USMLE®


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Time to test your knowledge.

The United States Medical Licensing Examination (USMLE) program supports medical licensing authorities in the United States through its leadership in the development, delivery, and continual improvement of high quality assessments across the continuum of physicians’ preparation for practice. We want to ensure you have meaningful information to be able to assess patients to assure their safety while engaging in medical educators and their institutions, licensing authority members, and practicing clinicians.

That’s where we come in.

What makes Test Prep Institute’s CenterPrep USMLE course uniquely successful? It’s simple. Our entire program is a partnership between our experts and yourself. It’s geared towards your individual goals and needs. We will not only help you with the content, but also guide you and motivate you every step of the way. We want you to pass every step with confidence in your abilities.

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Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for the maintenance of competence through lifelong learning.

Step 2 assesses whether you can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision, with emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine.

  • 2 CK
  • 2 CS

Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care.

The USMLE

(click on each title to learn more)

About USMLE

In the United States and its territories, the individual medical licensing authorities (“state medical boards”) of the various jurisdictions grant a license to practice medicine. Each medical licensing authority sets its own rules and regulations and requires passing an examination that demonstrates qualification for licensure. Results of the USMLE are reported to these authorities for use in granting the initial license to practice medicine. The USMLE provides them with a common evaluation system for applicants for initial medical licensure.

The USMLE is sponsored by the Federation of State Medical Boards of the United States, Inc. (FSMB), and the National Board of Medical Examiners® (NBME®).

The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care. Each of the three Steps of the USMLE complements the others; no Step can stand alone in the assessment of readiness for medical licensure. Because individual medical licensing authorities make decisions regarding use of USMLE results, physicians seeking licensure should contact the jurisdiction where they intend to apply for licensure to obtain complete information. Also, the FSMB can provide general information on medical licensure.

Step 1

a. Overview

Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning. Step 1 is constructed according to an integrated content outline that organizes basic science material along two dimensions: system and process.

b. Content Description

Step 1 consists of multiple-choice questions 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 is designed to measure basic science knowledge. Some questions test the examinee’s fund of information, but the majority of questions require the examinee to interpret graphic and tabular material, to identify gross and microscopic pathologic and normal specimens, and to solve problems through application of basic science principles.

Step 1 is constructed from an integrated content outline that organizes basic science content according to general principles and individual organ systems. Test questions are classified in one of these major areas depending on whether they focus on concepts and principles that are important across organ systems or within individual organ systems.

Sections 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 anatomy, behavioral sciences, biochemistry, microbiology, pathology, pharmacology, and physiology, as well as to interdisciplinary areas including genetics, aging, immunology, nutrition, and molecular and cell biology. While not all topics listed in the content outline are included in every examination, overall content coverage is comparable in the various examination forms that will be taken by different examinees.

The Step 1 content outline describes the scope of the examination in detail but is not intended as a curriculum development or study guide. It provides a flexible structure for test construction that can readily accommodate new topics, emerging content domains, and shifts in emphasis. The categorizations and content coverage are subject to change. Broadly based learning that establishes a strong general understanding of concepts and principles in the basic sciences is the best preparation for the examination. 

c. Examination Content

Step 1 includes test items in the following content areas:

  • anatomy
  • behavioral sciences
  • biochemistry
  • microbiology
  • pathology
  • pharmacology
  • physiology
  • interdisciplinary topics, such as nutrition, genetics, and aging

Step 1 is a broadly based, integrated examination. Test items commonly require you to perform one or more of the following tasks:

  • interpret graphic and tabular material,
  • identify gross and microscopic pathologic and normal specimens,
  • apply basic science knowledge to clinical problems.

Step 1 classifies test items along two dimensions: system and process.

Step 1 Specifications

System
25%–35% General principles
65%–75% Individual organ systems

  • hematopoietic / lymphoreticular
  • nervous/special senses
  • skin/connective tissue
  • musculoskeletal
  • respiratory
  • cardiovascular
  • gastrointestinal
  • renal/urinary
  • reproductive
  • endocrine
  • immune

Process
20%–30% Normal structure and function
40%–50% Abnormal processes
15%–25% Principles of therapeutics
10%–20% Psychosocial, cultural, occupational, and environmental considerations

  • anatomy
  • behavioral sciences
  • biochemistry
  • microbiology
  • pathology
  • pharmacology
  • physiology
  • interdisciplinary topics, such as nutrition, genetics, and aging

d. Test Question Formats

Step 1 consists of multiple choice questions with only one best answer. Each question will be structured with a statement or question followed by three to eleven response options, each labeled with a letter (e.g: A, B, C, D, E) and arranged logically or alphabetically. Some response options will be partially correct, but only one option will be the best and correct answer.

Strategies for Answering the Test Questions

  • Read each question carefully. It is important to understand what is being asked.
  • Try to generate an answer and then look for it in the option list.
  • Alternatively, read each option carefully, eliminating those that are clearly incorrect.
  • Of the remaining options, select the one that is most correct.
  • If unsure about an answer, it is better to guess since unanswered questions are automatically counted as wrong answers.

Example Question

A 32-year-old woman with type 1 diabetes mellitus has had progressive renal failure over the past 2 years. She has not yet started dialysis. Examination shows no abnormalities. Her hemoglobin concentration is 9 g/dL, hematocrit is 28%, and mean corpuscular volume is 94 m3. A blood smear shows normochromic, normocytic cells. Which of the following is the most likely cause?

