The United States Medical Licensure Examination (USMLE) is a series of tests that medical students and doctors must pass in order to practice medicine in the United States. These examinations were put in place so there would be a standard for everyone who wishes to treat patients in the United States. There are four separate tests that medical students and doctors must pass during their education before beginning patient care. These four examinations are called the USMLE Steps.

The USMLE Step 1 is a standardized test of medical students’ basic sciences. This examination is normally taken after the first two years of medical school. This will allow the students to have taken all their fundamental requirements, such as Biochemistry, Anatomy, Physiology, and Microbiology.

The USMLE Step 2 Clinical Knowledge is also a standardized test, but it is of the medical students’ ability to apply their patient care knowledge. This examination is taken prior to graduating medical school but after completing the core clinical rotations, such as Family Medicine, Internal Medicine, Surgery, and Obstetrics and Gynecology. The USMLE Step 2 Clinical Skills is another test given prior to completing medical school, which tests the students’ ability to understand and treat patients one-on-one. Medical students and doctors must go to designated centers across the United States to treat mock patients, where they will monitored and graded based upon their rapport with patients and actual treatment plans.

The USMLE Step 3 is a two-part examination, which spans over two days. The first day is the standardized test questioning doctors on basic and critical patient care. On the second day, physicians complete the standardized testing and then chart patient cases from the beginning to end of care of each patient, no matter at what point the case started, even if it began in the middle of the case. This test has to be completed after graduating medical school but prior to completing residency training. This will ensure to medical licensure boards that doctors actually do know how to treat various conditions and diseases, despite not being the main attending physician.

These USMLE Steps are to be taken throughout medical school and residency, prior to getting your license to practice medicine in the United States. There are also physicians from other countries and United States citizens that went abroad to medical schools that want to come to the United States to practice medicine. They must all pass these same examinations prior to beginning patient care. The severity of passing these Steps on the first attempt with very high percentages, will determine their career path because their choice of medical specialty is decided by residency committees looking for the best interview candidate to take into their residency program. For example, a minimal passing score of 75% with prior failures may only allow you to interview and complete a Family Medicine Residency Program in a rural area, unlike a superior score of 99% on the first attempt will guarantee you a General Surgery Residency interview and residency position in a metropolitan area.

I recommend all medical students and doctors who aspire to practice medicine in the United States to study focused and diligently. Have a study plan months in advance prior to scheduling any USMLE Step. The best advice I can ever give to any aspiring physician is not to take any of the USMLE Steps if you are not fully prepared and only walk in the Testing Center if you know you will pass the USMLE. It is worth the consequence of paying penalties to reschedule or cancel the examinations, in comparison to taking and then failing any USMLE Step. All failures are counted against you and will be added to your USMLE transcript. The transcript will include every attempt made at all the USMLE Steps, including all passing and failing scores along with the locations where the tests were taken. So just remember the USMLE is the number one factor that helps determine medical students’ and doctors’ fates in practicing medicine in the United States.

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