2010 Print Boi_2006 Print Boi.qxd.qxd
2010
Bulletin of
Information
A Joint Program of the Federation of State
Medical Boards of the United States, Inc.,
and the National Board of Medical Examiners®
TABLE OF CONTENTS
OVERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Applying for Step 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Examinees Who Require Personal Items in the
Purpose of the USMLE . . . . . . . . . . . . . . . . . . . . . . . . . 1
Testing Room . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
The Three Steps of the USMLE . . . . . . . . . . . . . . . . . . 2
Examinees with Disabilities Requesting Test
Examination Committees. . . . . . . . . . . . . . . . . . . . . . . . 2
Accommodations . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Ownership and Copyright of
Obtaining an Eligibility Period
Examination Materials . . . . . . . . . . . . . . . . . . . . . . . 2
for Step 1 and Step 2 CK . . . . . . . . . . . . . . . . . . . . 17
Computer-Based Testing (CBT) . . . . . . . . . . . . . . . . . . 2
Obtaining an Eligibility Period for Step 2 CS . . . . . . 18
USMLE Step 2 Clinical Skills (CS) . . . . . . . . . . . . . . . 2
Obtaining an Eligibility Period for Step 3 . . . . . . . . . 18
The Comprehensive Review of USMLE . . . . . . . . . . . 3
Scheduling Step 1, Step 2 CK, and Step 3 . . . . . . . . . 18
Scheduling Step 2 CS . . . . . . . . . . . . . . . . . . . . . . . . . . 20
ELIGIBILITY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Summary of Process . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Step 1, Step 2 CK, and Step 2 CS . . . . . . . . . . . . . . . . . 4
Step 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
TESTING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Who Is Required to Take Step 2 CS? . . . . . . . . . . . . . . 4
Testing Regulations and Rules of Conduct . . . . . . . . 23
Graduates of Unaccredited Medical Schools
Personal Items. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
in the United States and Canada . . . . . . . . . . . . . . . 5
Admission to the Test . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Sequence of Steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Step 1, Step 2 CK, and Step 3 . . . . . . . . . . . . . . . . . . . 25
Time Limit and Number of Attempts Allowed
Step 2 CS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
to Complete All Steps . . . . . . . . . . . . . . . . . . . . . . . . 6
Retakes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
SCORING AND SCORE REPORTING . . . . . . . . . . 29
Official Performance of Record for Examinees
Examination Results and Scoring. . . . . . . . . . . . . . . . 29
Retaking a Previously Passed Step . . . . . . . . . . . . . 7
Minimum Passing Scores . . . . . . . . . . . . . . . . . . . . . . . 30
Formerly Administered Examinations . . . . . . . . . . . . . 8
Examinee Score Reports . . . . . . . . . . . . . . . . . . . . . . . 30
Change in Eligibility Status . . . . . . . . . . . . . . . . . . . . . . 8
Score Rechecks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Score Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
EXAMINATION CONTENT . . . . . . . . . . . . . . . . . . . . 9
Official USMLE Transcripts and Providing
Step 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Scores to Third Parties . . . . . . . . . . . . . . . . . . . . . . 32
Step 2 Clinical Knowledge (CK) . . . . . . . . . . . . . . . . . 10
Electronic Residency Application Service
Step 2 Clinical Skills (CS) . . . . . . . . . . . . . . . . . . . . . . 11
(ERAS®) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Step 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
INDETERMINATE SCORES AND
PREPARING FOR THE TEST . . . . . . . . . . . . . . . . . 14
IRREGULAR BEHAVIOR . . . . . . . . . . . . . . . . . . 34
Sample Test Materials . . . . . . . . . . . . . . . . . . . . . . . . . 14
Validity of Scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Test Lengths and Formats . . . . . . . . . . . . . . . . . . . . . . 14
Irregular Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Practicing with the Software . . . . . . . . . . . . . . . . . . . . 14
Practice at Prometric Test Centers . . . . . . . . . . . . . . . 14
COMMUNICATING ABOUT USMLE . . . . . . . . . . . 36
Application and Registration Inquiries . . . . . . . . . . . 36
APPLYING FOR THE TEST AND SCHEDULING
Scheduling and Test Center Inquiries . . . . . . . . . . . . 37
YOUR TEST DATE . . . . . . . . . . . . . . . . . . . . . . . . 16
Test Administration Problems/Inquiries . . . . . . . . . . 37
Application Materials. . . . . . . . . . . . . . . . . . . . . . . . . . 16
General Inquiries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Applying for Step 1, Step 2 CK, and Step 2 CS. . . . . 16
Step 3 and Medical Licensure Inquiries. . . . . . . . . . . 37
Copyright © 2009 by the Federation of State Medical Boards of the United States, Inc., and the National Board of Medical
Examiners® (NBME®). The USMLE is a joint program of the Federation of State Medical Boards of the United States, Inc.,
and the National Board of Medical Examiners.
OVERVIEW
INTRODUCTION
and requires passing an examination that demonstrates
qualification for licensure. Results of the USMLE are
The United States Medical Licensing Examination®
reported to these authorities for use in granting the ini-
(USMLE®) is a three-step examination for medical
tial license to practice medicine. The USMLE provides
licensure in the United States and is sponsored by the
them with a common evaluation system for applicants
Federation of State Medical Boards (FSMB) and the
for medical licensure.
National Board of Medical Examiners® (NBME®).
The USMLE assesses a physician's ability to apply
The Composite Committee, appointed by the FSMB
knowledge, concepts, and principles, and to demonstrate
and NBME, establishes policies for the USMLE pro-
fundamental patient-centered skills, that are important in
gram. Membership includes representatives from the
health and disease and that constitute the basis of safe
FSMB, NBME, Educational Commission for Foreign
and effective patient care. Each of the three Steps com-
Medical Graduates (ECFMG®), and the American
plements the others; no Step can stand alone in the
public.
assessment of readiness for medical licensure. Because
individual medical licensing authorities make decisions
regarding use of USMLE results, you should contact the
Note: You must become familiar with the
jurisdiction where you intend to apply for licensure to
information in this bulletin if you are an
obtain complete information. Also, the FSMB can pro-
applicant with an eligibility period in 2010. If
vide general information on medical licensure.
your eligibility period extends into 2011 and
you test in 2011, you must become familiar
with and will be subject to the policies and
USMLE Mission Statement
procedures detailed in the 2011 Bulletin of
Information. Eligibility periods are explained on
The United States Medical Licensing Examination
pages 17–18. To apply for the USMLE, you must
(USMLE) program supports medical licensing
contact the appropriate registration entity (see
authorities in the United States through its leader-
page 36).
ship in the development, delivery, and continual
improvement of high quality assessments across the
continuum of physicians' preparation for practice.
Changes in the USMLE program may occur after the
release of this bulletin. If changes occur, information
Goals:
will be posted at the USMLE website. You must
obtain the most recent information to ensure an accu-
q To provide to licensing authorities meaningful
rate understanding of current USMLE rules. If you
information from assessments of physician
are unable to access updated USMLE information via
characteristics—including medical knowledge,
the Internet, you may contact the USMLE Secretariat
skills, values, and attitudes—that are important to
in writing (see page 37) for updated information.
the provision of safe and effective patient care.
http://www.usmle.org
q To engage medical educators and their
Visit the USMLE website for
institutions, licensing authority members, and
up-to-date information.
practicing clinicians in the design and
development of these assessments.
PURPOSE OF THE USMLE
q To assure fairness and equity to physicians
through the highest professional testing standards.
In the United States and its territories ("United States"
or "US"), the individual medical licensing authorities
q To continue to develop and improve assessments
("state medical boards") of the various jurisdictions
for licensure with the intent of assessing
grant a license to practice medicine. Each medical
physicians more accurately and comprehensively.
licensing authority sets its own rules and regulations
1
OVERVIEW
THE THREE STEPS OF THE USMLE
OWNERSHIP AND COPYRIGHT OF
EXAMINATION MATERIALS
Step 1 assesses whether you understand and can apply
important concepts of the sciences basic to the prac-
The examination materials used in the USMLE are
tice of medicine, with special emphasis on principles
copyrighted. If you reproduce and/or distribute any
and mechanisms underlying health, disease, and
examination materials, by any means, including
modes of therapy. Step 1 ensures mastery of not only
memorizing and reconstructing them, without explic-
the sciences that provide a foundation for the safe and
it written permission, you are in violation of the
competent practice of medicine in the present, but
rights of the owners. In addition to actions described
also the scientific principles required for maintenance
on pages 34–35, every legal means available to pro-
of competence through lifelong learning.
tect USMLE copyrighted materials and secure
redress against those who violate copyright law may
Step 2 assesses whether you can apply medical knowl-
be pursued.
edge, skills, and understanding of clinical science
essential for the provision of patient care under super-
COMPUTER-BASED TESTING (CBT)
vision and includes emphasis on health promotion and
disease prevention. Step 2 ensures that due attention is
Parts of the USMLE are administered by computer.
devoted to principles of clinical sciences and basic
Prometric™ provides scheduling and test centers for
patient-centered skills that provide the foundation for
the computer-based components of USMLE. Step 1
the safe and competent practice of medicine.
and Step 2 CK are given around the world at Prometric
Test Centers (PTCs). USMLE Step 3 is given at PTCs
Step 3 assesses whether you can apply medical
in the United States and its territories only.
knowledge and understanding of biomedical and clin-
ical science essential for the unsupervised practice of
USMLE STEP 2 CLINICAL SKILLS (CS)
medicine, with emphasis on patient management in
ambulatory settings. Step 3 provides a final assess-
Implementation of the clinical skills examination
ment of physicians assuming independent responsi-
began in June 2004. The clinical skills examination is
bility for delivering general medical care.
a separately administered component of Step 2 and is
referred to as Step 2 Clinical Skills, or Step 2 CS.
EXAMINATION COMMITTEES
The computer-based, multiple-choice component of
Step 2 is referred to as Step 2 Clinical Knowledge, or
Examination committees composed of medical edu-
Step 2 CK.
cators and clinicians prepare the examination materi-
als. Committee members broadly represent the teach-
USMLE Step 2 CS is administered at five regional
ing, practicing, and licensing communities across the
test centers (CSEC Centers) in the United States.
United States. At least two of these committees criti-
cally appraise each test item or case. They revise or
discard any materials that are in doubt.
2
OVERVIEW
The Comprehensive Review of USMLE
Background
The USMLE examination program was designed in the late 1980s and introduced during the period 1992 to
1994. The program replaced the NBME Part Examination program and the Federation Licensing Examination
(FLEX) program, which were the widely accepted medical licensing examination programs at that time. While
the content and design for the USMLE Step examinations have been continuously reviewed and refreshed, there
had been no in-depth review of overall program design and structure since the sequence was first conceived. In
2004, the USMLE Composite Committee called for a comprehensive review of the entire USMLE program to
determine if the mission and purpose of USMLE are effectively and efficiently supported by the current design,
structure, and format of the USMLE.
The primary responsibility for this review was given to the Committee to Evaluate the USMLE Program
(CEUP), reflecting perspectives of students, residents, fellows, Deans and Associate Deans, basic science and
clinical faculty, international medical graduates, state medical boards, practicing physicians, and the public.
To inform CEUP, staff members used surveys and focus groups to gather information about the impact and rele-
vance of the USMLE program from a wide range of individuals and organizations, including representatives
from the medical licensing authorities, the US undergraduate and graduate education communities, and institu-
tional and national leaders from the international medical education community.
Current Status
The CEUP report and the implications of its recommendations were carefully reviewed by the staff and govern-
ing bodies of ECFMG, FSMB, and NBME. In 2009, the proposal for changes to the USMLE was approved.
Research, planning, and implementation have begun. Up-to-date information on the current status of this
process is posted at the USMLE website.
3
ELIGIBILITY
STEP 1, STEP 2 CK, AND STEP 2 CS
Note: A physician who received his or her basic
To be eligible, you must be in one of the following
medical degree or qualification from a medical
categories at the time of application and on the test
school outside the United States and Canada may
day:
be eligible for certification by the ECFMG if the
medical school and graduation year are listed in
q a medical student officially enrolled in, or a
the International Medical Education Directory
graduate of, a US or Canadian medical school
(IMED) of the Foundation for Advancement of
program leading to the MD degree that is
International Medical Education and Research
accredited by the Liaison Committee on Medical
(FAIMER®). This applies to citizens of the
Education (LCME),
United States who have completed their medical
education in schools outside the United States and
q a medical student officially enrolled in, or a
Canada but not to foreign nationals who have
graduate of, a US medical school leading to the
graduated from medical schools in the United
DO degree that is accredited by the American
States and Canada. Specific eligibility criteria for
Osteopathic Association (AOA), or
students and graduates of medical schools outside
the United States and Canada to take Step 1 and
q a medical student officially enrolled in, or a
Step 2 are described in the Information Booklet
graduate of, a medical school outside the United
provided by the ECFMG.
States and Canada and eligible for examination
by the ECFMG.
Application and other requests for services will
not be processed if it is determined that doing so
If you have been dismissed from medical school, you
would be violative of any applicable federal laws
are not eligible for USMLE, even if you are appeal-
or regulations.
ing the school’s decision to dismiss you.