  • Acute blood loss
  • Chronic lymphocytic leukemia
  • Erythrocyte enzyme deficiency
  • Erythropoietin deficiency
  • Immunohemolysis
  • Microangiopathic hemolysis
  • Polycythemia vera
  • Sickle cell disease
  • Sideroblastic anemia
  • b-Thalassemia trait

(Answer: D)

Sequential Item Sets

A single patient-centered vignette may be associated with two or three consecutive questions about the information presented. Each question is linked to the initial patient vignette but is testing a different point. Questions are designed to be answered in sequential order. You are required to select the one best answer to each question. Other options may be partially correct, but there is only ONE BEST answer. You must click “Proceed to Next Item” to view the next item in the set; once you click on this button, you will not be able to add or change an answer to the displayed (previous) item.

Step 2 CK

a. Overview

Step 2 assesses whether you can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine.

Step 2 CK is constructed according to an integrated content outline that organizes clinical science material along two dimensions: physician task and disease category.

b. Content Description

Step 2 Clinical Knowledge (Step 2 CK) consists of multiple-choice questions 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. Test questions focus on the principles of clinical science that are deemed important for the practice of medicine under supervision in postgraduate training. The examination is constructed from an integrated content outline that organizes clinical science material along two dimensions.

Normal Conditions and Disease categories (Dimension 1) form the main axis for organizing the outline. The first section deals with normal growth and development, basic concepts, and general principles. The remaining sections deal with individual disorders.

Sections focusing on individual disorders are subdivided according to Physician Task (Dimension 2). The first set of physician tasks, Promoting Preventive Medicine and Health Maintenance, encompasses the assessment of risk factors, appreciation of epidemiologic data, and the application of primary and secondary preventive measures.

The second set of tasks, Understanding Mechanisms of Disease, encompasses etiology, pathophysiology, and effects of treatment modalities in the broadest sense.

The third set of tasks, Establishing a Diagnosis, pertains to interpretation of history and physical findings and the results of laboratory, imaging, and other studies to determine the most likely diagnosis or the most appropriate next step in diagnosis.

The fourth set of tasks, Applying Principles of Management, concerns the approach to care of patients with chronic and acute conditions in ambulatory and inpatient settings. Questions in this category will focus on the same topics covered in the diagnosis sections.

The diseases noted in the outline do not represent an all-inclusive registry of disorders about which questions may be asked. They reflect the development of a “High-Impact Disease List” that includes common problems, less common problems where early detection or treatability are important considerations, and noteworthy exemplars of pathophysiology. Questions are generally, but not exclusively, focused on the listed disorders. In addition, not all listed topics are included on each examination.

c. Examination Content

Step 2 CK includes test items in the following content areas:

  • internal medicine,
  • obstetrics and gynecology
  • pediatrics,
  • preventive medicine
  • psychiatry,
  • surgery
  • other areas relevant to provision of care under supervision.

Most Step 2 CK test items describe clinical situations and require that you provide one or more of the following:

  • diagnosis,
  • a prognosis,
  • an indication of underlying mechanisms of disease,
  • the next step in medical care, including preventive measures.

Step 2 CK is a broadly based, integrated examination. It frequently requires interpretation of tables and laboratory data, imaging studies, photographs of gross and microscopic pathologic specimens, and results of other diagnostic studies. Step 2 CK classifies test items along two dimensions: disease category and physician task, as shown under Step 2 CK Specifications.

Please note that much of the content that addresses normal growth and development and general principles of care is also related to the individual organ systems categories, so that the number of questions that deal solely with normal growth and development and general principles of care is relatively small.

Step 2 CK Specifications

Normal Conditions and Disease Categories:
Normal growth and development and general principles of care
Individual organ systems or types of disorders

  • immunologic disorders
  • diseases of the blood and blood-forming organs
  • mental disorders
  • diseases of the nervous system and special senses
  • cardiovascular disorders
  • diseases of the respiratory system
  • nutritional and digestive disorders
  • gynecologic disorders
  • renal, urinary, and male reproductive systems
  • disorders of pregnancy, childbirth, and the puerperium
  • disorders of the skin and subcutaneous tissue
  • diseases of the musculoskeletal system and connective tissue
  • endocrine and metabolic disorders

Physician Task:
15%–20% Promoting preventive medicine and health maintenance
20%–35% Understanding mechanisms of disease
25%–40% Establishing a diagnosis
15%–25% Applying principles of management

d. Test Question Formats

Test Question Formats
Step 2 CK consists of multiple choice questions with only one best answer. Each question will be structured with a statement or question followed by three to twenty-six response options, each labeled with a letter (e.g: A, B, C, D, E) and arranged logically or alphabetically. Some response options will be partially correct, but only one option will be the best and correct answer.
Strategies for Answering the Test Questions

  • Read each question carefully. It is important to understand what is being asked.
  • Try to generate an answer and then look for it in the option list.
  • Alternatively, read each option carefully, eliminating those that are clearly incorrect.
  • Of the remaining options, select the one that is most correct.
  • If unsure about an answer, it is better to guess since unanswered questions are automatically counted as wrong answers.

Example Question

A 32-year-old woman with type 1 diabetes mellitus has had progressive renal failure over the past 2 years. She is not yet on dialysis. Examination shows no abnormalities. Her hemoglobin concentration is 9 g/dL, hematocrit is 28%, and mean corpuscular volume is 94 m3. A blood smear shows normochromic, normocytic cells. Which of the following is the most likely cause?

