The United States Medical Licensing Examination (USMLE) is a series of examinations which medical undergraduate, postgraduate and professionals need to take in order to enter into a residency in the United States.
There a total of 4 exams:-
Step 1 – Covers pre-clinical subjects (e.g. Anatomy, Physiology etc)
Step 2 CK (Clinical Knowledge) – Covers clinical subjects (e.g. Medicine, Surgery etc) with emphasis on diagnosis
Step 2 CS (Clinical Skills) – Clinical case encounters with simulated patients
Step 3 – Clinical subjects with more emphasis on actual management (Not required to enter into residency)
Eligibility Criteria and Application
The USMLE exams can be taken anytime after completion of at least 2 years of medical school or the basic science medical component. These exams may be taken in any order which the applicant chooses. For e.g. Step 2 CS may be taken first followed by Step 1 and then Step 2 CK.
Please note that that there is no requirement that an applicant needs to complete his/her medical school before taking the exam. Essentially this means that anyone can take the Step 2 CS exam after passing the basic science years (The ECFMG website recommends but does not enforce that the applicant should have completed their core clinical rotations before taking the exam).
All international medical graduates (IMG) need to apply for these exams through the ECFMG (Educational Commission for Foreign Medical Graduates). The ECFMG provides both an online and paper based application form. The online form is generally processed much faster than the paper based version. Also one should note that even the online version of the form requires you to print the “Certification of Identification form” (Form 186) after completion of the online part and send it by regular mail.
When an applicant registers for an exam, they are required to select a 3 month period during which they will take the exam. After receiving the registration (orange card), the applicant needs to contact Thomson Prometric by either phone or register online to set up a date to take the exam. The exam can be taken throughout the year except on Saturday and Sunday.
ECFMG Certificate
The ECFMG certificate is awarded after the successful completion of Step 1 and 2 (CK and CS). This certificate is necessary to participate in the National Residency Matching Program (NRMP) or the Match and therefore to enter into a residency program.
Costs Involved
The whole process to get into a residency in the United States is an expensive affair. Lets make some rough calculations -
| USMLE Step 1 | $700 |
| USMLE Step 2CK | $700 |
| USMLE Step 2CS | $1200 |
| Residency Applications (Approx 50 programs) | $1000 |
| Traveling for interviews (Approx 10-12) | $4000 |
| Total | $9100 |
So the whole process for the IMG approximately costs between $8000 – $12000.


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