USMLE Exams: Steps, Eligibility, Registration, Fees etc

USMLE for Indian
Medical Graduates

Request a call back

Note: The education loan information on this page is provided only for the information of the website users, DBS Bank doesn’t offer this product at the moment.

USMLE

Test Name: USMLE
Description: The test is a computerised conducted in 3 steps, broadly referred to as Step 1, Step 2 (CK) and Step 3, conducted over a period of 3+ years.
Suitable For: Medical graduates’ intending to study and practice medicine in USA
Number of Countries in which Accepted: USA, but students with graduate level medical degrees from countries worldwide can apply.
Score range: 1-300
Flexibility: You can reschedule test dates and appear for the same step, up to three times in a 12-month period. Subsequent attempts should be at least 12 months after the first attempt, and at least six months after the most recent attempt. You cannot retake a step you have previously passed.
Registration fee: $690 - $935(depends on USMLE Step you are appearing for).

About USMLE – Quick Facts

Introduced between 1992 -1994.
Designed to study and practice medicine in USA.
Computerised test conducted over 3 steps.
Steps 1 and 2 tests are conducted over 1 day, Step 3 test is conducted over 2 days.
Taken by 12,000 students each year, 8,000 are Indian students.

What is USMLE? – An Introduction

If you have always dreamed of going abroad, specifically to the United States of America, and practising medicine, you need to appear for the USMLE exam. Short for the United States Medical Licensing Examination (USMLE), this test is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). The USMLE is a three-step examination that you must take if your goal is to earn a license to practice medicine in the USA. The exam assesses a medical student’s ability to apply medical knowledge, principles and concepts. It also evaluates how well the medical practitioner can demonstrate fundamental and critical patient-centred skills, which are incredibly crucial in the practice of health and diseases. These skills constitute the foundation of effective and safe patient care procedures.

The USMLE exam was first designed in the late 1980s but introduced between 1992 and 1994. It replaced two of the most widely accepted medical licensing examination programs in the medical profession of that time, namely the NBME Part Examination Program, as well as the Federation Licensing Examination or FLEX program. Read on to know more about the USMLE.

Request a call back

USMLE Steps

The three steps of the USMLE are divided as Step 1, Step 2 CK (Clinical Knowledge), and Step 3. While you can appear for Steps 1 and 2 in any sequence, you must pass the two steps before appearing for the Step 3 test.

USMLE Test Step	Exam Type	Total Duration	Number of Questions	Skills Assessed
Step 1	Computer based	1 Day	7 blocks of 40 MCQs, 280 in total	Basic Science Concepts + Application to medical practice
Step 2	Computer based	1 Day	316 MCQs across 8 blocks	Clinical Science Concepts + Application
Step 3	Computer based	2 Days	233+180 MCQs across 6 blocks (Day 1 & 2) +13 computer-based simulations	Biomedical & clinical science concept + applications, patient management, ambulance care etc.

The three steps of the USMLE are divided as Step 1, Step 2 CK (Clinical Knowledge), and Step 3. Until 2020, Step 2 also included a CS (Clinical Skills) component as part of Step 2. However, the NBME and FSME announced the cancellation of Step 2 CS permanently in March 2021. While you can appear for Steps 1 and 2 in any sequence, you must pass the two steps before appearing for the Step 3 test.

Items	USMLE Step-1	USMLE Step-2 (CK)	USMLE Step-3
Test-Type	Computer-based	Computer-based	Computer-based
Total Duration (including break time)	8 hours	9 hours	8 hours on Day 1
Total Duration (including break time)	8 hours	9 hours	9 hours on Day 2
Format	280 MCQs divided into 7 sixty-minute blocks each with 40 MCQs. 90 seconds for each question.	About 316 MCQs divided into 8 sixty minute blocks. 91 seconds for each question.	Day 1:
			About 233 MCQs divided into 6 sixty minute blocks.
			Day 2:
			About 180 MCQs divided into 6 forty five minute blocks.
			13 computer-based case simulations (CCS). 10-20 minutes for each simulation.

USMLE Step 1

The USMLE Step 1 assesses your knowledge of basic science principles, including anatomy, biochemistry, behavioural science, microbiology, pharmacology, pathology and physiology. Step 1 also tests your knowledge of interdisciplinary areas like genetics, nutrition, and immunology.

USMLE Step 2

Step 2 CK assesses your ability to apply medical knowledge and skill and understand clinical science, critical to patient care, under supervision. It further emphasises diseases prevention and health promotion. The test includes a 45 minutes break and an optional tutorial of 15 minutes.

