The journey of a doctor from high school to the day they get a license to practice medicine is an arduous one. The preparation for the MCAT exam and clearing it before being accepted into a med school is tough. But nothing compares to clearing USMLE short for the United States Medical Licensing Examination.
The USMLE is a tough exam that is divided into three steps. Step 1 and Step 2 of the exam can be attempted by the eligible person in any order, but Step 3 of the USMLE exam can be attempted only after clearing both Step 1 and Step 2. Out of the three, any medical aspirant will agree that USMLE Step 1 preparation is very important as it is the toughest of all three.
An eligible person can attempt each USMLE Step only four times. Failure to clear any step disallows them from writing the next step in the sequence. And failure to clear USMLE will mean that a medical graduate cannot be licensed to practice medicine without supervision. Though the exam is notoriously famous for being a tough cookie to crack, there is no substitute for hard work. With the right approach for preparation, the chances of clearing USMLE are high.
Steps in USMLE
USMLE exam steps can be compared based on the eligibility and their level of difficulty.
Step 1 and Step 2
A person eligible to take Step 1 and 2 can take the exam in any sequence. However, in case of an incomplete or a failed attempt, one cannot take Step 2 without clearing Step 1. Vice versa is true if a person decides to write Step 2 before Step 1.
Step 1 of the exam is an assessment of the examinee’s basic concepts of science related to practice of medicine, health, disease and therapy. This step ensures core competency in present and also lifelong learning of scientific principles.
Step 1 examination is held for a day which is categorized into 7 blocks spread across eight hours. Each block is for sixty minutes each and has a maximum of forty questions in each block. The total number of questions will not exceed 280 items. A break of forty five minutes with optional tutorial time of fifteen minutes forms a part of the exam format.
There is no fixed syllabus or curriculum for USMLE Step 1 preparation. It is however a standard practice amongst exam takers to prepare and take Step 1 when they are in second year of their med school. The topics are fresh in their mind and they are able to give it a good shot. A person who is not from continuous education may need six to twelve months to prepare for the Step 1 exam. Before taking the main exam an examinee can register for a practice paper that is proctored by a Prometric center.
Step 2 is the assessment of the exam takers competence in applying the knowledge they acquired while studying medicine. This exam stresses on an examinee’s understanding of clinical science that is required for patient care under supervision. The topic areas of promoting health and preventing diseases are also covered in this exam. Adequate importance is given to patient centric skills and clinical science principles to ensure safe practice of medicine under supervision.
Step 2 examination is held for a day which is categorized into 8 blocks of sixty minutes each. It is spread across nine hours. Each block will have a maximum of forty questions and the total number of items in all the blocks is not more than 318 items.
Step 2 scores are important as residency program directors often check this when making decisions about who they are going to hire as the hospital’s new batch of resident doctors. It pays well to prepare on the Step 2 topics and solve at least a few sample questions before registering for a practice exam proctored by Prometric centers.
Examinee’s who have successfully cleared Step 2 always recommend a few best practices when answering the questions.
- Read the question carefully and understand the clinical scenario of the case cited
- If you are not sure of the answers then eliminate the most incorrect answers
- Unanswered questions are treated as wrong answers, so it is better to guess an answer and mark it.
- There may be answers that are partially correct but there is only one completely correct answer. So be extra careful when reading the question.
Step 3 examination is an assessment of the skills of a doctor who will assume independent charge and practice medicine without any external supervision. This exam emphasizes on care provided for those who are not hospitalized and are able to walk-in for their treatment plan. It is the last leg of the USMLE exam and upon successfully clearing this exam, a license to practice medicine is given to the examinee.
Step 3 examination is held for two days. The first day of the exam is categorized into 6 blocks of sixty minutes each. Each block has a maximum of 39 questions. The total number of items of day 1 format are 232 items.
Second day of the Step 3 exam is for nine hours and is divided into 6 blocks of forty-five minutes each. Each block has 30 multiple choice questions IMCQ) and there are 180 items in the entire exam. The MCQ is followed by case thirteen case simulations. Ten to twenty minutes maximum is given for each case simulation. There is a forty five minutes break between the MCQ and case simulations.
Step 3 exam emphasizes on the urgency of the care under clinical settings and providing care as per the case. It also covers medical ethics which are integral to becoming a good doctor. It is good to prepare the case simulations by registering for practice exams.
Overall though USMLE is tough, the number of people who scored above the passing cutoff have been significant. This goes on to prove that dedication, hard word and practice exams can help one clear the different steps of this all important exam.