The United States Medical Licensing Examination (USMLE) is a multi-part professional exam sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). Physicians with an M.D. degree are required to pass this examination before being permitted to practice medicine in the United States; see below for requirements of physicians with a D.O. degree
Purpose:
The USMLE assesses a physician's 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 effective patient care. Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
Overview:
Students and graduates of U.S. or Canadian medical school programs accredited by either the Liaison Committee on Medical Education (LCME) or Committee on Accreditation of Canadian Medical Schools, leading to the Doctor of Medicine (M.D.) degree, or by the American Osteopathic Association (AOA), leading to the Doctor of Osteopathic Medicine (D.O.) degree, register for Step 1 and Step 2 of the USMLE with the NBME. Students and graduates of medical schools outside the United States or Canada register for Step 1 and Step 2 with the Educational Commission for Foreign Medical Graduates (ECFMG).
Graduates of medical schools in and outside the United States and Canada register for Step 3 with the FSMB or with a medical licensing authority in the United States. Each of the three steps of the USMLE examination complements the other; no step stands alone in the assessment of readiness for medical licensure. The USMLE program recommends that for Step 3 eligibility, licensure authorities require the completion, or near completion, of at least one postgraduate training year in a program of graduate medical education accredited by the Accreditation Council on Graduate Medical Education (ACGME) or the American Osteopathic Association (AOA).
All three steps of the USMLE exam must be passed before 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 multi-part 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 first-time takers), 94% for U.S. D.O. osteopathic medical school graduates (94% in first-time takers), and 72% for international medical school graduates (79% for first-time takers). Overall USMLE Step 2 CK test taker pass rates in 2013-2014 are: 97% for U.S. M.D. medical school graduates (98% in first-time takers) and 96% for U.S. D.O. medical school graduates (96% in first-time takers).
Overall USMLE Step 2 CS test taker pass rates in 2013-2014 are: 97% for U.S. M.D. medical school graduates (98% in first-time takers) and 89% for U.S. D.O. medical school graduates (89% in first-time takers), though this figure may be somewhat misleading since there were 19,757 M.D. first-time test takers and 63 D.O. first-time test takers. Overall pass rates for USMLE Step 3 test takers in 2013-2014 are: 96% for U.S. M.D. medical school graduates (97% in first-time takers), 92% for U.S. D.O. medical school graduates (96% in first-time takers), and 83% for international medical school graduates (87% in first-time takers).
These statistics may be somewhat misleading since there were 19,086 M.D. first-time test takers for Step 3 and 23 D.O. first-time test takers. (In these statistics, "U.S. M.D. medical school graduates" includes graduates of Canadian M.D. programs.)
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. 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
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