Your Complete Guide to National Interest Waivers and EB1 Green Cards

USMLE Examination

male-and-female.jpgThe United States Medical Licensing ExaminationTM (USMLETM) is a three step examination for medical licensing in the United States sponsored by the Federation of State Medical Boards of the United States, Inc. (FSMB) and the National Board of Medical Examiners® (NMBE®). In the United States and its territories, the medical licensing authorities (i.e., state medical boards) of the various jurisdictions grant a license to practice medicine. As part of the licensure process, these medical licensing authorities require applicants to pass an examination that demonstrates their qualification. The USMLE proves these authorities with a common evaluation system for applicants for initial medical licensure.

The FSMB and NBME appoint a Composite Committee to establish the USMLE program’s policies. Members of the Composite Committee include representatives from the NBME, FSMB, Educational Commission for Foreign Medical Graduates (ECFMG®), and the American public. Changes in the USMLE program may occur and will appear on the USMLE website. If you cannot access the website, please write to the USMLE Secretariat for current rules.

In addition, medical educators and clinicians comprise the examination committees that prepare the examination materials. Committee members represent a broad sample of the many teaching, practicing, and licensing communities throughout the United States. A minimum of two such committees evaluate each test item or case, revising or discarding any materials in doubt.

The USMLE Examination

The USMLE examination assesses the physician’s ability to apply knowledge, concepts, and principles; and requires the physician to demonstrate the fundamental skills necessary for successful patient care. The examination is designed such that each of the test’s three steps complements the others; no one Step is individually sufficient to assess a physician’s preparation for medical licensure. Since individual medical licensing authorities make their own decisions about the use of USMLE results, you must request information from the jurisdiction in which you plan to apply for licensure. Additionally, the FSMB offers general information about medical licensure.

The Three Steps

Step 1 evaluates whether you are able to comprehend and apply key scientific concepts essential to the practice of medicine. Particular emphasis is placed on mechanisms and principles of health, disease, and methods of treatment. Step 1 verifies mastery of the sciences on which the safe and competent practice of modern medicine is based, as well as the scientific principles necessary to maintain competence through lifelong learning.

Step 2 determines whether you can apply the medical knowledge, skills, and comprehension of clinical science vital for providing supervised patient care, with particular emphasis on disease prevention and health promotion. The purpose of Step 2 is to ensure that you devote sufficient attention to principles of clinical sciences and the essential patient-centered skills needed for a physician to practice medicine in a safe and competent manner.

Step 3 judges whether you can apply the medical knowledge and understanding of clinical and biomedical science necessary for practicing medicine without supervision, with an emphasis on managing patients in ambulatory settings. Step 3 is the final evaluation of the physician’s ability to assume independent responsibility for providing general medical care.

Step 2 Clinical Skills (CS)

The original design of the USMLE includes a clinical skills examination. The NBME had the task of including a clinical skills test using standardized patients when such a test was demonstrably practical, reliable, and valid. Research by the NBME and other organizations that administer clinical skills tests demonstrates that such tests measure skill sets distinct from those assessed by multiple-choice questions. It is important to the protection of the public that individuals who seek medical licensure have mastery of not only cognitive skills, but of clinical and communication skills as well.

The clinical skills examination was first implemented in June 2004. It is a separately administered part of Step 2 and is called Step 2 Clinical Skills (or Step 2 CS). The multiple-choice, computer-based section of Step 2 is called Step 2 Clinical Knowledge (or Step 2 CK). There are five regional test centers (CSEC centers) in the United States that administer Step 2 CS.

Computer-based Testing (CBT)

Some sections of the USMLE are administered by computer. Thomson Prometric provides scheduling and test centers for the computer-based portions of the test. Step 1 and Step 2 CK are available throughout the world at Prometric Test Centers (PTCs). However, Step 3 is only offered at PTCs in the United States and its territories.

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