USMLE Exam: Guide for Medical Students
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Want to become a doctor in USA and practice medicine there? Then you will have to take USMLE exam. In this guide, we explain steps, fees and how to apply for the USMLE. USMLE or United States Medical Licensing Examination is for those wanting a license as physicians in USA.
USMLE test checks knowledge and skills before allowing them to work as doctors. The USMLE assesses medical knowledge, clinical concepts and patient centered skills. The USMLE exam is tested in three steps - Step 1 is for basic medical knowledge, Step 2 is Clinical Knowledge and Step 3 tests if you can apply medical knowledge in real life situations. This exam is not easy to crack and needs preparation. Many international medical graduates (IMGs) take USMLE to get a chance to work in the USA. Doing well in the exam helps in getting a residency in the USA, which is a big step toward becoming a doctor there. After clearing USMLE Step 1 and Step 2, the next step is getting into residency. Learn more about how to get medical residency in US.
- USMLE Exam: Key Highlights
- USMLE Full Form
- What is USMLE Exam?
- USMLE Exam Dates 2025
- USMLE Eligibility for Indian Students
- USMLE Application Process
- How to Apply for USMLE from India
- Some Important Things
- USMLE Exam Fees in India 2025
- USMLE Exam Centre 2025
- USMLE Exam Pattern
- USMLE Exam Syllabus
USMLE Exam: Key Highlights
| Feature |
Details |
|---|---|
| Full Form |
United States Medical Licensing Examination |
| Short Form |
USMLE |
| Conducting Body |
The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) |
| Exam Type |
Licensing Examination for Medical Graduates |
| Exam Level |
International |
| Purpose |
To assess a physician's ability to apply knowledge and skills for safe and effective patient care |
| Exam Format |
3 Steps
|
| Exam Mode |
Computer-based |
| Accepted In |
United States |
| Exam Duration |
Step 1:8 Hours Step 2 CK: 9 Hours Step 3: 2 days |
| Mode of Application |
Online |
| Language |
English |
| Official Website |
www.usmle.org |
Other Medical Exams:
USMLE Full Form
USMLE full form is United States Medical Licensing Examination. The test is owned by two by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). It is one of the toughest exams in the world. If you are exploring higher education in the medical field post-MBBS, consider the Masters of Medicine & Health Sciences in USA.
What is USMLE Exam?
The USMLE is part of licensed medical practice in USA. The exam includes a three step assessment process: USMLE Step 1, Step 2 and Step 3. Those who pass each sub exam in USMLE can become medical practitioners in USA with license.
Predict your IELTS, TOEFL, and PTE in just 4 steps!
USMLE Step 1
Test includes 280 MCQs divided into seven 60 minute blocks. This test is eight hours long.
USMLE Step 2
Assesses ability to apply medical knowledge, clinical skills and understanding clinical science concepts. The test includes 318 MCQs divided into eight 60 minute blocks. The test is nine hours long.
USMLE Step 3
Assesses ability to apply medical knowledge and understanding of biomedical and clinical sciences in real life cases of medicine.
Step 3 exam is spread over two days:
- Day 1 – Foundations of Independent Practice (FIP): Tests 232 MCQs in six 60 minute blocks.
- Day 2 – Advanced Clinical Medicine (ACM): Tests on 180 MCQs in six 45 minute blocks with 13 computer-based case simulations (CCS), each lasting for about 10 to 20 minutes
USMLE Exam Dates 2025
The USMLE exam has no fixed dates. The USMLE test dates 2025 are available year-round. Candidates choose a three-month eligibility period during registration and can schedule their exam on any available date within that window.
Step 1 and Step 2 CK can be taken at Prometric centers in India and abroad, based on slot availability. Students usually take Step 1 after the second year of MBBS, and Step 2 CK after clinical rotations or the final year.
Step 3 must be taken only in the US and spans two consecutive days. It is available only to those who have cleared Step 1 and Step 2 CK and received ECFMG certification.
Popular months like May-August and November-January fill up quickly, so it is best to book at least 6–8 weeks in advance. Always use the Prometric website with the scheduling permit to check and secure a preferred slot.
USMLE Eligibility for Indian Students
Medical aspirants who are planning to take the USMLE test must fulfill the eligibility requirements to apply for the test. The USMLE test eligibility for Step 1, Step 2 CK, and Step 3 is as follows:
USMLE Step 1 and Step 2 CK Eligibility
- Medical students or graduates from a US or Canadian MD program accredited by the LCME are eligible to apply for USMLE Step 1 and Step 2 CK.
- Candidates or graduates who have a US DO program accredited by COCA.
- A student or graduate from an international medical school listed in the World Directory of Medical Schools and meeting ECFMG eligibility requirements can apply for the USMLE.