  1. Acute blood loss
  2. Chronic lymphocytic leukemia
  3. Erythrocyte enzyme deficiency
  4. Erythropoietin deficiency
  5. Immunohemolysis
  6. Microangiopathic hemolysis
  7. Polycythemia vera
  8. Sickle cell disease
  9. Sideroblastic anemia
  10. ß-Thalassemia trait

(Answer: D)

Sequential Item Sets

A single patient-centered vignette may be associated with two or three consecutive questions about the information presented. Each question is linked to the initial patient vignette but is testing a different point. Questions are designed to be answered in sequential order. You are required to select the one best answer to each question. Other options may be partially correct, but there is only ONE BEST answer. You must click “Proceed to Next Item” to view the next item in the set; once you click on this button, you will not be able to add or change an answer to the displayed (previous) item.

Matching Sets

This format consists of a series of questions related to a common topic. All matching sets contain set-specific instructions, a list of lettered response options, and at least two questions. There will be between four and twenty-six response options. Each set is preceded by a box that indicates the number of questions in the set associated with the response options that follow. Examinees are directed to select one answer for each question in the set. Questions will be presented one at a time, with instructions and response options repeated for each subsequent question.

Strategies for Answering Matching Sets

  • Begin each set by reading through the option list to become familiar with the available responses.
  • Read each question carefully.
  • Within a set, some options may be used several times, while other options may not be used at all. Respond to each question independently.
  • For matching sets with large numbers of options, try to generate an answer to the question and then locate the answer in the option list. This is more efficient than considering each option individually.

Example Questions (Matching Set)

(The response options for items 2-3 are the same. You will be required to select one answer for each item in the set.)

  1. Chronic lymphocytic leukemia
  2. Drug reaction
  3. Hodgkin disease
  4. Infectious mononucleosis
  5. Metastatic carcinoma
  6. Sarcoidosis
  7. Systemic lupus erythematosus
  8. Toxoplasmosis
  9. Tuberculosis
  10. Tularemia

For each patient with lymphadenopathy, select the most likely diagnosis.

2. A previously healthy 30-year-old man has had fever, night sweats, pruritus, and an enlarging lump above his left clavicle for 3 weeks. Examination shows a 3-cm, nontender, rubbery, supraclavicular lymph node. An x-ray of the chest shows mediastinal lymphadenopathy.

(Answer: C)

3. A 41-year-old woman comes to the physician for a follow-up examination. She has taken aspirin for chronic headaches and phenytoin for a seizure disorder for 2 years. Examination shows mild epigastric tenderness and bilateral, 3-cm, nontender axillary lymph nodes. A lymph node biopsy shows hyperplasia.

(Answer: B)

Pharmaceutical Advertisement (Drug Ad) Format

The drug ad item format includes a rich stimulus presented in a manner commonly encountered by a physician, eg, as a printed advertisement in a medical journal. Examinees must interpret the presented material in order to answer questions on various topics, including:

  • Decisions about care of an individual patient
  • Biostatistics/epidemiology
  • Pharmacology/therapeutics
  • Development and approval of drugs and dietary supplements
  • Medical ethics

Abstract Format

The abstract item format includes a summary of an experiment or clinical investigation presented in a manner commonly encountered by a physician, eg, as an abstract that accompanies a research report in a medical journal. Examinees must interpret the abstract in order to answer questions on various topics, including:

  • Decisions about care of an individual patient
  • Biostatistics/epidemiology
  • Pharmacology/therapeutics
  • Use of diagnostic studies

Eligibility

If eligibility requirements are met, you may take Step 1 and Step 2 CK in any sequence.

To be eligible, you must be in one of the following categories at the time you apply and on your test day: on your test day:

  • a medical student officially enrolled in, or a graduate of, a US or Canadian medical school program leading to the MD degree that is accredited by the Liaison Committee on Medical Education (LCME),
  • a medical student officially enrolled in, or a graduate of, a US medical school leading to the DO degree that is accredited by the American Osteopathic Association (AOA), or
  • a medical student officially enrolled in, or a graduate of, a medical school outside the United States and Canada who meets the eligibility criteria of the ECFMG.

If you are dismissed or withdraw from medical school, you are not eligible for USMLE, even if you are appealing the school’s decision to dismiss you or otherwise contesting your status.

Attempts / Time Limits

Number of Attempts Allowed To Complete All Steps and Time Limits 

The USMLE program recommends to medical licensing authorities that they:

  • require that the dates of passing the Step 1, Step 2, and Step 3 examinations occur within a seven-year period; and
    allow no more than six attempts to pass each Step or Step Component without demonstration of additional educational experience acceptable to the medical licensing authority.


Multiple Attempts

 

The USMLE Program has introduced a limit on the total number of times an examinee can take the same Step or Step Component. An examinee is ineligible to take a Step or Step Component if the examinee has made six or more prior attempts to pass that Step or Step Component, including incomplete attempts.

The effective date for the six-attempt limit depends upon whether an examinee took any Step or Step Component (including incomplete attempts) before January 1, 2012.

Examinees who did NOT take a Step or Step Component before January 1, 2012: If you did not take any Step or Step Component before January 1, 2012, the six-attempt limit went into effect for all exam applications submitted on or after January 1, 2012.

Examinees who took a Step or Step Component before January 1, 2012: If you took any Step or Step Component (including incomplete attempts) before January 1, 2012, the six-attempt limit will go into effect for all exam applications that you submit on or after January 1, 2013. Beginning on that date, all attempts at a Step or Step Component will be counted toward the limit, regardless of when the exams were taken.

