USMLE | Key points about the United States Medical Licensing Examination

What is USMLE?

The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. USMLE is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME).

For doctors / students from India, who wish to practice medicine in the US, you will need to do all the USMLE tests (within a total of 7 years from the date when you took the USMLE Step 1).

USMLE is THREE step test-series that is required for anyone who wants to practice medicine in the United States. The first TWO steps are typically taken while a student is still in medical school. The third step is take after graduation.


Questions about USMLE Step 1 Exam

What is the USMLE Step 1 test format?
  • USMLE Step 1 is a computer based test
  • USMLE Step 1 is taken in a single day over an 8 hour period (divided in to seven 60 minute blocks of no more than 40 questions in each block)
    • Since one hour is allotted for each of the seven sections, it translates to an average of 1.18 minutes per question
    • The total number of items on the overall examination form will not exceed 280
    • USMLE Step 1 test takers are allowed a total of 45 minutes for personal breaks. You can also add any additional time saved out of the allotted hour for each section. If you choose to skip the optional 15 minute tutorial period that is offered at the beginning of the test, you can add the same to your personal break time too
  • USMLE Step 1 emphasizes basic science principles, specifically anatomy, behavioral science, biochemistry, microbiology, pathology, pharmacology, and physiology. Interdisciplinary areas such as genetics, immunology, and nutrition are also tested
  • Some questions test your understanding of basic facts and definitions. But the majority deal with your ability to solve problems using basic scientific principles. For example, you’ll be asked to interpret graphs, identify gross and microscopic pathology and normal specimens, and apply concepts and principles relevant to individual organ systems
  • During the test, you are only allowed to bring soft foam earplugs into the examination room. Nothing else is allowed – no bags, electronics, phones, or even jackets are allowed. Be sure to check with the exam monitor prior to entering the test room for complete details
When should I take the USMLE Step 1 test?

Students typically take USMLE Sep 1 test after the basic science years ie. after the first two years of medical school

What are the USMLE Step 1 test dates?

The test is administered by appointment on a year-round basis

What is the passing mark in the USMLE Step 1 test?

The current minimum passing score in USMLE Step 1 test 1 is 192

Can I reappear for the USMLE Step 1 test if I believe my score is not as expected?

No. You cannot retake the USMLE Step 1 test if you have managed to secure the minimum passing mark of 192

When do I get the USMLE Step 1 test result?

Scores of USMLE Step 1 test are available in about 3 to 4 weeks from the test date. Scores are released each Wednesday.

Even though USMLE Step 1 test is a computer-based test, several quality assurance steps need to be taken to ensure the security and accuracy of the test and the score

Can I take the USMLE Step 1 test if I did not pass the exam?

Yes. You can take the USMLE Step 1 exam a maximum of three times within a 12 month period. Your fourth attempt must be at least 12 months after your first attempt, and at least six months after your most recent attempt

What is the USMLE Step 1 fees for Indian students?

USMLE Step 1 test costs $895 for foreign medical graduates. International Test Delivery Surcharge is an additional of $150 for India testing region

How long should be the preparation time for USMLE Step 1 test?

Students can factor in about 6 to 9 months of preparation for USMLE Step 1 test. Ideally, students begin preparation at the end of year of 1 of studying medicine (MBBS)

Questions about USMLE Step 2 – Clinical Knowledge (CK)

USMLE Step 2 is divided in to TWO separate exams:

  • USMLE Step 2 CK (Clinical Knowledge)
  • USMLE Step 2 CS (Clinical Skills)

About USMLE Step 2 CK (Clinical Knowledge):


What is the USMLE Step 2 test format?
  • USMLE Step 2 CK test is a multiple-choice exam
  • USMLE Step 2 CK test includes two multiple-choice formats: Single Best Answer and Single Answer Matching. The exam may also contain patient-centered vignettes with a series of associated questions. Topics are presented randomly. Test item formats may vary within each block. It is constructed according to an integrated content outline that organizes clinical science material along two dimensions: physician task and disease category
  • USMLE Step 2 CK test includes approximately 355 questions over a 9 hour period of testing
  • USMLE Step 2 CK test is broken down into eight 1 hour blocks of about 45 questions each
  • USMLE Step 2 CK test is designed to determine whether the examinee possesses the medical knowledge and understanding of clinical science considered essential for the provision of patient care under supervision
How long should be the preparation time for USMLE Step 2 CK test?

Students can factor in about 4 to 6 months of preparation for USMLE Step 2 CK test. Ideally, students begin preparation at the end of year of 1 of studying medicine (MBBS)

When should I take the USMLE Step 2 CK test?

Students typically take USMLE Step 2 CK test during the clinical years ie the third and fourth years of medical school

About USMLE Step 2 CS (Clinical Skills)


What is tested in USMLE Step 2 CS?
Clinical skills applied to “ standardized patient” scenarios (that is, actors presenting symptoms or problems a typical doctor may encounter)
When is USMLE Step 2 CS taken?
Typically taken in the fourth year of medical school
How long is the Step 2 CS exam?
One day, 8 hours
What are the length and format?
12 patient cases, with 15 minutes for the patient encounter and 10 minutes to record notes for each case

Step 3

What is tested?: Ability to apply clinical science to patients in an unsupervised patient care setting

When is it taken?: Typically following medical school graduation during residency training

How long is the exam?: Two days:

Day 1 – Foundations in Independent Practice (FIP)
Concepts tested: Scientific principles required for effective medical care

Duration of Day 1: One day, 7 hours
How many questions are there?: 260 multiple-choice questions

Day 2 – Advanced Clinical Medicine (ACM)
Concepts tested: Applying medical knowledge to patient management and evolving disease processes

Duration of Day 2: One day, 9 hours
How many questions are there?: 200 multiple-choice questions, 13 computer-based clinical simulations

Format of exam: Computer-based​

​Min. Score: 190


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