USMLE Step 3 Eligibility
- Candidates need to achieve passing scores on Step 1 and Step 2 CK.
- Candidates must fulfill all the eligibility criteria as listed in the USMLE Bulletin of Information.
- Candidates must have an MD or DO degree from a US or Canadian medical school accredited by LCME or COCA, OR an equivalent MD degree from an international medical school listed in the World Directory of Medical Schools, and must also obtain ECFMG Certification.
Before applying for USMLE understand MD in USA because there is no MBBS in USA.
USMLE Application Process
Check out separate application processes for USMLE
| USMLE Step(s) |
Who Can Apply |
Where to Apply |
|---|---|---|
| Step 1, Step 2 CK, Step 2 CS |
Students/graduates of LCME or AOA-accredited US/Canada med schools |
NBME on NLES (NBME Licensing Exam Services) |
| Step 1, Step 2 CK, Step 2 CS |
Students/graduates of international medical schools |
ECFMG on IWA (Interactive Web Applications) |
| Step 3 |
Graduates who passed Step 1, Step 2 CK, and Step 2 CS |
FSMB (Federation of State Medical Boards) |
How to Apply for USMLE from India
If you are an MBBS student in India and want medical residency in USA you have to appear for USMLE from India. Follow how can you register for USMLE from India.
Get Your USMLE or ECFMG ID
- First, go to the ECFMG website.
- Click on “I want to apply for ECFMG Certification.”
- Fill in your details like full name, email, date of birth, etc.
- After 4 to 5 working days, you'll get your USMLE or ECFMG ID and password on email.
- This ID is very important. You will need it for other exams also.
Login on IWA Portal
- Now go to the IWA (Interactive Web Applications) login page.
- Use your ECFMG ID and password to login.
- Fill the form carefully. Name, DOB, and passport details should match.
- If anything is wrong, it can delay your process badly.
Apply for ECFMG Certification
- Once you're logged in, click on "Apply for ECFMG Certification".
- Fill application and pay USD 160.
- After this, complete Form 186, which is an identity form.
- This is filed through video call using NotaryCam.
Apply for USMLE Step 1 or Step 2
- When ECFMG cert is accepted, go back to IWA and click on "Begin New Application".
- Select the exam - Step 1 or Step 2 CK.
- Choose your eligibility period when you want to give the exam.
- Select India as your exam location.
- Pay the exam fees Step 1 is USD 1215 total. That's around INR 1 Lakh to INR 1.05 lakh in Indian rupees.
Send Form 183 from Your College
- After payment, you will get access to Form 183.
- Download and take it to your Dean's office. They must sign, stamp, and seal it in a college envelope.
- Then courier it to ECFMG office in the USA
| IWA – ECFMG 3624 Market Street, Philadelphia, PA 19104-2685, USA |
Wait for the Scheduling Permit
- After sending Form 183, wait 2 to 3 weeks.
- Once ECFMG approves, they'll send you a scheduling permit on email.
- This permit is used to book your test date.
Book Your Exam Date on Prometric
- Go to Prometric.com, search for USMLE exam.
- Click your exam (Step 1 or Step 2), and select Indian exam center.
- Enter your details and use the scheduling permit to book the date.
- You must take the test in within 3 month window you selected.
Some Important Things
- Keep your passport ready – not expired.
- Make sure all names and details match exactly in all forms.
- If you miss your 3-month slot, you’ll have to pay and apply again.
- You can reschedule your test date, but extra fee may apply.
USMLE Exam Fees in India 2025
| USMLE Process / Item |
USMLE Fee (USD) |
USMLE Fee (INR) |
|---|---|---|
| Application for ECFMG Certification |
USD 160 |
INR 13,841.60 |
| USMLE Step 1 |
USD 1020 - Examination Fee + International Test Delivery Surcharge, if testing outside the United States and Canada |
INR 88,237.20 |
| USMLE Step 2 CK |
USD 1020 - Examination Fee + International Test Delivery Surcharge, if testing outside the United States and Canada |
INR 88,237.20 |
| USMLE Step 3 |
USD 935 |
INR 80,878 |
| Extension of Eligibility Period (Step 1/Step 2 CK) |
USD 100 per exam |
INR 8,651.00 |
| Testing Region Change (Step 1/Step 2 CK) |
USD 90 per change |
INR 7,785.90 |
| USMLE Rescheduling Fee (Step 1/Step 2 CK) |
Varies (can be USD 0) |
INR 0 or more |
| USMLE Score Recheck (Step 1/Step 2 CK) |
USD 80 per exam |
INR 6,920.80 |
USMLE Exam Centre 2025
The USMLE exam is held at Prometric test centres in the US and some other countries. International students can take Step 1 and Step 2 CK at approved centres outside the US. But Step 3 must be taken only in the United States, as it is the final step for getting a medical license.
