To become a licensed physician in the united states



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It is necessary for obtaining ECFMG Certicicate as well as for registration for USMLE Step 2 CS

  • It is necessary for obtaining ECFMG Certicicate as well as for registration for USMLE Step 2 CS

  • It assesses

    • understanding and ability to apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy
    • mastery of science that provide foundation for the safe and competent practice of medicine in the present, as well as the scientific principles required
  • It is a computerized test of the basic medical sciences administered at Prometric Testing Centres



It has two separately administered components:

  • It has two separately administered components:

    • STEP 2 Clinical Skills (STEP 2 CS) – administered at five U.S. regional test centres (Philadelphia, Chicago, Atlanta, Houston, Los Angeles )
    • STEP 2 Clinical Knowledge (STEP 2 CK) – a computerised test administered at Prometric Testing Centres
  • It assesses your ability to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision, and includes emphasis on health promotion and disease prevention

  • It ensures that due attention is devoted to the principles of clinical sciences and basic patient- centered skills that provide the foundation for the safe and effective practice of medicine



It is the final examination in the USMLE sequence providing a final assessment of physicians assuming independent responsibility for delivering general medical care, and leading to a license to practice medicine without supervision

  • It is the final examination in the USMLE sequence providing a final assessment of physicians assuming independent responsibility for delivering general medical care, and leading to a license to practice medicine without supervision

  • It assesses

    • whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings (however, inpatient encounters of significant complexity and reflecting contemporary trends also are represented)
    • selected physician tasks, i.e. evaluating severity of patient problems and managing therapy (clinical problems involve mainstream, high-impact diseases as well as less common but important clinical problems)
    • incorporating applied basic and clinical science concepts, especially as they relate to justification for prognosis or management
  • Its content reflects a data-based model of generalist medical practice in the United States

  • The test items and cases

    • reflect the clinical situations that a general physician might encounter within the context of a specific setting
    • are patient centered, starting with a description of a clinical encounter (vignette); both the multiple-choice items and case simulations pose action-related challenges that require clinical decisions or judgment
  • the prerequisite: Step 1 and Step 2 examinations



THE FIRST DAY OF TESTING

  • THE FIRST DAY OF TESTING

  • 336 multiple-choice items in 7 blocks of 48 items each

  • 60 minutes of time allowed for completion of each block of test items

  • a maximum of 7 hours of testing on the first day

  • a minimum of 45 minutes of break time and a 15-minute optional tutorial

  • Note 1: The amount of time available for breaks may be increased by finishing a block of test items or the optional tutorial before the allotted time expires.

  • Note 2: Items with an associated pharmaceutical ad or abstract are included in some of these multiple choice blocks. Those blocks that include these item types will contain 46–47 items per block. The timing will remain the same for all blocks.



Students and graduates of medical schools outside the USA and Canada apply by following the instructions on the ECFMG website ( http://www.ecfmg.org )

  • Students and graduates of medical schools outside the USA and Canada apply by following the instructions on the ECFMG website ( http://www.ecfmg.org )

  • Before applying for USMLE, international students/graduates must

      • Obtain a USMLE/ECFMG Identitification Number
      • Submit an Application for ECFMG Certification
      • Read the appropriate editions of ECFMG Information Booklet and the USMLE Bulletin of Information
  • To apply, use ECFMG‘s Interactive Web Application (IWA)

      • It consists of the online part and other required documents outlined in IWA
      • Review the instructions which accompany the application before you begin working on the application; while completing the application, follow the instruction carefully
      • Prepare necessary items in advance (they may include photographs, official signatures, photocopies of your medical diploma in case you are a graduate)
      • ECFMG lets you know by e-mail when your application is received
      • ECFMG processes your exam application and verify your eligibility to take the exam you requested


our medical faculty participates in EMSWP (ECFMG Medical School Web Portal)

  • our medical faculty participates in EMSWP (ECFMG Medical School Web Portal)

  • you must print a Certification of Identification Form (Form 186) after completing the online part of the application

  • this form must be completed by you and certified by an authorized official of our medical school within 4 months (bring it to International Studies Office)

  • the verified and signed original must be sent to ECFMG by International Studies Office

  • once accepted by ECFMG, Form 186 remains valid for five years so applications and requests to extend Step 1 and Step 2CK eligibility periods can be completed entirely online during this five-year period

  • if there are any additional documents required to complete your your application, these documents must be sent to ECFMG with your Form 186, and must be accompanied by a completed IWA DOCUMENT SUBMISSION FORM (FORM 187)

