USMLE Exam Details: Eligibility, Cost & Scoring

usmle exam details

Knowing all USMLE exam details is necessary if you want a medical license to practice in the USA. The United States Medical Licensing Examination (USMLE) is a three-step exam and measures a candidate’s ability to apply the knowledge, concepts, and patient-centered skills that form the basis for safe and effective care.

 The FSMB (Federation of State Medical Boards) and NBME (National Board of Medical Examiners) are co-sponsors of the USMLE. 

 One of the crucial USMLE exam details for Indian students is that the assessment takes place online, while Step 2 takes place offline. It is because Step 2 has CS (clinical skills) and CK (clinical knowledge). 

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USMLE Exam Details- Eligibility Criteria

 Checking USMLE exam eligibility before applying is necessary. Every stage of the examination comes with specific requirements. 

Criteria for Steps 1, 2 CK, and 2 CS: 

  • Should be a graduate of a Canadian or US medical school program or enrolled in a program, leading to the MD qualification, as accredited by the Liaison Committee on Medical Education (LCME)
  • Should be a medical student enrolled officially in a US medical school, leading to a DO degree or a graduate of the same, as per accreditation from the American Osteopathic Association (AOA). 
  • A medical student with official enrollment or graduation from a medical school outside Canada or the US, which is listed in the World Directory of Medical Schools. 

Applicants have to fulfill any one of these criteria to take Steps 1 and 2. 

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Criteria for USMLE Step 3: 

 Here are the Step 3 USMLE exam eligibility requirements for Indian students: 

Step 3: 

  • Aspirants should successfully clear Steps 1, 2 CK, and 2 CS.¬†
  • They should have MD or DO degrees from LCME or AOA accredited Canadian or US medical schools.¬†
  • An alternative to the above criteria may be an equivalent degree to MD from any medical school outside Canada and USA, with a listing in the World Directory of Medical Schools.¬†

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USMLE Examination Requirements: 

 There are many USMLE requirements for international students that you should keep in mind: 

  • After completing the application procedure, applicants will get an email notification about scheduling permit availability. 
  • They have to go to the Prometric official site to schedule the examination date. 
  • Applicants should safely keep their scheduling permits for the examination. 

 Aspirants should carefully review the Rules of Conduct for the test while following all instructions at the testing center and carrying copies of scheduling permits and identity proof. They should not bring any other family members or friends to the testing venue. 

 They should avoid unauthorized accessories though soft-foam earplugs are permitted. Only the stethoscope and white laboratory coat are permissible for Step 2 CS. They should never write on laminated note boards before visiting the CIN (Candidate Identification Number) and beginning the session. 

 Step 1 and Step 2 CK can be attempted in any sequence, but Step 3 can only be attempted after completing the first two steps. 

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USMLE Steps In Detail: 

 Here is a step-wise explanation for your benefit: 

Step 1: 

  • Aims at evaluating knowledge and capabilities regarding various scientific and medical concepts. 
  • A total of 280 multiple-choice questions spread into seven blocks of 60 minutes each. 
  • Online testing mode covering a day‚Äôs session. 

Step 2 (CK): 

  • Evaluate capabilities of applying medical skills and knowledge. 
  • A total of 318 multiple-choice questions spread through eight blocks of 60 minutes each. 
  • Online testing mode covering a day‚Äôs session. 

Step 2 (CS): 

  • Standardized patients are used for testing capabilities to gather patient information, conduct physical examinations, and communicate observations to patients. 
  • Twelve patient cases of 15 minutes each + 10 minutes for recording every patient. 
  • Offline testing in one day. 

Step 3: 

  • Evaluate knowledge of scientific and medical principles for efficient medical care. Evaluate the application of extensive health and disease-linked knowledge for managing patients.¬†
  • There are 180 multiple-choice questions in six blocks of 45 minutes each. 13 computer-based case simulations are allotted 10-20 minutes each in real-time.¬†
  • Online testing mode covers one day.¬†

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USMLE Exam Details: Retakes, Time Limits & Number of Attempts

 USMLE applicants can take a Step or part of a Step more than three times within 12 months. The fourth attempt should be at least 12 months after your first attempt at that examination. It should also be at least six months after the last examination attempt. 

 Aspirants can sit for the same exam Step or part of the Step more than six times, including incomplete test attempts. All attempts count towards computing the limit, irrespective of the examination time. If the applicant passes the Step or Step Component, then there are no retakes for it, except for complying with the time limit given by the authority for US physician licensing. It means that all Steps require completion within this deadline. 

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USMLE Exam Centers: 

Candidates may check examination center lists on the official Prometric website. The testing regions like India, Japan, the Middle East, and Europe are grouped, and applicants should choose the examination center at the time of registration. Note that centers may change without any advance notice. Here is a list for your perusal (Steps 1 and 2 only): 

Area of TestingSpecific Areas

The United States and Canada
Alberta, Guam, British Columbia, Puerto Rico, Labrador and Newfoundland, the Virgin Islands, Manitoba, Saskatchewan, Nova Scotia, Quebec, and Ontario.
AfricaKenya, Ghana, Uganda, and South Africa.

