What is the USMLE?

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  • Written By: Mary McMahon
  • Edited By: Bronwyn Harris
  • Last Modified Date: 19 October 2019
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The United States Medical Licensing Exam (USMLE) is a three part examination administered to people who want to practice medicine in the United States. Graduates of allopathic medical schools must take the USMLE for certification, while osteopathic doctors may opt to take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX). This standardized test ensures that all doctors across the United States perform at the same basic level, and it is a requirement for practicing medicine independently. Doctors who fail the USMLE may opt to take it again.

The three stages of the USMLE are administered at different points during a doctor's medical education to assess a variety of skills. When a doctor successfully passes all three stages of the USMLE it indicates that she or he has clinical, problem solving, and patient handling skills, along with the basic knowledge required to practice medicine safely and successfully. The test is extremely demanding, and it covers an exhaustive range of topics. After a medical residency has completed, a doctor may also apply to be certified by a specialty board, such as the American Board of Anesthesiology or the American Board of Thoracic Surgery, among many others.


The first stage of the USMLE is administered after the second year of medical school. It tests basic medical and biological knowledge over the course of an eight hour exam. Many residency programs consider a doctor's score on this examination in applications, although this practice is not widely encouraged. At the conclusion of a student's fourth year, he or she takes step two, which actually consists of two sections. The first section is a nine hour multiple choice test covering a range of medical specialties and topics. The second section involves simulated patient interactions.

The third stage of the USMLE is administered during medical residency, typically after the first year. It tests the doctor's ability to practice medicine independently and safely. The exam includes multiple choice questions and patient simulations in which the doctor must rapidly make sound choices which will keep the “patient” alive. After a doctor successfully passes this part of the USMLE, he or she must still finish residency before embarking on a life of practicing medicine.

Two organizations oversee the administration of the USMLE, commonly called the “board exam.” The National Board of Medical Examiners works with the Federation of State Medical Boards to come up with questions and simulations for the exam. The structure of the USMLE has changed radically over the years, and the exam is designed to allow doctors to apply for certification to practice medicine in any state.


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