STEP 3
Note: The USMLE program recommends that for
To be eligible for Step 3, prior to submitting your
Step 3 eligibility, licensing authorities require the
application, you must:
completion, or near completion, of at least one
postgraduate training year in a program of gradu-
q obtain the MD degree (or its equivalent) or the
ate medical education accredited by the
DO degree,
Accreditation Council for Graduate Medical
Education (ACGME) or the AOA. You should
q pass Step 1, Step 2 CK, and, if required based
contact the FSMB for state-specific eligibility
upon the rules referenced below, Step 2 CS,
requirements for Step 3. These requirements for
sitting Step 3 are similar, but not always identical,
q obtain certification by the ECFMG or
to requirements for licensure in that jurisdiction.
successfully complete a "Fifth Pathway" program
(see Special Notice Regarding the Fifth
Pathway Program on page 5) if you are a
WHO IS REQUIRED TO TAKE STEP 2 CS?
graduate of a medical school outside the
United States and Canada, and
In order to be eligible to register for USMLE Step 3, the
current examination requirements for graduates of
q meet the Step 3 requirements set by the medical
LCME-accredited medical school programs or AOA-
licensing authority to which you are applying.
accredited medical schools include passing Step 1 and
Step 2. Such individuals must have passed Step 2 CS as
part of the examination requirements for Step 3 if they:
(a) have medical school graduation dates in 2005 or
4
ELIGIBILITY
later, or (b) graduated from medical school prior to 2005
In order to register for Step 3, eligible Fifth Pathway
but did not pass the CK component of Step 2 taken on or
participants must have taken and passed either the
before June 30, 2005. Note: After June 30, 2012, all
CSA or the Step 2 CS (see Special Notice).
graduates of LCME- and AOA-accredited medical
schools will be required to take and pass Step 2 CS in
Individuals who have passed Step 2 prior to the
order to be eligible for Step 3.
implementation of Step 2 CS are not permitted to
take Step 2 CK, except under the specific exceptions
to the retake policy approved by the Composite
Special Notice Regarding the Fifth Pathway
Committee (see page 7), but are permitted to take
Program
Step 2 CS, provided they meet all other eligibility
requirements.
In November 2007, the American Medical
Association (AMA) determined that it would
Individuals who are not required to pass Step 2 CS
withdraw its support of the Fifth Pathway pro-
for Step 3 eligibility but elect to take Step 2 CS and
gram. Per the AMA, the last Fifth Pathway pro-
fail the examination are not eligible for Step 3 until
gram class to be supported will be the January
such time as the individual’s Step 2 CS performance
2009 entering class, which will be supported until
of record (i.e., most recent performance) is a pass and
its completion in December 2009.
the individual meets all other Step 3 requirements.
The USMLE Composite Committee and the USMLE
GRADUATES OF UNACCREDITED MEDICAL
parent organizations (FSMB and NBME) have deter-
SCHOOLS IN THE UNITED STATES AND
mined that the USMLE program will cease accept-
CANADA
ance of Fifth Pathway certificates issued after
December 31, 2009 for the purpose of meeting
If you are eligible for licensure by a US medical
Step 3 eligibility requirements. For valid Fifth
licensing authority but are not in one of the eligibili-
Pathway certificates issued through December 31,
ty categories listed on page 4, you may take the
2009, the USMLE program has not yet determined
USMLE only upon specific request by that medical
whether they will be accepted indefinitely for purpos-
licensing authority. A licensing authority may sponsor
es of meeting Step 3 eligibility criteria or whether a
you to take Step 1 and Step 2, followed by Step 3 if
cutoff date will be imposed. Individuals holding Fifth
Step 1 and Step 2 are passed, if all the following con-
Pathway certificates that are not accepted by the
ditions apply to you:
USMLE program for purposes of meeting Step 3 eli-
gibility will be required to obtain ECFMG certifica-
q You are a graduate of an unaccredited medical
tion in order to be eligible for Step 3.
school program in the United States or Canada;
Information and updates about the Fifth Pathway
q You are an applicant for initial medical licensure
program and USMLE will be posted on the
in the jurisdiction of the sponsoring licensing
USMLE website (www.usmle.org).
authority; and
q The sponsoring licensing authority certifies
Step 2 CS replaced the Clinical Skills Assessment
that you have met all of the requirements for
(CSA®) formerly administered by the ECFMG.
licensure in the jurisdiction except for the
Effective June 14, 2004, Step 2 CS became a
examination requirement.
requirement for ECFMG certification of internation-
al medical graduates who have not passed the CSA.
If these conditions apply to you, the medical licensing
To register for Step 3, ECFMG certificate holders
authority should submit the request to sponsor you to the
must have taken and passed either the CSA or the
USMLE Secretariat at the address shown on page 37 in
Step 2 CS.
advance of your application for the Step.
5
ELIGIBILITY
SEQUENCE OF STEPS
then moving to graduate school studies and research
for a three- or four-year period. Following comple-
If eligibility requirements are met (see page 4), you
tion of PhD course work and all or most of their
may take Step 1, Step 2 CK, and Step 2 CS in any
research projects, these students return to complete
sequence.
their two clinical years, thus completing the medical
degree in seven to nine years after first matriculating.
TIME LIMIT AND NUMBER OF ATTEMPTS
ALLOWED TO COMPLETE ALL STEPS
The USMLE program recognizes that the recom-
mended seven-year time limit may pose problems for
Although there is no limit on the total number of
medical licensure for some candidates with a com-
times you can retake a Step or Step Component you
bined degree (i.e., MD/PhD). It is for this reason that
have not passed, the USMLE program recommends
the USMLE program recommends to licensing juris-
to medical licensing authorities that they:
dictions that they be willing to consider exceptions to
the seven-year limit for MD/PhD candidates who
q require the dates of passing the Step 1, Step 2,
meet certain narrow requirements. The recommend-
and Step 3 examinations to occur within a
ed requirements are as follows:
seven-year period; and
1. The candidate has obtained both degrees in
q allow no more than six attempts to pass each
an institution or program accredited by the
Step or Step Component without demonstration
LCME and regional university accrediting body.
of additional educational experience acceptable
2. The PhD studies should be in a field of biological
to the medical licensing authority.
sciences tested in the Step 1 content. These fields
include but are not necessarily limited to
For purposes of medical licensure in the United
anatomy, biochemistry, physiology, microbiology,
States, any time limit to complete the USMLE is
pharmacology, pathology, genetics, neuroscience,
established by the state medical boards. Most, but not
and molecular biology. Fields explicitly not
all, use the recommended seven years as the time
included are business, economics, ethics, history,
limit for completion of the full USMLE sequence.
and other fields not directly related to biological
While medical schools may require students to pass
science.
one or more Steps for advancement and/or gradua-
3. Candidates seeking an exception to the seven-
tion, you should understand the implications for
year rule should be required to present a
licensure. For states that establish a time limit for
verifiable and rational explanation for the fact
completion of all three Steps, the "clock" starts run-
that he or she was unable to meet the seven-year
ning on the date the first Step or Step Component is
limit. Although these explanations will vary
passed or, in some cases, on the date of the first
considerably, each licensing jurisdiction will
attempt at any Step. General information regarding
need to decide on its own which explanation
state-specific requirements for licensure can be
justifies an exception.
obtained from the FSMB (www.fsmb.org). For defini-
tive information, you should contact directly the
Students who pursue both degrees should understand
licensing authority in the jurisdiction in which you
that while many states' regulations provide specific
intend to seek licensure.
exceptions to the seven-year rule for dual-degree can-
didates, others do not. Students pursuing a dual
Special Notice for MD/PhD Candidates
degree are advised to check the state-specific require-
ments for licensure listed by the FSMB.
The common pathway for MD/PhD students involves
completing the first two years of medical school and
6
ELIGIBILITY
Special Notice for International Medical Students
An exception to the policy of requiring the time limit
and Graduates
to expire before applying to retake a previously
passed Step or Step Component can be granted if, at
ECFMG policy requires that applicants pass those
the time of application and testing:
USMLE Steps or Step Components required for
ECFMG certification within a seven-year period.
q you are currently enrolled in an LCME- or AOA-
(You should refer to ECFMG’s Information Booklet
accredited medical school program leading to the
for complete details, as some exceptions may apply.)
MD or DO degree;
This policy applies only to ECFMG certification.
The USMLE program recommends, although not all
q you have previously passed Step 1 and/or Step 2
jurisdictions impose, a seven-year limit for comple-
but have not passed Step 3;
tion of the three-Step USMLE program. You should
contact the FSMB or the medical licensing authority
q you are expected to graduate from the medical
of the jurisdiction where you plan to apply for licen-
school program six or more years after the date
sure for state-specific requirements.
you first passed Step 1 and/or Step 2; and
RETAKES
q you are otherwise eligible to retake the
examination.
If you fail or do not complete a Step or Step
Component and want to retake it, you must reapply
The number of attempts allowed to pass each Step or
by submitting a new application and fee.
Step Component and the time allowed to complete all
Steps vary among jurisdictions. To obtain specific
q For the computer-based examinations (Step 1,
information, you should contact the medical licensing
Step 2 CK, Step 3), you may take the failed or
authority in the jurisdiction where you intend to
incomplete examination no more than four
apply for medical licensure or the FSMB for eligibili-
times within a 12-month period.
ty requirements for Step 3.
q For Step 2 CS, you may take the failed or
incomplete evaluation no more than three times
See pages 36–42 for information on how to
within a 12-month period.
contact the FSMB and medical licensing authorities.
If you pass a Step or Step Component, you are not
allowed to retake it, except to comply with the time
OFFICIAL PERFORMANCE OF RECORD FOR
limit of a medical licensing authority for the comple-
EXAMINEES RETAKING A PREVIOUSLY
tion of all Steps or a requirement imposed by another
PASSED STEP
authority recognized by the USMLE program for this
purpose. The medical licensing or other authority
In order to meet the examination requirements for
must provide information indicating that you are
Step 3 eligibility, you must achieve a passing
applying to retake the passed Step or Step Component
performance on the most recent administration of the
in order to comply with its requirement. If you are
examinations intended to meet those requirements.
repeating a Step or Step Component because of a time
limit, you may apply to retake the examination only
If you have not yet passed Step 3 and wish to retake
after the applicable time limit has expired.
a previously passed Step 1 or Step 2 examination in
order to meet a time limit imposed by a medical
licensing or other recognized authority, you should
7
ELIGIBILITY
understand the implications for Step 3 eligibility of a
license by a US medical licensing authority, you may
failing performance on a retake. Specifically, if a fail-
take any Step(s) for which you are otherwise eligible.
ing performance on a retake is the most recent
administration of that examination, that failing score
CHANGE IN ELIGIBILITY STATUS
will preclude Step 3 eligibility.
If your eligibility for a Step or Step Component
FORMERLY ADMINISTERED EXAMINATIONS
changes after you submit your application but before
your scheduled test date(s), you must notify your reg-
The NBME certifying examinations, Part I, Part II, and
istration entity promptly. Failure to notify your regis-
Part III, and the Federation Licensing Examination
tration entity that you may no longer be eligible to
(FLEX) Components 1 and 2 are no longer administered.
take the examination may result in a determination of
Use of the former NBME Parts or FLEX Components to
irregular behavior (see pages 34–35). If you take a
fulfill eligibility requirements for Step 3 is no longer
Step or Step Component for which you are not eligi-
accepted. If you have passed all or a portion of these
ble, scores for that examination may not be reported
examinations and have never been granted a medical
or, if previously reported, may be revoked.
8
EXAMINATION CONTENT
STEP 1
Table 1: USMLE Step 1 Specifications*
Step 1 includes test items in the following content
areas:
System**
q anatomy,
q
40%–50% General
principles
behavioral sciences,
q
50%–60%
Individual organ systems
biochemistry,
q
• hematopoietic/lymphoreticular
microbiology,
q
• nervous/special senses
pathology,
q
• skin/connective tissue
pharmacology,
q
• musculoskeletal
physiology,
q
• respiratory
interdisciplinary topics, such as nutrition,
• cardiovascular
genetics, and aging.
• gastrointestinal
• renal/urinary
Step 1 is a broadly based, integrated examination.
• reproductive
Test items commonly require you to perform one or
• endocrine
more of the following tasks:
q
Process
interpret graphic and tabular material,
q identify gross and microscopic pathologic and
30%–50%
Normal structure and function
normal specimens,
q
30%–50% Abnormal
processes
apply basic science knowledge to clinical
15%–25%
Principles of therapeutics
problems.
10%–20% Psychosocial,
cultural,
occupational, and environmental
Step 1 classifies test items along two dimensions:
considerations
system and process, as shown in Table 1.
*
Percentages are subject to change at any time.
See the USMLE website for the most up-to-date
http://www.usmle.org
information.
Sample Step 1 test materials and further
** The general principles category includes test
information on Step 1 test content are
items concerning those normal and abnormal
available at the USMLE website.
processes that are not limited to specific organ
systems. Categories for individual organ systems
include test items concerning those normal and
abnormal processes that are system specific.
9
EXAMINATION CONTENT
STEP 2 CLINICAL KNOWLEDGE (CK)
Table 2: USMLE Step 2 CK Specifications*
Step 2 CK includes test items in the following
content areas:
Normal Conditions and Disease Categories
q internal medicine,
q Normal growth and development and general
q obstetrics and gynecology,
principles of care
q pediatrics,
q Individual organ systems or types of
q preventive medicine,
disorders
q psychiatry,
• immunologic
disorders
q surgery,
• diseases of the blood and blood-forming
q other areas relevant to provision of care under
organs
supervision.
