A Comprehensive Guide to USMLE Exam Pattern
The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) jointly sponsor the United States Medical Licensing Examination (USMLE), a three-part examination program for medical licensure in the United States that physicians with a medical degree and international medical graduates must complete to receive their medical license after successful completion of medical practice.
USMLE Exam Pattern
A specific step of the USMLE 2021 exam has a different exam pattern than another. Each USMLE step is designed to assess a particular set of skills and abilities.
- Step 1 checks a candidate’s comprehension of and ability to apply key principles from basic sciences to the practice of medicine.
- In Step 2 CS, the capacity of the candidate to collect information from patients and perform physical examinations is evaluated.
As a result, the applicant must distinguish between the USMLE test pattern 2021 and the stages they are practising. To gain an understanding of each step and the subjects covered, it is imperative to follow the USMLE 2021 exam pattern intently.
The USMLE is a three-part exam to get a license to practice medicine in the United States.
- Steps 1 and 2 are divided into two parts – Clinical Skills (CS) and Clinical Knowledge (CK), which can be completed in any order.
- Step 3 can be attempted after Steps 1 and 2 have been cleared (both components).
For USMLE Step 1, 2 CK & CS, and Step 3, different criteria are established for each step of the exam. The criteria for Step 1, Step 2 CS, Step 2 CK, and Step 3 are listed below.
Eligibility for the USMLE
First and foremost candidates should check the World Directory of Medical Schools to see if the institute they are pursuing is included. Visit the “wdoms” website and click on the “Search the World Directory” page to see if your medical school is listed. It has a drop-down box for selecting a country, and after entering the data of your city and college, you could see if the college is listed or not.
Step 1
Eligibility:
Students must be enrolled in or have graduated from a medical school listed in the World Directory of Medical Schools that is located outside of the United States and Canada. The student must meet the certification eligibility standards to receive an ECFMG Certificate. You must meet the qualifying requirements at the time of application.
Step 2
CS and Step 2 CK Eligibility: Students must be enrolled in or have graduated from a medical school listed in the World Directory of Medical Schools that are not in the United States or Canada.
- By ECFMG Certificate, the student must meet the certification eligibility conditions.
- Must meet eligibility criteria at the time of application.
Step 3
Eligibility:
- Step 1 CK, Step 2 CS and Step 2 CS must all be completed.
- The candidate must hold an MD equivalent degree from a medical school listed in the World Directory of Medical Schools in the United States or Canada.
- Have valid fifth pathway credentials.
- If the candidate does not hold the fifth pathway certificate, has to get ECFMG certification.
Syllabus for USMLE Step 1
Candidates who have enrolled in or graduated from a medical school listed in the World Directory of Medical Schools are eligible to take the USMLE Step 1 examination.
The USMLE Step 1 exam assesses their scientific understanding concerning medical practice in a variety of fields and inter-disciplines.
In the USMLE Step 1 exam, the following disciplines and inter-disciplines will be covered:
Disciplines
- Microbiology
- Pharmacology
- Biostatistics and Epidemiology
- Behavioural sciences
- Pathology
- Physiology
- Biostatistics and Epidemiology
- Anatomy
- Biochemistry
Inter-disciplines
- Nutrition
- Ageing
- Genetics
- Immunology
- Molecular and cell biology
Syllabus for USMLE Step 2
The second part of the USMLE exam focuses on patient care under physician supervision. It is a test of the candidate’s clinical scientific knowledge and skills, which are required for patient care under supervision and illness prevention. It applies basic clinical scientific ideas and patient-centered skills to provide safe and competent medical practice.
Step 2 CK (Clinical Knowledge) is a one-day examination, just like the Step 1 exam. The test lasts 9 hours and is divided into 8 blocks of 60 minutes each. The total amount of USMLE step 2 questions will be 350, with only 40 questions on each block. The USMLE Step 2 CK test will have the same format as the Step 1 CK test.
Candidates will face standardized patients who have been trained to portray genuine patients in Step 2 CS (Clinical Science). This is a test of their clinical knowledge and patient communication skills. Candidates must listen to patients, communicate with them, treat them professionally, identify their medical problems, and respond to their medical questions.
Disciplines covered in USMLE Step 2
- Immune System
- Skin & Subcutaneous Tissue
- Musculoskeletal System
- Blood & Lymphoreticular Systems
- Behavioral Health
- Cardiovascular System
- Nervous System & Special Senses
- Respiratory System
The USMLE stage 2 exam is divided into three sections:
- Communication and Interpretation Skills for Integrated Clinical Encounters
- Proficiency in spoken English
Syllabus for USMLE Step 3
Aspirants who have enrolled in or graduated from medical school take the Step 1 and Step 2 tests, while those who have finished the program take the Step 3 exam. This includes students from the United States and Canada, as well as international medical graduates who have graduated from a medical school recognized in the World Directory of Medical Schools.
Step 3 determines whether the candidate can provide unsupervised medical practice. Only applicants who pass USMLE Step 3 receive a final license to practice medicine.
The Step 3 exam takes two days to complete.
As follows, it is separated into two subcategories:
- Foundations of Independent Practice
- Advanced Clinical Medicine
Exam Pattern for the USMLE
Prometric Centers, which are organized into testing zones, will host the computer-based Step 1, Step 2 Clinical Knowledge (CK), and Step 3 assessments. Candidates will learn about the exam format, test duration, and the purpose of each step and Step Component in the USMLE 2021 exam pattern 2021. The candidate will align their preparation to exam requirements by
There will be 280 questions on the USMLE Step 1 exam. The questions will be as a multiple-choice quiz. The Step 1 exam lasts 8 hours and is administered on a single day. The eight hours are divided into seven 60-minute parts. In the Step 1 examination, each block will have 40 questions.