For purposes of medical licensure in the United States, any time limit to complete the USMLE is established by the state medical boards. Many require completion of the full USMLE sequence within seven years from the date the first Step or Step Component is passed or, in some cases, from the date of the first attempt at any Step or Step Component. While medical schools may require students to pass one or more Steps for advancement and/or graduation, you should understand the implications of time limits for licensure. General information regarding state-specific requirements for licensure can be obtained from the FSMB (www.fsmb.org). For definitive information, contact the licensing authority in the jurisdiction in which you intend to seek licensure.


Special Notice for MD/PhD Candidates

The common pathway for MD/PhD students involves completing the first two years of medical school and then moving to graduate school studies and research for a three- or four-year period. Following completion of PhD course work and all or most of their research projects, these students return to complete their two clinical years, thus completing the medical degree in seven to nine years after first matriculating.

The USMLE program recognizes that the recommended seven-year time limit may pose problems for medical licensure for some candidates with a combined degree (i.e., MD/PhD). For this reason, the USMLE program recommends to licensing jurisdictions that they consider allowing exceptions to the seven-year limit for MD/PhD candidates who meet certain narrow requirements. The recommended requirements are as follows:

    1. The candidate has obtained both degrees from an institution or program accredited by the LCME and regional university accrediting body.
    2. The PhD studies should be in a field of biological sciences tested in the Step 1 content. These fields include, but are not necessarily limited to, anatomy, biochemistry, physiology, microbiology, pharmacology, pathology, genetics, neuroscience, and molecular biology. Fields explicitly not included are business, economics, ethics, history, and other fields not directly related to biological science.
    3. A candidate seeking an exception to the seven-year rule should be required to present a verifiable and rational explanation for the fact that he or she was unable to meet the seven-year limit. These explanations will vary and each licensing jurisdiction will need to decide on its own which explanation justifies an exception.

Students who pursue both degrees should understand that while many states’ regulations provide specific exceptions to the seven-year rule for dual-degree candidates, others do not. Students pursuing a dual degree are advised to check the state-specific requirements for licensure listed by the FSMB.

Special Notice for International Medical Students and Graduates

ECFMG policy requires that applicants pass those USMLE Steps or Step Components required for ECFMG certification within a seven-year period. (You should refer to ECFMG’s Information Booklet for complete details.) This policy applies only to ECFMG certification. The USMLE program recommends, although not all jurisdictions impose, a seven-year limit for completion of the three-Step USMLE program. You should contact the FSMB or the medical licensing authority of the jurisdiction where you plan to apply for licensure for state-specific requirements.

Retakes

You may take the same examination no more than three times within a 12-month period. Your fourth and subsequent attempts must be at least 12 months after your first attempt at that exam and at least six months after your most recent attempt at that exam.

When you reapply for Steps 1, 2 CK, or 2 CS, your exam eligibility period will be adjusted, if necessary, to comply with these rules. When you reapply for Step 3, you must wait to submit your application until any time limits have expired.

If you pass a Step or Step Component, you are not allowed to retake it, except to comply with certain state board requirements which have been previously approved by USMLE governance. For example, you may retake a passed Step to comply with the time limit of a medical licensing authority for the completion of all Steps or a requirement imposed by another authority recognized by the USMLE program for this purpose. The medical licensing authority must provide information showing that you are an applicant for licensure in that jurisdiction; have fulfilled all requirements for licensure in that jurisdiction; are eligible for licensure except for the out-of-date examination; and have completed the full USMLE sequence, including Step 3. Information regarding retakes allowed to comply with ECFMG requirements is provided at the time of exam application using ECFMG’s Interactive Web Applications (IWA).

If you are repeating a previously passed Step or Step Component because of a time limit, you may apply to retake the examination only after the applicable time limit has expired. An exception to this policy can be granted if, at the time of application and testing:

  • you are currently enrolled in an LCME- or AOA-accredited medical school program leading to the MD or DO degree;
  • you have previously passed Step 1 and/or Step 2 but have not passed Step 3;
  • you are expected to graduate from the medical school program six or more years after the date you first passed Step 1 and/or Step 2; and
  • you are otherwise eligible to retake the examination.

Official Performance of Record for Examinees Retaking a Previously Passed Step

In order to meet the examination requirements for Step 3 eligibility, you must achieve a passing performance on the most recent administration of the examinations intended to meet those requirements.

If you have not yet passed Step 3 and wish to retake a previously passed Step 1 or Step 2 examination in order to meet a time limit imposed by a recognized authority other than a medical licensing authority, you should understand the implications of a failing retake performance on your Step 3 eligibility. Specifically, if a failing performance on a retake is the most recent administration of that examination, that failing score will preclude Step 3 eligibility.

Scoring

a. Examination Results & Scoring

When you take Step 1, Step 2 CK, or Step 3, the computer records your responses. After your test ends, your responses are transmitted to the NBME for scoring. The number of test items you answer correctly is converted into a three-digit score and an associated two-digit score. Both scores are used for score-reporting purposes.

