USMLE - FAQ

The USMLE is designed for students of Allopathic Medicine, who are on the path to an MD (Post-Graduation)

A medical student officially enrolled in MBBS/MD program leading to the MD/MBBS degree or graduate from any part of the world provided your University falls into IMED (International Medical Education Directory) or it is recognised by IMED then you are eligible to apply for USMLE steps.

ECFMG is the body that conducts USMLE exams. These exams are divided into four parts i.e.

• Step 1
• Step 2 CK (Clinical Knowledge)
• Step 2 CS (Clinical Skills)
• Step 3

Step 1 & Step 2 CK can be taken in your home country. In case Prometric centres are not available in your country then it can be taken in another country, where Step 2 CS & Step 3 exams are taken in United States.

In India there are more than 11 to 13 Prometric centres where these examinations are conducted. The USMLE Step 1 examination can be taken throughout the year except the first 2 weeks of January, the rest of the year ECFMG is opened. The exam can be taken on all week days except Saturdays and Sundays and may be holidays.

There are two different procedures to apply for USMLE Step 1. One is for a Student who is doing Medical Graduation and the other is for a Medical Graduate.

For a Student :

• Fill the Application form
• Pay application fee (Online)
• Take a printout of the form and get it sign by your Dean
• Send the signed application Form to ECFMG and your Form will be accepted.

For a Medical Graduate :

• Fill the Application form
• Pay Application fee (Online)
• Take a printout of the form and get signed by your college Dean
• Attached all your documentations (Degree, Transcripts, entire set of paper like the hours you spent in your clinical and non-clinical subjects, Marksheet)
• Send the signed application form with all the documents to ECFMG
• ECFMG will verify all the documents by your college

Once the documents get verified then your application will be accepted and you will be given a permit to take an exam.

The duration for USMLE each exams are as follows :

Step 1 : 8 hours

Step 2 : –

• CK : 9 hours
• CS : 8 hours

Step 3 : –

• Day 1 FIP (Foundation of Independent Practice) : 7 hours
• Day 2 ACM (Advanced Clinical Medicine) : 9 hours

The USMLE Step 1 exam is a one day online exam of 8 hours which can be given in Prometric centres available worldwide. The exam generally comprises of 280 multiple-choice questions.

The minimum passing marks required for USMLE Step 1 is 194 and for USMLE Step 2 CK is 209.

It is better to appear in 3^rd year or after 3^rd year or during your Internship. One should always remember that after MBBS/MD it becomes slightly difficult to get back to Basic Sciences.

The cost for Step 1 exam is around $1000 appx.

The subject that covers for USMLE Step 1 exams are:

Anatomy, Physiology, Biochemistry, Microbiology, Pathology, Pharmacology, Behavioral Sciences which is again divided into a Psychiatry portion and Pedagogy & Statistics and Ethics part and Immunology which is genetics immunology. These are smaller topics but a kind of make a difference to your score if you mastered in them.

Some of the topics like Pathology and Pharmacology are highly questioned. There are lots of questions which come from these topics because they have more relevance to clinical scenario.

A lot of this exam depends on how you understand Basic Sciences with respect to Clinical Sciences.

Once you passed USMLE Step 1, Step 2 CK & Step 2 CS your next step should be applying for USMLE Residency Programmes, which is called as NRMP (National Residency Matching Programme).

Always remember, the year you are graduated after finishing your internship and you have your degree in your hand you can apply for NRMP (National Residency Matching Programme) from 15th of September onwards of the same year. This is the earliest you can apply for NRMP.

This is another important aspect of USMLE, Letter of Recommendations (LOR’s). You need minimum atleast 3 – 5 LOR’s from US preferably because anything you do in India there would be lot of letter you may be able to get from various resources. They are important but fulfill only 15% of your requirement. So you need around 85% of LOR’s from outside of India and maximum from US. That is the reason your electives, internship, observership, externship, research electives anything you do outside of India is more important.

There is something called MSPE (Medical Student Performance Evaluation) which is probably all US schools/Philippines schools/ Caribbean schools (or school following US study pattern) mandatory awards this evaluation. This is a format which is available online. If your medical school can actually provide this, it would make your application document look a lot more professional. So that is something you can probably add to your application. Again your USMLE score is extremely important. The higher score the better chance of getting call.

The different type of Visa that you will get for US Residency is J1 and H1 visa.

Clinical Electives, you can only do it after you finish your final year and while you are doing your internship before you receive your degree. So this is the only window that most students can get in India to be able to apply for the US match. So to make sure that you are having that period free. Sometimes students take a drop from their internship may be a few months of delay their degree, sometimes even if it means taking an extra 1 yr for applying to the programme I still would say it is very superior over trying to do it after your internship. Because once you complete you internship and get your degree you are considered as graduate and once you are a graduate you can only get an observership or may be externships in smaller hospitals. So the hands on work part or may be a sub internship where they actually make you do a rotation or duty along with the US resident that entire kind of exciting thing can only happen if you are still a student. If you like to work in the US I would certainly recommend that you go ahead and do an elective sometimes during your internship because that really works very-very high and getting an LOR while on work while on duty from some of the top names in US will definitely help you.

Sometimes doing an elective in the program also helps you because they can call you for an interview because they have seen you working, they like you, and you have your scores. So those things are advantage so make sure you try to do as many electives as possible during your internship because that would definitely help you and any kind of research publications you do in your medical school or volunteer any programme, leadership any extra-curricular activity. Anything that sets you apart that lets you understand that you are not just a book worm; you are not somebody who just reads and doesn’t do anything beyond that. Any kind of prices, awards whether it is for essay writing, singing songs, dancing, cookery whatever it is that gives you slightly different dimension than what you already have is very-very welcome. They would like to see whatelse you can do beyond studies which they can see from your scores. So just try to do something beyond what you already know and what you are comfortable with.