and knowledge of diseases/conditions that would be imperative for the treatment of real patients. The Step 2 CK covers patient care and the clinical sciences, which is largely learned during in-person Clinical Medicine rotations (year three and four of medical school). Step 2 is taken when you are ready for the examination, near the end of the 10-semester MD program.
USMLE Step 3: Final Step Details
USMLE Step 3 is the final step in the USMLE exam series. The main purpose is to test whether a candidate’s skills and maturity levels are advanced enough for them to practice medicine without supervision. This part of the test can only be taken in the U.S. and is taken over two test days. Participants generally take Step 3 during the residency portion of their medical education.
What Is the Eligibility Criteria of the USMLE Exam?
To be eligible for each USMLE stage, you must be in one of the following categories when applying and on the day of the examination. Here is the eligibility criteria:
- A medical student enrolled in, or graduate of, a U.S. or Canadian medical school that grants a medical degree that is accredited by the LCME, or
- A student officially enrolled in, or graduate of, a U.S. medical school that grants a DO degree that is accredited by the Commission on Osteopathic College Accreditation, or
- A medical student enrolled in, or graduate of, a medical school that is outside the U.S. and Canada but that is listed in the World Directory of Medical Schools and meets the ECFMG eligibility requirements.
How Many Times Can You Take the USMLE?
An individual is allowed a maximum of four attempts per step. Examinees who have failed to pass an USMLE step after four attempts are ineligible to apply for the exam.
How to Register for the USMLE Exam
Registering for the USMLE exam starts with confirming your USMLE eligibility. If you are a medical student or graduate from a U.S. or Canadian medical school, you register through the National Board of Medical Examiners (NBME). International medical students and graduates must register via the Educational Commission for Foreign Medical Graduates (ECFMG).
To register for USMLE, first create an account on the appropriate platform (NBME or ECFMG). Once your eligibility is verified, you can apply for the desired exam step and submit required documentation. After approval, you will receive a scheduling permit.
Next, schedule your exam date through the Prometric website, choosing a test centre and time that suits your availability. Keep in mind that early registration is recommended. Fees must be paid during registration and differ depending on the exam step and candidate location.
For detailed guidance on how to register for the USMLE steps, official policies and up-to-date requirements, visit the official USMLE website.
Importantly, the SUSOM faculty and staff team will support you throughout the USMLE preparation and registration processes. They can also answer questions and provide additional guidance as-needed.
Conclusion
If you are looking for a medical school that will prepare you to succeed on all three USMLE step exams, and go on to practice in the U.S. and Canada, then consider Saba University School of Medicine!
Founded in 1992 on the island of Saba, SUSOM has delivered rigorous medical education and training for 3,500+ graduates. Our MD program features two years of classroom and lab-based learning on our Basic Sciences campus, followed by two years of clinical rotations at affiliated teaching hospitals, clinics and medical centers in the U.S., and select elective rotation sites in Canada. Alumni then go on to achieve residency placements, hold medical licenses and practice across North America!
To learn more about our student outcomes, support services, island home and more, check out this video testimonial from a practicing alum:
Then start your very own journey by contacting us or learning how to apply!
FAQs About the USMLE
Preparation time for the USMLE exam varies by individual and the specific step. On average, students spend about 3 to 6 months preparing for USMLE Step 1, which is considered one of the most challenging medical exams. Factors such as prior knowledge, study habits and available resources affect how long you need to study. Planning a consistent schedule and allowing time for practice exams can improve readiness.
After successfully completing all three USMLE steps, the next step is to apply for medical licensure in the state or jurisdiction where you plan to practice. Passing the U.S. Medical Licensing Examination is required for residency placement (Steps 1 and 2) and obtaining a full medical license after residency (Step 3).
Effective preparation for the USMLE exams includes a combination of review books, question banks and practice tests. Popular resources include the USMLE official practice materials, UWorld question bank, First Aid for the USMLE Step 1 and Kaplan review courses. Additionally, our school’s Student Support Services and faculty team provide support and guidance throughout your preparation.
The USMLE and MCAT serve different purposes, so comparing difficulty depends on individual strengths. The MCAT tests foundational science knowledge before medical school, while the USMLE exam assesses clinical knowledge and readiness for medical practice. Many students find USMLE Step 1 harder due to its clinical focus and high-stakes nature, but both require dedicated study and a strong understanding of the material in question.