  • do not include Form 187 if you do not have additional documents to submit to ECFMG

  • all forms and documents required to complete your application must be sent to ECFMG in one envelope



our medical faculty participates in EMSWP (ECFMG Medical School Web Portal)

  • our medical faculty participates in EMSWP (ECFMG Medical School Web Portal)

  • you must provide copies of his/her final medical diploma with the exam application, if your diploma has not been submitted to ECFMG previously

  • before you can be registered for USMLE, your status as a medical school graduate must be verified directly by your medical school

    • the medical school verifies your status through EMSWP
  • you must print a Certification of Identification Form (Form 186) after completing the online part of the application in case you do not have a valid Form 186 on file with ECFMG

  • this form must be completed by you and certified by an authorized official of our medical school within 4 months and the verified and signed original must be sent to ECFMG by International Studies Office of our medical faculty

  • when you complete the on-line part of the exam application, IWA will produce the appropriate version of Form 186 based on the type of official(s) that are acceptable to certify/sign the form; print the version of Form 186 for the official(s) who will certify/sign your Form 186

  • once accepted by ECFMG, Form 186 remains valid for five years so applications and requests to extend Step 1 and Step 2CK eligibility periods can be completed entirely online during this five-year period

  • if there are any additional documents required to complete your application, these documents must be sent to ECFMG with your Form 186, and must be accompanied by a completed IWA DOCUMENT SUBMISSION FORM (FORM 187)

  • do not include Form 187 if you do not have additional documents to submit to ECFMG

  • all forms and documents required to complete your application must be sent to ECFMG in one envelope



STEP 1, STEP 2 CK, AND STEP 2 CS ARE OFFERED REGULARLY THROUGHOUT THE YEAR

  • STEP 1, STEP 2 CK, AND STEP 2 CS ARE OFFERED REGULARLY THROUGHOUT THE YEAR

  • Note that STEP 1 and STEP 2 CK are not available during the first 14 days of January



pay all applicable fees at the time you apply for examination

  • pay all applicable fees at the time you apply for examination

  • if you do not pay all fees, your application will be rejected

  • if your application is rejected, any payment received with that application will be credited to your ECFMG financial account (see Payment in Your ECFMG Financial Account)

  • For Step 1 or Step 2 CK, there is an additional international test delivery surcharge, if you choose a testing region other than the United States/Canada

  • these surcharges represent the additional cost of offering Step 1 and Step 2 CK by computer outside the United States and Canada

  • if you choose to take the exam in the United States or Canada, you do not need to pay a surcharge

  • for the current exam fees and international test delivery surcharges, see the Fees

  • all fees are in U.S. dollars and are subject to change without notice



Step 2 CS is held at regional test centers in Atlanta, Chicago, Houston, Los Angeles, and Philadelphia in the USA

  • Step 2 CS is held at regional test centers in Atlanta, Chicago, Houston, Los Angeles, and Philadelphia in the USA

  • you cannot choose a test center when you apply; you will select a test center when you schedule your testing appointment

  • if you are unable to keep your testing appointment at the test center you select, you can reschedule for a different center, subject to availability

  • to avoid a rescheduling fee, you must cancel or reschedule more than 14 days before your scheduled testing appointment; see Rescheduling





Both officially enrolled students and graduates from a medical school that is listed in International Medical Education Directory (IMED) of the Foundation for Advancement of International Medical Education and Research (FAIMER) are eligible to take the test

  • Both officially enrolled students and graduates from a medical school that is listed in International Medical Education Directory (IMED) of the Foundation for Advancement of International Medical Education and Research (FAIMER) are eligible to take the test

  • Eligibility period: a three-month period of your choice

  • ! ! ! Important note: If your eligibility for an exam changes after you apply but before you take the exam, you are required to inform ECFMG immediately of this change in your status



To be eligible for Step 3 you must:

  • To be eligible for Step 3 you must:

  • obtain the MD degree (or its equivalent) from a medical school outside the US and Canada that is listed in the IMED

  • pass Step 1, Step 2 CK, and Step 2 CS

  • obtain certification by the ECFMG or successfully complete a "Fifth Pathway" program if you are a graduate of a medical school outside the United States and Canada

  • meet the Step 3 requirements set by the medical licensing authority to which you are applying.

  • Eligibility period: The eligibility periods for Step 3 can not be chosen. Your eligibility will begin upon approval of your application.