USMLE Exam Centre in India
A total of 9 USMLE exam centres are available in India. These test centres are located in major cities like Chennai, Hyderabad, Ahmedabad, Bangalore, Kolkata, Allahabad, Mumbai, and New Delhi.
| City |
Test Centre Name |
Address |
|---|---|---|
| Chennai |
Prometric Testing Pvt. Ltd. |
No - 15/7, 2nd Floor, Jagannathan Road, Nungambakkam, Chennai 600034 Contact: 044-2824 1840 |
| Hyderabad |
Prometric Testing Pvt. Ltd. |
Avenue 1, Street 20, Plot 1672, Road 12, Banjara Hills, Hyderabad 500034 Contact: 040-2330 3903 |
| Ahmedabad |
Prometric Testing Pvt. Ltd. |
301-302 Abhijeet II, Mithakhali Six Roads, Ellisbridge, Ahmedabad 380006 Contact: 079-2656 1088 |
| Bangalore |
Prometric Testing Pvt. Ltd. |
Maini Sadan, 1st Floor, No. 38, Lavelle Road, 7th Cross Rd, Bangalore 560001 Contact: 080-2229 1770 |
| Kolkata |
Prometric Testing Pvt. Ltd. |
Flat 1/C, Sukh Sagar Bldg, 2/5 Sarat Bose Road, Kolkata 700020 Contact: 033-2485 2792 |
| Allahabad |
Institute of Psychological & Educational Measurement |
119/25-A, Mahatma Gandhi Marg, Civil Lines, Allahabad 211001 Contact: 0532-2427048 |
| Mumbai |
Prometric Testing Pvt. Ltd. |
Marwah House, Saki Vihar Road, Sakinaka, Andheri (E), Mumbai 400072 Contact: 022-2857 3160 |
| Mumbai |
United States Education Foundation in India |
4 - New Marine Lines, Mumbai 400020 Contact: 022-2262 4603 |
| New Delhi |
Prometric Testing Pvt. Ltd. |
2nd Floor, DLF Infinity Tower-A, Gurgaon 122002 Contact: 0124-4147700 |
USMLE Exam Pattern
Step 1 and Step 2 are administered at Prometric centers worldwide, while Step 3 is taken in the USA. Understand USMLE paper pattern
USMLE Step 1 Exam Pattern
Step 1 consists of MCQs around interpreting images, graphs, or tables created by expert committees of doctors, educators, and researchers from US organized by organ systems and foundational sciences.
USMLE Step 1 Test Section Weightage
| System |
Range % |
|---|---|
| Human Development |
1-3 |
| Blood & Lymphoreticular/Immune Systems |
9-13 |
| Behavioral Health & Nervous Systems/Special Senses |
10–14 |
| Musculoskeletal, Skin & Subcutaneous Tissue |
8-12 |
| Cardiovascular System |
7-11 |
| Respiratory & Renal/Urinary Systems |
11-15 |
| Gastrointestinal System |
6-10 |
| Reproductive & Endocrine Systems |
12–16 |
| Multisystem Processes & Disorders |
8-12 |
| Biostatistics & Epidemiology/Population Health |
4–6 |
| Social Sciences: Communication and Interpersonal Skills |
6–9 |
USMLE Step 2 CK Exam Pattern
USMLE Step 2 is a one day long exam. with MCQs testing Sequential case Questions Scientific abstracts Items with audio or video findings
- Standard MCQs
- Sequential case questions
- Scientific abstracts
- Items with audio or video findings
USMLE Step 2 Test Section Weightage
| System |
Range, % |
|---|---|
| Human Development |
2–4 |
| Immune System |
3–5 |
| Blood & Lymphoreticular System |
3–6 |
| Behavioral Health |
5–10 |
| Nervous System & Special Senses |
5–10 |
| Musculoskeletal System/Skin & Subcutaneous Tissue |
6–12 |
| Cardiovascular System |
6–12 |
| Respiratory System |
5–10 |
| Gastrointestinal System |
5–10 |
| Renal & Urinary System & Reproductive Systems |
7–13 |
| Pregnancy, Childbirth & the Puerperium |
3–7 |
| Endocrine System |
3–7 |
| Multisystem Processes & Disorders |
4–8 |
| Biostatistics & Epidemiology/Population Health/Interpretation of Medical Literature |
3–5 |
| Social Sciences: Legal/Ethical Issues & Professionalism/Systems-based Practice & Patient Safety |
10-15 |
USMLE Step 3 Paper Pattern
Step 3 is the final exam in the USMLE series that assesses whether a candidate is ready to practice medicine without supervision. Step 3 content mirrors the types of clinical challenges seen in actual practice. Questions are based on 18 major content areas and include a broad mix of patient demographics (age, gender, culture, occupation).
