United States Medical License Examination (USMLE) is a three-step examination. It is mandatory for all medical graduates in order to get residency and to practice medicine in the United States of America (USA). You should pass USMLE Step 1, Step 2 CK and Step 2 CS to be qualified to apply for residency in the USA. Step 3 pass is mandatory to practice medicine without supervision.
USMLE Step 1 Examination:
Step 1 assesses your understanding of basic sciences and application of this knowledge on clinical situations. Most of the questions are clinical scenarios followed by a question and 4 or more answers and you choose the correct one. It is one day examination. The test includes 280 questions divided into 7 blocks. Each block is 1 hour. There is also a presentation of 15 minutes before the test and 45 minutes of break time.
Subjects covered by USMLE Step 1 are: anatomy, physiology, Biochemistry and cell biology, pathology, pharmacology, microbiology, behavioral sciences, epidemiology and statistics.
USMLE Step 2 CK Examination:
Step 2 CK assesses your decisions on clinical situations regarding diagnosis and treatment and patient care. It is one day examination and it includes 320 questions divided into 8 blocks. Each block is one hour. There is also a presentation for 15 minutes and 45 minutes of break time. It has the same format of multiple-choice questions as Step 1 examination.
Subjects covered by USMLE Step 2 CK are: general and systematic medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry and forensic medicine.
USMLE Step 1 and Step 2 CK can be taken in different countries and not only in the USA.
USMLE Step 2 CS Examination:
Step 2 CS assesses your interaction with the patients in terms of patient care, communication, history taking, physical examination and documentation. It uses standardized patients (actors not real patients). The test includes 12 cases. You have 15 minutes to stay inside the room with each standardized patient to take a history, perform exam and discuss the case with the patient. After you leave the room you will have 10 minutes to write patient notes. There is a lunch break of 30 minutes after 4 cases and another break of 15 minutes after 4 more cases. This test is only taken in the USA test centers.
USMLE Step 3 Examination:
This is the final examination of the USMLE series and it assesses your ability to take decisions in clinical situations and follow up without supervision. It is a 2- day exam. The first day includes 256 multiple choice questions divided into 6 blocks. Each block is one hour. There are 5-minute tutorial and 45 minutes of break time. The second day includes 198 multiple choice questions divided into 6 blocks. Each block is 45 minutes. These blocks are followed by 13 case simulations (CCS). These cases are advancing scenarios on the computer, not standardized patients as in Step 2 CS. Each case takes 10-20 minutes and there is 45 minutes of break time. This test is also taken only in the USA test centers.