  • ! ! ! Important note: If your eligibility for an exam changes after you apply but before you take the exam, you are required to inform ECFMG immediately of this change in your status



when you apply for Step 1 or Step 2 CK, you must select a three-month period (January-February-March or February-March-April, etc.) during which you would like to take the exam  this three-month period is referred to as your eligibility period

  • when you apply for Step 1 or Step 2 CK, you must select a three-month period (January-February-March or February-March-April, etc.) during which you would like to take the exam  this three-month period is referred to as your eligibility period

  • you must take the exam during the eligibility period assigned to you; you can take the exam on any day that it is offered during your assigned eligibility period, provided there is space available at the test center that you choose



if you are unable to take Step 1/Step 2 CK during the three-month eligibility period assigned to you, you may request a one-time extension (this eligibility period cannot overlap with your original eligibility period)

  • if you are unable to take Step 1/Step 2 CK during the three-month eligibility period assigned to you, you may request a one-time extension (this eligibility period cannot overlap with your original eligibility period)

  • you may request an extension on-line using IWA

  • you may request only once for each exam registration after your eligibility period has begun; the processing of your request must be completed by the published deadline or your request will be rejected

  • if your eligibility period is extended, NBME will issue a revised scheduling permit reflecting the extension

  • you must access this revised scheduling permit using IWA and bring a printed copy to the test center on the date of your exam



when you are registered for Step 2 CS, you are assigned a 12-month eligibility period that begins on the date that the processing of your application is completed

  • when you are registered for Step 2 CS, you are assigned a 12-month eligibility period that begins on the date that the processing of your application is completed

  • your eligibility period will be listed on your Step 2 CS scheduling permit

  • you must take the exam during your eligibility period

  • you can schedule a testing appointment for any available date in your eligibility period

  • your eligibility period cannot be changed or extended but you can reschedule a testing appointment for a different date within your eligibility period, subject to availability

  • to avoid a rescheduling fee, you must cancel or reschedule more than 14 days before your scheduled testing appointment

  • you may take Step 2 CS only once during each assigned eligibility period

  • if you take and fail the exam, you must reapply, including payment of the examination fee, to obtain a new eligibility period

  • you may reapply approximately 24 hours after your failing score report becomes available (you do not need to wait for the previously assigned eligibility period to end)

  • if you do not take the exam within your eligibility period, you must reapply, including payment of the examination fee, to take the exam.



applicants cannot retake a Step or Step Component if they have already passed that Step or Step Component

  • applicants cannot retake a Step or Step Component if they have already passed that Step or Step Component

  • if you fail or do not complete a Step or Step Component, you must reapply (including payment of the fee), to retake the exam

  • if you do not take an exam during your assigned eligibility period, you must reapply (including payment of the fee), if you wish to take the exam (in this event ECFMG cannot begin to process a subsequent application for this exam until at least four weeks after the end of the eligibility period for the exam you did not take)

  • Number of Attempts Allowed

  • the USMLE program limits the total number of times an examinee can take the same Step or Step Component

  • an examinee is ineligible to take a Step or Step Component if the examinee has made six or more prior attempts to pass that Step or Step Component, including incomplete attempts.

  • all attempts are counted toward the limit, regardless of when the exams were taken

  • for the purpose of U.S. medical licensure, the USMLE program recommends to state medical licensing authorities a limit on the number of attempts allowed to pass each Step or Step Component. See Number of Attempts Allowed to Complete All Steps and Time Limits and Retakes in the USMLE Bulletin of Information. You should contact the FSMB for general information and the medical licensing authority of the jurisdiction where you plan to apply for licensure for definitive information, since licensure requirements vary among jurisdictions.



the USMLE program sets rules on how quickly you can retake the same Step or Step Component

  • the USMLE program sets rules on how quickly you can retake the same Step or Step Component

  • you may take the same examination no more than three times within a 12-month period and your fourth and subsequent attempts must be at least 12 months after your first attempt at that exam and at least six months after your most recent attempt at that exam

  • when you reapply, your eligibility period will be adjusted, if necessary, to comply with these rules

  • you must read the editions of the ECFMG Information Booklet and the USMLE Bulletin of Information that pertain to the eligibility period in which you take the exam



when your registration is complete, you will be issued an exam scheduling permit, unless your eligibility period begins in more than six months

  • when your registration is complete, you will be issued an exam scheduling permit, unless your eligibility period begins in more than six months

  • if you apply for more than one exam at the same time, you will be issued separate scheduling permits for each exam

  • includes instructions for scheduling your testing appointment and a description of the form(s) of identification you must bring to the test center on your exam date

  • a very important document (do not to lose it)  you must bring a printed copy of your scheduling permit to the test center on your exam date (if you do not, you will not be allowed to take the exam).