USMLE Step 3 Test Section Weightage
| System |
Range, % |
|---|---|
| Human Development |
1–3 |
| Immune System, Blood & Lymphoreticular System, and Multisystem Processes/Disorders |
6–8 |
| Behavioral Health |
4–6 |
| Nervous System & Special Senses |
8–10 |
| Skin & Subcutaneous Tissue |
4–6 |
| Musculoskeletal System |
5–7 |
| Cardiovascular System |
9–11 |
| Respiratory System |
8–10 |
| Gastrointestinal System |
6–8 |
| Renal/Urinary & Male Reproductive Systems |
4–6 |
| Pregnancy/Childbirth & Female Reproductive System & Breast |
7–9 |
| Endocrine System |
5–7 |
| Biostatistics & Epidemiology/Population Health & Interpretation of the Medical Literature |
11–13 |
| Social Sciences: Communication Skills/Ethics/Patient Safety |
7–9 |
USMLE Exam Syllabus
Here is a brief USMLE syllabus with main topics and sub topics:
| System/Area |
Key Topics |
|---|---|
| 1. General Principles of Foundational Science |
Biochemistry: Gene expression, protein synthesis, enzymes, energy metabolism. |
| 2. Immune System |
Immune Cells: T cells, B cells, NK cells, APCs. |
| 3. Blood & Lymphoreticular System |
Hematology: RBC, WBC, platelet production, coagulation. |
| 4. Behavioral Health |
Normal: Coping, adherence, stress responses. |
| 5. Nervous System & Special Senses |
Neuroanatomy: Brain, spinal cord, cranial nerves. |
| 6. Skin & Subcutaneous Tissue |
Normal Processes: Embryonic & neonatal development; Structure, barrier & thermal regulation; Eccrine function & repair across lifespan. |
| 7. Musculoskeletal System |
Normal Processes: Organ & cell structure of bones, joints, muscles; Exercise physiology. |
| 8. Cardiovascular System |
Normal Physiology: Heart structure, conduction, circulation, regulation; ANP secretion, vascular resistance. |
| 9. Respiratory System |
Normal Anatomy & Physiology: Airways, gas exchange, surfactant, ventilation; Defense mechanisms and flora. |
| 10. Gastrointestinal System |
Normal Physiology: GI anatomy, motility, hormones, absorption; Liver, pancreas, salivary glands. |
| 11. Renal & Urinary System |
Normal Processes: Embryonic development; Kidney structure/function, acid-base balance; Hormones (renin, aldosterone, vasopressin); Micturition. |
| 12. Pregnancy, Childbirth & the Puerperium |
Normal Processes: Fertilization, implantation, embryonic development; Labor and delivery; Lactation. |
| 13. Female Reproductive System & Breast |
Normal Processes: Ovulation, menstrual cycle, puberty; Breast development. |
| 14. Male Reproductive System |
Normal Processes: Spermatogenesis, puberty; Genital and prostate function. |
| 15. Endocrine System |
Normal Processes: Structure and hormones of pituitary, thyroid, adrenal, pancreas; Hormone synthesis. |
| 16. Multisystem Processes & Disorders |
Normal Processes: Nutrition and metabolism; Electrolyte/water balance; Intracellular storage disorders. |
| 17. Biostatistics, Epidemiology/Population Health & Medical Literature |
Study design and selection; Screening principles; Diagnostic test evaluation; Error types and bias; Statistical measures (sensitivity, specificity); Epidemiologic measures (incidence, prevalence); Critical appraisal of clinical studies; Risk assessment. |
| 18. Social Sciences |
Medical ethics and jurisprudence; Consent, confidentiality, advance directives; Cultural competence and health disparities; Public health systems; Health economics; Patient safety and quality; Communication and teamwork. |
Thinking about long-term goals? Here's what you can expect to earn after residency. Check the average doctor salary in USA.
Yes, you can give USMLE after MBBS. In fact, many students start preparing for it during MBBS or internship. Once you finish MBBS from a recognised medical college, you can apply for the exam. So yes, after MBBS is a good time to give USMLE if you want to go to the USA for PG.
USMLE is not valid in India to directly practice as a doctor. Even if you pass USMLE, you cannot work in India unless you also clear NEXT or other Indian medical exams. But if you finish your residency in the USA, you can come back and work in India after registering with the NMC (National Medical Commission). So USMLE is for the USA, not a replacement for NEET PG or FMGE in India.
Statement of Purpose
Letter of Recommendation
Student Visa Application
Admission Essay Writing
Student Curriculum Vitae
Yes, many students say that USMLE is harder than NEET, especially for Indian students. NEET mostly checks your memory and basic understanding. But USMLE is more about concepts, clinical thinking, and applying knowledge in real-life patient cases. Also, it is in English, and the question style is different. So, yes, it feels more tough, but it's not impossible.