On the three-digit scale, most Step 1, 2 CK, or 3 scores fall between 140 and 260. The mean score for first-time examinees from accredited medical school programs in the United States is in the range of 215 to 235, and the standard deviation is approximately 20. Your score report will include the mean and standard deviation for recent administrations of the examination. All score users are urged to rely on the three-digit score since its equivalence is maintained over time through statistical procedures. The two-digit score is derived from the three-digit score and the current passing score. Consequently, two-digit scores are not equivalent over time across the entire scale. The two-digit scale is used in score reporting because some medical licensing authorities have requirements that include language describing a “passing score of 75.” The two-digit score is derived in such a way that a score of 75 always corresponds to the minimum passing score. The USMLE program has begun the process of limiting the reporting of scores on the two-digit scale. Visit the USMLE website for more information.

USMLE score reports and transcripts show your scores (for Step 1, Step 2 CK, and Step 3) and an indication of whether you passed or failed (for all examinations). The same information is sent to medical licensing authorities upon your authorization for their use in granting the initial license to practice medicine.

Except as otherwise specified below, to receive a score on Step 1, Step 2 CK, and Step 3, you must begin every block of the test. If you do not begin every block, no results are reported, and the “incomplete” attempt appears on your USMLE transcript. If you register for but do not begin an examination, no record of the test will appear on your transcript.

If your Step 1, Step 2 CK, or Step 3 examination is incomplete, you may be given the option to request that your score be calculated and reported, with all missed test items or cases scored as incorrect. This score is likely to be lower than the score you would have achieved had you completed all sections of the examination. If this option is available to you, you will receive notification from the NBME. Not all examinees will receive notification regarding an incomplete attempt.

If you do receive notification, contact the NBME in writing no later than 45 days after the date the notification was sent to you if you would like further information on having the score calculated and reported. If you decide to request calculation and reporting of your score, the score will appear on your USMLE transcript as though it were complete; it will remain the permanent score for the examination administration.

Some examination materials are included in the USMLE to enhance the examination system and to investigate the measurement properties of the examinations. Such materials are not scored. 

Scoring for Multiple-Choice Items

Multiple-choice items are provided in blocks of approximately 45 to 60 minutes. Blocks of items are constructed to meet specific content specifications. As a result, the combination of blocks of items creates a form of the examination that is comparable in content to all other forms. The percentage of correctly answered items required to pass varies from form to form. However, examinees typically must answer 60 to 70 percent of items correctly to achieve a passing score.

b. Passing Scores

With the exception of Step 2 CS (which is reported as Pass/Fail), USMLE results are reported on a 3-digit scale.

The current minimum passing scores are as follows:

Step 1: 188
Step 2 CK: 196
Step 3: 190

The USMLE program provides score users with a recommended pass or fail outcome for all Step examinations. Recommended performance standards for the USMLE are based on a specified level of proficiency. As a result, no predetermined percentage of examinees will pass or fail the examination. The recommended minimum passing level is reviewed periodically and may be adjusted at any time. Notice of such review and any adjustments will be posted at the USMLE website. The recommended minimum passing level in place on the day you test will be the level used for scoring purposes.

A statistical procedure ensures that the performance required to pass each test form is equivalent to that needed to pass other forms; this process also places scores from different forms on a common scale.

For Step 3, your performance on the case simulations will affect your Step 3 score and could affect whether you pass or fail. The proportional contribution of the score on the case simulations is no greater than the amount of time you are allowed for the case simulations. 

c. Score Reporting

When your scores are available, you will receive an e-mail notification from your registration entity. Follow the instructions in the e-mail notification for accessing your USMLE score report. Your score report will remain available for approximately 120 days from the date of e-mail notification. Using password protection, you will be able to view, download, and print your score report. Once the score report is removed from the website, your scores will be provided to you only in the form of an official USMLE transcript. To obtain a transcript, you will be required to submit a request to your registration entity and to pay a fee.

After taking Step 1, Step 2 CK, or Step 3, you should allow at least eight weeks after your test date to receive notification that your score report is available.

The NBME reports the results of the USMLE to LCME- and AOA-accredited medical school programs for their students, who are enrolled at the time of application, and graduates.

If you are a student or graduate of an LCME- or AOA-accredited medical school program and you do not want your Step 1, Step 2 CK, or Step 2 CS results reported to your medical school, you must send a signed request to the NBME. Your request must be postmarked or faxed at least two weeks before your scheduled test date. If you make this request, the score information provided to the medical school will list your name and the notation “record withheld at the request of the examinee.” If you want your scores reported to your medical school subsequently, you must submit a transcript request and pay the required fee.

The ECFMG may provide the results of the USMLE to international medical schools for their students and graduates. If you are a student or graduate of an international medical school and you do not want your Step 1, Step 2 CK, or Step 2 CS results reported to your medical school, you must submit a request for each exam administration using ECFMG’s Interactive Web Applications (IWA), available on the ECFMG website at www.ecfmg.org. Your request must be submitted at least 10 days before your scheduled test date. If you make this request, the score information provided to the medical school for that exam administration will list your name and the notation “withheld at the request of the examinee.” If you want your score for that exam administration reported to your medical school subsequently, you must submit a transcript request and pay the required fee.

If you are a graduate of an LCME- or AOA-accredited medical school program, you must indicate on your Step 3 application your preference for reporting your Step 3 score to the school from which you graduated.

d. Examinee Score Reports & Rechecks

Examinee Score Reports

For Steps 1, 2 CK, and 3, your score report includes a pass/fail designation, numerical scores, and graphical performance profiles summarizing areas of strength and weakness to aid in self-assessment. These profiles are developed solely for your benefit and will not be reported or verified to any third party.