  • check all information included in your scheduling permit - your name, the exam for which you registered, and the eligibility period during which you must take the exam, and your testing region (in case of Step 1 and Step 2 CK)  if any of the information on the scheduling permit is incorrect, contact ECFMG by e-mail, telephone, or fax



scheduling permits are issued in electronic format and can be accessed using ECFMG’s IWA; once your scheduling permit is available, you will be sent a notification to the e-mail address in your ECFMG record (approximately six months before the beginning of the assigned eligibility period)  You will not receive the scheduling permit or notification by postal mail.

  • scheduling permits are issued in electronic format and can be accessed using ECFMG’s IWA; once your scheduling permit is available, you will be sent a notification to the e-mail address in your ECFMG record (approximately six months before the beginning of the assigned eligibility period)  You will not receive the scheduling permit or notification by postal mail.

  • applicants must print a copy of the scheduling permit and bring it to the test center on their exam date

  • the Step 1/Step 2 CK scheduling permit includes two important numbers:

  • 1) Your Scheduling Number (you must provide this number when you schedule your testing appointment)

  • 2) Your Candidate Identification Number (CIN) (you must enter your CIN into the computer at the test center to start the exam and to re-enter the exam after a break. You must keep this number confidential. For your own protection, do not share your CIN with anyone (except of test center staff on your test day)

  • if the name / region / Step 1/Step 2 CK eligibility period in your ECFMG record is changed / extended while you are registered, a revised scheduling permit reflecting this change will be issued (you must access this revised scheduling permit using IWA and bring a printed copy to the test center on your test date)

  • if you lose your scheduling permit, you can reprint it by accessing IWA



scheduling permits are issued in electronic format and can be accessed using ECFMG’s IWA; once your scheduling permit is available, you will be sent a notification to the e-mail address in your ECFMG record  You will not receive the scheduling permit or notification by postal mail.

  • scheduling permits are issued in electronic format and can be accessed using ECFMG’s IWA; once your scheduling permit is available, you will be sent a notification to the e-mail address in your ECFMG record  You will not receive the scheduling permit or notification by postal mail.

  • if the name in your ECFMG record is changed while you are registered, a revised scheduling permit reflecting this change will be issued (you must access this revised scheduling permit using IWA and bring a printed copy to the test center on your test date)

  • if you lose your scheduling permit, you can reprint it by accessing IWA



  • you can schedule your testing appointment as soon as you obtain your exam scheduling permit which includes instructions for reviewing available test dates and centers and scheduling a testing appointment

  • to schedule a testing appointment, you must select a test date and center

  • the test date you select must fall within your assigned eligibility period

  • for Step 1/Step 2 CK, the test center you select must be located within your testing region

  • testing appointments are available on a “first-come, first-served” basis so monitor the availability of test dates within your eligibility period

  • if you do not schedule and take the exam during your eligibility period, you will lose your payment for the exam and you will need to reapply, including payment of applicable fees, to take the exam in the future.



you can schedule your testing appointment with Prometric up to six months in advance

  • you can schedule your testing appointment with Prometric up to six months in advance

  • you must schedule before 12:00 noon (local time at the Regional Registration Center for your testing region) at least two business days prior to the exam date that you want

  • when you schedule, you must provide the Scheduling Number listed on your scheduling permit

  • you will receive your Prometric Confirmation Number

  • be sure to keep this number

  • if you need to reschedule your testing appointment, you will need your Prometric Confirmation Number



a schedule for reporting Step 2 CS results is available on the ECFMG and USMLE websites; please refer to this information before scheduling a testing appointment if you need your results by a specific deadline.

  • a schedule for reporting Step 2 CS results is available on the ECFMG and USMLE websites; please refer to this information before scheduling a testing appointment if you need your results by a specific deadline.

