Anyone who wishes to practice medicine in the United States must pass the United States Medical Licensure Exam. Through a four-step exam process, the USMLE aims to determine whether a student passes a minimum standard for patient care. Each of the four steps is a separate exam and taken at different points of your medical career.

Step 1

The USMLE Step 1 focuses on assessing a student’s understanding of basic health sciences. Step 1 evaluates whether a student can apply concepts of science to the practice of medicine with an emphasis on principles and mechanisms underlying health, disease, and modes of therapy. The Step 1 exam is a one-day exam which consists of 280 multiple choice questions, broken into 7 hour-long segments of 40 questions each. The entire exam is administered in an eight-hour long testing session. Step 1 is normally taken at the end of the second year of medical school for U.S. medical students. International medical graduates (IMGs) who wish to practice in the United States must take it before they apply for the Residency Match. Kaplan, a USMLE test prep organization, recommends spending at least 6 to 8 months reviewing for Step 1 of the USMLE.

Step 2

The USMLE Step 2 is split into two components: clinical knowledge (CK) and clinical science (CS). Step 2 CK tests whether a student can apply medical knowledge under physician supervision. Step 2 CK asks questions regarding patient-centered scenarios organized by physician task and disease category. The Step 2 CK exam is a one-day exam. The entire exam is 318 questions. These questions are split into 8 one-hour blocks of 40 questions each. Kaplan recommends spending 4 to 6 months preparing for Step 2 CK of the USMLE.

Step 2 CS of the USMLE requires students to travel to one of five testing centers located around the United States. During the exam, students will be tested on their encounters with twelve standardized patients. Step 2 CS assesses a students’ ability to perform physical examinations, gather patient information, and communicate findings to both patients and colleagues. It is especially important for IMGs to demonstrate fluent English and good bedside manner throughout the exam. The exam is pass/fail. Kaplan recommends spending 6 weeks preparing for Step 2 CS of the USMLE.

Step 3

The USMLE Step 3 is the final exam in the licensing process. While many U.S. medical students take Step 3 after acceptance into a residency program, IMGs may benefit from taking Step 3 before residency. Step 3 examines a student’s ability to evaluate a patient’s medical history and physical exam information, order diagnostic tests, manage the patient, and select initial treatment. The exam is computerized and takes place over two days. There are 413 multiple-choice questions and computer-based case simulations. After passing this exam, students receive a license to practice medicine without supervision.

While the licensure process is extensive, it ensures a high standard of care within the United States. Through test prep programs such as Kaplan, you can gain some preparation for the USMLE. Completing clinical experiences, whether through AMOpportunities or your medical school, not only improves your chances of success on the USMLE, but also enriches your application to residency programs down the line.    

Experience in the American health care system can help you prepare for the USMLE. Apply for your own rotation with AMOpportunities to get the experience you need.