The United States Medical Licensure Examination (USMLE) is a culmination of four different exams that medical students and doctors must take in order to practice medicine here in the United States. The four components of the USMLE are Step 1, Step 2 Clinical Knowledge (CK), Step 2 Clinical Skills (CS), and Step 3. The USMLE Step 1 should be taken after students complete the first two years of medical school. These couple years consist of Basic Science courses, including Anatomy, Physiology, and Biochemistry. This eight-hour examination is composed of three hundred twenty-two multiple choice questions that are broken up into seven blocks of forty-six questions that should be taken in one hour increments. There is a fifteen-minute tutorial that is given at the beginning of the test that can be skipped, for which this time can be added onto the forty-five minute break that can be taken after completion of any examination block. The USMLE Step 2 Clinical Knowledge should be taken after medical students have completed their core clinical rotations, such as Family Medicine, Pediatrics, and Surgery but prior to graduation from medical school. This invaluable time in medical school should be used as a stepping stone in USMLE preparation, while they are taking crucial electives like Cardiology, Pulmonology, and Renal. The USMLE Step 2 CK is a nine-hour timed examination composed of three hundred fifty-two multiple choice questions, with no more than forty-five questions in each of the eight blocks. There is also a fifteen-minute tutorial given at the beginning of the test that can be skipped, for which the time can be added to the forty-five-minute break that can be taken upon completion of a test block. The USMLE Step 2 Clinical Skills should also be taken prior to graduation from medical school, after students have mastered the art of doctor-patient encounter skills. This eight-hour examination is composed of twelve cases for which medical students must spend no more than fifteen minutes in a room with a mock patient conducting medical histories and physical examinations and then diagnosing and scheduling lab work and tests needed to treat the patient, but at all times maintaining a good rapport with the patients making sure they understand and are comfortable with everything that is done. Upon completion of each encounter, medical students will have ten minutes to document on a computerized program all findings and schedule the appropriate lab work, tests and follow-up visits. The USMLE Step 3 should be taken after the first year of a residency program but prior to its completion. This two-day examination is composed of one day of seven blocks of forty-eight multiple choice questions to be completed in seven hours, along with a fifteen-minute tutorial whose time can be combined with the forty-five minute break, if not taken at the beginning of examination. The second day of USMLE Step 3 is composed of another four blocks of thirty-six multiple choice questions that should be completed in three hours and then twelve clinical case simulations that should be done in four hours, along with a ten-minute tutorial whose time can be added to the forty-five minutes of break, if not used. If you are medical student or graduate of a medical school outside of the United States, the time frame of when to take these examinations maybe different because your school may not influence you to practice is the United States. Most international graduates take their USMLE Steps after graduation, but they must have taken and passed USMLE Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills prior to starting residency. If you are requiring a Visa, some residency programs require the international doctors to have passed their USMLE Step 3 prior to applying and starting residency. In order to apply to a medical residency program in the United States, medical students and doctors must apply through the Electronic Residency Application Service (ERAS). Medical students and doctors can begin working on their application on July 1 each year but cannot apply until September 1. USMLE Step 1 must be passed in order to apply but Step 2 Clinical Knowledge and Step 2 Clinical Skills are mandatory to have passed before February 20, when the National Resident Matching Program (NRMP) requires medical students, doctors, and residency programs to submit their rank-order list of where applicants should go for residency. All four USMLE Steps are required to complete residency and receive a medical license in the United States. These are all crucial factors that medical students and doctors must know in order to practice medicine in the states of their choice. So the next time someone asks you "When should I take my USMLE Steps", you can tell them. Written By : Dr. Adrienne Hicks-Lillard Source