Results for computer-based examinations (Steps 1, 2 CK, and 3) are typically available within three to four weeks after your test date. However, delays are possible for various reasons. In selecting your test date and inquiring about results, you should allow at least eight weeks to receive notification that your score report is available.

Score Rechecks

For all Steps and Step Components, a change in your score or in your pass/fail outcome based on a recheck is an extremely remote possibility. However, a recheck will be done if you submit a written request and service fee to the entity that registered you for the examination. Your request must be received by your registration entity no later than 90 days after your result was released. 

For Steps 1, 2 CK, and 3, standard quality assurance procedures ensure that the scores reported for you accurately reflect the responses recorded by the computer. When a request for a score recheck is received, the original response record is retrieved and rescored using a system that is outside of the normal processing routine. The rechecked score is then compared with the original score. 

e. Transcripts

Requesting a Transcript of USMLE Scores  

To obtain your USMLE transcript or have it sent to a third party, you must contact the ECFMG, FSMB, or NBME. Which entity you contact depends on which Steps you have taken and where you want your transcript sent. Use the table below to determine which entity you should contact based on your specific details and needs.  

Step(s)/Component(s) Taken
Recipient of Transcript
Contact
One or more USMLE Steps
Medical licensing authority
All three USMLE Steps; or Step 1 and Step 2 CK and CS (if required), only when registered for or after taking Step 3
Any recipient
Step 1 and/or Step 2 CK and/or CS only, registered by ECFMG
Any recipient other than a medical licensing authority
Step 1 and/or Step 2 CK and/or CS only, registered by NBME
Any recipient other than a medical licensing authority

Applying and Scheduling

a. Applying

Students and graduates of LCME-accredited programs and AOA-accredited medical schools should apply for Step 1, Step 2 CK, and Step 2 CS by following the instructions at the NBME website (http://www.nbme.org). Review and follow the application instructions, complete your application, and submit it to the NBME.

Students and graduates of medical schools outside the United States and Canada should apply for Step 1, Step 2 CK, and Step 2 CS by following the instructions at the ECFMG website (http://www.ecfmg.org). Review and follow the application instructions, complete your application, and submit it to the ECFMG.

If you are dismissed or withdrawn from medical school, you are not eligible for USMLE, even if you are appealing the school’s decision to dismiss you or are otherwise contesting your status.

Applying for Step 3  

To request information on Step 3 eligibility requirements and application procedures, follow the instructions at the FSMB website (http://www.fsmb.org), or contact the FSMB or the medical licensing authority to which you wish to apply.

Application procedures for Step 3 vary among jurisdictions. You should begin inquiries at least three months in advance of the dates on which you expect to take the test.

After you obtain application materials, review and follow the application instructions to complete your application and submit it to the medical licensing authority or the FSMB as directed in the instructions.

b. Obtaining an Eligibility Period

Obtaining an Eligibility Period for Step 1 and Step 2 CK  

When applying for Step 1 or Step 2 CK, you must select a three-month period, such as January-February-March or February-March-April, during which you prefer to take the examination. A Scheduling Permit with instructions for making an appointment at a Prometric Test Center will be issued to you after your registration entity processes your application and determines your eligibility. The Scheduling Permit specifies the three-month eligibility period during which you must complete the examination. During peak periods, allow approximately four weeks for processing of your application. After obtaining your Scheduling Permit, you are able to contact Prometric immediately to schedule a test date.

Prometric schedules testing appointments for Steps 1 and 2 CK up to six months in advance. If your application is submitted more than six months in advance of your requested eligibility period, it will be processed, but your Scheduling Permit will be issued no more than six months before your assigned eligibility period begins.

If you are unable to take the test within your eligibility period, contact your registration entity to inquire about obtaining a one-time contiguous three-month eligibility period extension. A fee is charged for this service. Visit your registration entity’s website for more information. If you do not take the test within your original or extended eligibility period and wish to take it in the future, you must reapply by submitting a new application and fee(s). The USMLE Steps 1 and 2 CK fees are nonrefundable and nontransferable from one eligibility period to another or from one application to another.

Note: USMLE examinations are available year-round and you may select the testing time period that is most appropriate for you. You may reschedule your testing appointment if you decide not to test on the scheduled date. Except in the case of USMLE Step 2 CS, you may, for a small fee, extend your testing eligibility period if you need to defer your exam. Accordingly, you should not feel compelled to test on a particular if you are ill, under unusual stresses of personal life, feeling unprepared for the examination, or otherwise not ready to test.

c. Scheduling

Scheduling Step 1, Step 2 CK, and Step 3

Testing Regions

Step 1 and Step 2 CK are administered in the United States and Canada and in more than 50 other countries. International testing locations are distributed among defined international testing regions. There is an additional international test delivery surcharge.

