USMLE or United States Medical Licensing Exam commonly called the ‘the Boards’, is very challenging three step Licensing Exam to get Medical License to practice Medicines in the United States. First, two steps can be taken while a student is in med-school but step-3 can only be taken after graduation.

Students who are looking forward to pursuing a career in Medical know that they will have to face a very difficult and challenging educational pathway. Students who

USMLE 1 - What is the USMLE? [All three Steps Explained]

are looking forward to pursuing a career in the USA have to pass through even a more challenging path.

This Exam assesses the physician’s ability to apply knowledge, concepts, and also demonstrates the fundamental concepts that are important in health and disease. This exams tests, whether a physician can apply the basic sciences knowledge and clinical knowledge to practice medicine.


Step-1, Step-2 CK, and Step-2 CS can be taken by students while in Medical School,

Step-3 can only be taken after graduation by,

  • US and Canadian Med-School Students recognized by Liaison Committee on Medical Education (LCME)
  • US and Canadian Med-School Students recognized by American Osteopathic Association
  • Students outside US and Canadian Med-Schools recognized by International Medical Education Directory (IMED) and Educational Commission for Foreign Medical Graduates. (ECFMG).


Although USMLE is a 3-steps exam, it still takes 5 days of testing. Today taking USME steps is very time consuming and rigorous. Step-1 is considered to be the most difficult of all the steps and things start getting easier afterward.

Below is a brief overview of the USMLE-Steps (Relevant articles regarding each step will be shared soon),

USMLE Step-1 or Basic Sciences Knowledge

Step-1 is the hardest part to go through. Once cleared, bingo! Next two are piece of cake.

What is asked? Application of knowledge of basic sciences to practice medicines.

When to take? Usually after first two years of Medical School.

Time Duration: 8 hours (one day), broken into 7 blocks and 1 hour for each block with 40 MCQ’s in each block.

MCQ questions: Typically, 280

Format: Computer-Based

Test Place: Prometric Sites Internationally


 Kindly read a fully comprehensive guide on USMLE Step-1;

USMLE Step-1 [A Comprehensive Guideline]

USMLE Step-2 CK or Clinical Knowledge

Step 2 is the actual application of Physician’s clinical knowledge under supervision.

What is asked? How to apply clinical Knowledge to practice medicines.

When to take? During 3rd and 4th year. (Clinical Years)

Time Duration:  9 hours (one day), broken into 8, one hour block with 45 questions per block.

MCQ Questions: 355

Format: Computer-Based

Test Place: Prometric Sites Internationally


To know how to clear USMLE STEP-2 CK, follow the link below;

USMLE STEP-2 [Study Guideline]

USMLE Step-2 CS or Clinical Skills

What is asked? Application of ‘Clinical Skills’ on ‘Standardized Patients’. Fostering

  • Fostering Relationship
  • Information Provision
  • Decision Making
  • Emotional Support
  • Patient Behavior’s Handling

When to take? Usually, during the 4th year of Medical School.

Time Duration: 8 hours (one day)

Format: 12 patients, 15 minutes for encountering patient and 10 minutes to take notes.

Test Place:  5 Test Centers (Philadelphia, Huston, Atlanta, Chicago, Los-Angeles)


To know more about USMLE STEP-2 CS, read this blog:



USMLE Step-3 or Patient Management
Step-3 is the final stage through which a Physician has to apply the understanding and concepts of clinical science knowledge without any supervision.

What is asked? Ability to apply clinical science knowledge to patients without any supervision.

When to take? After graduation.

Time Duration: Step-3 usually takes 2 days.

MCQ Questions: Usually, 500 MCQ’s

Format: Computer-Based

Place: Prometric Test Sites in the USA

  • DAY 1: Foundations in independent Practice (FIP)
  • What is asked? What are the scientific principles for effective medical care? (Concepts based)
  • Time: 7 hours (one day)
  • MCQ Questions: 260 MCQs
  • DAY 2: Advanced Clinical Medicines (ACM)
  • What is asked? Patient Management and Evolving Disease Process by applying medical knowledge.
  • Duration: 9 hours (one day)
  • MCQ Questions: 200 MCQs

Fee Structure

Fee criteria of USMLE Steps vary according to the region. Typically, there are 2 fee structures for students.

  1. Students living in USA or Canada,
Exam 2017 2018
Step-1 $605 $610
Step-2 CK $605 $610
Step-2 CS $1280 $1285
Step-3 $845 $850



  1. Students from outside USA or Canada, applying through ECFMG
Exam 2017 2018
Step-1 $895 Not specified
Step-2 CS $895 Not specified
Step-2 CK $1550 Not Specified


Additional Fees

Step-1 and Step-2 eligibility Extension $70
Step-3 eligibility Extension $70
Score Recheck step-1, step-2 and step-3 $80 per-exam
Step-1 and Step-2 Testing region Change $65 per region
Step-1 and Step-2 Rescheduling Region $0-$569 depending on region
Step-2 Rescheduling Exam fee $0-$1280 depending on date of cancellation


Scoring Criteria

Minimum Scores required to pass the exams are described below:

Exam Minimum Scores to pass
Step-1 192
Step-2 CK 209
Step-2 CS Pass/Fail
Step-3 190



Step-1, Step-2 CS and Step-2 CK students:

  • In USA or Canada: Via NBME (National Board of Medical Exam) online website.
  • Outside USA or Canada Via ECFMG (Educational Commission for Foreign Medical Graduates)


All the medical graduates are required to register through FSMB website.


A word from the Author:

This is all about USMLE in general. I will be sharing each and every relevant article related to USMLE-Steps soon. So, stay tuned for some amazing, full of knowledge and informative articles.

Good luck! 🙂



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