  • Step 2 CS is administered in both morning (AM) and afternoon (PM) sessions - you can select your test date and center but you cannot choose your test session  you will be assigned to either an AM or PM session

  • you will be able to print a confirmation notice; do not forget to bring it to the test centre on your test date; it includes:

  • if you lose the confirmation notice, you can reprint it by accessing Step 2 CS Calendar and Scheduling

  • How Step 2 CS Test Dates Become Available

  • testing appointments are available on a “first-come, first-served” basis so it is possible that you will not be able to obtain a testing appointment for the first time period and/or test center you prefer

  • the availability of testing appointments will change frequently as a result of applicant scheduling and rescheduling

  • you can change your scheduled test date and/or center, subject to availability; a fee may be charged for this service.



if you are unable to keep your testing appointment on the scheduled date or at the scheduled test center, you may change your date and/or center, subject to availability

  • if you are unable to keep your testing appointment on the scheduled date or at the scheduled test center, you may change your date and/or center, subject to availability

  • you may cancel and reschedule at the same time, or you may cancel and then reschedule at a later date  your new test date must fall within your assigned eligibility period and your new test center must be located within your testing region (prepare Prometric Confirmation Number)

  • to reschedule your appointment, follow the instructions for contacting Prometric on your scheduling permit; a fee may be charged if you change your appointment

  • if you cannot take the exam during your assigned eligibility period, you may request an extension; however, you must still cancel a scheduled testing appointment if you cannot keep the appointment

  • requesting an extension of your eligibility period does not cancel a scheduled testing appointment

  • if you cannot take the exam in the testing region you selected, you may request to change your testing region



If you have a scheduled testing appointment and are unable to take the exam on your scheduled test date / at your scheduled test center, you can cancel your scheduled testing appointment and reschedule (a fee may be charged for this); to cancel or reschedule, access STEP 2 CS CALENDAR AND SCHEDULING (DO IT AS SOON AS POSSIBLE)

  • If you have a scheduled testing appointment and are unable to take the exam on your scheduled test date / at your scheduled test center, you can cancel your scheduled testing appointment and reschedule (a fee may be charged for this); to cancel or reschedule, access STEP 2 CS CALENDAR AND SCHEDULING (DO IT AS SOON AS POSSIBLE)

  • Before canceling and/or rescheduling a scheduled testing appointment, you will have the opportunity to review available test dates at all testing locations; your rescheduled test date must fall within your assigned eligibility period (no limit on the number of times you can cancel and reschedule your testing appointment but a rescheduling fee can be charged); you can cancel and reschedule at the same time, or you can cancel and reschedule later

  • 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 (however, you risk there are no testing appointments during your eligibility period ; if you do not reschedule within your eligibility period, you must reapply, including payment of the exam fee, to take the exam)

  • There is no fee to cancel a scheduled testing appointment

  • A RESCHEDULING FEE:

    • If you cancel more than 14 calendar days before (but not including) your scheduled test date, there is no fee to reschedule.
    • If you cancel during the 14-day period before (but not including) your scheduled test date, your fee will be $150 when you reschedule.
    • If you miss your scheduled testing appointment without canceling, your fee will be $400 when you reschedule.


Step 1 is a one-day, multiple-choice exam administered by computer

  • Step 1 is a one-day, multiple-choice exam administered by computer

  • the test has approximately 325 multiple-choice test items with only one best answer (no minus points for incorrect answers)

  • each question is structured with a statement or question followed by three to eleven response options, each labeled with a letter (e.g: A, B, C, D, E) and arranged logically or alphabetically; some response options will be partially correct, but only one option will be the best and correct answer

  • the test is divided into seven sixty-minute blocks and administered in one eight-hour testing session

  • the number of questions per block on a given examination form may vary but will not exceed 46

  • during the defined time to complete the items in each block, you may answer the items in any order, review your responses, and change answers

  • after you exit the block, or when time expires, you can no longer review test items or change answers



Step 2 CK is a one-day, multiple-choice exam administered by computer

  • Step 2 CK is a one-day, multiple-choice exam administered by computer

  • the test is divided into seven sixty-minute blocks and administered in one nine-hour testing session

  • the number of questions per block on a given examination form may vary but will not exceed 45

  • the number of items in a block will be displayed at the beginning of each block

  • the total number of items on the overall examination form will not exceed 355 items

  • 60 minutes are allotted for the completion of each block.

