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Attempt limit for USMLE examinations

Posted: June 20, 2012

Examinees who have made six or more attempts to pass a Step or Step component, including incomplete attempts, should be aware that all applications to register for additional attempts will not be processed unless they are submitted on or before December 31, 2012. This limit was first announced in August of 2011.

The effective date for the six-attempt limit depends upon whether an examinee has taken any Step or Step Component (including incomplete attempts) before January 1, 2012.

 Examinees who had NOT taken any Step or Step Component before January 1, 2012
If you did not take any Step or Step Component before January 1, 2012, the six-attempt limit went into effect for all exam applications that you submitted on or after January 1, 2012.

Example 1: On January 15, 2012, Examinee A submits his application for his first attempt at any Step or Step Component. The six-attempt limit is effective at that time for all Steps and Step Components and Examinee A will be allowed to take each Step or Step Component no more than six times, including incomplete attempts.

• Examinees who have taken any Step or Step Component before January 1, 2012
If you have taken any Step or Step Component (including incomplete attempts) before January 1, 2012, the six-attempt limit is in effect for all exam applications that you submit on or after January 1, 2013.  After that date, all attempts at a Step or Step Component will be counted toward the limit, regardless of when the exams were taken.

Example 2: Examinee B’s application for a seventh attempt at a particular Step or Step Component is received on December 15, 2012. For this examinee, the six-attempt limit will not prevent the seventh attempt, since the application was submitted before January 1, 2013.  However, if Examinee B fails the exam, he will not be eligible to submit an application after January 1, 2013 to retake that Step or Step Component.

Example 3:  Examinee C attempts to submit an application for a seventh attempt at a particular Step or Step Component on or after January 1, 2013. The application will not be processed, since all exam applications submitted on or after January 1, 2013 will be subject to the six-attempt limit.


Please refer to the 2012 Bulletin of Information for more complete information on time and attempt limits.



Updated information materials for the Step 2 CK examination are now available

Posted: July 25, 2014
Updated: July 29, 2014

Updated information materials for the Step 2 Clinical Knowledge (CK) examination have been posted to the USMLE website. They include:


• USMLE Step 2 CK Sample Test Questions booklet (PDF)
 USMLE Step 2 CK Content Description and General Information booklet (PDF)
• Tutorial and practice test questions for multiple-choice items

Updates to the information materials include information regarding test specifications for the Step 2 CK examination that correspond to the organization of content areas in the USMLE Content Outline for all USMLE examinations, as well as test specifications that correspond to the organization of content areas in the USMLE Physician Task/Competencies outline. All USMLE examinations published in 2014 are being constructed using the classification systems in these two documents. Each Step exam will continue to have test specifications specific to that Step. Each Step exam will emphasize certain parts of both the content and task/competencies outline, and no single examination will include questions on all topics in the content outline.

Please note that changes to the Step 2 CK exam in 2014 resulting from use of the new outlines are minor, and the examination content will be similar to content on previous examinations. One change to note, however, is that the downloadable Step 2 CK practice test questions now include a multi-media item assessing recognition of breath sounds, similar in format to items assessing heart sounds.

The previous Step 2 CK content outline will remain available on the USMLE website for reference.


USMLE Physician Tasks/Competencies

Posted: July 10, 2014

USMLE Physician Tasks/Competencies, a publication that provides a common organization of competencies and tasks assessed in USMLE examinations, is now available.

The outline comprises seven major sections:

  • Medical Knowledge/Scientific Concepts
  • Patient Care: Diagnosis
  • Patient Care: Management
  • Communication and Interpersonal Skills
  • Professionalism, including Legal and Ethical Issues
  • Systems-based Practice, including Patient Safety
  • Practice-based Learning

While this outline is common to all USMLE examinations, each Step will continue to have test specifications specific to that Step and will emphasize certain parts of the outline.

The USMLE Step 3 Content Description and General Information booklet contains a description of physician tasks/competencies covered in the restructured Step 3 examination for examinees taking the Step 3 examination on or after November 3, 2014. An updated USMLE Step 2 CK Content Description and General Information booklet containing a description of physician tasks/competencies covered in that examination will be available in July 2014.

USMLE Physician Tasks/Competencies is useful for understanding competencies assessed by multiple-choice question (MCQ) formats such as Step 1, Step 2 Clinical Knowledge, and the MCQ portion of Step 3. The outline will be updated as work to identify competencies covered by non-MCQ exam formats progresses.


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