India, Bangladesh, Nepal, Japan, Malaysia, Thailand, People’s Republic of China, Taiwan, Indonesia, Singapore, and the Philippines.
OceaniaAustralia and New Zealand
EuropeDenmark, Ireland, Armenia, France, Croatia, Italy, Turkey, Latvia, Israel, Netherlands, Spain, Portugal, Switzerland, and the United Kingdom.
Latin AmericaBrazil, Argentina, Chile, Bolivia, Colombia, Dominican Republic, Costa Rica, Guatemala, Peru, Mexico, Venezuela, and Trinidad and Tobago.
Middle EastUAE (United Arab Emirates), Kuwait, Qatar, Egypt, Jordan, Saudi Arabia, Lebanon, and Oman.

Step 3 is only possible within the US and its territories.

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USMLE Scoring System: 

 Results are published online by the USMLE, and officials release scorecards with candidates‚Äô marks. Authorities also intimate all applicants about result availability. FSMB officials issue notifications when Step 3 results are published. 

 Electronic formats generate score reports, with results declared three-four weeks post exam completion. Candidates should get at least 194 in Step 1 and 209 in Step 2 (CK). They should get at least 196 in Step 3. The result of Step 2 (CS) will only declare Pass/Fail. 

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USMLE Registration Entity:

 The examination covers three steps. Separate application forms exist for every step in the digital mode. Candidates should clear USMLE Steps 1, 2 CS, and 2 CK for completing Step 3. They have to submit application forms to respective entities for registration. After applying, they have to schedule examination dates. 

 Here is a guide for you: 

USMLE Steps 1, 2 CK and 2 CSUSMLE Steps 1, 2 CK and 2 CSUSMLE Step 3
For graduates or students of AOA or LCME accredited medical courses in Canada or the US. For graduates or students of medical schools outside Canada and the USA.All graduates of medical school who have cleared Steps 1, 2 CK, and 2 CS.
Applications at the official NBME website.  Applications on IWA through ECFMG.Application via FSM.

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USMLE Exam Costs:

 For AOA or LCME accredited graduates or students in Canada or the US, applications are done via NBME. The costs are the following: 

  • $610 (INR 45,203)- Step 1 Application Costs
  • $610 (INR 45,203)- Step 2 CK Application Costs
  • $1285 (INR 95,223)- Step 2 CS Application Costs 
  • $0-506 (up to INR 37,496)- Step 1 Rescheduling Costs
  • $0-569 (up to INR 42,164)- Step 2 Rescheduling Costs
  • $0-1280 (up to INR 94,853)- Step 3 Rescheduling Costs 

 For graduates or medical students outside Canada or the US, applications happen via ECFMG (Educational Commission For Foreign Medical Graduates). The costs include: 

  • ECFMG Application Charges- $75 (INR 5,558)
  • Application Fees for Step 1- $910 (INR 67,434)
  • Application Fees for Step 2- $910 (INR 67,434)
  • Application Fees for Step 3- $1565 (INR 1,15,972)
  • Extension of Eligibility Tenure for Step 1 or 2 CK- $70 for each Step
  • Step 1 or 2 CK Change in Testing Region- $65 for each Step (INR 4,817) 
  • Rescheduling Charges- $0-569 for Step 1, $0-1285 for Step 2 CK and $0-1280 for Step 2 CS (up to INR 42,164 or INR 94,853)
  • Score Rechecking Fee- $80 for Step 1 and $80 for Step 2 CK (INR 5,928)
  • ECFMG Examination Chart- $50 for Step 1 (INR 3,705)
  • ECFMG CSA History Chart- $50 for Step 1 (INR 3,705)
  • USMLE Transcript Paper- $70 (INR 5,187) for each request (up to 10 transcripts) 
  • USMLE Transcript- Electronic Transmission (ERAS)- $80 (INR 5,928) for each session of ERAS

 Step 3 comes after candidates successfully clear Steps 1 and 2. The costs include: 

  • Application Fees for Step 3- $850 (INR 62,988)
  • Rescheduling Fees for Step 3- $0-114 (up to INR 8,448)

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Is USMLE Valid in India?

Technically speaking, US residency degrees have validity in India. The residency should have ACGME (Accreditation Council for Graduate Medical Education) accreditation, however. All residency program degree holders (accreditation from ACGME) will have equivalence with MD degrees in India. One doesn’t need to give any other entrance to practice in India.

How to Apply for USMLE for Indian Students?

The application procedure covers applying for USMLE/ECFMG identification numbers, setting up accounts, and completing applications. It also involves completing and notarizing the certificate of identification form 183. This form is sent to Philly, and after two to three weeks, you will get an email with a scheduling permit. The final step is booking a date at Prometric.

Is USMLE Hard?

The USMLE Step 1 is regarded as one of the toughest medical examinations in the world. The performance in this test will set the foundation for a good residency program ahead. More than anything, USMLE is a long process and tests a candidate’s patience. Also, the exam is very competitive.

When are USMLE Exams Held?

A. The USMLE Step 1 may be taken throughout the year, with the first week of January and major public holidays exceptions. The conducting bodies do not reveal the USMLE exam details. The candidate needs to book the exam date for a particular step after registration and receipt of the eligibility period.

Which Countries Accept USMLE?

USMLE is one of the most reputed medical licensing exams. It is difficult to crack because of its level of toughness and competition. Medical licensing authorities accept the USMLE program in the United States, Israel, New Zealand, UAE, and Qatar. These countries accept the USMLE scores and exempt candidates from other eligibility criteria.

Who Can Give the USMLE Exam from India?

Indian doctors should pass their equivalent examination with more than 230 marks to take the USMLE exam. Students may sit for USMLE-2 CK examinations to qualify for a Residency in the United States. They may apply for US work visas upon receiving confirmation of residency.

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