USMLE

United States Medical Licensing Examination (USMLE)                

Introduction

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.

Note: You must become familiar with the information in this bulletin if you are an applicant with an eligibility period in 2009. If your eligibility period extends into 2010 and you test in 2010, you must become familiar with and will be subject to the policies and procedures detailed in the 2010Bulletin of Information. Eligibility periods are explained in this Bulletin. To apply for the USMLE, you must contact the appropriate registration entity.

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.

http://www.usmle.org                                                

Visit the USMLE website for up-to-date information.

Purpose of the USMLE
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 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.

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 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.

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 Irregular Behavior, every legal means available to protect USMLE copyrighted materials and secure redress against those who violate copyright law may be pursued.

COMPUTER-BASED TESTING (CBT)
Parts of the USMLE are administered by computer. Thomson Prometric™, a part of The Thomson Corporation, provides scheduling and test centers for the computer-based components of 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.

USMLE STEP 2 CLINICAL SKILLS (CS)
Implementation of the clinical skills examination began in June 2004. 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 USMLE

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 has been no in-depth review of overall program design and structure since they were first conceived approximately two decades ago. In 2004, around the time that USMLE was nearing implementation of the Step 2 CS program, the USMLE Composite Committee called for a comprehensive review of the entire USMLE program to determine if the mission and purpose of USMLE are 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), which includes members who bring the perspective 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 this process. Some, but not all, members of the committee have had previous experience in the USMLE program as item writers, reviewers, or test committee members.

To inform CEUP, staff members have 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 a sampling of representatives from the medical licensing authorities and from the US undergraduate and graduate education communities. Input has also been sought from institutional and national leaders from the international medical education community. Recent USMLE examinees, both US-trained and internationally trained, were surveyed, as were leaders of local and national student groups.

The CEUP report and information on the feasibility and implications of its recommendations will receive substantial review by the staff and governing bodies of ECFMG, FSMB, and NBME. Proposals for major changes to USMLE will need to be approved by the house of delegates of FSMB and by the full board of NBME. This will not occur any earlier than spring 2009. If changes are approved, it will take at least two additional years to work out the details for a reasonable transition to the new design and structure, and to begin implementation.

USMLE™ - United States Medical Licensing Examination Centers
The following are postal addresses and phone numbers of the centers, where the US Medical Licensing Examination is held in India. This has started since May this year, with USMLE Step 1, and the Step 3 examination has also been shifted to the computer-based testing (CBT) since November 1.

What is it like?
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles that are important in health and disease and that constitute the basis of safe and effective patient care.
The USMLE means actually three exams, called STEPS. Each of the three steps complements the others; no step can stand alone in the assessment of readiness for medical licensure.

Step 1 has approximately 350 multiple-choice test items, divided into seven 60-minute blocks, administered in one eight-hour testing session.

Step 2 CK has approximately 370 multiple-choice test items, divided into eight 60-minute blocks, administered in one nine-hour testing session.

Step 2 CS has 12 patient cases. You will have 15 minutes for each patient encounter and 10 minutes to record the patient note. If you do not use the entire 15 minutes for the patient encounter, the remaining time will be added to the time you have to record the patient note. The testing session is approximately eight hours.

Step 3 has approximately 480 multiple-choice test items, divided into blocks of 35 to 50 items. You will have 45 to 60 minutes to complete each of these blocks. Step 3 is a two-day examination containing computer simulations.

For further information about the Examination Content please visit the website address www.usmle.org.