Exam Pattern for USMLE Step 1
| Duration | Total Questions | Number of Blocks | Number of questions in each Block. |
| 8 Hours | 280 | 7 | 40 |
Exam Pattern for USMLE Step 2
| Step 2 of the USMLE | Duration | Total Questions | Number of Blocks | Number of questions in each Block. |
| Step 2 CK of the USMLE | 9 Hours | 318 | 8 | 40 |
| Step 2 CS of the USMLE | – | 12 Patients | 15 Minutes Each | – |
Exam Pattern for Step 3 of the USMLE
Day 1 of the USMLE Step 3: Foundations of Independent Practice (FIP)
The first day of the Step 3 exam assesses a candidate’s understanding of core scientific and medical principles necessary for providing quality treatment. It’s also a test of how well you know your patient’s history and physical exam, as well as how well you diagnose and apply diagnostic tests.
Day 1’s test will last 7 hours and is divided into six blocks. Each block has 38 to 40 items in between. On Day 1, there will be only 260 USMLE Step 3 questions.
Day 2 of the USMLE Step 3: Advanced Clinical Medicine (ACP)
The Step 3 exam’s second day is devoted to assessing the application of knowledge on inpatient management and sickness manifestation. It also evaluates diagnostics and prognosis, health maintenance, screening, treatments, and medical decision-making.
Day 2’s examination will last 9 hours and is categorised into six blocks. Each block comprises 33 questions. On Day 2, there are 200 USMLE Step 3 questions.
There are also computer-based case simulations in the test.
Exam Pattern for USMLE Step 3
| USMLE Step 3 | Duration | Total Questions | Number of Blocks | Number of questions in each Block. |
| Day 1 of the USMLE Step 3 | 7 hours | 233 | 6 | 38-40 |
| Day 2 of the USMLE Step 3 | 9 hours | 180 | 6 (30 minutes each) | 33(Simulations in 13 cases) |
Scores on the United States Medical Licensing Examination (USMLE) in 2021
Except for Step 2 CS, which is decreed as pass or fail, USMLE results rest on a three-digit scale. To pass, the candidate must score the minimum cutoff mark in the corresponding step or step component.
The results of the exam are available on the NBME website. Officials will also hand out a scorecard detailing the candidate scores. The authority would notify candidates when the USMLE results are available. When the results of step 3 are available, the FSMB will notify the candidates.
The score report will only be available in electronic format. Three to four weeks after the test gets completed, the results are announced. To pass the exam, students must achieve the minimum score listed below:
The following are the minimal USMLE passing scores:
| Steps for the USMLE | Minimum Requirements |
| Step 1 | 194 |
| Step 2 | 209 |
| Step 3 | 196 |
There will be no scoring. But the pass/fail is reported as the outcome of Step 2 CS.
For the USMLE, there are no fixed linked or sanctioned courses. A general, complete USMLE Step 1 preparation of the topics covered in the exam description is the best strategy to prepare for the USMLE examination. Students can refer to and self-assess sample exam materials on the USMLE website. The NBME website also has self-assessment information and materials. Candidates who wish to get a feel for Prometric Testing Centers and the environment can sign up for a CBT (Computer-Based Test) practice session that ranges from $75 to $266 based on the region. Only the United States offers three practice tests.
USMLE Fee Structure
- The fee for each exam registration for USMLE Step 1 and Step 2 Clinical Knowledge (CK) is $940.
- For each exam enrollment, the fee for Step 2 Clinical Skills (CS) is $1,580.
- A fee of $80 will be charged for an extension of eligibility time for USMLE Step 1 and Step 2 CK.
Aspirants may take the test as many times as the authority allows. If the candidate fails, they can retake it. The number of retakes, tries, and time constraints are listed below:
Retakes
In one year, candidates may take the step or step component only three times.
Aspirants must wait at least 12 months after their first attempt and at least six months after their most recent attempt before taking their fourth and subsequent trial.
Time Limit And Number Of Attempts
- The test-taker may repeat the same step or component up to six times, including failed trials.
- Regardless of the time of examination, all attempts at a step or step component count toward the limit.
- If the aspirant passes a step or step component, they may not retake it, unless a time limit specified by a US physician licensing authority for completion of all steps is met.
Application and Scheduling for the USMLE
The USMLE Exam is categorised into three sections. Aspirants must complete a separate online application form for each phase. To apply for Step 3, candidates must pass USMLE Step 1, Step 2 CK, and Step 2 CS. Aspirants must fill out an application form and submit it to the registration entity. Candidates will be allowed to schedule the examination date after submitting their application. The registration entity for filling out the USMLE application form is listed below:
Registration of USMLE
| Step1, Step 2 CK and Step 2 CS of the USMLE | Step 1, Step 2 CK, and Step 2 CS of the USMLE | Step 3 of the USMLE |
| For LCME or AOA-accredited students/graduates medical programs in the US or Canada: | For students and alumni of medical colleges in the United States. outside the US and Canada: | All medical school graduates who passed Steps 1, 2, and 2 CK and CS: |
| Apply through the NBME’s official website. | On IWA, apply through ECFMG. | Use FSM to submit your application. |
Date of the event
- Candidates will receive an email after completing the application procedure informing them of the availability of a scheduling permit.
- Candidates must visit the Prometric official website to set up an appointment for the test.
- Aspirants must keep their scheduling permits safely to appear for the exam.
Exam Centers for the USMLE
On Prometric’s official website, candidates can find a list of exam centers. Officials have grouped Prometric testing regions such as India, the Middle East, Japan and Europe. During registration, applicants have the option of selecting an exam center. Aspirants should keep in mind that test centers are subject to change without notice. Therefore they should check the website periodically.
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