USMLE

United States Medical Licensing Examination (USMLE) for General Practitioners (GPs)

The United States Medical Licensing Examination (USMLE) is a multi-step exam required for medical graduates (both U.S. and international) who wish to practice as General Practitioners (GPs) or other physicians in the United States. The exam is conducted by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME).

Exam Structure

The USMLE consists of three steps:

1. USMLE Step 1 (Basic Medical Sciences)

• Format: 280 multiple-choice questions (MCQs), divided into 7 blocks.
• Duration: 8 hours (with breaks).
• Content Areas:
  • Anatomy, Physiology, Pathology, Biochemistry, Pharmacology, Microbiology.
  • Foundations of disease and basic clinical concepts.
  • Pass/Fail system (since 2022).

2. USMLE Step 2 CK (Clinical Knowledge)

• Format: 318 multiple-choice questions (MCQs), divided into 8 blocks.
• Duration: 9 hours (with breaks).
• Content Areas:
  • Internal Medicine, Surgery, Pediatrics, Obstetrics & Gynecology, Psychiatry.
  • Patient management and diagnosis.
  • Scored out of 300 (pass mark ~214-220).

(Step 2 CS (Clinical Skills) was discontinued in 2020.)

3. USMLE Step 3 (Clinical Practice & Decision-Making)

• Format: Two-day exam:
  • Day 1: 232 MCQs (Foundations of Independent Practice).
  • Day 2: 180 MCQs + 13 Computer-based Case Simulations (CCS).
• Duration: 16 hours over 2 days.
• Content Areas: Patient diagnosis, clinical decision-making, public health, ethics.
• Pass/Fail system with a minimum passing score (~198-200).

Eligibility & Application Process

• Candidates must have an MBBS or equivalent degree.
• International Medical Graduates (IMGs) must register with ECFMG (Educational Commission for Foreign Medical Graduates).
• Step 1 and Step 2 CK can be taken outside the U.S., but Step 3 requires ECFMG certification and is usually taken in the U.S.

Preparation Tips

• Study USMLE First Aid, UWorld QBank, Kaplan Notes, Pathoma, and SketchyMedical.
• Practice with NBME self-assessments.
• Focus on clinical guidelines and U.S.-specific medical protocols.
• Develop time management skills for long exam sessions.

Next Steps After Passing

1. Complete USMLE Step 1 & Step 2 CK → Apply for ECFMG certification.
2. Match into a U.S. Residency Program through ERAS & NRMP Match.
3. Complete Residency (3 years for Family Medicine/General Practice).
4. Take USMLE Step 3 during Residency.
5. Obtain a Full Medical License to work as a GP or apply for Board Certification (e.g., ABFM – American Board of Family Medicine).