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USMLE Step 1

USMLE Step 1 which consists of 322 multiple choice questions (MCQs) divided into 7 blocks of 46 questions each. Two types of multiple choice questions are seen on this test are: 

1) MCQs with only single one best answer, and 

2) MCQs with single patient-centered vignette sequential item sets. 

The Step 1 is designed to test the basic sciences knowledge of doctors and is taken during the Second year of Medical School.


USMLE STEP 2 CK consists of a maximum of 355 multiple choice questions (MCQs) divided into 8 blocks of maximum 45 questions each. The Step 2 CK consists of three types of questions: 

1) single one best answer questions,

2) sequential item sets containing single-patient clinical vignettes, and 

3) matching sets. 

The Step 2 CK assesses the Clinical Knowledge of Fourth year U.S. Medical Students and International Medical Graduates (IMGs). It requires a three-digit score of 196 to pass the USMLE Step 2 CK. It tests the clinical application of the integrated basic knowledge in all medical/surgical specialties.


USMLE Step 2 CS is a Standardized Patient-Based Exam designed to evaluate the competency in the Bed-Side Manners, English Communication Skills, Cultural Awareness, and Clinical Skills - History and Physical (including telephone patient encounters, caregiver or family encounters), Diagnostic, Clinical Decision Making, Evaluation and Management skills, and Computerized Documentation skills using Standard EMR/EHR (Patient Note) of 4th year U.S. Medical students and International Medical Graduates before starting a Medical/Surgical Residency in the United States.  

The time provided for each encounter is 15 minutes and 10 minutes for Patient Note. 

The three areas that are evaluated and scored separately need to be passed independently in order to pass the USMLE Step 2 CS. These areas include: Integrated Clinical Encounter (ICE), Communication and Interpersonal Skills (CIS), and Spoken English Proficiency (SEP).

It is only administered in the U.S. in the following 5 cities:

1) Philadelphia,

2) Atlanta,

3) Chicago,

4) Los Angeles, and

5) Houston.

USMLE Step 3

USMLE Step 3 is the Final Examination in the USMLE Exam series and tests the examinee in their application of biomedical and clinical science knowledge which is considered essential for the unsupervised practice of medicine in the United States. 

The Step 3 focuses on the generalist medical practice with emphasis on ambulatory care. It consists of Multiple Choice Questions and the Primum Computer-based Case Simulations. 

The examinee must satisfactorily pass the USMLE Step 1, USMLE Step 2 CK, USMLE Step 2 CS in order to be eligible to take USMLE Step 3 which can only be taken in the United States.

USMLE Step 3 is a two-day exam:

First Day - 336 MCQs divided into 7 Blocks of 48 questions each, and

Second Day - 144 MCQs divided into 4 Blocks of 36 questions followed by four hours of 12 Primum Computer-based Case Simulations.

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