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fore a physician with an M.D. degree is eligible to apply for an unrestricted license to practice medicine in the
United States. U.S. osteopathic medical school graduates are permitted to take the USMLE for medical licensure, which they can also obtain by passing the multipart Comprehensive Osteopathic Medical Licensing Examination (COMLEX) professional exam. Students who
have graduated from medical schools outside the US and
Canada must pass all three steps of the USMLE to be licensed to practice in the US, regardless of the title of their
degree. Overall pass rates for USMLE Step 1 test takers
in 2013-2014 are: 95% for U.S. M.D. medical school
graduates (97% in rst-time takers), 94% for U.S. D.O.
osteopathic medical school graduates (94% in rst-time
takers), and 72% for international medical school graduates (79% for rst-time takers).[3] Overall USMLE Step
2 CK test taker pass rates in 2013-2014 are: 97% for
U.S. M.D. medical school graduates (98% in rst-time
takers) and 96% for U.S. D.O. medical school graduates (96% in rst-time takers).[4] Overall USMLE Step
2 CS test taker pass rates in 2013-2014 are: 97% for
U.S. M.D. medical school graduates (98% in rst-time
takers) and 89% for U.S. D.O. medical school graduates (89% in rst-time takers), though this gure may be
somewhat misleading since there were 19,757 M.D. rsttime test takers and 63 D.O. rst-time test takers.[5] Overall pass rates for USMLE Step 3 test takers in 2013-2014
are: 96% for U.S. M.D. medical school graduates (97%
in rst-time takers), 92% for U.S. D.O. medical school
graduates (96% in rst-time takers), and 83% for international medical school graduates (87% in rst-time takers). These statistics may be somewhat misleading since
there were 19,086 M.D. rst-time test takers for Step 3
and 23 D.O. rst-time test takers. (In these statistics,
U.S. M.D. medical school graduates includes graduates
of Canadian M.D. programs.)[6]
Purpose
The USMLE assesses a physicians ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health
and disease and that constitute the basis of safe and
eective patient care.[2] Examination committees composed of medical educators and clinicians from across the
United States and its territories prepare the examination
materials each year.
Overview
3 Step 1
4 STEP 2
reason the Step 1 is unanimously viewed as the most arduous and paramount examination a medical student will
ever sit during his or her entire career. It has substantial
bearing on the specialties and location a residency applicant is competitive for.
Physiology,
Microbiology,
Biochemistry,
4 Step 2
Anatomy,
Philadelphia
Chicago
Atlanta
Houston
Los Angeles
If the student passes the exam, he or she may not repeat Before 2004, a similar exam, the Clinical Skills Assessit to achieve a higher score, and any failed attempt is per- ment (CSA) was used to assess the clinical skills of formanently recorded. This one-time deal situation is the eign medical graduates.
Step 3
7 Performance
Grade point average in undergraduate science courses
and performance on the MCAT, particularly the biological sciences and physical sciences sections, are strong predictors of performance on the USMLE step 1 and step 2
exams, though it is unclear whether the verbal reasoning
portion of the MCAT has any predictive value.[14] The
selectivity of undergraduate institution is also a predictor
of step 1 and step 2 performance, even when controlling
for undergraduate GPA and MCAT score.[14]
8 Similar exams
The Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) is required for
osteopathic physicians in the United States
Format
The USMLE rst started out as a paper examination, converting to a computer based multiple choice examination.
The test can be taken at Prometric test centers worldwide. However, the Step 2 CS and the Step 3 can only
be taken in the USA. The software used to administer
the test, the NBME FREDtm , was upgraded in 2008 to
a new version, FREDtm V2. The implementation of this
changeover continues.
In other countries
9 References
[1] United States Court of Appeals for the Third Circuit.
1605859. John Doe v. National Board of Medical Examiners, appellant, D.C. Civ. No. 99-cv-04532. AltLaw
[2] 2010 Bulletin of Information: USMLE. A publication of
the FSMB and the NBME. 2009.
[3] 2013 Performance Data. Step 1 Administrations. Federation of Medical State Boards. 2014. Retrieved 26 February 2015.
[4] 2013 Performance Data. Step 2 CK Administrations.
Federation of Medical State Boards. 2014. Retrieved 26
February 2015.
[5] 2013 Performance Data. Step 2 CS Administrations.
Federation of Medical State Boards. 2014. Retrieved 26
February 2015.
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[6] 2013 Performance Data. United States Medical Licensing Examination. 2014. Retrieved 26 February 2015.
[7] USMLE web site, 2007 bulletin
[8] USMLE.org.
[9] USMLE.org.
[10] usmle.org
[11] http://www.nrmp.org/data/programresultsbyspecialty.
pdf
[12] http://www.nrmp.org/wp-content/uploads/2014/09/
Charting-Outcomes-2014-Final.pdf
[13] http://medicalopedia.org/2648/
usmle-new-changes-2014-step-3-going-to-be-divided-into-two-parts/
[14] Kleshinski, James; Sadik A. Khuder; Joseph I. Shapiro;
Jerey P. Gold (7 November 2007). Impact of preadmission variables on USMLE step 1 and step 2 performance (PDF). Advances in Health Science Education
(Springer) 14: 6978. doi:10.1007/s10459-007-9087-x.
Retrieved August 22, 2010.
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