USMLE® Exam Series Summary

USMLE Step by Step

You are required to take the USMLE exams to gain ECFMG certification and eventually Board Certification in the US.

ECFMG (Educational Commission for Foreign Medical Graduates) Certification is required for all International Medical Graduates who wish to work or train in the US and to gain this you'll need to take and pass the USMLE Step 1, Step 2CK and Step 2CS exams.

To gain State Licensure, you'll need to take the USMLE Step 3, which is typically taken by US Medical Graduates after their first year of Residency.

To gain Board Certification, enabling you to work in any US state, in any job, you will need to complete a Residency Training Program.

USMLE Step 1 Step 2 CK Step 2 CS Step 3
Tests Basic Sciences
Mechanisms of Health & Disease
Clinical Sciences
Application to patient care
Clinical Skills
Communication, Spoken English Proficiency, Patient Interaction
Patient Management
& follow up treatment
Subjects Anatomy 
Behavioral Science 
Biochemistry Pharmacology Physiology 
Internal Medicine
Public Health
Common Clinical Problems Internal Medicine 
Ethics & Epidemiology
US Graduates Test After Y2 at Med School After Y4 at Med School After Y4 at Med School After Y1 of Residency
Passing Score 194 209 Pass/Fail 196
Exam Format Computer Based
Multiple Choice Questions
7 Blocks of Questions
Computer Based
Multiple Choice Questions
8 Blocks of Questions
Live Exam
Standardized Patient Interactions
Computer Based
Multiple Choice Question
7 Blocks on day 1
4 blocks + Clinical Case Simulations on day 2
Question Format Multiple Choice
One Best Answer
Clinical Vignette
Multiple Choice
One Best Answer
Clinical Vignette & Extended Matching
12 Standardized Patients Multiple Choice
One Best Answer
Clinical Vignette & Clinical Case Simulations
Timing 8 Hours 9 Hours 9 Hours 2 day exam
Day 1-7 hours
Day 2-6 hours
Exam Order No order No order No order Must pass Step 1, 2CK & 2CS
Register for the Exam ECFMG ECFMG ECFMG FSMB
Exam Fee $820
$130-$330 international test delivery charge
$130-$330 international test delivery charge
$1,295 $690
Exam Location International International LA, Houston, Philadelphia, Atlanta, Chicago US only