USMLE or The United States Medical Licensing Examination, as the phrase shows, is an eminent medical examination and is specifically designed for the prospective doctors who wish to practice medicine in the United States. USMLE is thought to be a difficult and a serious exam which requires extensive and thorough medical knowledge on the part of the candidates. The pattern of the exam is entirely different in comparison to that of many other entry tests. The test consists of three stages called ‘three steps’. The medical graduates are required to pass all the three steps before applying for medical practitioner license in the United States of America. For U.S. osteopathic medical school graduates, there is a substitute exam if they do not appear in USMLE. As an alternative they can pass Comprehensive Osteopathic Medical Licensing Examination (COMLEX) to obtain license for medical practice. But USMLE is a compulsory exam for the international medical graduates and they are bound to pass USMLE as the only gateway to enter into medical practice in America.


Step 1 of USMLE comprises fundamental science subjects such as Anatomy, Behavioral sciences, Biochemistry, Microbiology, Pathology, Pharmacology, Physiology, and Interdisciplinary topics, such as nutrition, genetics, and aging. The Step 1 assesses the candidates whether they know and apply elementary concepts of science that are thought to be integral part of medical practice. There are seven sub-sections in Step 1 USMLE, each containing 50 questions. Thus there are 350 questions in total, which the candidates have to solve in eight-hour time. All the questions are in multiple-choice format. USMLE Step 2 is specifically concerned with patient care and thus the examination of clinical science. USMLE Step 2 is further sub-divided into Step 2-CK and Step 2-CS. Step 2-CK assesses the candidates in subjects of clinical science such as Surgery, Pediatrics, Psychiatry, Internal Medicine and Obstetrics & Gynecology. The questions in Step 2-CK are all multiple-choice questions to be solved in 9-hour time. Step 2-CS was included in USMLE in 2004. This portion of the exam evaluates the candidate’s ability to examine a patient, history of disease and finally suggesting some initial tests for the patient. There is time limit for each segment and the candidates have to complete patient’s examination within the specified time.


The third step of USMLE consists of a lengthy exam held consecutively two days. On each day, the candidates have to solve an eight-hour long multiple-choice paper. The first day exam contains 336 questions while the second day exam includes 144 queries.


The exam is conducted and administered by the US prestigious medical authorities namely the National Board of Medical Examiners and the Federation of State Medical Boards. According to survey reports, the percentage of the successful candidates in USMLE is quite encouraging. 93% of the U.S. allopathic medical school graduates called M.D. pass step 1 of USMLE in their first attempt. While the success rate for U.S. osteopathic medical school graduates is 76% and 71% of the international candidates clear the step 1 in their first attempt. The candidates have to employ strenuous efforts to pass such a detailed and thorough exam like USMLE.