  • a minimum of 45 minutes of break time and a 15- minute optional tutorial

  • the amount of time available for breaks may be increased by finishing a block of test items or the optional tutorial before the allotted time expires.



practice materials for all Steps and Step Components are available on the USMLE website (they are updated periodically)

  • practice materials for all Steps and Step Components are available on the USMLE website (they are updated periodically)

  • practice Step 1/Step 2 CK test materials will help you become familiar with the types of questions and exam software that you will encounter on the date of your exam; it is recommended that you practice with the exam software before taking the exam

  • for Step 2 CS, the materials include the Step 2 Clinical Skills (CS) Content Description and General Information booklet (a simulation of the computerized patient note-taking program that you will use to type your post-encounter patient notes, and an orientation video)



the NBME offers web-based self-assessments to help medical students and graduates evaluate their readiness for computer-based Steps and Step Components (Step 1, Step 2 CK, and Step 3)

  • the NBME offers web-based self-assessments to help medical students and graduates evaluate their readiness for computer-based Steps and Step Components (Step 1, Step 2 CK, and Step 3)

  • STEP 1  the Comprehensive Basic Science Self-Assessment (CBSSA; at least seven unique CBSSA forms available, each featuring 200 multiple-choice questions divided into four sections)

  • STEP 2 CK  the Comprehensive Clinical Science Self-Assessment (CCSSA; at least four unique CCSSA forms available, each featuring 184 multiple-choice questions divided into four sections)

  • STEP 3  the Comprehensive Clinical Medicine Self-Assessment (CCMSA)

  • participants can choose to take the self-assessments under two timing conditions: standard USMLE pacing or self-pacing

  • prticipants receive immediate performance feedback (standard or expanded) in the form of a performance profile showing content areas of strength and weakness

  • the self-assessments are available for $50.00 per form for standard forms and $60.00 per form for expanded feedback forms

  • for complete information, to view a sample assessment, or to purchase an assessment, access the NBME Self-Assessment Services website.



after obtaining your scheduling permit, you can register to take a practice session for this exam at a Prometric test center (charged with a fee)

  • after obtaining your scheduling permit, you can register to take a practice session for this exam at a Prometric test center (charged with a fee)

  • the material used for the practice sessions at Prometric test centers is shorter than the actual USMLE examinations

  • for taking a practice session, you can obtain more information and register for a practice session on the USMLE website



arrive at the Prometric test center 30 minutes before your scheduled testing appointment (if you arrive after your appointment time, you may not be allowed to take the exam)

  • arrive at the Prometric test center 30 minutes before your scheduled testing appointment (if you arrive after your appointment time, you may not be allowed to take the exam)

  • if you arrive more than 30 minutes after your scheduled testing appointment or do not have both a printed copy of your scheduling permit and acceptable identification, you will not be allowed to take the exam

  • bring both a printed copy of your scheduling permit / revised scheduling permit and acceptable identification.

  • if you need directions to the test center, visit the Prometric website or contact Prometric in advance of your test date

  • if you are testing in the United States/Canada, call the test center using the telephone number provided when you scheduled your appointment; if you are testing outside the United States/Canada, contact the Regional Registration Center for your testing region using the contact information on your scheduling permit

  • after you start taking an examination, you cannot cancel or reschedule that examination

  • if you start the examination but do not complete it for reasons other than a technical problem or expiration of time, you should promptly write to NBME Test Administration explaining, in detail, the reasons you decided not to finish the exam (see Test Administration Inquiries or Problems in the USMLE Bulletin of Information); the attempt may appear as an “incomplete” on your USMLE transcript



When you arrive at the test center, you must present your scheduling permit and the required identification described on your scheduling permit. Acceptable forms of identification include the following forms of unexpired identification:

  • When you arrive at the test center, you must present your scheduling permit and the required identification described on your scheduling permit. Acceptable forms of identification include the following forms of unexpired identification:

  • passport,

  • driver's license with photograph,

  • national identity card,

  • other form of dated, unexpired, government issued identification,

  • ECFMG-issued identification card.

  • Important Note: Your name as it appears on your scheduling permit must match the name on your form(s) of identification exactly. Refer to your scheduling permit for limited exceptions. If the name listed on your scheduling permit is not correct, contact your registration entity immediately.

  • Your identification must contain both your signature and recent (no more than 10 years earlier) photograph. If it contains your photograph but not your signature, you can use another form of unexpired identification that contains your signature, such as a student/employee identification card or a credit card, to supplement your photo-bearing, governmentissued identification.