• mental
disorders
• diseases of the nervous system and
Most Step 2 CK test items describe clinical situations
special senses
and require that you provide one or more of the
• cardiovascular
disorders
following:
• diseases of the respiratory system
• nutritional and digestive disorders
q a diagnosis,
• gynecologic
disorders
q a prognosis,
• renal, urinary, and male reproductive
q an indication of underlying mechanisms
systems
of disease,
• disorders of pregnancy, childbirth, and
q the next step in medical care, including
the puerperium
preventive measures.
• disorders of the skin and subcutaneous
tissue
Step 2 CK is a broadly based, integrated examina-
• diseases of the musculoskeletal system
tion. It frequently requires interpretation of tables and
and connective tissue
laboratory data, imaging studies, photographs of
• endocrine and metabolic disorders
gross and microscopic pathologic specimens, and
results of other diagnostic studies. Step 2 CK classi-
Physician Task
fies test items along two dimensions: disease catego-
ry and physician task, as shown in Table 2.
15%–20% Promoting preventive medicine
and health maintenance
Please note that much of the content that addresses
20%–35% Understanding mechanisms
normal growth and development and general princi-
of disease
ples of care is also related to the individual organ
25%–40% Establishing a diagnosis
systems categories, so that the number of questions
15%–25% Applying principles of management
that deal solely with normal growth and development
and general principles of care is relatively small.
*
Percentages are subject to change at any time.
See the USMLE website for the most up-to-date
http://www.usmle.org
information.
Sample Step 2 CK test materials and further
information on Step 2 CK test content are
available at the USMLE website.
10
EXAMINATION CONTENT
STEP 2 CLINICAL SKILLS (CS)
The cases that make up each administration of the
Step 2 CS examination are based upon an examina-
Step 2 CS assesses whether you can demonstrate the
tion blueprint. An examination blueprint defines the
fundamental clinical skills essential for safe and
requirements for each examination, regardless of
effective patient care under supervision. There are
where and when it is administered. The sample of
three subcomponents of Step 2 CS (see Table 3):
cases selected for each examination reflects a balance
Integrated Clinical Encounter (ICE), Communication
of cases that is fair and equitable across all exami-
and Interpersonal Skills (CIS), and Spoken English
nees. While the set of cases administered on a given
Proficiency (SEP).
day will differ from the set of cases administered on
another day, each set of cases is comparable.
Table 3: The Subcomponents of Step 2 CS
The intent is to ensure that examinees encounter a
broad spectrum of cases reflecting common and
Integrated Clinical Encounter (ICE)
important symptoms and diagnoses. The criteria that
are used to define the blueprint and create individual
• Data gathering – patient information
examinations focus primarily on presenting com-
collected by history taking and physical
plaints and conditions. Presentation categories
examination
include, but are not limited to, cardiovascular, consti-
• Documentation – completion of a patient
tutional, gastrointestinal, genitourinary, musculo-
note summarizing the findings of the patient
skeletal, neurological, psychiatric, respiratory, and
encounter, diagnostic impression, and initial
women's health. Examinees will see cases from
patient workup
some, but not all, of these categories. The selection
of cases is also guided by specifications relating to
Communication and Interpersonal Skills (CIS)
acuity, age, gender, and type of physical findings pre-
sented in each case.
• Questioning skills
• Information-sharing skills
• Professional manner and rapport
http://www.usmle.org
Spoken English Proficiency (SEP)
Further information on Step 2 CS
is available at the USMLE website.
• Clarity of spoken English communication
within the context of the doctor-patient
encounter
STEP 3
Step 2 CS uses standardized patients, i.e., people
Step 3 is organized along two principal dimensions:
trained to portray real patients. You are expected to
clinical encounter frame and physician task (see
establish rapport with the patients, elicit pertinent his-
Table 4). Step 3 content reflects a data-based model
torical information from them, perform focused physi-
of generalist medical practice in the United States.
cal examinations, answer questions, and provide coun-
seling when appropriate. After each interaction with a
Encounter frames capture the essential features of
patient, you will record pertinent history and physical
circumstances surrounding physicians' clinical activi-
examination findings, list diagnostic impressions, and
ty with patients. They range from encounters with
outline plans for further evaluation, if necessary. The
patients seen for the first time for nonemergency
cases cover common and important situations that a
problems, to encounters with regular patients seen in
physician is likely to encounter in common medical
the context of continued care, to patient encounters in
practice in clinics, doctors’ offices, emergency depart-
(life-threatening) emergency situations. Encounters
ments, and hospital settings in the United States.
occur in clinics, offices, skilled nursing care facili-
11
EXAMINATION CONTENT
ties, hospitals, emergency departments, and on the
Primum® Computer-Based Case
telephone. Each test item in an encounter frame also
Simulations (CCS)
represents one of the six physician tasks. For exam-
ple, initial care encounters emphasize taking a history
Step 3 examinees test using two formats: multiple-
and performing a physical examination. In contrast,
choice questions and Primum computer-based case
continued care encounters emphasize decisions
simulations (CCS), a testing format that allows you
regarding prognosis and management.
to provide care for a simulated patient. You decide
which diagnostic information to obtain and how to
treat and monitor the patient's progress. The comput-
Table 4: USMLE Step 3 Specifications*
er records each step you take in caring for the patient
and scores your overall performance. This format
Clinical Encounter Frame
permits assessment of clinical decision-making skills
in a more realistic and integrated manner than other
20%–30%
Initial care
available formats.
50%–60%
Continued care
15%–25%
Emergency care
In Primum CCS, you may request information from
the history and physical examination; order laborato-
Physician Task
ry studies, procedures, and consultants; and start
medications and other therapies. Any of the thou-
8%–12%
Obtaining history and performing
sands of possible entries that you type on the "order
physical examination
sheet" are processed and verified by the "clerk."
8%–12%
Using laboratory and diagnostic
When you have confirmed that there is nothing fur-
studies
ther you wish to do, you decide when to reevaluate
8%–12%
Formulating most likely diagnosis
the patient by advancing simulated time. As time
8%–12%
Evaluating severity of patient's
passes, the patient's condition changes based on the
problems
underlying problem and your interventions; results of
8%–12%
Applying scientific concepts and
tests are reported, and results of interventions must
mechanisms of disease
be monitored. You suspend the movement of simulat-
45%–55%
Managing the patient
ed time as you consider next steps. While you cannot
• health maintenance
go back in time, you can change your orders to
• clinical intervention
reflect your updated management plan.
• clinical therapeutics
• legal and ethical issues
The patient's chart contains, in addition to the order
sheet, the reports resulting from your orders. By
selecting the appropriate chart tabs, you can review
* Percentages are subject to change at any time.
vital signs, progress notes, patient updates, and test
See the USMLE website for the most up-to-date
results. You may care for and move the patient
information.
among the office, home, emergency department,
intensive care unit, and hospital ward.
High-frequency, high-impact diseases also organize
the content of Step 3. Clinician experts assign clinical
problems related to these diseases to individual clini-
http://www.usmle.org
cal encounter frames to represent their occurrence in
Sample Step 3 test materials and further
generalist practice.
information on Step 3 test content
are available from the FSMB
and at the USMLE website.
12
EXAMINATION CONTENT
The cases used in the CCS portion of the Step 3
infectious/parasitic diseases, injuries/wound/toxic
examination are based upon a CCS examination blue-
effects/burns, and health maintenance issues.
print. The blueprint defines the requirements for CCS
Presenting locations include the outpatient office,
examination forms. The CCS blueprint is used to
emergency department, inpatient unit, intensive care
construct CCS examination forms focusing primarily
unit, and the patient's home.
on presenting symptoms and presenting locations.
Presenting symptoms relate to the Step 3
You will see cases related to some, but not all, of
Problem/Disease List and are associated with the
these problem/disease and location categories. The
central nervous system, eye/ear/nose/mouth/throat,
intent is to ensure that all examinees encounter a
respiratory system, circulatory system, digestive sys-
broad range of cases reflecting common and impor-
tem, behavioral/emotional disorders, musculoskeletal
tant symptoms and diagnoses. The selection of cases
system, skin/subcutaneous tissue, endocrine/nutri-
is also guided by specifications relating to age and
tion/metabolic disorders, kidneys/urinary tract, repro-
gender. Each CCS examination form is structured to
ductive system, pregnancy/childbirth, neonate/child-
reflect a balance of cases that is fair and equitable for
hood illnesses, blood and blood-forming organs,
all examinees.
13
PREPARING FOR THE TEST
SAMPLE TEST MATERIALS
items in each block, you may answer the items in any
order, review your responses, and change answers.
The best preparation for the USMLE is a general,
After you exit the block, or when time expires, you
thorough review of the content reflected in the exami-
can no longer review test items or change answers.
nation descriptions on pages 9–13. You should also
review further information on the examination content
Step 2 CS cases and Step 3 case simulations must be
and test formats available on the USMLE website or
taken in the order presented. After you exit the case
from your registration entity and run the sample test
or session, or when time expires, you can no longer
materials available on the USMLE website or on the
review test items or cases, change answers, or collect
2010 USMLE compact disc (CD). The 2010 USMLE
additional information.
CD is available through your registration entity.
There are no test preparation courses affiliated with
http://www.usmle.org
or sanctioned by the USMLE program. Information
on such courses is not available from the ECFMG,
Note: The test descriptions provided here, includ-
FSMB, NBME, USMLE Secretariat, or medical
ing test length and number of test items or cases,
licensing authorities.
may be changed at any time. Notice of any
changes will be posted at the USMLE website.
TEST LENGTHS AND FORMATS
q Step 1 has approximately 336 multiple-choice
PRACTICING WITH THE SOFTWARE
test items, divided into seven 60-minute blocks,
administered in one eight-hour testing session.
For Steps 1, 2 CK, and 3, you should acquaint your-
self with the test software well before your test
q Step 2 CK has approximately 352 multiple-choice
date(s). Practice time is not available on the test day,
test items, divided into eight 60-minute blocks,
and test center staff are not authorized to provide
administered in one nine-hour testing session.
instruction on use of the software. A brief tutorial on
the test day provides a review of the test software,
q Step 2 CS has 12 patient cases. You will
including navigation tools and examination format,
have 15 minutes for each patient encounter and
prior to beginning the test. It does not provide an
10 minutes to record each patient note. If you do
opportunity to practice. Step 3 examinees should
not use the entire 15 minutes for the patient
review the Primum CCS orientation materials and
encounter, the remaining time will be added to
practice with all of the sample cases well in advance
the time you have to record the patient note. The
of the testing day to have a thorough understanding
testing session is approximately eight hours.
of how the software works.
q Step 3 has approximately 480 multiple-choice
Sample test materials to practice with the software
test items, divided into blocks of 35 to 50 items.
(both multiple-choice questions and Primum CCS
You will have 45 to 60 minutes to complete each
cases) are available at the USMLE website.
of these blocks. There are approximately nine
computer-based case simulations (see page 12),
PRACTICE AT PROMETRIC TEST CENTERS
with one case in each block. You will have a
maximum of 25 minutes to complete each of
If you wish to experience some of the conditions of
these blocks. Step 3 is administered in two eight-
test administration for Step 1, Step 2 CK, or Step 3,
hour testing sessions.
you may schedule time to review sample test materi-
als at a Prometric Test Center for a fee. Although
For Step 1, Step 2 CK, and Step 3 multiple-choice
shorter than an actual USMLE examination and con-
sections, during the defined time to complete the
taining the same sample test materials provided at the
14
PREPARING FOR THE TEST
USMLE website, this option allows you to experi-
ence USMLE sample test materials in the same envi-
Note: If you register for the practice session, you
ronment as your actual test. After your registration
will be issued a separate Scheduling Permit
for a Step or Step Component is complete and you
specifically for the practice session. You must
have obtained your Scheduling Permit, you may reg-
have this Permit before you can contact Prometric
ister for a practice session for that examination by
to schedule the practice session. You should allow
following the instructions at the USMLE website.
seven business days for issuance of your practice
session Scheduling Permit.
15
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
APPLICATION MATERIALS
Application procedures for Step 3 vary among juris-
dictions. You should begin inquiries at least three
If you meet the eligibility requirements on page 4,
months in advance of the dates on which you expect
you can apply for Step 1, Step 2 CK and CS, or Step
to take the test.
3. Applications are available from the appropriate
registration entity. You must use current application
After you obtain application materials, review and
materials to apply.
follow the application instructions to complete your
application and submit it to the medical licensing
authority or the FSMB as directed in the instructions.
Note: See page 36 for information on how to
contact your registration entity to apply for a Step
EXAMINEES WHO REQUIRE PERSONAL
or Step Component.
ITEMS IN THE TESTING ROOM
As more fully explained on page 23, unauthorized
APPLYING FOR STEP 1, STEP 2 CK, AND
possession of personal items while you are in the
STEP 2 CS
secure areas of the testing center is prohibited.
