Introduction

So, you’ve heard a few people talking about the United States Medical Licensing Examination (USMLE) and wonder what it’s all about. This series will give you a starting point to think about whether sitting the USMLE exams is right for you. 

The Exams

Most people in medical school talk about USMLE Step 1, but actually there are 4 USMLE exams.

Step 1

Step 1 tests some clinical and all basic pre-clinical knowledge. The Step 1 exam has 280 questions, which has to be done in 7 hours (with 1-hour break, split however you like)

Step 2 (Part 1: CK & Part 2: CS)

Step 2 is split into 2 exams, clinical knowledge (CK) and clinical skills (CS). The CK exam has ~318 questions in 8 hours (with 1-hour break, split however you like). The CS is an OSCE-style exam which you need to sit in the US.

Step 3

Step 3 is a more extensive exam testing applied clinical knowledge, as well as computer-based simulations. The Step 3 exams has ~500 questions split over 2 days (day 1: foundations of independent practice, day 2: advanced clinical medicine).

Working in the US

To work in the US, you need to get ECFMG certification (Education Commission for Foreign Medical Graduates) .  The ECFMG is the governing body for international medical graduates (IMGs) in the US, which you get after passing Step 1, Step 2 CS and Step 2 CK. As an IMG, you need ECFMG certification for fellowships and for Residency (Specialty Training). If you are thinking of working permanently in the US, it’s important to know that you cannot become an Attending (consultant) unless you have completed residency in the US.

Most of the information I have is from attending a course run by LibertyMedics in London, and Google. If you are considering applying to the US, I strongly recommend you attend this thorough and comprehensive course (though beware it is biased towards those who would like to train in the US).