USMLE Step 3

Step 3 is a two-day examination, a final assessment that evaluates your ability to apply your medical knowledge and understanding of clinical and biomedical science in an unsupervised environment. It emphasises patient management under ambulatory settings and assesses if you can assume independent responsibility in delivering primary medical care. You have to answer 232 multiple-choice items, spread over six blocks of 38-39 items on the first day of Step 3. You are allotted 60 minutes to complete each block over a test time of 7 hours, including a break of 45 minutes and a 5-minute optional tutorial. The second day comprises a test session of 9 hours, which includes an optional tutorial of 5 minutes, followed by 180 multiple-choice items, spread over six blocks of 30 items, with a break time of 45 minutes. You are required to complete each block in 45 minutes. Further, you have to take a 7-minute CCS tutorial followed by 13 case simulations of 10-20 minutes each.

Request a call back

USMLE - Eligibility Criteria

Eligibility for USMLE Step 1 & 2 Exams

To be eligible for the USMEL Step 1 and Step 2 exams, you should meet any one of the below eligibility criteria:

You should be officially enrolled in or have graduated from a medical school in the USA or Canada, leading to the MD degree. The medical school in the US or Canada should be accredited by the Liaison Committee on Medical Education or LCME, the accrediting body of MD programs in the two countries, and recognised by the US Department of Education.
You should be officially enrolled in or have graduated from a medical school in the USA, leading to the DO degree. Such a school should be accredited by the American Osteopathic Association (AOA) Commission on Osteopathic College Accreditation (COCA), the accrediting body for osteopathic educational institutions in the USA, as recognised by the US Department of Education.
You should be enrolled in or have graduated from a medical school listed in the World Directory of Medical schools or WDOMS, outside the US and Canada. Such a school should meet the Educational Commission for Foreign Medical Graduates (ECFMG) eligibility requirements and criteria.

Eligibility criteria for USMLE Step 3

To appear for the USMLE Step 3, you need to meet with ALL of the below-mentioned eligibility criteria:

Ensure you hold an MD (or equivalent, such as MBBS) degree from an LCME-accredited medical school in the US or Canada.
Alternatively, secure a DO degree from an AOA-accredited medical school in the US, or an MD (or equivalent, such as MBBS) degree from a WDOMS-listed medical school outside the US and Canada, and possess ECFMG Certification.
Successfully clear USMLE Step 1 and Step 2 CK examinations.

Before registering for the USMLE exam, verify that your medical school is listed in the World Directory of Medical Schools (WDOMS). Visit the official WDOMS website., use the “Search the World Directory” tab on the Home Page, and enter your medical school’s name. Alternatively, use the drop-down menu to select your country, then enter details about your city and college to check if it is listed.

Request a call back

USMLE Exam Fees

The schedule of USMLE fees for students from the US or Canada

Medical students from LCME or AOA accredited institutions or graduates from medical schools in the USA, or Canada need to apply via the NBME website to register for the exam.

The following is the structure of USMLE fees for Step 1 and Step 2 exams.

USMLE Fee Type	USMLE Cost for Step 1	USMLE Cost for Step 2 (CK)
Application Fee	$680	$680
Rescheduling Fees	Up to $140	Up to $157

USMLE registration for international students

If you wish to register for USMLE but are not a medical student from the USA or Canada, you will have to send your application through the ECFMG website. You will need to pay an $150 to apply for the ECFMG certification.

Additional costs associated with USMLE Step 1 and Step 2 exams

USMLE Fee type	USMLE Price for Step 1	USMLE Price for Step 2 (CK)
Fee to Extend Eligibility Period	$70	$70
Fee to Change Testing Region	$85	$85
Fee to recheck scores	$80	$80
Fee for ECFMG Exam Chart	$50 per request form (up to three copies)	NA
Fee for ECFMG CSA History Chart	$50 per request form (up to three copies)	NA
FEE for USMLE Transcript paper	$70 per request (up to 10 transcripts)	$70 per request (up to 10 transcripts)
USMLE Transcript – Electronic Transmission for ERAS	$80 per ERAS session	$80 per ERAS session

USMLE Fees for Step 3

You can apply for USMLE Step 3 exam only after clearing Step 1 and Step 2 exams. You are required to send your applications for Step 3 exam via the FSMB website after creating your account and logging in. You need to pay the below fees:

USMLE Fee Type	USMLE test fees
Application Fee	$935
Rescheduling Fee	N.A. (non-refundable and non-transferable)

DBS Bank provides international remittance services at preferential rates! Download the app to know more.

Request a call back

How to Register for USMLE exam?

Step 1 Create your ECFMG account.

Step 2 Fill the USMLE step 1 application.

Step 3 Fill and Mail Form 183 to Philadelphia.

Step 4 Wait for your Scheduling Permit.

Step 5 Book your date at a Prometric Centre.

As an international student intending to appear for the USMLE exam, you need to follow the steps mentioned below.

