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USMLE Eligibility

Step 1, Step 2 CK, and Step 2 CS

globe-and-stethescope.jpgTo be eligible to take the USMLE examination, you need to be in one of the following categories at the time of your application and on the day of the test:

  • A medical student officially enrolled in (or a graduate of) an MD program accredited by the Liaison Committee on Medical Education (LCME) at a US or Canadian medical school;
  • A medical student officially enrolled in (or a graduate of) a DO program accredited by the American Osteopathic Association (AOA) at a US medical school; or
  • A medical student officially enrolled in (or a graduate of) a medical school outside the US and Canada and eligible for examination by the ECFMG.

Step 3

There are additional requirements that must be met before you may take Step 3. Before you submit your application you need to:

  • Attain an MD degree (or an equivalent degree) or a DO degree;
  • Pass Step 1, Step 2 CK, and if required by the rules below, Step 2 CS;
  • Receive certification from the ECFMG or complete a “Fifth Pathway” program if you graduated from a medical school outside the US and Canada (information is provided by ECFMG);
  • Meet the Step 3 requirements set by the medical licensing authority to which you are applying.

Note: For Step 3 eligibility, the USMLE programs recommend the completion (or near completion) of at least one postgraduate training year in a graduate medical education program accredited by the AOA or Accreditation Council for Graduate Medical Education (ACCGME). Please contact the FSMB or individual licensing authority for complete information on Step 3 eligibility criteria in the state where you seek licensure.

Who Must Take Step 2 CS?

To be eligible to register for USMLE Step 3, current students and graduates of LCME- or AOA-accredited medical school programs must pass Steps 1 and 2. Those individuals must also pass Step 2 CS as part of the examination requirement for Step 3 if they: (a) graduated or will graduate from medical school in 2005 or later, or (b) graduated from medical school before 2005 but failed to pass the Step 2 CK by June 30, 2005. For international medical school graduates, the ECFMG’s previously administered Clinical Skills Assessment (CSA┬«) has now been replaced by Step 2 CS. As of June 14, 2004, international medical school graduates who have not passed the CSA must pass Step 2 CS as part of the ECFMG certification process. Moreover, holders of ECFMG certificates and Fifth Pathway graduates must have taken and passed either Step 2 CS or the CSA before they can register for Step 3.

Note: Physicians whose basic medical degrees or qualifications were awarded by medical schools outside the US and Canada may be eligible for certification by the ECFMG if their medical school and graduation year appear in the International Medical Education Directory (IMED) of the Foundation for Advancement of International Medical Education and Research (FAIMER┬«). This also applies to US citizens who completed their medical education outside the US and Canada, but not to foreign nationals who graduated from US or Canadian medical schools. Specific eligibility requirements for students and graduates of medical schools outside the US and Canada to take Steps 1 and 2 may be found in the ECFMG’s Information Booklet.

Graduates of Unaccredited Medical Schools in the US and Canada

If you are eligible for licensure by a US medical licensing authority but do not fall into one of the eligible categories described above, you may take the USMLE only at the specific request of the medical licensing authority. Through the sponsorship of that medical licensing authority, you may then take Steps 1 and 2, then Step 3 (if you pass the first two Steps) and all of the following conditions apply:

  • You graduated from an unaccredited medical school in the US or Canada;
  • You are applying for initial medical licensure in the jurisdiction of the licensing authority sponsoring you; and
  • The licensing authority sponsoring you certifies that you meet all of the criteria for licensure in its jurisdiction with the exception of the examination requirement.

If all of these conditions apply, then the medical licensing authority should submit a request to sponsor you to the USMLE Secretariat before your application for the examination.

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