  • If you do not bring a printed copy of your scheduling permit and acceptable identification, you will not be admitted to the test. In that event, you must pay a fee to reschedule your test. Your rescheduled test date(s) must fall within your eligibility period.



the time of your arrival will be listed on the confirmation notice you will print after scheduling your testing appointment

  • the time of your arrival will be listed on the confirmation notice you will print after scheduling your testing appointment

  • if you arrive during the on-site orientation, you may be allowed to test; however, you will be required to sign a Late Admission Form

  • if you arrive after the on-site orientation, you will not be allowed to test

  • bring a printed copy of your scheduling permit / revised scheduling permit and acceptable identification

  • also, bring your confirmation notice to the test center (you can reprint your confirmation notice by accessing Step 2 CS Calendar and Scheduling)

  • travel information for each test center can be accessed through the USMLE website.

  • for detailed information on procedures upon arrival and throughout the testing day, see the USMLE Step 2 Clinical Skills (CS) Content Description and General Information booklet, available on the USMLE website, and Testing in the USMLE Bulletin of Information.

  • If you start to test but do not complete the examination, the attempt may appear as an “incomplete” on your USMLE transcript



The Rules of Conduct

  • The Rules of Conduct

  • When you apply to take the USMLE, you are agreeing to the following Rules of Conduct:

  • You are the person named on the scheduling permit for the examination.

  • You will not give, receive, or obtain any form of unauthorized assistance during the examination or during breaks.

  • 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.

  • You will place in a locker or cubicle all personal belongings, including cell phones, watches, pagers, tablet PCs, iPods/media players, any device with transmitting or receiving capabilities (e.g., bluetooth), formulas, study materials, notes, papers, pens/pencils, and your purse or wallet, before you enter the testing room (or Orientation Room for Step 2 CS).

  • 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 personal telephone at any time while you are in the testing center.

  • 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 personal telephone at any time while you are in the testing center.

  • You will not remove materials in any form (written, printed, recorded, or any other type) from the test center.

  • 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.



applicants traveling to the United States to take an exam are responsible for making the necessary travel and accommodation arrangements

  • applicants traveling to the United States to take an exam are responsible for making the necessary travel and accommodation arrangements

  • you are responsible for obtaining required travel documents (a visa to enter the United States)

  • Step 2 CS is administered only in the United States; ECFMG provides Step 2 CS applicants with a letter that may assist during the process of applying for a visa

  • you can request this letter when you apply for Step 2 CS

  • after completion of the registration process, ECFMG will issue the letter, and it will be available to you through IWA

  • if you are unable to obtain the appropriate visa to enter the United States to take Step 2 CS, you may request a full refund of the exam fee (see Refunds in Your ECFMG Financial Account)

  • if you are traveling from a distant location, you should consider arriving a day or two before the examination in order to be rested



the USMLE program’s definition of irregular behavior includes, “any action by applicants, examinees, potential applicants, or others when solicited by an applicant and/or examinee that subverts or attempts to subvert the examination process”

  • the USMLE program’s definition of irregular behavior includes, “any action by applicants, examinees, potential applicants, or others when solicited by an applicant and/or examinee that subverts or attempts to subvert the examination process”

  • USMLE exams are monitored through use of audio and video monitors, recording equipment, and by test center staff

  • failure to adhere to the instructions of test center staff during the exam may result in a determination of irregular behavior and permanent annotation of your USMLE record and transcripts

  • if staff observe you violating test administration rules or engaging in other forms of irregular behavior during an exam, the center staff will not necessarily tell you of the observation at the time of the exam

  • test center staff are required to report such incidents to the USMLE program; each report is investigated

  • Important Notes: 

    • postings and discussion of examination content on the Internet are violations of the USMLE Rules of Conduct
    • examination content includes questions, case content, and answers
    • if there is evidence that you have violated this or any other test administration rule, actions may be taken under the USMLE policies and procedures on irregular behavior
    • if you are found to have engaged in irregular behavior, information regarding this determination becomes part of your USMLE record
    • you may also be barred from taking the USMLE in the future; additionally, your exam results may be withheld or invalidated


for ECFMG Certification, you must obtain at least the USMLE-recommended pass outcome for each required Step or Step Component

  • for ECFMG Certification, you must obtain at least the USMLE-recommended pass outcome for each required Step or Step Component

  • the USMLE-recommended minimum passing level is reviewed periodically and may be adjusted at any time

  • notice of such review and any adjustments will be posted on the USMLE website

  • the recommended minimum passing level in place on the day you test will be the level used for scoring purposes (see Minimum Passing Scores in the USMLE Bulletin of Information)



NBME is responsible for determining the results of USMLE exams and for issuing the score reports (see Scoring and Score Reporting in the USMLE Bulletin of Information)