However, in certain limited circumstances, excep-
Students and graduates of LCME-accredited pro-
tions to this policy may be made for medical reasons,
grams and AOA-accredited medical schools should
provided that permission is granted in advance of test
apply for Step 1, Step 2 CK, and Step 2 CS by fol-
administration. If you believe that you have a med-
lowing the instructions at the NBME website
ical condition that requires you to use medication, an
(http://www.nbme.org). Review and follow the appli-
external appliance, or electronic device in the secure
cation instructions, complete your application, and
areas of the test center, please submit a written
submit it to the NBME.
request via e-mail to PIE@nbme.org, via fax to 215-
590-9422, or via mail to Personal Item Exception
Students and graduates of medical schools outside the
Coordinator, 3750 Market Street, Philadelphia, PA,
United States and Canada should apply for Step 1,
19104 at least four weeks prior to your anticipated
Step 2 CK, and Step 2 CS by following the instruc-
test date. You will need to explain the necessity for
tions at the ECFMG website (http://www.ecfmg.org).
the exception and provide documentation from your
Review and follow the application instructions, com-
medical professional substantiating your need to use
plete your application, and submit it to the ECFMG.
the item(s) during test administration. Professional
documentation must be typewritten on the profes-
If you have been dismissed from medical school, you
sional’s letterhead. Examples of appliances and
are not eligible for USMLE, even if you are appeal-
devices to which this policy applies include insulin
ing the school’s decision to dismiss you.
pumps, inhalers, medications, TENS units, breast
pumps, hearing aids, electronic or digitally amplified
APPLYING FOR STEP 3
or otherwise enhanced non-standard stethoscopes (for
Step 2 CS), wheelchairs, canes, crutches and casts.
To request information on Step 3 eligibility require-
This list is not exhaustive; if you are unsure whether
ments and application procedures, follow the instruc-
you should request an exception, please contact the
tions at the FSMB website (http://www.fsmb.org), or
Personal Item Exception Coordinator via e-mail at
contact the FSMB or the medical licensing authority
PIE@nbme.org.
to which you wish to apply.
You are not required to obtain advance permission to
wear eyeglasses or contact lenses during testing, or to
Note: See pages 37–42 for information on how to
consume food or medication on authorized breaks.
contact medical licensing authorities.
All personal items, including those permitted as an
exception under this policy, are subject to inspection
16
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
at the test center. If you bring an item, including an
OBTAINING AN ELIGIBILITY PERIOD FOR
appliance or device, to your test administration with-
STEP 1 AND STEP 2 CK
out obtaining permission in advance, you may not be
permitted to test, you may be required to relinquish
When applying for Step 1 or Step 2 CK, you must
the item, you may be investigated for irregular
select a three-month period, such as January-
behavior, and/or your score may be held until you
February-March or February-March-April, during
provide adequate documentation from your medical
which you prefer to take the examination. A
professional.
Scheduling Permit with instructions for making an
appointment at a Prometric Test Center will be issued
EXAMINEES WITH DISABILITIES
to you after your registration entity processes your
REQUESTING TEST ACCOMMODATIONS
application and determines your eligibility. The
Scheduling Permit specifies the three-month eligibili-
The USMLE program provides reasonable accommo-
ty period during which you must complete the exami-
dations for examinees with disabilities who are cov-
nation. During peak periods, allow up to approximate-
ered under the Americans with Disabilities Act as
ly four weeks for processing of your application.
amended (ADA). If you are a disabled individual
After obtaining your Scheduling Permit, you are able
covered under the ADA and require test accommoda-
to contact Prometric immediately to schedule a test
tions, the following guidelines apply to you:
date.
q You must obtain information regarding
Prometric schedules testing appointments for
procedures and documentation requirements in
Steps 1 and 2 CK up to six months in advance. If your
advance of applying for each Step or Step
application is submitted more than six months in
Component. This information is available from
advance of your requested eligibility period, it will be
the USMLE website.
processed, but your Scheduling Permit will be issued
no more than six months before your assigned eligibili-
q Your application and your request for accommo-
ty period begins.
dations and accompanying documentation must
be submitted at the same time to the appropriate
If you are unable to take the test within your eligibility
addresses. All documentation received with your
period, contact your registration entity to inquire about a
request will be audited, and you will be contacted
one-time contiguous three-month eligibility period
if additional information is needed. Processing
extension. A fee is charged for this service. Visit your
may take up to eight weeks from the date
registration entity’s website for more information. If you
sufficient documentation of the impact of your
do not take the test within your original or extended eli-
reported impairment is received.
gibility period and wish to take it in the future, you must
reapply by submitting a new application and fee(s).
q When test accommodations are granted for
USMLE Steps and Step Components, score
reports and transcripts may include an annotation
http://www.prometric.com
that an accommodation was granted. Score
Use the Prometric website for
recipients who inquire about the annotation will
up-to-date information on the locations
be provided with information about the nature of
of Prometric Test Centers and to schedule
the accommodation only.
an appointment.
17
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
OBTAINING AN ELIGIBILITY PERIOD FOR
dates. The Scheduling Permit specifies the eligibili-
STEP 2 CS
ty period (beginning immediately and extending for
approximately 90 calendar days) during which you
Step 2 CS is offered regularly throughout the year;
must complete the examination. If you are unable to
however, there may be occasional, brief periods when
take the test within your eligibility period, contact
all centers are closed. In planning the timing of your
the FSMB to inquire about a one-time contiguous
application, see below for information on how Step 2
three-month eligibility period extension. A fee is
CS eligibility periods are assigned. You should be
charged for this service, and some restrictions may
aware that demand for test dates/centers at certain
apply. Visit the FSMB website (http://www.fsmb.org)
times during the year may exceed the number of test-
for more detailed information. If you do not take the
ing spaces available.
test within your original or extended eligibility period
and wish to take it in the future, you must reapply by
When you apply for Step 2 CS you are assigned a 12-
submitting a new application and fee(s). The USMLE
month eligibility period that begins when processing
Step 3 fee is non-refundable and non-transferable
of your application is completed. A Scheduling
from one eligibility period to another or from one
Permit with instructions for making a testing appoint-
application to another.
ment will be issued to you.
SCHEDULING STEP 1, STEP 2 CK, AND STEP 3
Your eligibility period will be listed on your
Scheduling Permit. You must take the exam during
Testing Regions
your eligibility period. You can schedule a testing
appointment for any available date in your eligibility
Step 1 and Step 2 CK are administered in the United
period. Once your eligibility period is assigned, it
States and Canada and in more than 50 other coun-
cannot be changed. If you do not take the exam with-
tries. International testing locations are distributed
in your eligibility period, you must reapply to take
among defined international testing regions. There is
the exam, including payment of the examination fee.
an additional international test delivery surcharge.
Although you cannot change your assigned eligibility
period, you can reschedule a scheduled testing
Your Scheduling Permit
appointment within your eligibility period (see
Rescheduling). A fee is charged if a change is made
Your Scheduling Permit will be issued to you when
during the 14 days before your scheduled appoint-
the processing of your application is complete. You
ment.
should verify the information on your Scheduling
Permit before scheduling your appointment. Your
OBTAINING AN ELIGIBILITY PERIOD FOR
Scheduling Permit includes the following:
STEP 3
q your name (see Important Note, page 25),
Step 3 eligibility periods are assigned immediately
q the examination for which you registered,
once your application has been processed and
q your eligibility period,
approved. Time for processing will vary depending
q your testing region,
on the particular medical licensing authority and the
q your Scheduling Number,
volume of applications. Check the FSMB website
q your Candidate Identification Number (CIN).
for more detailed information on processing times.
Upon complete processing of your Step 3 applica-
tion and confirmation of eligibility, a Scheduling
Permit will be issued to you with instructions for
making an appointment at a Prometric Test Center.
On receipt of your Scheduling Permit, you should
contact Prometric immediately to schedule the test
18
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
day of testing. In that event, Prometric will
assign you to the next day the center is open for
Note: You will not be able to take the test if
your second day of testing. In all other cases, you
you do not bring your Scheduling Permit to
must take Step 3 on two consecutive days at the
the test center.
same test center.
Your Scheduling Permit includes specific information
for contacting Prometric to schedule your test date(s)
Note: Your Scheduling Number is needed when
at the test center of your choice.
you contact Prometric to schedule test dates. It
differs from your Candidate Identification
http://www.prometric.com
Number (CIN), which is your private key, and is
Use the Prometric website for up-to-date
needed to test. Prometric does not have access to
information on the locations of Prometric Test
your CIN.
Centers and to schedule your test.
Scheduling Test Dates
You will be required to provide information found
only on your Scheduling Permit. When you schedule
When applying for the USMLE Steps 1, 2 CK, and 3
your appointment, you will receive the following
or scheduling test dates, please keep the following in
specific information:
mind:
q the confirmed test day(s), date(s), and time;
q You must have your Scheduling Permit before you
q the address and telephone number of the
contact Prometric to schedule a testing appointment.
Prometric Test Center where you will test; and
Appointments are assigned on a "first-come,
q your Prometric Confirmation Number(s).
first-served" basis; therefore, you should contact
Prometric to schedule as soon as possible after
After you schedule your testing appointment, you can
you receive your Scheduling Permit.
print a confirmation of your appointment from the
Prometric website. Scheduling a testing appointment
q You may take the test on any day that it is
for a specific date at a Prometric Test Center is not a
offered during your assigned eligibility period,
guarantee that the scheduled test time or location will
provided that there is space at the Prometric Test
remain available. The Prometric Test Center at which
Center you choose.
you are scheduled may become unavailable after you
have scheduled your appointment. In that event,
q Prometric Test Centers are closed on major
Prometric will attempt to notify you in advance of
local holidays.
your scheduled testing appointment and to schedule
you for a different time and/or center. However, on
q USMLE Steps 1, 2 CK, and 3 are not available
rare occasions, rescheduling your appointment for a
during the first two weeks of January.
different time or center may occur at the last minute.
To avoid losses you would incur as a result, you
q The busiest testing times in the Prometric testing
should try to maintain flexibility in your travel
network in the United States and Canada are May
arrangements. You are encouraged to confirm your
through July and November through December.
testing appointment one week prior to your test date.
q Some, but not all, Prometric Test Centers are
Rescheduling Test Dates
open on weekend days. When you schedule your
Step 3 test dates, the two days on which you take
If you are unable to keep your testing appointment on
the test must be consecutive, unless the center
the scheduled date(s) or at the scheduled location, you
is closed on the day that follows your first
19
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
may change your date(s) or center by following the
able on the USMLE website. Please refer to this cal-
instructions on your Scheduling Permit for contacting
endar before scheduling a testing appointment if you
Prometric. You will need to provide your Prometric
need your results by a specific deadline.
Confirmation Number when you reschedule.
After you confirm your testing appointment, you will
To avoid a rescheduling fee, you must cancel or
be able to print a confirmation notice from the sched-
reschedule your appointment at least five business
uling system. The confirmation notice includes your
days before your appointment. If you are testing in
scheduled test date, arrival time, test center, and other
the United States or Canada, you must cancel or
important information. If you lose the confirmation
reschedule by noon Eastern Time at least five busi-
notice, you can reprint it by accessing Step 2 CS
ness days before your appointment. If you are testing
Calendar and Scheduling on the website of your reg-
outside the United States or Canada, you must cancel
istration entity.
or reschedule by noon local time of the Regional
Registration Center for your testing region at least
How Test Dates Become Available
five business days before your appointment. If you
provide less than five business days' notice,
q Testing appointments are available on a “first-
Prometric will charge you a fee to reschedule your
come, first-served” basis (although some
test date(s). Your rescheduled test date(s) must fall
scheduling restrictions may be imposed). It is
within your assigned eligibility period.
possible that you will not be able to obtain a
testing appointment for the first time period
SCHEDULING STEP 2 CS
and/or center you prefer.
Step 2 CS is administered at five test centers: Atlanta,
q The availability of testing appointments will
Georgia; Chicago, Illinois; Houston, Texas; Los
change frequently as a result of examinee
Angeles, California; and Philadelphia, Pennsylvania.
scheduling and rescheduling.
Your Scheduling Permit
q It is possible that testing appointments will
become available for a time period and/or center
After your registration for Step 2 CS is complete, your
that you prefer after you have scheduled an
registration entity will issue you a Scheduling Permit.
appointment for a different time period and/or
The Scheduling Permit contains the following:
center. In this event, you can change your
scheduled test date and/or center. See page 21
q your name (see Important Note, page 25),
for rescheduling fees.
q your USMLE identification number, and
q your eligibility period.
q Although you can monitor available test
dates for your preferred time period and test
Scheduling Test Dates
center, availability is not guaranteed. You must
take the exam during your eligibility period;
Follow the instructions on your Scheduling Permit to
if the exam is not taken during the eligibility
schedule your test date(s) at the test center of your
period, you must reapply and pay the full exam
choice. To browse available test dates in your eligi-
fee in order to take the examination.
bility period at each of the five test centers, you can
use on-line Step 2 CS Calendar and Scheduling.
Rescheduling Test Dates
Before accessing Step 2 CS Calendar and
Scheduling, you should review the important infor-
If you have a scheduled testing appointment and are
mation in How Test Dates Become Available.
unable to take the exam on your scheduled test date
or at your scheduled test center, you can cancel your
A schedule for reporting Step 2 CS results is avail-
scheduled testing appointment and reschedule for a
20
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
different date and/or center, subject to availability. A
There is no fee to cancel a scheduled testing appoint-
fee may be charged for this service depending on
ment; the fee, if applicable, is due at the time of
how much notice you provide when canceling your
rescheduling. However, the date that you cancel
appointment. To cancel or reschedule, follow the
your appointment, using Eastern Time in the United
instructions on your Scheduling Permit for accessing
States, will determine whether you pay a reschedul-
Step 2 CS Calendar and Scheduling.
ing fee and the amount of this fee.