Request a call back

USMLE - Step-wise Syllabus

Below is a step-wise categorisation of the USMLE syllabus

Step 1 Syllabus

USMLE Step 1 Syllabus comprises mainly the subjects learned by students during the first two years of their medical school. Here is the subject-specific information along with the weightage range.

USMLE Step 1 subject-wise distribution

USMLE Fee Type	USMLE Cost for Step 1	USMLE Cost for Step 2 (CK)
Application Fee	$680	$680
Rescheduling Fees	Up to $140	Up to $157

Process

Process	Range
Abnormal Processes	55% - 60%
Normal Processes	10% - 15%
Principles of Therapeutics	15% - 20%
Other	10% - 15%

Step 2 Syllabus

Below is the information about subjects, along with the weightage range for those subjects for USMLE Step 2 CK:

System	Range
General Principles of Foundational Science	1% - 3%
Population Health / Biostatistics & Epidemiology	1% - 5%
Interpretation of the Medical Literature	1% - 5%
Immune System	85% - 95%
Multisystem Processes & Disorders
Blood & Lymph reticular Systems
Endocrine System
Behavioural Health
Male Reproductive System
Female Reproductive System & Breast
Nervous System & Special Senses
Renal & Urinary Systems
Skin & Subcutaneous Tissue
Gastrointestinal System
Musculoskeletal System
Respiratory System
Cardiovascular System

Step 3 Syllabus

The various competencies and weightage held for the USMLE Step 3 exam are as under:

Competency	Foundations of Independent Practice	Advanced Clinical Medicine
Communication and Professionalism	8% - 12%	NA
Medical Knowledge / Scientific Concepts	18% - 22%	NA
Systems-based Practice / Patient Safety and Practice-based Learning	22% - 27%	NA
Patient Care: Diagnosis	40% - 45%	NA
1. History/Physical Examination
2. Laboratory/Diagnosis Studies
3. Diagnosis
Prognosis/Outcome	NA	20% - 25%
Patient Care: Management	NA	75% - 80%
1. Health Maintenance/Disease Prevention
2. Pharmacotherapy
3. Mixed Management
4. Surveillance for Disease Recurrence
5. Clinical Interventions

USMLE - Scores Calculation

The USMLE scoring system varies across its three steps. USMLE Step 1 is now reported as pass/fail, eliminating the numerical score that previously influenced residency applications. In contrast, USMLE Step 2 CK and Step 3 are still numerically scored on a scale of 1 to 300. A higher numerical score on these exams can enhance a medical student's competitiveness for residency programs, with higher scores generally indicating a stronger performance.

Request a call back

Conclusion

Earning a degree in a medical field form a prestigious university abroad can set you on your preferred career path. Since US degrees are recognised worldwide, you also get the freedom to practice in any corner of the world. The USMLE is by no means, an easy exam to crack as is evident by the various steps and the syllabus required. But the good news is that you can access all the study material you need and take practice tests to get an idea about the exam. Here is wishing you all the luck to pass these exams with flying colours.

Download DBS Bank app to experience the seamless process of sending and receiving money from abroad.

Request a call back

. Can I retake the USMLE? If yes, what are the rules surrounding retaking the exam?

Yes, you may retake the USMLE. You may appear for the same examination (or step) up to three times within a period of 12 months. Any attempts made after the 12 months should be at least 1 year after the first attempt of that particular step and at least six months after your most recent attempt at that step.

I have graduated from a medical school in India and want information on what is needed to enter a graduate medical school and/or practice medicine in the US. How can I get the same?

You can get information by visiting the website of the ECFMG website. ECFMG, through its certification program, assesses if you are ready to enter fellowship and residency programs in the US. You can get details about the ECFMG certification and preliminary information about entering into US programs in the ECFMG® Certification Fact Sheet.

How should I prepare for the USMLE? Are there recommended resources?

To effectively prepare for the USMLE, leverage the practice materials and self-assessment resources available on the official USMLE and NBME websites. Additionally, consider taking a practice exam at a Prometric test center to familiarize yourself with the testing environment.

Where are the USMLE test centres located in India?

Students appearing for the prometric USMLE test in India can give their exam in Chennai, Hyderabad, Ahmedabad, Bangalore, Kolkata, Allahabad, Mumbai or New Delhi for step 1 and step 2 tests. For step 3 exams, there are no USMLE centres in India. Students can attempt it only in the USA.

What are the next steps after passing all three USMLE steps?

Successfully completing all three steps of the United States Medical Licensing Examination (USMLE) significantly broadens your professional prospects. It qualifies you to apply for residency programs, enabling specialization in a medical field of your choice. Additionally, passing the USMLE is a prerequisite for obtaining a medical license in the United States, allowing you to practice medicine independently.