  • NBME is responsible for determining the results of USMLE exams and for issuing the score reports (see Scoring and Score Reporting in the USMLE Bulletin of Information)

  • Important Note: 

    • the USMLE program routinely monitors examinee performance on the Step examinations for unusual results
    • if such review raises concerns, e.g., about your readiness to test or your level of motivation in trying to pass the examination, you may be contacted by representatives of the USMLE program
    • unusual performance patterns may result in your access to reapply and/or retest being delayed and/or your retesting being subject to conditions
    • if you wish to become more familiar with the USMLE examinations, you should utilize the materials designed for this purpose (See Preparing for the Test in the USMLE Bulletin of Information)


results for Step 1/Step 2 CK are typically available within three to four weeks after your test date (delays are possible for various reasons)

  • results for Step 1/Step 2 CK are typically available within three to four weeks after your test date (delays are possible for various reasons)

  • in selecting your test date and inquiring about results, you should allow at least eight weeks after your test date to receive notification that your score report is available

  • results for Step 2 CS are available according to the Step 2 CS Schedule for Reporting Results, available on the USMLE and ECFMG websites

  • to avoid misinterpretation and to protect the privacy of examinees, ECFMG will not provide scores or pass/fail outcomes by telephone, fax, or e-mail to anyone, including examinees

  • score reports are available for approximately 120 days from the date of e-mail notification

  • once the score report is removed from the website, your results will be provided to you only in the form of an official USMLE transcript

  • to obtain a transcript, you will be required to submit a request and pay a fee (print and/or save your score report while it is available)



Step 1 and Step 2 CK

  • Step 1 and Step 2 CK

  • score reports for Step 1 and Step 2 CK include a pass/fail designation, numerical score, and graphical performance profiles, summarizing areas of strength and weakness to aid in self-assessment; these profiles are developed solely for the benefit of examinees and will not be reported or verified to any third party

  • to receive a score for Step 1/Step 2 CK, you must begin every block of the test; if you do not, no results are reported, and the “incomplete” attempt appears on your USMLE transcript as “incomplete“

  • Step 2 CS

  • performance on Step 2 CS is reported as pass or fail

  • score reports include performance profiles, which reflect the relative strengths and weaknesses of the examinee’s performance across the subcomponents of Step 2 CS

  • for Step 2 CS, if you leave the test early, or otherwise fail to carry out one or more of the cases, your performance may be assessed on those cases you completed

  • if this assessment were to result in a passing outcome no matter how poorly you may have performed on the missed case(s), then a “pass” would be reported

  • if this assessment were to result in a failing outcome even with the highest rating on the missed case(s), then a “fail” would be reported

  • otherwise, the attempt may be recorded as an “incomplete.”



for all Steps and Step Components, a change in your score or in your pass/fail outcome based on a recheck is an extremely remote possibility

  • for all Steps and Step Components, a change in your score or in your pass/fail outcome based on a recheck is an extremely remote possibility

  • a recheck will be done if you submit a Request for Recheck of USMLE® Step 1, Step 2 CK, or Step 2 CS Score (Form 265) and the fee for this service to ECFMG (form 265 is available in the Resources section of the ECFMG website and from ECFMG, upon request)

  • your request must be received at ECFMG no later than 90 days after your score report release date

  • for Step 1/Step 2 CK, standard quality assurance procedures ensure that the scores reported for you accurately reflect the responses recorded by the computerFor Step 2 CS, score rechecks involve retrieval of the ratings received from the standardized patients and from the physician note raters



to request an official USMLE transcript, you must contact the appropriate registration entity

  • to request an official USMLE transcript, you must contact the appropriate registration entity

  • you must contact the Federation of State Medical Boards if you are registered for or have taken Step 3 and/or you want to send your transcript to a medical licensing authority

  • in all other cases, submit your transcript request to ECFMG by sending a completed Request for Official USMLE® Transcript (Form 172) and the appropriate fee to ECFMG (Form 172 available in the Resources section of the ECFMG website and from ECFMG, upon request)

  • you can use OASIS to check whether your USMLE transcript has been sent



http://www.ecfmg.org/

  • http://www.ecfmg.org/

  • http://www.usmleworld.com/step1/step1.aspx

  • http://www.com.msu.edu/Students/PDF/Student_Test_Prep.pdf

  • http://www.ecfmg.org/fees/usmle-surcharge.html

  • http://www.usmle.org/




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