Overview
- Introduction
- Purpose
- The Three Steps
- Exam Committees
- Ownership and Copyright
- CBT
- Step 2 CS
- Comprehensive Review
Introduction
Note: You must become familiar with the information in this Bulletin if you are an applicant with an eligibility period in 2012. If your eligibility period extends into 2013 and you test in 2013, you must become familiar with and will be subject to the policies and procedures detailed in the 2013 Bulletin of Information. Eligibility periods are explained under Obtaining an Eligibility Period. To apply for the USMLE, you must contact the appropriate registration entity.
The United States Medical Licensing Examination® (USMLE®) is a three-step examination for medical licensure in the United States and is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®).
The Composite Committee, appointed by the FSMB and NBME, establishes policies for the USMLE program. Membership includes representatives from the FSMB, NBME, Educational Commission for Foreign Medical Graduates (ECFMG®), and the American public.
Changes in the USMLE program may occur after the release of this Bulletin. If changes occur, information will be posted at the USMLE website. You must obtain the most recent information to ensure an accurate understanding of current USMLE rules. If you are unable to access updated USMLE information via the Internet, you may contact the USMLE Secretariat in writing for updated information.
Purpose of the USMLE
USMLE Mission Statement
The United States Medical Licensing Examination (USMLE) program supports medical licensing authorities in the United States through its leadership in the development, delivery, and continual improvement of high quality assessments across the continuum of physicians' preparation for practice.
In the United States and its territories ("United States" or "US"), the individual medical licensing authorities ("state medical boards") of the various jurisdictions grant a license to practice medicine. Each medical licensing authority sets its own rules and regulations and requires passing an examination that demonstrates qualification for licensure. Results of the USMLE are reported to these authorities for use in granting the initial license to practice medicine. The USMLE provides them with a common evaluation system for applicants for medical licensure.
The USMLE assesses a physician's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care. Each of the three Steps complements the others; no Step can stand alone in the assessment of readiness for medical licensure. Because individual medical licensing authorities make decisions regarding use of USMLE results, you should contact the jurisdiction where you intend to apply for licensure to obtain complete information. Also, the FSMB can provide general information on medical licensure.
USMLE Goals:
- To provide to licensing authorities meaningful information from assessments of physician characteristics—including medical knowledge, skills, values, and attitudes—that are important to the provision of safe and effective patient care.
- To engage medical educators and their institutions, licensing authority members, and practicing clinicians in the design and development of these assessments.
- To assure fairness and equity to physicians through the highest professional testing standards.
- To continue to develop and improve assessments for licensure with the intent of assessing physicians more accurately and comprehensively
The Three Steps of the USMLE
Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for the maintenance of competence through lifelong learning.
Step 2 assesses whether you can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine.
Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care.
Examination Committees
Examination committees composed of medical educators and clinicians prepare the examination materials. Committee members broadly represent the teaching, practicing, and licensing communities across the United States. At least two of these committees critically appraise each test item or case. They revise or discard any materials that are in doubt.
Continue to: Ownership and Copyright of Examination Materials »
Ownership and Copyright of Examination Materials
The examination materials used in the USMLE are copyrighted. If you reproduce and/or distribute any examination materials, by any means, including memorizing and reconstructing them, without explicit written permission, you are in violation of the rights of the owners. In addition to actions described under Indeterminate Scores and Irregular Behavior, every legal means available to protect USMLE copyrighted materials and secure redress against those who violate copyright law may be pursued.
CBT - Computer Based Testing
Parts of the USMLE are administered by computer. Prometric provides scheduling and test centers for the computer-based components of the USMLE. Step 1 and Step 2 CK are given around the world at Prometric Test Centers (PTCs). Step 3 is given at PTCs in the United States and its territories only.
Step 2 CS (Clinical Skills)
The clinical skills examination is a separately administered component of Step 2 and is referred to as Step 2 Clinical Skills, or Step 2 CS. The computer-based, multiple-choice component of Step 2 is referred to as Step 2 Clinical Knowledge, or Step 2 CK. USMLE Step 2 CS is administered at five regional test centers (CSEC Centers) in the United States.
The Comprehensive Review of the USMLE
Background
The USMLE examination program was designed in the late 1980s and introduced during the period 1992 to 1994. The program replaced the NBME Part Examination program and the Federation Licensing Examination (FLEX) program, which were the widely accepted medical licensing examination programs at that time. While the content and design for the USMLE Step examinations have been continuously reviewed and refreshed, there had been no in-depth review of overall program design and structure since the sequence was first conceived. In 2004, the USMLE Composite Committee called for a comprehensive review of the entire USMLE program to determine if the mission and purpose of USMLE were effectively and efficiently supported by the current design, structure, and format of the USMLE.
The primary responsibility for this review was given to the Committee to Evaluate the USMLE Program (CEUP), reflecting perspectives of students, residents, fellows, Deans and Associate Deans, basic science and clinical faculty, international medical graduates, state medical boards, practicing physicians, and the public.
To inform CEUP, staff members used surveys and focus groups to gather information about the impact and relevance of the USMLE program from a wide range of individuals and organizations, including representatives from the medical licensing authorities, the US undergraduate and graduate education communities, and institutional and national leaders from the international medical education community
Current Status
The CEUP report and the implications of its recommendations were carefully reviewed by the staff and governing bodies of ECFMG, FSMB, and NBME. In 2009, the proposal for changes to the USMLE was approved. Research, planning, and implementation have begun. Learn about the latest CRU developments »
