All doctors wishing to practise in the United States have to take the
United States Medical Licensing Exam, irrespective of whether they are US graduates or international medical graduates. International medical graduates may take the USMLE to apply for a residency programme, research programme, or work in a superspecialised area.
Once you have passed the USMLE and have been certified with the Educational Commission for Foreign Medical Graduates (ECFMG), there is no distinction between international medical graduates and
US graduates when applying for programmes.
What does a residency programme entail?
Residency is a period of training an individual has to do after graduating from medical school. It lasts three to eight years, depending on the specialty. For licensure in the United States you have to complete residency training and step 3 and have ECFMG certification.2 After this you can apply for a fellowship (equivalent to specialist training).
What are the parts of the USMLE?
The USMLE has several steps: step 1, step 2 clinical knowledge and
clinical skills, and step 3.
Step 1 is an eight hour multiple choice exam and tests basic medical
sciences such as anatomy, physiology, biochemistry, and microbiology and
their clinical applications. It is a computed exam and it can be taken in several parts of the world.
Step 2 clinical knowledge is a nine hour exam and tests the clinical specialties such as internal medicine, surgery, obstetrics and gynaecology,
and psychiatry. This is also a multiple choice computed exam, and it can be
taken in several parts of the world.
Step 2 clinical skills tests an individual’s clinical skills and ability to
communicate with patients and can be taken only in the United States.
Participants must register for the exam before 1 July and take the exam by
31 December to qualify for a residency starting the next year.
Step 3 tests the clinical management of patients and is administered only
in the United States. The programme will normally specify if step 3 should be taken before or during residency.
The step 1 and step 2 exams may be taken in any order. To register for the exams go to www.ecfmg.org for steps 1 and 2 and www.fsmb.org for step 3. All associated costs are listed on the application form.
What do I need to score to get into a top residency programme?
Scoring highly in the USMLE step 1 and step 2 clinical knowledge exams
makes the difference between getting a cutting edge residency programme and an average one. In general, scoring 75 percentile (60% to 70%) is enough to pass step 1 and step 2 clinical knowledge, but may not be enough to get into a residency programme.
Exams cannot be retaken to improve a score once an individual has
passed. You should aim for percentiles in the late 80s and early 90s
for an internal medicine residency and late 90s for a surgical residency.