Before canceling and/or rescheduling a scheduled
q If you cancel more than 14 calendar days
testing appointment, you will have the opportunity to
before (but not including) your scheduled test
review available test dates at all testing locations.
date, there is no fee to reschedule.
Your rescheduled test date must fall within your
assigned eligibility period. There is no limit on the
q If you cancel during the 14-day period
number of times you can cancel and reschedule your
before (but not including) your scheduled test
testing appointment. However, a rescheduling fee is
date, your fee will be $150 when you reschedule.
charged for each rescheduled testing appointment
that does not meet the notice requirements described
q If you miss your scheduled testing appointment
below. Any change to a scheduled testing appoint-
without canceling, your fee will be $400 when
ment constitutes rescheduling.
you reschedule.
You can cancel and reschedule at the same time, or
If you are unable to keep your scheduled testing
you can cancel and reschedule later. You can cancel
appointment, you should cancel your appointment
and/or reschedule at any time through the end of the
as soon as possible to avoid a rescheduling fee,
day before your scheduled test date. However, no
regardless of whether you are ready to reschedule.
canceling is allowed beginning at 12:00 AM, Eastern
Time in the United States, on the scheduled test date.
If you do not cancel and you miss your scheduled
testing appointment, you can reschedule within your
assigned eligibility period once it is confirmed that
you did not take the test (typically one to two days).
IMPORTANT NOTE: If you cancel without
rescheduling or miss your scheduled testing
appointment, there is no guarantee that testing
appointments during your eligibility period
will be available at a given test center, or at
any test center, when you attempt to resched-
ule. If you do not reschedule within your eligi-
bility period, you must reapply, including pay-
ment of the exam fee, to take the exam.
21
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
Summary of Process
In summary, to take Steps 1, 2 CK, 2 CS, and 3, you must meet the eligibility requirements shown on page 4
and do the following:
q Contact the appropriate registration entity for application materials (see page 36).
q Complete your application materials and submit them to your registration entity.
q Obtain a Scheduling Permit verifying your eligibility and authorizing you to schedule the examination.
q Follow the instructions on your Scheduling Permit to schedule your test date(s) at a specific Prometric
Test Center (for Step 1, Step 2 CK, and Step 3) or CSEC center (for Step 2 CS).
q On the scheduled test date(s) and at the scheduled time, bring to the test center your Scheduling Permit
and the required identification.
q Take the test.
Changes to Check-in/Check-out Procedures for Computer-based Testing
Beginning in July 2009, the USMLE program will adopt new check-in/check-out procedures consistent with
Prometric’s Biometric Management System in most locations. When implemented, these new procedures will
include electronic capture of your identification, including your fingerprints and photograph. These measures
not only help prevent fraud and protect the integrity of the exam, but also will reduce the need for you to pro-
duce your identification at every break.
Please monitor the USMLE website for up-to-date information on the implementation of these procedures.
22
TESTING
The USMLE program has established rules to govern
USMLE transcript. It is important that you read and
administration of the examinations to ensure that no
understand the rules regarding personal possessions;
examinee or group of examinees receives unfair
the rules for Steps 1, 2 CK, and 3 differ from those
advantage on the examination, inadvertently or other-
for Step 2 CS.
wise. The rules include standard test administration
conditions consistent with the principles on which the
For Step 1, Step 2 CK, and Step 3, unauthorized
examinations are developed and scored. For example,
items include, but are not limited to:
examinations are designed to sample knowledge
across specified content domains, and unauthorized
q mechanical or electronic devices, such as cellular
access to examination content prior to testing violates
telephones, personal digital assistants (PDAs),
that principle.
calculators, watches of any type, electronic
paging devices, recording or filming devices,
If there is a reason to believe that the integrity of the
radios;
examination process is jeopardized, the USMLE par-
q outerwear, such as coats, jackets, head wear, gloves;
ent organizations may invalidate all or any part of an
q book bags, backpacks, handbags, briefcases, wallets;
examination. If information indicates that continued
q books, notes, written materials, or scratch paper;
testing would jeopardize the security of examination
q food, candy, gum, or beverages.
materials or the integrity of scores, the USMLE par-
ent organizations reserve the right to suspend or can-
For the computer-based examinations, you may bring
cel test administration.
soft-foam earplugs into the testing room. However, they
must be out of the packaging and ready for inspection
TESTING REGULATIONS AND RULES OF
by test center staff during check-in. Earplugs must be
CONDUCT
left at the workstation during all breaks.
Test center staff monitor all testing sessions for
For Step 2 CS, unauthorized items include, but are
USMLE Steps. You must follow instructions of test
not limited to:
center staff throughout the examination. Failure to do
so may result in a determination of irregular behavior
q mechanical or electronic devices, such as cellular
(see pages 34–35) and permanent annotation of your
telephones, personal digital assistants (PDAs),
USMLE transcript.
calculators, watches of any type, electronic
paging devices, recording or filming devices,
Test center staff are not authorized to answer ques-
radios;
tions from examinees regarding examination content,
q book bags, backpacks, briefcases;
testing software, or scoring. Test center staff are also
q books, notes, written materials, or scratch paper;
not authorized to answer inquiries with regard to reg-
q medical equipment of any kind other than a
istration or retesting.
standard stethoscope (without digital amplifica-
tion, electronic, or any other enhancement).
If staff observe you violating test administration rules
or engaging in other forms of irregular behavior during
For Step 2 CS, you should understand that the entire
an examination, the center staff will not necessarily tell
testing session from orientation until the evaluation is
you of the observation at the time of the examination.
completed, including all breaks, is considered a closed
Test center staff are required to report such incidents to
and secure testing session, and that the entire test center,
the USMLE program; each report is fully investigated.
including the orientation room and the restrooms, is a
secure testing area. Therefore the rules regarding unau-
PERSONAL ITEMS
thorized possession during Step 2 CS extend to the ori-
entation room and to all breaks.
Unauthorized possession of personal items while in the
secure areas of the testing centers may lead to a finding
For all Steps, if you bring personal items to the test
of irregular behavior and permanent annotation of your
center, you must store them in a designated locker out-
23
TESTING
side the secure testing area or in the designated storage
any USMLE examination materials will be confiscat-
area for Step 2 CS. You should keep in mind that the
ed. Making notes of any kind during an examination,
storage facilities are small and that all stored mechani-
except on the materials provided by the test center for
cal or electronic devices must be turned off. Personal
this purpose, is not permitted. Removal of those mate-
items and their contents are subject to inspection. Any
rials from the secure testing area is prohibited.
materials that reasonably appear to be reproductions of
Rules of Conduct
When you apply to take the USMLE, you are agreeing to the following Rules of Conduct:
1. You are the person named on the Scheduling Permit for the examination.
2. You will not give, receive, or obtain any form of unauthorized assistance during the examination or
during breaks.
3. You will not have any formulas, study materials, notes, papers, or electronic devices of any kind in
your possession while you are in the secure areas of the center.
4. You will place in a locker or cubicle all personal belongings, including cellular telephones, watches, pagers,
personal digital assistants (PDAs), formulas, study materials, notes, papers, and your purse or wallet, before
you enter the testing room (or Orientation Room for Step 2 CS).
5. During the computer-based examinations (Steps 1, 2 CK, and 3), you will not leave your testing station for
breaks unless the break screen is visible on your monitor. It will be considered a violation of the Rules of
Conduct if you indicate on the center log that your break screen is visible when it is not.
6. During computer-based testing (Steps 1, 2 CK, and 3) you may use a telephone or other communication
device while outside the secure testing area and only during an authorized break. You may not use it for any
purpose related to test content. During Step 2 CS you may not use a telephone at any time while you are in
the testing center.
7. You will not remove materials in any form (written, printed, recorded, or any other type) from the test center.
8. All examination materials remain the property of the USMLE parent organizations, and you will maintain
the confidentiality of the materials, including the multiple-choice items, and the case content for Step 2 CS
and Primum CCS. You will not reproduce or attempt to reproduce examination materials through
memorization or any other means. Also, you will not provide information relating to examination content
that may give or attempt to give unfair advantage to individuals who may be taking the examination. This
includes postings regarding examination content and/or answers on the Internet.
If you violate these Rules of Conduct, you may be directed to leave the test center before you com-
plete the examination. Also, evidence of violation of any test administration rule, including these
Rules of Conduct, will result in actions being taken under USMLE policies and procedures on irregu-
lar behavior. If you are found to have engaged in irregular behavior, your score report and tran-
scripts will include this finding, and you may be barred from taking the USMLE in the future.
24
TESTING
ADMISSION TO THE TEST
including video and audio monitoring and recording, and
use of digital cameras to record the identity of examinees.
When you arrive at the test center, you must present
your Scheduling Permit and the required identifica-
Individual examinations are drawn from large pools of
tion described on your Scheduling Permit.
content-parallel test forms, which are in turn created
Acceptable forms of identification include the fol-
from very large banks of test materials. Individual exam-
lowing forms of unexpired identification:
inations vary within and across test centers, and within
and across test days. Electronic encryption is employed
q passport,
to protect the security of item banks, test forms, and test
q driver's license with photograph,
responses. Physical security at test centers is maintained
q national identity card,
by proctoring and video surveillance and recording.
q other form of unexpired, government-issued
identification,
You should arrive at the Prometric Test Center 30
q ECFMG-issued identification card.
minutes before your scheduled testing appointment
on your testing day(s). If you arrive after your
Your identification must contain both your signature
appointment time, you may not be admitted. If you
and recent (no more than 10 years earlier) photo-
arrive more than 30 minutes after your scheduled
graph. If it contains your photograph but not your
testing appointment, you will not be admitted. In that
signature, you can use another form of unexpired
event, you must pay a fee to Prometric to reschedule
identification that contains your signature, such as a
your test. Your rescheduled test date(s) must fall
student/employee identification card or a credit card,
within your assigned eligibility period.
to supplement your photo-bearing, government-
issued identification.
There are no waiting facilities for family and friends
at the center; plan to meet them elsewhere after the
If you do not bring your Scheduling Permit and
examination ends.
acceptable identification, you will not be admitted to
the test. In that event, you must pay a fee to resched-
ule your test. Your rescheduled test date(s) must fall
http://www.prometric.com
within your eligibility period.
Use the Prometric Test Center Locator for
directions to Prometric Test Centers.
Important Note: Your name as it appears on
your Scheduling Permit must match the name on
your form(s) of identification exactly. If the name
Upon arrival at the test center, you must present the
listed on your Scheduling Permit is not correct,
required identification, sign a test center log, be pho-
contact your registration entity immediately.
tographed, and store your personal items in your
assigned locker. You will be asked to empty and turn
your pockets inside out prior to entry into the testing
STEP 1, STEP 2 CK, AND STEP 3
room to confirm that you have no prohibited items.
You will be asked to repeat this process prior to every
Test Centers and Testing Conditions
entry into the testing room after a break. In addition,
your identification document and fingerprint may be
Prometric provides computer-based testing services for
scanned electronically. (To learn more about this
academic assessment, professional licensure, and certifi-
process, please visit the USMLE website at
cation. USMLE Step 1 and Step 2 CK are given at
www.usmle.org.) You will be instructed to write your
Prometric Test Centers around the world. USMLE Step 3
name and Candidate Identification Number (CIN) on
is given at Prometric Test Centers in the United States
one of the laminated writing surfaces provided. Your
and its territories. These centers provide the resources
Scheduling Permit will be retained at the Test Center
necessary for secure administration of the USMLE,
Administrator’s station. You may request access to the
25
TESTING
permit during the examination if it becomes necessary
test center staff neglect to return the permit to you.
for you to rewrite the CIN on the laminated writing
surface. In addition to the laminated writing surfaces,
After you start taking an examination, you cannot can-
you will be provided with dry-erase markers and an
cel or reschedule that examination unless a technical
eraser. Test center staff will escort you to your
problem prevents you from completing your examina-
assigned testing station and provide brief instructions
tion. If you experience a computer problem during the
on use of the computer equipment. You must enter
test, notify test center staff immediately. The testing
your CIN to start the examination. You may then take
software is designed to allow the test to restart at the
a brief tutorial prior to starting the first test block.
point it was interrupted. In most cases, your test can
be restarted at the point of interruption with no loss of
Completing the Test
testing time. However, it is possible that a technical
problem may occur that does not permit you to com-
Once you begin a block of the test, no authorized breaks
plete your examination. In the rare event that this
are provided during the block. Each block lasts approx-
occurs, please send a written description of the inci-
imately 30 to 60 minutes. During blocks, the block and
dent to Test Administration Services at the NBME
daytime clocks continue to run even if you leave the
(refer to Test Administration Problems/Inquiries for
testing room, (e.g., for a personal emergency). If you
details). Your problem will be thoroughly investigat-
leave during a block, the test center staff will report that
ed, and if necessary, arrangements will be made to
fact as an irregular incident. In addition, the “unautho-
allow you to test at a later date at no additional charge.
rized break” screen, described in the examination tutori-
al, may appear on the monitor at your workstation dur-
If you start to test and elect not to complete the exami-
ing a testing block. As explained in the tutorial, the
nation, you may contact the NBME for consultation
unauthorized break screen will appear after a defined
(see page 36). The attempt may appear as an “incom-
period of inactivity (no mouse click or key entry).
plete examination” on your USMLE transcript (see
Thirty seconds before the appearance of the unautho-
Examination Results and Scoring for further details).
rized break screen, an “inactivity timeout” warning will
appear. If you do not click as instructed on the warning
How Break Time Works
screen, the unauthorized break screen will appear after
30 seconds. You will then have to enter your CIN in
Your entire testing session is scheduled for a fixed
order to continue with the examination. Each time you
amount of time. The computer keeps track of your
leave the testing room, you are required to sign out and
overall time and the time allocated for each block of
sign in when you return. You must present your identi-
the test. At the start of the testing session, you have a
fication each time you sign in. Each block ends when
total of 45 minutes of break time. This allotment of
its time expires or when you exit from it.
time is used for authorized breaks between blocks and
may also be used to make transitions between blocks.
