USMLE exams

United States Medical Licensing Examination Examination is a series of exams required for all American and international medical students in order to enter into a medical residency training program in the United States (information on

ECFMG (Educational Commission for Foreign Medical Graduates) is an organization that provides USMLE exams and other services specifically for foreign medical graduates (= international medical graduates, i.e. IMG). Therefore look for information and apply for USMLE exams through this website and not through that is for American graduates.
On the ECFMG website, click on "Applicant Portal" in the blue field in the top right corner. You will find a menu where you can easily search.
The first step is to obtain the "USMLE/ECFMG Identification Number". When registering, enter your name and other information without accents; use only English characters. Once you get your "USMLE/ECFMG Identification Number" you can apply under „Application for ECFMG Certification" for a charge of $50. It is easy to get oriented on this website and to find out how to proceed.

USMLE consists of 3 exams:

  • Step 1 – a written exam on a computer; 322 multiple-choice questions in 7 one-hours blocks, total duration 8 hours; cost $1050
  • Step 2 CK – a written exam on a computer; 346 multiple-choice questions in 8 one-hours blocks, total duration 9 hours; cost $1070
  • Step 2 CS – a practical exam in selected examination centers in the US designed into 12 clinical encounters with "patients"; total duration 8 hours with two breaks (30 and 15 minutes); the result is only pass/fail and not a score as in Step 1 and Step 2 CK; cost $1500

Where can I take the USMLE exams?

What is the best timing of the USMLE exams?

You have 7 years from the first exam to complete the last one and to obtain the ECFMG certificate. There are no other restrictions known to me.
You find the information on how to time your exams in respect to the medical school graduation at the end of the page ERAS & Match under "How to time the application process into the residency program?"

How should I prepare myself for the exams?

  • It is crucial to study from text books designed specifically for the USMLE exams. You find more information on the study materials for each exam here: Step 1, Step 2 CK and Step 2 CS
  • It is also necessary to familiarize yourself with:
    • the American medical vocabulary, abbreviations, normal laboratory values (often different from the metric system), etc.
    • the specific manner of USMLE testing; for a success it is necessary to practise the model multiple choice questions. You find more information on the study materials for each exam here: Step 1, Step 2 CK and Step 2 CS

Does my USMLE score matter?

If you want to increase your chances and make it easier for yourself to enter into a good residency training program, it is necessary to have a high score. For your orientation, the passing score for Step 1 is currently 188 points, the average score of all tested participants (including Americans) is 221 points, but the best programs require a minimum of 240 points. Once you pass the exam, you cannot retake it. You can only retake an exam you failed.

Note: The last exam of the USMLE series is the Step 3 and is not a part of the ECFMG certification. You will pass the Step 3 with no problem during your residency training.