The USMLE is a series of exams for aspiring physicians, divided into three steps. Passing all three steps is necessary to practice medicine independently in the US. The exams are produced by the NBME and FSMB and assess knowledge of various medical subjects and skills.
The United States Medical Licensing Examination (USMLE) is a series of tests given to people trained to become physicians. The exam is divided into three parts, or steps, taken at different points in the medical training process. You must pass steps 1-3 of the USMLE to independently practice medicine in the US and obtain a medical license. USMLE tests are produced as a joint effort of the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB).
Step 1 of the USMLE tests assess basic knowledge of anatomy, pathology, biochemistry, physiology, behavioral sciences, pharmacology, and microbiology. The questions on the test reflect knowledge acquired during the first two years of medical school, in which students traditionally learn in a classroom format. Most students take the Step 1 test in the summer between their second and third year of medical school. The test itself consists of 350 multiple-choice questions and is administered as a computer-based exam.
Like the Step 1 test, the Step 2 of the USMLE tests are usually taken during medical school. Its purpose is to assess whether a student can care for patients under the supervision of a licensed professional. This exam has two parts, Step 2 – Clinical Knowledge (CK) and Step 2 – Clinical Skills (CS). Both tests are usually taken during the fourth year of medical school.
The Step 2 CK test has a similar format to the Step 1 test in that it is computer based and consists of multiple choice questions. It tests knowledge that should have been acquired during a medical student’s third-year clinical rotations. Included are questions focusing on the areas of internal medicine, surgery, pediatrics, psychiatry, obstetrics, gynecology, family medicine, and neurology.
Unlike the Step 2 CK test, the Step 2 CS test uses patterned patients, who are actors hired to pretend to be patients with different illnesses. The purpose of the test is to assess the extent to which a student can obtain histories of patients’ illnesses, perform physical examinations, discuss treatment options with patients, and write summaries of patient encounters. It also assesses the student’s ability to speak English and interact with patients in a professional manner.
The purpose of Step 3 of the USMLE tests is to verify that the student has learned enough to practice medicine independently. Traditionally, it is performed after the first year of residency training, although some trainees postpone the test until later. The Step 3 test contains some multiple choice questions. In addition, it includes computer simulations of patient cases that require the participant to make real-time decisions about what should be done to best treat the patient. The scope of the test includes assessing whether the student knows what questions to ask patients, what lab tests to order, how to diagnose illness, and how to treat a variety of conditions.
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