The test session ends when you have started and exited
Authorized breaks include any time taken between
all sections or the total time for the test expires. You will
test blocks whether you take a brief break at your seat
sign out as you leave the test center, hand in the lami-
or you leave the testing room. If you complete the
nated writing surfaces, and receive a notice that you
tutorial or other blocks of the test early, the remaining
appeared for the test. If you encounter an error message
time will be available as break time. It will not be
at the conclusion of your exam, the notice that you
available to complete other blocks of the test.
appeared for the test may not print. However, please be
assured that it does not affect your examination data or
As you progress through the blocks of the test, you
our receipt of the data. If your test is scheduled for mul-
should use the features available in the testing soft-
tiple days, be sure to ask test center staff to return your
ware to monitor how many blocks are remaining and
permit to you at the end of your test day; you will need
how much break time is remaining. If you take too
it for check-in on the following day(s). Note: You can
much break time and exceed the allocated or accu-
reprint your permit for the consecutive day(s), should
mulated break time, your time to complete the last
26
TESTING
block(s) in the testing session will be reduced. You
q Test center staff (wearing name tags) will direct
should use the time summary feature (as explained
you throughout the day, and their instructions
in the tutorial) to keep track of the number of
should be followed at all times.
blocks completed and the number remaining.
q There will be an on-site orientation to
When section time runs out, you will not be able to move
demonstrate the equipment available for you to
to any new screens within that section. The computer will
use in the examination rooms, as well as to
close the section. After you complete or run out of time
acquaint you with procedures and regulations.
for each block during the test, you must respond when
the computer asks you to indicate whether you want to
q Once you enter the secure area of the test center
take a break or continue. After the test blocks, you may
(beginning with the orientation), you may not
be asked to complete an additional block that contains
leave that area until the examination has been
survey questions about your testing experience.
completed. The examination lasts about 8 hours.
Two breaks are provided (one 30-minute
STEP 2 CS
break and one 15-minute break). A light meal is
provided during the first break; however, you
The time you should arrive at the testing center is
may bring your own food (provided that no
listed on the confirmation notice you will print after
refrigeration or preparation is required). No
scheduling your appointment. If you arrive during the
special meals are available.
on-site orientation, you may be allowed to test; how-
ever, you will be required to sign a Late Admission
q You may not discuss the cases with your fellow
Form. If you arrive after the on-site orientation, you
examinees at any time, and conversation among
will not be allowed to test. You will have to resched-
examinees in any language other than English is
ule your testing appointment and will be required to
prohibited at all times. Proctors will monitor all
pay the rescheduling fee. If you start to test and elect
examinee activity.
not to complete the examination, the attempt may
appear as an “incomplete examination” on your
q Should you wish to file a concern regarding your
USMLE transcript.
Step 2 CS testing experience, you may do so at
the test center on your test day. If you do not file
At the time of check-in, you will be required to
a report at the test center, you must notify NBME
present your Scheduling Permit and unexpired
Test Administration (see page 37) in writing
identification (see Admission to the Test, page 25).
within three weeks of your testing date(s).
You will be given a small storage cubicle in which
you must place personal belongings. These cubicles
q The USMLE program retains the right to remove
are not secure, so do not bring valuables. In addition,
from the examination and/or to impose
please note the following:
conditions upon retesting for any examinee who
appears to represent a health or safety risk to the
q You should bring your own stethoscope and
standardized patients or test center staff. This
white laboratory coat; all other equipment is
includes, but is not limited to, examinees who
provided at the center. Please be sure that all of
appear ill, are persistently coughing or sneezing,
the pockets of your laboratory coat are empty.
have open skin lesions, or have evidence of
active bleeding. Examinees who are not feeling
q You should wear comfortable, professional
well are encouraged to seek medical advice prior
clothing.
to arrival at the center and, if consistent with
medical advice, should consider requesting a
q There are no waiting facilities for family and
change in the date of their examination.
friends at the center; plan to meet them
elsewhere after the examination ends.
27
TESTING
NOTE: Behaviors that could constitute a real or
Visitors from medical testing and academic
potential threat to a standardized patient’s safety,
organizations will on some occasions be
such as careless or dangerous actions during
observing an examination in progress. They
physical examination, may impact your pass/fail
will be given no information regarding exami-
determination, may result in a determination of
nee identity or performance and will have no
irregular behavior and annotation of your
interaction with examinees.
USMLE record, and/or may result in the imposi-
tion of conditions on retesting.
Patient Note: Important Information
You will not receive credit for listing parts of examination you would have done or questions you would have
asked had the encounter been longer. Write only the information you elicited from the patient and describe only
the physical examination that you did. Patient notes and videos of encounters may be reviewed for compliance.
28
SCORING AND SCORE REPORTING
EXAMINATION RESULTS AND SCORING
If your Step 1, Step 2 CK, or Step 3 examination is
incomplete, you may request that a score be calculat-
When you take Step 1, Step 2 CK, or Step 3, the com-
ed and reported, with all missed test items or cases
puter records your responses. After your test ends,
scored as incorrect. This score is likely to be lower
your responses are transmitted to the NBME for scor-
than the score you would have achieved had you
ing. The number of test items you answer correctly is
completed all sections of the examination. If you
converted to two equivalent scores, one on a three-
receive notification that your examination resulted in
digit score scale and one on a two-digit score scale.
an incomplete attempt, contact the NBME in writing
Both scales are used for score-reporting purposes.
no later than 45 days after the date the notification is
sent to you if you would like further information on
On the three-digit scale, most Step 1, 2 CK, or 3
having the score calculated and reported. If you
scores fall between 140 and 260. The mean score for
decide to request calculation and reporting of your
first-time examinees from accredited medical school
score, the score will appear on your USMLE tran-
programs in the United States is in the range of 210
script as though it were complete; it will remain the
to 230, and the standard deviation is approximately
permanent score for the examination administration.
20. Your score report will include the mean and stan-
dard deviation for recent administrations of the
For Step 2 CS, if you leave the test early, or for some
examination. The two-digit score is derived from the
other reason you fail to carry out one or more of the
three-digit score. It is used in score reporting because
cases, your performance may be assessed on those
some medical licensing authorities have requirements
cases completed. If this assessment would result in a
that include language describing a "passing score of
passing outcome no matter how poorly you may have
75." The two-digit score is derived in such a way that
performed on the missed case(s), then a "pass" will
a score of 75 always corresponds to the minimum
be reported. If this assessment would result in a fail-
passing score.
ing outcome no matter how good your performance
on the missed case(s), then a "fail" will be reported.
For Step 2 CS, examinees are assessed on their data-
Otherwise, the attempt may be recorded as an
gathering and communication skills (including spo-
"incomplete examination."
ken English) by the standardized patients, and on
their ability to complete an appropriate patient note
Note: The USMLE program routinely monitors
by physician raters. Performance on Step 2 CS is
the scoring of the Step examinations for unusual
reported as pass or fail, with no numerical score.
performance results, such as very low perform-
ance. If this process raises concerns, e.g., about
USMLE score reports and transcripts (described on
your readiness to test or your level of motivation
pages 30–32) show your scores (for Step 1,
in trying to pass the examination, you may be
Step 2 CK, and Step 3) and an indication of whether
contacted by representatives of the USMLE pro-
you passed or failed (for all examinations). The same
gram. Unusual performance patterns may result in
information is sent to medical licensing authorities
your being unable to re-apply and re-test pending
upon your authorization for their use in granting the
an acceptable explanation for the noted aberran-
initial license to practice medicine.
cies. Lack of an acceptable response from you
may result in referral to the Committee on
Except as otherwise specified below, to receive a score
Irregular Behavior and Score Validity, imposition
on Step 1, Step 2 CK, and Step 3, you must begin
of conditions on retesting, and/or a bar from
every block of the test: If you do not begin every block,
USMLE examinations.
no results are reported, and the "incomplete examina-
tion" attempt appears on your USMLE transcript. If
If you wish to become more familiar with the
you register for but do not begin an examination, no
USMLE examinations, you should utilize the
record of the test will appear on your transcript.
practice materials available on the USMLE web-
site before taking the examination.
29
SCORING AND SCORE REPORTING
If it is determined that you took a Step for which you
result, no predetermined percentage of examinees will
were not eligible, results for that test may not be
pass or fail the examination. The recommended mini-
reported or, if previously reported, may be revoked
mum passing level is reviewed periodically and may
(see pages 8 and 34).
be adjusted at any time. Notice of such review and any
adjustments will be posted at the USMLE website.
Some examination materials are included in the
USMLE to enhance the examination system and to
investigate the measurement properties of the exami-
Note: Visit the USMLE website at
nations. Such materials are not scored.
http://www.usmle.org for up-to-date information.
Scoring for Multiple-Choice Items
A statistical procedure ensures that the performance
Multiple-choice items are provided in blocks of
required to pass each test form is equivalent to that
approximately 45 to 60 minutes (see page 14).
needed to pass other forms; this process also places
Blocks of items are constructed to meet specific con-
scores from different forms on a common scale.
tent specifications. As a result, the combination of
blocks of items creates a form of the examination
For Step 3, your performance on the case simula-
that is comparable in content to all other forms. The
tions will affect your Step 3 score and could affect
percentage of correctly answered items required to
whether you pass or fail. The proportional contribu-
pass varies from form to form. However, examinees
tion of the score on the case simulations is no
typically must answer 60 to 70 percent of items cor-
greater than the amount of time you are allowed for
rectly to achieve a passing score.
the case simulations.
Scoring for Primum CCS
EXAMINEE SCORE REPORTS
The CCS scoring process compares your patient
For Steps 1, 2 CK, and 3, your score report includes
management strategy with policies obtained from
a pass/fail designation, numerical scores, and graphi-
experts. Actions resembling a range of optimal strate-
cal performance profiles summarizing areas of
gies will produce a higher score. You must balance
strength and weakness to aid in self-assessment.
thoroughness, efficiency, avoidance of risk, and time-
These profiles are developed solely for your benefit
liness in responding to the clinical situation.
and will not be reported or verified to any third party.
Dangerous and unnecessary actions will detract from
your score.
Performance on Step 2 CS is reported as pass or fail.
Score reports include performance profiles, which
Scoring for Step 2 CS
reflect the relative strengths and weaknesses of your
performance across the subcomponents of Step 2 CS.
Passing performances on all three subcomponents
(ICE, CIS, SEP) in a single administration are
required to obtain the overall designation of passing
Note: To avoid misinterpretation and protect your
on Step 2 CS. Additional score information is found
privacy, scores or pass/fail outcomes are not pro-
in the Step 2 CS Content Description and General
vided by telephone, e-mail, or fax to anyone.
Information, available at the USMLE website.
MINIMUM PASSING SCORES
Results for computer-based examinations (Steps 1, 2
CK, and 3) are typically available within three to four
The USMLE program provides a recommended pass
weeks after your test date. However, delays are possi-
or fail outcome for all Step examinations.
ble for various reasons. In selecting your test date
Recommended performance standards for the USMLE
and inquiring about results, you should allow at least
are based on a specified level of proficiency. As a
eight weeks to receive notification that your score
30
SCORING AND SCORE REPORTING
report is available.
SCORE REPORTING
Results for Step 2 CS are available according to the
When your scores are available, you will receive an
Step 2 CS Schedule for Reporting Results, available
e-mail notification from your registration entity.
on the USMLE website. Before selecting your test
Follow the instructions in the e-mail notification for
date, you should consult the reporting schedule.
accessing your USMLE score report. Your score report
will remain available for approximately 120 days from
SCORE RECHECKS
the date of e-mail notification. Using password protec-
tion, you will be able to view, download, and print
For Steps 1, 2 CK, and 3, standard quality assurance
your score report. Once the score report is removed
procedures ensure that the scores reported for you
from the website, your scores will be provided to you
accurately reflect the responses recorded by the com-
only in the form of an official USMLE transcript. To
puter. When a request for a score recheck is received,
obtain a transcript you will be required to submit a
your original response record is retrieved and
form to your registration entity and to pay a fee.
rescored using a system that is outside of the normal
processing routine. The rechecked score is then com-
After taking Step 1, Step 2 CK, or Step 3, you should
pared with your original score.
allow at least eight weeks after your test date to
receive notification that your score report is avail-
For Step 2 CS, score rechecks first involve retrieval of
able. For Step 2 CS results, you should refer to the
the ratings you received from the standardized patients
Step 2 CS Schedule for Reporting Results
and from the physician note raters. These values are
(www.usmle.org).
then re-summed and re-converted into final scores in
order to confirm that the reported pass/fail outcome
The NBME reports the results of the USMLE to
was accurate. There is no re-rating of your encounters
LCME- and AOA-accredited medical school pro-
or of your patient notes; videos of encounters are not
grams for their students, who are enrolled at the time
reviewed. Videos are used for general quality control
of application, and graduates.
and for training purposes and are retained only for a
limited period of time.
