USMLE Preparation

The USMLE is a benchmark that must be passed by all medical students in the United States. In order to become a full practicing physician, you must first pass all four United Stated Medical License Exam. This section is intended as a starting point in your preparation for getting past the first hurdle, Step 1. 

 USMLE - What is it for?

To become a licensed physician in the United States, individuals must pass a series of examinations conducted by the National Board of Medical Examiners (NBME). These examinations are the United States Medical Licensing Examinations or USMLE. Currently, there are four separate exams which must be passed to be eligible for medical licensure:

  • Step 1 is taken after the completion of the second year of medical school;
  • Step 2 Clinical Knowledge (CK), usually taken by December 31st of Year 4
  • Step 2 Clinical Skills (CS), usually be taken   by December 31st of Year 4
  • Step 3, typically taken during the first (intern) year of postgraduate training.

Requirements other than passing all of the above-mentioned steps for licensure in each state are set by each state’s medical licensing board. For example, each state board determines the maximum number of times that a person may take each Step exam and still remain eligible for licensure. In Texas, individuals are limited to three attempts at each Step exam. Some states allow more attempts, some allow fewer. Our goal is for all of our students to be eligible for licensure in every state.

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 2 Clinical Knowledge (CK) assesses whether you can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes an 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 Clinical Skills (CS) A clinical skills examination was part of the original design of USMLE.   The NBME was charged with including a test of clinical skills using standardized patients when such an examination was shown to be valid, reliable, and practical. NBME research and the work of other organizations administering clinical skills examinations demonstrate that clinical skills examinations measure skill sets different from those measured by traditional multiple-choice questions. Mastery of clinical and communication skills, as well as cognitive skills, by individuals seeking medical licensure is important to the protection of the public.

The clinical skills examination began in June 2004 and is a separately administered component of Step 2. USMLE Step 2 CS is currently administered at five regional test centers (CSEC Centers) in the United States:  Philadelphia, PA; Atlanta, GA; Chicago, IL; Houston, TX; and Los Angeles, CA.

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.