Your Scheduling Permit

Your Scheduling Permit will be issued to you when the processing of your application is complete. You should verify the information on your Scheduling Permit before scheduling your appointment. Your Scheduling Permit includes the following:

 

  • your name (Your name as it appears on your Scheduling Permit must match the name on your form(s) of identification exactly. Refer to your Scheduling Permit for limited exceptions. If the name listed on your Scheduling Permit is not correct, contact your registration entity immediately.)
  • the examination for which you registered
  • your eligibility period
  • your testing region
  • your Scheduling Number
  • your Candidate Identification Number (CIN)

Scheduling Test Dates

 

When applying for USMLE Steps 1, 2 CK, and 3 or scheduling test dates, please keep the following in mind:

 

  • You must have your Scheduling Permit before you contact Prometric to schedule a testing appointment. Appointments are assigned on a “first-come, first-served” basis; therefore, you should contact Prometric to schedule as soon as possible after you receive your Scheduling Permit.
  • You may take the test on any day that it is offered during your assigned eligibility period, provided that there is space at the Prometric Test Center you choose.
  • Prometric Test Centers are closed on major local holidays.
  • USMLE Steps 1, 2 CK, and 3 are not available during the first 14 days of January.
  • The busiest testing times in the Prometric testing network in the United States and Canada are May through July and November through December.
  • Some, but not all, Prometric Test Centers are open on weekend days. When you schedule your Step 3 test dates, the two days on which you take the test must be consecutive, unless the center is closed on the day that follows your first day of testing. In that event, Prometric will assign you to the next day the center is open for your second day of testing. In all other cases, you must take Step 3 on two consecutive days at the same test center.

Your Scheduling Permit includes specific information for contacting Prometric to schedule your test date(s) at the test center of your choice. You will be required to provide information found only on your Scheduling Permit. When you schedule your appointment, you will receive the following specific information:

 

  • the confirmed test day(s), date(s), and time;
  • the address and telephone number of the Prometric Test Center where you will test; and
  • your Prometric Confirmation Number(s).

After you schedule your testing appointment, you can print a confirmation of your appointment from the Prometric website. Scheduling a testing appointment for a specific date at a Prometric Test Center is not a guarantee that the scheduled test time or location will remain available. The Prometric Test Center at which you are scheduled may become unavailable after you have scheduled your appointment. In that event, Prometric will attempt to notify you in advance of your scheduled testing appointment and to schedule you for a different time and/or center. However, on rare occasions, rescheduling your appointment for a different time or center may occur at the last minute. To avoid losses you would incur as a result, you should try to maintain flexibility in exam scheduling and in your travel arrangements. You are encouraged to confirm your testing appointment one week prior to your test date. Your registration entity cannot refund expenses incurred as a result of center closures due to inclement weather or natural disasters. 

 

How Test Dates Become Available

 

  • Testing appointments are available on a “first-come, first-served” basis (although some scheduling restrictions may be imposed). It is possible that you will not be able to obtain a testing appointment for the first time period and/or center you prefer.
  • The availability of testing appointments will change frequently as a result of examinee scheduling and rescheduling.
  • It is possible that testing appointments will become available for a time period and/or center that you prefer after you have scheduled an appointment for a different time period and/or center. In this event, you can change your scheduled test date and/or center. See Rescheduling Test Dates for rescheduling fees.
  • Although you can monitor available test dates for your preferred time period and test center, availability is not guaranteed. You must take the exam during your eligibility period; if you do not take the exam during the eligibility period, you must reapply and pay the full exam fee in order to take the examination.
Rescheduling Test Dates

If you have a scheduled testing appointment and are unable to take the exam on your scheduled test date or at your scheduled center, you can cancel your scheduled testing appointment and reschedule for a different date and/or center, subject to availability. A fee may be charged for this service depending on how much notice you provide when canceling your appointment. To cancel or reschedule, follow the instructions on your Scheduling Permit for accessing Step 2 CS Calendar and Scheduling.

Before canceling and/or rescheduling a scheduled testing appointment, you will have the opportunity to review available test dates at all testing locations. Your rescheduled test date must fall within your assigned eligibility period. There is no limit on the number of times you can cancel and reschedule your testing appointment. However, a rescheduling fee is charged for each rescheduled testing appointment that does not meet the notice requirements described below. Any change to a scheduled testing appointment constitutes rescheduling.


You can cancel and reschedule at the same time, or you can cancel and reschedule later. You can cancel and/or reschedule at any time through the end of the day before your scheduled test date. However, no canceling is allowed beginning at 12:00 AM, Eastern Time in the United States, on the scheduled test date. If you do not cancel and you miss your scheduled testing appointment, you can reschedule within your assigned eligibility period once it is confirmed that you did not take the test
.

IMPORTANT NOTE: If you cancel without rescheduling or miss your scheduled testing appointment, there is no guarantee that testing appointments during your eligibility period will be available at a given test center, or at any test center, when you attempt to reschedule. If you do not reschedule within your eligibility period, you must submit a new application and payment in order to take the exam.

 

There is no fee to cancel a scheduled testing appointment; the fee, if applicable, is due at the time of rescheduling. However, the date that you cancel your appointment, using Eastern Time in the United States, will determine whether you pay a rescheduling fee and the amount of this fee.

  • If you cancel more than 14 calendar days before (but not including) your scheduled test date, there is no fee to reschedule.
  • If you cancel during the 14-day period before (but not including) your scheduled test date, your fee will be $150 when you reschedule.
  • If you miss your scheduled testing appointment without canceling, your fee will be $400 when you reschedule.
If you are unable to keep your scheduled testing appointment, you should cancel your appointment as soon as possible to avoid a rescheduling fee, regardless of whether you are ready to reschedule. regardless of whether you are ready to reschedule.

Why Prep?

Review Kaplan’s world-class videolectures at your own pace at Test Prep Institute.

The USMLE is a professional exam that many students study for by utilizing USMLE prep courses and it’s best to find the courses that balance personal budget with convenience and effective preparation. CenterPrep can help you meet all three requirements for the best pre.