If you are a student or graduate of an LCME- or
AOA-accredited medical school program and you do
Patient notes are carefully reviewed, in some instances
not want your Step 1, Step 2 CK, or Step 2 CS
by multiple physicians, before scores are released. As
results reported to your medical school, you must
part of the quality control procedures for initial scor-
send a signed request to the NBME. Your request
ing, examinees who fail Step 2 CS solely on the basis
must be postmarked or faxed at least two weeks
of the Integrated Clinical Encounter subcomponent
before your scheduled test date. If you make this
and who are performing at a level that is near the min-
request, the score information provided to the med-
imum passing point have their patient notes rated by
ical school will list your name and the notation
multiple physician note raters. Therefore, patient notes
"record withheld at the request of the examinee." If
are not reviewed again when a recheck is requested.
you want your scores reported to your medical
school subsequently, you must submit a transcript
For all Steps and Step Components, a change in your
request and pay the required fee.
score or in your pass/fail outcome based on a recheck
is an extremely remote possibility. However, a
The ECFMG may provide the results of the USMLE
recheck will be done if you submit a written request
to international medical schools for their students and
and service fee to the entity that registered you for
graduates. If you are a student or graduate of an
the examination. Your request must be received by
international medical school and you do not want
your registration entity no later than 90 days after
your Step 1, Step 2 CK, or Step 2 CS results reported
your result was released.
to your medical school, you must submit a request
for each exam administration using ECFMG’s
31
SCORING AND SCORE REPORTING
Interactive Web Application (IWA), available on the
q your history of any examinations for which no
ECFMG website at www.ecfmg.org. Your request
results were reported;
must be submitted at least 10 days before your sched-
q indication of whether you have previously taken
uled test date. If you make this request, the score
the former NBME Parts I, II, or III, Federation
information provided to the medical school for that
Licensing Examination (FLEX), or ECFMG
exam administration will list your name and the nota-
Clinical Skills Assessment (CSA);
tion “record withheld at the request of the examinee.”
If you want your score for that exam administration
q annotation(s) if you were provided with test
reported to your medical school subsequently, you
accommodations (see page 17);
must submit a transcript request and pay the required
fee.
q annotation(s) and information documenting
classification of any scores as indeterminate
If you are a graduate of an LCME- or AOA-accredited
(see page 34);
medical school program, you must indicate on your
q annotation(s) and information documenting
Step 3 application your preference for reporting your
any irregular behavior (see pages 34–35); and
Step 3 score to the school from which you graduated.
q notation(s) of any actions taken against you by
OFFICIAL USMLE TRANSCRIPTS AND
medical licensing authorities or other
PROVIDING SCORES TO THIRD PARTIES
credentialing entities that have been reported
to the FSMB Board Action Databank.
If you want to send your USMLE scores to a third
party, you must submit a request and pay a fee. Your
scores will be provided in the form of an official
Note: Graphical performance profiles, which are
USMLE transcript.
included on your original score reports, are not
included in your USMLE transcript.
Examination data (including performance informa-
tion and recorded patient encounters) from USMLE
examinations may be used by the USMLE program
To obtain your USMLE transcript or have it sent to a
or made available to third parties for research. In
third party, you must contact the ECFMG, FSMB, or
such instances, the data will be confidential, and indi-
NBME. Which entity you contact depends on which
vidual examinees will not be identified in any publi-
examinations you have taken and where you want
cation. If you do not wish your score to be made
your transcript sent. Contact the FSMB if you want
available for research purposes, you must advise the
your transcript sent to a medical licensing authority
USMLE Secretariat in writing (see page 37).
at any time. If you have not registered for or taken
Step 3 and want your transcript sent to anyone other
Except as described in this bulletin, USMLE results
than a medical licensing authority, the request should
will not be reported to you or third parties without
be sent to the last entity that registered you.
your request and payment of the transcript fee.
ELECTRONIC RESIDENCY APPLICATION
Your USMLE transcript includes the following:
SERVICE (ERAS®)
q your name and other personal identification
If you use ERAS, you may request electronic trans-
information, including your date of birth;
mittal of your USMLE transcript to residency pro-
grams that participate in ERAS. Information on
q your complete results history of all Steps and
ERAS is available for students and graduates of
Step Components that you took;
LCME- and AOA-accredited medical school pro-
grams from the medical schools, and for students and
32
SCORING AND SCORE REPORTING
graduates of medical schools outside the United
States and Canada from the ECFMG. The Association
Visit these websites for information on ERAS:
of American Medical Colleges (AAMC) and ECFMG
http://www.aamc.org
websites also include information on ERAS and/or
http://www.ecfmg.org
links to the ERAS website.
Requesting USMLE Transcripts
Step(s)/Component(s) Taken
Recipient of Transcript
Contact
(see page 36)
One or more USMLE Steps
Medical licensing authority
FSMB
All three USMLE Steps; or
Any recipient
FSMB
Step 1 and Step 2 CK and CS (if
required), only when registered
for or after taking Step 3
Step 1 and/or Step 2 CK and/or
ECFMG
CS only, registered by ECFMG
Any recipient other than a medical
licensing authority
Step 1 and/or Step 2 CK and/or
NBME
CS only, registered by NBME
33
INDETERMINATE SCORES AND IRREGULAR BEHAVIOR
VALIDITY OF SCORES
tion about the indeterminate classification will be
provided to entities that receive or have received
The USMLE program assures the validity of scores
your USMLE transcript.
reported for USMLE examinations by every means
available. Your scores may be classified as indetermi-
If irregular behavior appears to have contributed to a
nate if the scores are at or above the passing level
decision that your scores are indeterminate, action
and the USMLE program cannot certify that they
will also be taken as described below.
represent a valid measure of your knowledge or com-
petence as sampled by the examination. The USMLE
IRREGULAR BEHAVIOR
program may make such a determination when aber-
rancies in performance are detected for which there is
Irregular behavior includes any action by applicants,
no reasonable and satisfactory explanation. A classifi-
examinees, potential applicants, or others when
cation of indeterminate may result from irregular
solicited by an applicant and/or examinee that sub-
behavior (see following section) or from other fac-
verts or attempts to subvert the examination process.
tors, such as unexplained inconsistency in perform-
ance within a Step or Step Component or between
If you have information or evidence indicating that
takes of the same Step or Step Component.
any type of irregular behavior or any infringement of
legal rights has occurred, you should submit a written
The performance of all examinees is monitored and
report to or telephone the USMLE Secretariat (see
may be analyzed statistically to detect aberrancies
page 37) or the registration entity (see page 36).
indicating that your scores may be indeterminate. In
addition, evidence of irregular behavior may suggest
Specific examples of conduct that is deemed to be
that your scores do not represent a valid measure of
irregular behavior include, but are not limited to, the
your knowledge or competence as sampled by the
following:
examination. In these circumstances, your score
report may be delayed, pending completion of further
q seeking and/or obtaining unauthorized access to
analysis and investigation. If your score report is
examination materials;
delayed, you and any other party to whom scores
would normally be reported will be notified. You will
q providing false information or making false
be provided with a copy of the USMLE Policies and
statements on or in connection with application
Procedures Regarding Indeterminate Scores, which
forms, Scheduling Permits, or other USMLE-
describes the process for reaching final decisions.
related documents;
You will have an opportunity to provide information
that you consider relevant.
q taking an examination without being eligible for
it or attempting to do so;
After review and analysis of all available informa-
tion, scores will be classified as valid and will be
q impersonating an examinee or engaging someone
reported, or scores will be classified as indeterminate.
else to take the examination for you;
If the scores are classified as indeterminate, you will
be advised of the options for retaking the examina-
q giving, receiving, or obtaining unauthorized
tion. Scores classified as indeterminate do not appear
assistance during the examination or attempting
on your transcript; rather, an annotation indicates that
to do so;
the scores were classified as indeterminate. Scores
classified as indeterminate will not be reported to
q making notes of any kind while in the secure
anyone. Anyone who has received a report of scores
areas of the test center except on the writing
that are later classified as indeterminate will be noti-
materials provided at the test center for this
fied of the indeterminate classification. The USMLE
purpose;
Policies and Procedures Regarding Indeterminate
Scores describes the circumstances in which informa-
34
INDETERMINATE SCORES AND IRREGULAR BEHAVIOR
q failing to adhere to any USMLE policy,
If information received suggests that irregular behav-
procedure, or rule, including instructions of
ior has occurred, statistical analyses may be conduct-
the test center staff;
ed and additional information may be gathered.
q verbal or physical harassment of test center
You will be advised of the alleged irregular behavior,
staff or other disruptive or unprofessional
and you will have an opportunity to provide informa-
behavior at a test center;
tion that you consider relevant to the evaluation of the
allegation. Your scores may be withheld, if they have
q possessing any unauthorized materials, including
not been reported previously. Applications may not be
photographic equipment, or communication or
processed, and you may not be permitted to take sub-
recording devices, including electronic paging
sequent examinations until a final decision regarding
devices and cellular telephones, in the secure
irregular behavior is made. You will be provided with
testing areas;
a copy of the USMLE Policies and Procedures
Regarding Irregular Behavior, which describes in
q altering or misrepresenting examination scores;
detail the process for reaching final decisions regard-
ing irregular behavior. If the evidence suggests that the
q any unauthorized reproduction by any means,
alleged irregular behavior affects score validity, the
including reconstruction through memorization,
score will also be reviewed as described on page 34.
and/or dissemination of copyrighted examination
materials by any means, including the Internet;
If it is determined that you engaged in irregular
and
behavior, information regarding this determination
becomes part of your USMLE record. Your score
q communicating or attempting to communicate
report (if applicable) and USMLE transcript will con-
about specific test items, cases, and/or answers
tain a notation regarding the irregular behavior.
with another examinee, potential examinee, or
formal or informal test preparation group at any
Information about the irregular behavior will be pro-
time before, during, or after an examination.
vided to third parties that receive or have received
your USMLE transcript. Such information may also
be provided to other legitimately interested entities. If
NOTE: Looking in the direction of another
it is determined that the irregular behavior is egre-
examinee's computer monitor or talking to anoth-
gious and/or threatens the integrity of the examina-
er examinee during the examination may be
tion system, you may be barred from future USMLE
reported as evidence of giving, receiving, or
examinations and/or special administrative proce-
obtaining unauthorized assistance. The report
dures may be implemented for your future examina-
may result in a determination of irregular behav-
tions. The USMLE program also reserves the right to
ior. Discussion of examination content or answers
take such actions when information regarding behav-
on the Internet may also result in a determination
ior of examinees on predecessor examinations indi-
of irregular behavior.
cates such actions may be necessary to ensure the
security of the USMLE.
Anomalous Performance
Unusually low scores or unusual performance history on USMLE may be indicative of possible irregular
behavior (see Scoring). If your performance raises concerns, e.g., about your readiness to test or motivation to
succeed, and no reasonable and satisfactory explanation for the unusual performance is available, the matter
may be referred to the Committee on Irregular Behavior and Score Validity. The Committee may prohibit you
from future testing until such time as you comply with certain conditions, e.g., produce evidence of additional
educational experience or motivation to succeed.
35
COMMUNICATING ABOUT USMLE
Examination
Type of Applicant
Registration Entity to Contact
Step 1
Students and graduates of medical
NBME
or
school programs in the United States and
Examinee Support Services
Step 2
Canada accredited by the Liaison
3750 Market Street
(CK or CS)
Committee on Medical Education
Philadelphia, PA 19104-3190
or students and graduates of medical
Website: http://www.nbme.org
schools in the United States accredited
Telephone: (215) 590-9700
by the American Osteopathic
Fax: (215) 590-9457
Association
E-mail: webmail@nbme.org
Step 1
Students and graduates of medical
ECFMG
or
schools outside the United States
3624 Market Street
Step 2
and Canada
Philadelphia, PA 19104-2685
(CK or CS)
Website: http://www.ecfmg.org
Telephone: (215) 386-5900
Fax: (215) 386-9196
E-mail: info@ecfmg.org
Step 3
All medical school graduates who have
FSMB
passed Step 1 and Step 2
Department of Examination Services
PO Box 619850
Dallas, TX 75261-9850
Website: http://www.fsmb.org
Telephone: (817) 868-4041
Fax: (817) 868-4098
E-mail: usmle@fsmb.org
or
Medical licensing authority
(see pages 37–42)
APPLICATION AND REGISTRATION
INQUIRIES
http://www.usmle.org
You must contact the appropriate registration entity
(see above) for the following:
Visit the USMLE website for
up-to-date information.
q information on how to apply for the USMLE,
q application materials,
q information on the status of your application or
Scheduling Permit.
36
COMMUNICATING ABOUT USMLE
SCHEDULING AND TEST CENTER INQUIRIES
the difficulty experienced. Please allow 10 to 15 busi-
ness days for your report to be thoroughly investigat-
For Steps 1, 2 CK, and 3, your Scheduling Permit
ed and evaluated. You will receive written notification
includes instructions on how to contact Prometric to
of the results of the investigation. If you have ques-
schedule your appointment to test. Inquiries about
tions, you may call (215) 590-9700 and press “4.”
your appointment, such as a request to reschedule an
appointment within your eligibility period, must be
directed to Prometric. For current information on the
Important Note: Written notification of prob-
locations of Prometric Test Centers, visit the
lems experienced during administration must be
Prometric website.
received by NBME Test Administration within
three weeks of your testing date for Step 2 CS
After you receive your Scheduling Permit, you can
and within 45 days of your testing date for
contact Prometric directly, as instructed on the
Steps 1, 2 CK, and 3.
