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United States Medical Licensing Examination

Aug 23, 2022
Vaagai Team

United States Medical Licensing Examination or USMLE is the 3-step qualifying examination for all the MD graduates who wants to practise medicine in the US. It is regulated by two entities – Federation of State Medical Boards (FSMB) and National Board Medical Examiners (NBME). Every medical licensing authority has its own rules and regulations to qualify the eligible doctors in the country, it represents. Likewise, USMLE is administered by a committee of ECFMG, FSMB, NBME and public.

Eligibility to apply for USMLE

The USMLE can be applied by the MD graduates studied or studying in the US or in any other country, wanting to get licensed to practise in the United States of America. As USMLE is a 3-phase examination, the qualification for the first two phases and the final third phase vary.

USMLE Format

Phase I & II The graduate must be doing medical studies in the US or Canada or any other country’s medical institution listed in the World Directory of Medical School by WHO.
Phase III
  • The candidate must have clear step 1, step 2 CK & step 2 CS.
  • The candidate must have obtained MD/D.O./equivalent medical degree from a medical school accredited by LCME or the AOA in the U.S. or Canada

USMLE Full Description: Format and duration

As USMLE follows 3-step process to identify the eligible candidates to practise medicine in the US, the full detailed description is given below,

USMLE – Step 1: System and Process

It is a one-day exam containing seven 60 minutes blocks and one 8-hour testing session. Each block has different numbers of questions but not exceeding 40 which does not exceed 280 questions overall.

The primary goal of the Step 1 of USMLE is to test the candidate’s practical/application knowledge on the basic concepts of medicine.

Step 1 of 1,2,3 & 4: test Specifications
USMLE Format Range %
General Principles 13-17
Behavioural Health & Nervous Systems / specific sciences 9-13
Blood & Lymphoreticular / Immune Systems 7-11
Cardiovascular System 6-10
Musculoskeletal, skin & subcutaneous tissue 6-10
Gastrointestinal Systems 5-9
Respiratory & Renal/Urinary systems 9-13
Multisystem processes & Disorders 7-11
Reproductive & Endocrine systems 9-13
Social Sciences: Communication skills / Ethics 3-5
Step 1 of 2: Process Specifications
Processes Range %
Normal Processes 10-15
Abnormal Processes 55-60
Principles of Therapeutics 15-20
Others 10-15
Step 1 of 3: Physician Tasks/Competencies Specifications
Competency Range %
Medical Knowledge 52-62
Patient Care: Diagnosis 20-30
Patient Care: Management 7-12
Communication/Professionalism 2-5
Practise-based Learning & Improvement 5-7
Step: 1 of 4: Discipline Specifications
System Range %
Pathology 45-52
Physiology 26-34
Pharmacology 16-23
Biochemistry & Nutrition 14-24
Gross Anatomy & Embryology 11-15
Histology & Cell Biology 9-13
Behavioural science 8-13
Genetics 5-9
USMLE – Step 2: CK & CS

Step 2 has 2 components i.e. Clinical Skills (CS) and Clinical Knowledge (CK).


USMLE – Step 3

Step 3 is the final step of the USMLE and is a two-day examination. To appear for USMLE step 3, ECFMG certificate to authenticate that the Medical graduate is duly eligible.

Day 1

USMLE step 3 Foundations of Independent Practice (FIP)

The assessment focuses on the knowledge of basic medical and scientific principles necessary for effective health care. Application o foundational sciences, interpretation of the medical literature, and understanding of biostatistics and epidemiology, and application of social sciences including interpersonal and communication skills, system-based practise, medical ethics and patient safety.

The first day of the test consists of 232 multiple-choice items of 6 blocks that roofs 38-39 items. Each block of the test has been to completed in 60 minutes. So, 7 hours in total is required with 45 minutes of break time and 5 minutes of optional tutorial are also given in-between to complete the day 1 test of the USMLE step 3.

Day 2

USMLE step 3 Advanced Clinical Medicine (ACM)

The ability to apply the comprehensive knowledge of health and disease in the context of patient management and the evolving signs of disease over time is assessed. The content areas focused on the step3 of the day 2 includes assessment of knowledge of diagnosis and management, health maintenance and screening, particularly focused on prognosis and outcome, therapeutics, and medical decision making.

The test format includes multiple-choice questions and computer-based case simulations. Approximately 9 hours is set for the Day 2 test. 180 items of MCQs segregated into 6 blocks of 30 items should be answered as each block is timed for 45 minutes with 5 minutes of optional tutorial. A 7-minute CCS tutorial is also included, which is followed by 13 case simulations. 10-20 minutes is allotted for each case simulations.


All American Institute of Medical Sciences (AAIMS), Jamaica provides MD degree facilitated by the expert professors, new-age technology and hands-on practical experience on clinical settings. And majorly the institute has international students, exposure to world-class educational standards and scope to practise medicine across the globe.

Integrated USMLE training is also granted. AAIMS award the MD degree along with the ECFMG certificate. So, it’s a promise that all the MD graduates from AAIMS is certified for the licensure to practice in the United States of America and also in the predominant countries in the world.

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