Finding the most comfortable format and structure of USMLE courses can often be essential to maximizing learning. Students who do well in more structured, lecture-based courses might want to pursue professionally-taught courses in learning centers, while those who are more independent might elect for self-guided online programs, books, or DVDs. Students might prefer to receive private tutoring or small-group workshops, while others prefer a larger classroom setting with many other students. Understanding one’s own learning style can be helpful in figuring out which format will ultimately offer the biggest advantages.

Many medical students and first-year residents are on a tight budget due to the increasing costs of student loans. As a result, cost can sometimes be the determining factor in finding the best professionally taught USMLE courses. USMLE courses generally range from thousands of dollars to tens of thousands of dollars. Planning out a budget well in advance can often give test takers a better idea of which study options are available to them.The CenterPrep course is quality materials at a reduced price compared to the US.

The required time commitment of various USMLE courses can also be an important factor in planning a study method. Not only do students and residents generally have little free time, they must also work in studying for their education around studying for the USMLE test.

CenterPrep is a perfect way to fit prep into your busy schedule.

You’ll benefit from high-yield lectures taught by the most distinguished medical faculty in the industry. Your CenterPrep experience also includes realistic exam simulations, subject-based assessments, Kaplan’s Personal Learning System, and much more.

Admissions

Review Kaplan’s world-class video lectures at your own pace at Test Prep Institute, Kaplan Certified Education Provider.  You’ll benefit from over 200 hours of high-yield lectures taught by the most distinguished medical faculty in the industry. Your CenterPrep experience also includes realistic exam simulations, subject-based assessments, Kaplan’s Personal Learning System, and much more.  CenterPrep is a perfect way to fit prep into your busy schedule.

What’s included:

Step 1 Kit includes: 7 Books of Lecture Notes for: Pharmacology, Pathology, Immunology & Microbiology, Biochemistry & Medical  Genetics, Behavioral Sciences, Physiology and Anatomy.

USMLE Step 1 Qbank: Kaplan’s Step 1 Qbank includes:

  • Over 3,000 questions. 2,200 Qbank questions, 1 diagnostic test, and 2 full simulated exams.
  • 100% exam-like practice. Written by faculty, reviewed by high scorers.
  • Until Your Test access (12 months). Get started earlier for a higher score.
  • Visually rich content. 750 images, 30 clinical videos, 20 heart sounds.
  • Full explanations. reKaps, high-yield overview tables and First Aid page references.
  • Free Integrated App for iPhone® and Android™: Download blocks of questions to your mobile device and practice on the go.
  • Qutorials. More than 900 mini-lectures from expert faculty on the most challenging questions.
  • Expert support. Need more help with questions? E-mail our academic team at medfeedback@kaplan.com.

Step 2 CK kit contains 5 Specialty Science Books of Lecture Notes for: Internal medicine, Obstetrics and gynecology, Pediatrics, Surgery and Psychiatry and epidemiology

USMLE Step 2 CK Qbank: Kaplan’s Step 2 CK Qbank includes:

    • Over 2,100 questions. Includes 1,200 revised questions, 1 diagnostic test, and 2 full-length simulated exams.
    • 100% exam-like practice. Written by faculty, reviewed by high scorers.
    • Full explanations. Detailed explanations and reKap summaries for all questions.
    • Free Integrated App for iPhone® and Android™: Download blocs of questions to your mobile device and practice on the go.
  • Until Your Test access (12 months). Get started earlier for a higher score.
  • Expert support. Need more help with questions? Email our academic team at medfeedback@kaplan.com

 

Duration: 6 months

Where to Prep:

Gefinor Center

FAQ

What is the cost of the USMLE exams?

Information about the cost of the exams is available on the websites of the appropriate registration entities.

How do I interpret my score?

Most scores fall between 140 and 260. The mean score for first-time examinees from accredited medical schools in the United States is in the range of 215 to 235, and the standard deviation is approximately 20. Your score report includes the mean and standard deviation for recent administrations of the Step. Data for each Step, including performance data by group, is posted each year for the previous year’s examinees.

When will I get my scores?

A. Step 1, Step 2 CK, or Step 3:
Scores for Step 1, Step 2 CK and Step 3 are released each Wednesday. Generally these will include scores for examinees who tested three to four weeks before the release date. However, there are many factors that may delay an individual score release. Usually these will be quickly resolved and the score released in the next weekly cycle. Your registration entity will notify you via email when your score becomes available. When released, your scores will be posted to your registration entity’s secure website: for Step 1 and Step 2, either NBME or ECFMG; for Step 3, FSMB. If you have not received your score within eight weeks of your test date, please contact us to determine the status of your score report. Please note that new scores are not released during the week of 4th of July or the week after Christmas.

B. Step 2 CS:
Scores for Step 2 CS are released on Wednesdays according to the posted score reporting schedule. Step 2 CS examinees are grouped into testing periods according to the dates on which they test. It is expected that results for the vast majority of examinees who take the exam during the testing period will be reported on the first Wednesday of the Reporting Period. Results for 98%-99% of examinees who take the exam during the testing period are reported by the third Wednesday in a Reporting Period. For a small percentage of examinees (1%-2%), scoring and quality assurance may be not completed in time for these examinees to be reported by the first three reporting dates; these will typically be examinees who took the exam in the latter part of the testing period. Results for these examinees will be reported each week throughout the reporting period, and should be reported no later than the last day of the score reporting period.

Occasionally test changes require widespread delays in score reporting. These delays are necessary to gather data, perform analyses, and complete quality assurance that ensures the minimum passing score is appropriately maintained. Information on score delays is posted in the announcement section of the USMLE website.

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