USMLE (United States Medical Licensing Examination) : Test Format

Pin It

USMLE examination consists of questions ("test items") presented in standard multiple choice formats, prepared by examination committees composed of faculty members, teachers, investigators, and clinicians with recognized prominence in their respective fields. Committee members are selected to provide broad representation from the academic, practice, and licensing communities across the United States and Canada. The test items are divided into "blocks". These items consist of a statement or question followed by three to thirteen response options arranged in alphabetical or logical order. A portion of the questions involves interpretation of graphic or pictorial materials. The response options for all questions are lettered (eg, A, B, C, D, E). Examinees are required to select the best answer to the question. Other options may be partially correct, but there is only ONE BEST answer.

USMLE Step 1

The first part, USMLE step 1, focusing on individual organ systems are subdivided according to normal and abnormal processes, principles of therapy, and psychosocial, cultural, and environmental considerations. Each examination covers content related to the traditionally defined disciplines of all the basic sciences - Anatomy, Biochemistry, Physiology, statistics, Behavioural science, Microbiology, Pharmacology, Pathology, ethics - and it is typically taken in the first half of the medical school curriculum at a time when these subjects have been covered.

USMLE step 1 is a multiple choice exam consisting of approximately 336 questions, divided into seven 60-minute blocks, administered in one eight-hour testing session.

USMLE Step 2

The second part is divided into two parts, USMLE step 2CK (clinical knowledge) and USMLE step 2CS (clinical skills). USMLE step 2 CK and CS is the examination that American medical students take before being allowed to graduate from medical school.

Step 2 Clinical Knowledge (CK)- USMLE step 2CK is a one day computer based examination covering all of the clinical sciences including medicine, surgery, Pediatrics, obstetrics and Gynecology, Psychiatry, forensics, emergency care, ENT, Ophthalmology, tropical health, ethics. It is usually taken in the final year of medical school, or beyond. USMLE step 2CK is a 9 hour testing session consisting of eight 60 minutes blocks. Step 2 CK exam has approximately 352 multiple-choice test items.

Step 2 Clinical Skills (CS) - USMLE step 2CK consists of a series of patient encounters in which the examinees must see standardized patients (SPs), take a history, do a physical examination, determine differential diagnoses, and then write a patient note based on their determinations. Each examinee faces 12 Standardized Patients (SPs) and has 15 minutes to complete history taking and clinical examination for each patient, and then 10 more minutes to write a patient note describing the findings, initial differential diagnosis list and a list of initial tests. If you do not use the entire 15 minutes for the patient encounter, the remaining time will be added to the time you have to record the patient note. The testing session is approximately eight hours.

USMLE Step 3

USMLE Step 3 tests several concepts that are often required to provide general health care to a patient. USMLE Step 3 is a mandatory exam that must be passed in order to obtain license as a practicing physician. Some International Medical Graduates are required to pass USMLE Step 3 in order to obtain an H1 Visa. This exam is only given in the United States.

USMLE Step 3 is a computerized 16 hour examination divided over two-days. Each day of testing must be completed within eight hours.
- The first day of testing consists of approximately 336 multiple choice questions divided into 7 blocks, each consisting of 48 items, with a 60 minute time period for each block.
- The second day consist of 2 parts. The first part of testing includes 144 multiple-choice items, divided into 4 blocks of 36 items. Examinees are required to complete each block within forty-five minutes. Approximately 3 hours are allowed for these multiple-choice item blocks. In the second part, there will be twelve Clinical Case Simulations, where the examinees are required to 'manage' patients in real-time case simulations. Examinees enter orders for medications and/or investigations into the simulation software, and the condition of the patient changes. Cases are of 20 or 10 minutes.

Approximately forty-five minutes to one hour break time is available on each of the two days of testing.