The United States Medical Licensing Examination, or USMLE for short, is a three-step examination that doctors with an MD degree are required to pass to practice medicine in the US. The USMLE examinations are sponsored by the National Board of Medical Examiners (NMBE) and the Federation of State Medical Boards (FSMB).

In this article, we will go over the three steps briefly and outline an effective USMLE study schedule.

What Is USMLE Step 1?

Step 1 of the USMLE is a computer-based, one-day, eight-hour-long examination, divided into seven one-hour question blocks with one hour of break time. The one-hour break time can be taken all at once or 5-10 minutes at a time after each question block. Each block consists of 40 questions. The subjects covered in Step 1 are biochemistry, anatomy, physiology, microbiology and immunology, pathology, pharmacology, genetics and ageing, biostatistics and epidemiology, medical ethics, and behavioural science.

Step 1 is a big deal because directors of medical residency programs consider the results of this exam while choosing candidates for the program. Moreover, you cannot retake the exam to get a higher score if you have already passed it once. Any failed attempts go on your permanent record.

Another point to keep in mind is that the result may be announced 2-4 months after you’ve taken the exam, so make sure you plan ahead for the next step.

Tips to Prepare for USMLE Step 1

  • Reach out to medical school faculty who have seen previous years’ exams or have reviewed the exams as they can advise you on the important topics and give you other exam tips.
  • Be thorough with the standard topics, as well as new additions. Exam content varies every year, so be sure to practice from different years’ exams.
  • Apart from standard topics, memorize terminologies and definitions well.
  • Practice complex concepts by explaining them to a friend or writing them down.
  • Understand your own weak and strong points, and focus on how to bridge the gap in your knowledge.

What is USMLE Step 2?

Step 2 CK is a one-day nine-hour examination, divided into eight 60-minute blocks. Each block may have a different number of questions, but will not exceed 40. The total number of items on the overall examination will not exceed 318.

Step 2 CK tests a medical student’s skills in applying their technical knowledge as well as their understanding of clinical science, which are essential for providing patient care under supervision. Step 2 CK focuses on health promotion and disease prevention and ensures that the student is equipped with a strong foundation in principles of clinical sciences and basic patient-centred skills.

Tips to Prepare for USMLE Step 2

  • Try to clear the exam before finishing medical school, so you have enough time in case you need a retake.
  • Practice previous years’ exam questions.
  • Prioritise absorbing as much knowledge as you can during the internship year to build a deep clinical knowledge base.
  • Revise as early as 2 weeks before the date of the exam.
  • Schedule breaks between study sessions to avoid burnout.

What is USMLE Step 3?

Step 3 is the final step in becoming a physician. Clearing this means you can now practice medicine without supervision. It is a two-day computerized exam that has 500 multiple-choice questions, and also includes computer-based case simulations (CCS). These are virtual versions of patient encounters to test how you apply your theoretical knowledge in everyday scenarios as a doctor.

Step 3 tests your ability to apply medical knowledge and understanding of biomedical and clinical science required to be able to practice unsupervised, with emphasis on patient management in ambulatory settings.

How to Prepare for USMLE Step 3

  • Review medical textbooks and practice questions from previous years’ exams.
  • While preparing for the CCS part of the exam, focus on familiarizing yourself with the software and being both thorough and efficient with your virtual patients. Practice handling different medical scenarios with your friends if possible.

It is recommended that you take approximately12 months to prepare for USMLE Step 1, and 4-7 months for USMLE Step 2 CK.