United States Medical Licensing Exam (USMLE)


The term United States Medical Licensing Exam refers to a three-step test that assesses the applicant's ability to apply their knowledge, in addition to their understanding of medical concepts and principles.  The USMLE is sponsored by the Federation of State Medical Boards as well as the National Board of Medical Examiners.  The purpose of the examination is to ensure physicians are able to provide safe and effective care for patients.


In the United States, state-level medical boards have the authority to grant an individual a license to practice medicine.  While each state has its own set of rules, they all require individuals to pass a test that demonstrates their qualifications.  The United States Medical Licensing Exam, or USMLE, provides a common system to use as part of the state's qualifications assessment and subsequent licensure.

The USMLE consists of a three-step process that assesses:

  • Step 1:  the applicant's mastery of the sciences required to provide safe and competent care to patients in addition to the scientific principles needed to maintain competence.
  • Step 2: the applicant's ability to apply their medical knowledge and understanding of clinical science and patient care skills.  Step 2 consists of a computer-based multiple choice examination that is administered through regional test centers.
  • Step 3: the applicant's knowledge of the biomedical and clinical science necessary to provide unsupervised medical care.  Emphasis is placed on the applicant's ability to provide patient care in ambulatory settings.

If the examinee has made six attempts to take a Step or a Step Component, they are no longer eligible to take that Step.  This rule applies to attempts made after January 1, 2012.  Applicants cannot take the same examination more than three times in a 12-month timeframe.  Fourth, fifth and sixth attempts must occur at least six months after the prior attempt.

Scores are typically available in three to four weeks after the date of the examination.  A three-digit scale is used to report the results of Step 1 and Step 3, while Step 2 CS is reported as Pass / Fail.

Related Terms

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