United States Medical Licensing Examination

The United States Medical Licensing Examination (USMLE) is a critical step for international medical graduates (IMGs) who wish to practice medicine or apply for residency in the United States. Here are the key steps to take:

1. Confirm Your Eligibility

• Educational Requirements:
  • IMGs must graduate from a medical school listed in the World Directory of Medical Schools as meeting eligibility for ECFMG certification.
  • Be enrolled in or graduated from an eligible institution at the time of application.
• ECFMG Certification: IMGs must be certified by the Educational Commission for Foreign Medical Graduates (ECFMG) to take certain steps of the USMLE and apply for residency in the U.S.

2. Apply for ECFMG Certification

• Create an Account: Visit the ECFMG website and create an account in the ECFMG Certification portal.
• Submit Documentation:
  • Medical school transcripts.
  • Verification form from your medical school.
  • Passport for identity verification.
• Pay Certification Fees: There is a fee for certification and verification.

3. Register for USMLE Exams

The USMLE is divided into three steps:

Step 1:

• Content: Focuses on basic medical sciences (e.g., anatomy, biochemistry, pathology, pharmacology).
• When to Take It: During or after medical school.
• Preparation: Use resources like First Aid, UWorld, and Kaplan Qbanks.

Step 2 CK (Clinical Knowledge):

• Content: Focuses on clinical sciences and medical management.
• When to Take It: After or during clinical rotations.

Step 2 CS (Clinical Skills): (Currently discontinued since 2020)

Clinical skills assessment is no longer part of USMLE.

Step 3:

• Content: Focuses on applying medical knowledge in patient care.
• When to Take It: After obtaining your ECFMG certification and during/after residency.
• Requirement: Not required for residency application but necessary for medical licensure in the U.S.

4. Prepare and Schedule the Exams

• Preparation Tips:
  • Use high-yield study materials (First Aid, UWorld, Pathoma, Kaplan).
  • Create a study schedule.
  • Take practice exams (NBME and UWorld Self-Assessments).
• Scheduling:
  • Register and pay fees via the ECFMG portal for Steps 1 and 2 CK.
  • Choose a test center (Prometric testing centers worldwide).

5. Obtain ECFMG Certification

• After passing Step 1 and Step 2 CK, you will receive ECFMG Certification. This is required to:
  • Apply for residency via the Electronic Residency Application Service (ERAS).
  • Participate in the Match (NRMP).

6. Apply for Residency (ERAS)

• Create an ERAS Account: Through the ECFMG OASIS portal.
• Submit Required Documents:
  • Medical school transcripts.
  • Personal statement.
  • Letters of recommendation.
  • ECFMG certificate.
• Participate in the Match (NRMP): Rank your residency preferences and match into a program.

7. Apply for Step 3 (Optional Before Residency)

• Completing Step 3 before applying for residency may improve your chances for competitive programs (especially for IMGs). However, it's commonly taken during residency.

8. Apply for a Visa

• IMGs typically require a visa to train in the U.S. Common visas include:
  • J-1 Visa: Sponsored by ECFMG.
  • H-1B Visa: Requires passing Step 3 and sponsorship by a residency program.

9. Start Residency Training

• Upon matching into a program, complete your training in the specialty of choice.

10. Obtain Medical Licensure

• After completing residency and passing all steps of the USMLE, apply for medical licensure in the state where you plan to practice.

Timeline Considerations:

• Start preparing and verifying documents 1–2 years before residency applications.
• Residency application deadlines usually fall between September and November each year.