Permit, for current information on a particular
test center.
GENERAL INQUIRIES
http://www.prometric.com
Complete information about the USMLE is available
Use the Prometric Test Center Locator for
at the USMLE website. General inquiries regarding
up-to-date information on the locations
the USMLE or inquiries for the USMLE Secretariat
of Prometric Test Centers.
may be directed to the NBME (see page 36) or the
USMLE Secretariat:
To schedule an appointment for Step 2 CS, follow the
USMLE Secretariat
instructions provided on your Scheduling Permit. For
3750 Market Street
test center availability and to schedule or reschedule
Philadelphia, PA 19104-3190
an appointment, access Step 2 CS Calendar and
Telephone: (215) 590-9700
Scheduling through the website of your registration
entity.
STEP 3 AND MEDICAL LICENSURE
INQUIRIES
If you receive a Scheduling Permit but experience a
problem that testing center staff are unable to resolve
Inquiries for Step 3 applications and general ques-
in scheduling your appointment or in administering
tions on medical licensure may be directed to the
your test on the testing day, you may contact your
FSMB. Specific inquiries regarding licensure may be
registration entity (see page 36).
directed to the following medical licensing authori-
ties or their representatives at the telephone numbers
TEST ADMINISTRATION
listed below.
PROBLEMS/INQUIRIES
Alabama State Board of Medical Examiners
If you wish to report a problem experienced during
848 Washington Avenue
the administration of the examination that test center
Montgomery, AL 36104
staff were unable to resolve to your satisfaction, you
(334) 242-4116
may forward a written description of your experience
to the NBME (attention: Test Administration; see
Alaska State Medical Board
page 36), by mail, e-mail (testadmin@nbme.org), or
550 West Seventh Avenue, Suite 1500
fax. Your correspondence should also include your
Anchorage, AK 99501
name, your USMLE ID number, the examination
(907) 269-8163
name (Step 1, 2 CK, 2 CS, or 3), date of administra-
Step 3 inquiries: call FSMB at (817) 868-4041
tion, test center location, and a detailed description of
37
COMMUNICATING ABOUT USMLE
Arizona Board of Osteopathic Examiners
District of Columbia Board of Medicine
in Medicine and Surgery
717 14th Street NW, Suite 600
9535 E Doubletree Ranch Road
Washington, DC 20005-3212
Scottsdale, AZ 85258
(202) 724-8800
(480) 657-7703
Florida Board of Medicine
Arizona Medical Board
4042 Bald Cypress Way, BIN #C-01
9545 E Doubletree Ranch Road
Tallahassee, FL 32399-7017
Scottsdale, AZ 85258
(850) 488-0595
(480) 551-2700
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
Florida Board of Osteopathic Medicine
Arkansas State Medical Board
4052 Bald Cypress Way, BIN #C-06
2100 Riverfront Drive
Tallahassee, FL 32399-3256
Little Rock, AR 72202-1747
(850) 245-4161
(501) 296-1802
Step 3 inquiries: call FSMB at (817) 868-4041
Georgia Composite State Board
of Medical Examiners
Medical Board of California
2 Peachtree Street, NW, 36th Floor
2005 Evergreen St., Suite 1200
Atlanta, GA 30303
Sacramento, CA 95815
(404) 656-3913
Licensure inquiries: (916) 263-2389
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
Guam Board of Medical Examiners
Osteopathic Medical Board of California
123 Chalan Kareta
1300 National Drive, Suite 150
South Route 10
Sacramento, CA 95834-1991
Barrigada, GU 96913-6304
(916) 263-3100
(671) 735-7406
Colorado Board of Medical Examiners
Hawaii Medical Board
1560 Broadway, Suite 1300
325 Merchant Street, Room 301
Denver, CO 80202-5151
Honolulu, HI 96801
(303) 894-7690
(808) 586-3000
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
Connecticut Medical Examining Board
Idaho State Board of Medicine
410 Capitol Avenue
1755 Westgate Drive #140
PO Box 340308 MS 13 PHO
Boise, ID 83704
Hartford, CT 06134
(208) 327-7000
(860) 509-7648
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
Illinois Department of Financial and
Delaware Board of Medical Practice
Professional Regulation
861 Silverlake Boulevard
320 W. Washington Street, 3rd Floor
Cannon Building, Suite 203
Springfield, IL 62786
Dover, DE 19904
(312) 814-4500
(302) 744-4520
Step 3 inquiries: call FSMB at (817) 868-4041
38
COMMUNICATING ABOUT USMLE
Medical Licensing Board of Indiana
Massachusetts Board of Registration in Medicine
402 W Washington Street, Room W064
200 Harvard Mill Square, Suite 330
Indianapolis, IN 46204
Wakefield, MA 01880
(317) 234-2013
(617) 654-9800
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
Iowa Board of Medicine
Michigan Board of Medicine
400 SW 8th Street, Suite C
611 W. Ottawa, 1st Floor
Des Moines, IA 50309-4619
Lansing, MI 48933
(515) 281-6492
(517) 335-0918
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
Kansas State Board of Healing Arts
Michigan Board of Osteopathic Medicine and Surgery
235 S Topeka Boulevard
611 W. Ottawa, 1st Floor
Topeka, KS 66603-3068
Lansing, MI 48933
(785) 296-7413
(517) 335-0918
Step 3 inquiries: call FSMB at (817) 868-4041
Minnesota Board of Medical Practice
Kentucky Board of Medical Licensure
2829 University Avenue, SE, Suite 500
Hurstbourne Office Park
Minneapolis, MN 55414-3246
310 Whittington Parkway, Suite 1B
(612) 617-2130
Louisville, KY 40222
Step 3 inquiries: call FSMB at (817) 868-4041
(502) 429-7150
Step 3 inquiries: call FSMB at (817) 868-4041
Mississippi State Board of Medical Examiners
1867 Crane Ridge Drive, Suite 200B
Louisiana State Board of Medical Examiners
Jackson, MS 39216
630 Camp Street
(601) 987-3079
New Orleans, LA 70190-0250
Step 3 inquiries: call FSMB at (817) 868-4041
(504) 568-6820
Step 3 inquiries: call FSMB at (817) 868-4041
Missouri Board of Registration
for the Healing Arts
Maine Board of Licensure in Medicine
3605 Missouri Boulevard
137 State House Station
PO Box 4
Augusta, ME 04333-0137
Jefferson City, MO 65109
(207) 287-3601
(573) 751-0098
Step 3 inquiries: call FSMB at (817) 868-4041
Montana Board of Medical Examiners
Maine Board of Osteopathic Licensure
PO Box 200513
142 SHS
301 S Park Avenue, 4th Floor
Augusta, ME 04333-0142
Helena, MT 59620-0513
(207) 287-2480
(406) 841-2361 or (401) 841-2364
Step 3 inquiries: call FSMB at (817) 868-4041
Maryland Board of Physicians
4201 Patterson Avenue, 4th Floor
Baltimore, MD 21215
(410) 764-4777 or (800) 492-6836
Step 3 inquiries: call FSMB at (817) 868-4041
39
COMMUNICATING ABOUT USMLE
Nebraska Board of Medicine and Surgery
North Carolina Medical Board
DHHS Licensure Unit
1203 Front Street
PO Box 94986
Raleigh, NC 27609-7533
Lincoln, NE 68509
(919) 326-1100
(402) 471-4911
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
North Dakota State Board of Medical Examiners
Nevada State Board of Medical Examiners
City Center Plaza
1105 Terminal Way #301
418 E Broadway, Suite 12
Reno, NV 89502
Bismarck, ND 58501
(775) 688-2559
(701) 328-6500
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
Nevada State Board of Osteopathic Medicine
Commonwealth of the Northern Mariana Islands
2860 E Flamingo Road, Suite D
Medical Profession Licensing Board
Las Vegas, NV 89121
PO Box 502078CK
(702) 732-2147
Saipan, MP 96950
Step 3 inquiries: call FSMB at (817) 868-4041
(670) 664-4811
New Hampshire Board of Medicine
State Medical Board of Ohio
2 Industrial Park Drive, Suite 8
30 East Broad Street, 3rd Floor
Concord, NH 03301-8520
Columbus, OH 43215-3414
(603) 271-1203
(614) 466-3934
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
New Jersey State Board of Medical Examiners
Oklahoma Board of Osteopathic Examiners
140 E Front Street
4848 N Lincoln Boulevard, Suite 100
Trenton, NJ 08608
Oklahoma City, OK 73105-3321
(609) 826-7100
(405) 528-8625
Step 3 inquiries: call FSMB at (817) 868-4041
Oklahoma State Board of Medical Licensure
New Mexico Board of Osteopathic
and Supervision
Medical Examiners
5104 N. Frances Avenue, Suite C
2550 Cerrillos Road
Oklahoma City, OK 73118-6020
Santa Fe, NM 87505
(405) 848-6841
(505) 476-4695
Step 3 inquiries: call FSMB at (817) 868-4041
New Mexico Medical Board
Oregon Medical Board
2055 S. Pacheco Street, Bldg. 400
1500 SW First Avenue, Suite 620
Santa Fe, NM 87505
Portland, OR 97201-5815
(505) 476-7220
(971) 673-2700
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
New York State Board for Medicine
Pennsylvania State Board of Medicine
89 Washington Avenue, 2nd Floor, West Wing
One Penn Center
Albany, NY 12203
2601 N. Third Street
(518) 474-3817
Harrisburg, PA 17110
Step 3 inquiries: call FSMB at (817) 868-4041
(717) 787-2381 or (717) 783-1400
Step 3 inquiries: call FSMB at (817) 868-4041
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COMMUNICATING ABOUT USMLE
Pennsylvania State Board of Osteopathic Medicine
Texas Medical Board
2601 N. Third Street
333 Guadalupe Tower 3, Suite 610
Harrisburg, PA 17110
Austin, TX 78701
(717) 783-4858
(512) 305-7010
Step 3 inquiries: call FSMB at (817) 868-4041
Puerto Rico Board of Medical Licensure
and Discipline
Utah Osteopathic Physicians and Surgeons
Tres Rios Building
Licensing Board
#27 Gonzales Guisti Avenue
Heber Wells Building
Guaynabo, PR 00968
160 E. 300 South, 4th Floor
(787) 782-8937
Salt Lake City, UT 84111
(801) 530-6628
Rhode Island Board of Medical Licensure
and Discipline
Utah Physicians Licensing Board
Department of Health
Heber Wells Building
Cannon Building, Room 205
160 E 300 South, 4th Floor
Three Capitol Hill
Salt Lake City, UT 84111
Providence, RI 02908-5034
(801) 530-6628
(401) 222-3855
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
Vermont Board of Medical Practice
South Carolina Board of Medical Examiners
108 Cherry Street
Department of Labor, Licensing and Regulation
PO Box 70
110 Centerview Drive, Suite 202
Burlington, VT 05402-0070
Columbia, SC 29210-8432
(802) 843-7200
(803) 896-4500
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
Vermont Board of Osteopathic Physicians and
South Dakota State Board of Medical
Surgeons
and Osteopathic Examiners
26 Terrace Street
101 N. Main Avenue, Suite 301
Montpelier, VT 05609
Sioux Falls, SD 57104
(802) 828-1134
(605) 367-7781
Step 3 inquiries: call FSMB at (817) 868-4041
Virginia Board of Medicine
Perimeter Center
Tennessee Board of Medical Examiners
9960 Maryland Drive, Suite 300
227 French Landing, Suite 300
Richmond, VA 23233
Nashville, TN 37243
(804) 662-9908
(615) 532-3202
Step 3 inquiries: call FSMB at (817) 868-4041
Step 3 inquiries: call FSMB at (817) 868-4041
Virgin Islands Board of Medical Examiners
Tennessee Board of Osteopathic Examiners
Virgin Islands Department of Health
227 French Landing, Suite 300
48 Sugar Estate, 2nd Floor
Nashville, TN 37243
St. Thomas, VI 00802
(615) 532-3202
(340) 774-0117
41
COMMUNICATING ABOUT USMLE
Washington Board of Osteopathic
West Virginia Board of Osteopathy
Medicine and Surgery
334 Penco Road
310 Israel Road, SE
Weirton, WV 25311
Tumwater, WA 98501
(304) 723-4638
(360) 236-4943
Step 3 inquiries: call FSMB at (817) 868-4041
Wisconsin Medical Examining Board
Department of Regulation and Licensing
Washington State Medical Quality Assurance
1400 E Washington Avenue, Room 178
Commission
Madison, WI 53703
243 Israel Road, SE
(608) 266-2112
PO Box 47866
Olympia, WA 98504
Wyoming Board of Medicine
(360) 236-4788
320 W. 25th Street, Suite 103
Step 3 inquiries: call FSMB at (817) 868-4041
Cheyenne, WY 82002
(307) 778-7053
West Virginia Board of Medicine
Step 3 inquiries: call FSMB at (817) 868-4041
101 Dee Drive, Suite 103
Charleston, WV 25301
(304) 558-2921
Step 3 inquiries: call FSMB at (817) 868-4041
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