Understanding Medical Exams: USMLE 1, 2 and 3

UNDERSTANDING THE USMLE EXAMS

The United States Medical Licensing Examination® (USMLE®) is a three-step examination for medical licensure in the United States and is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®). Physicians with an M.D. degree are required to pass this examination before being permitted to practice medicine in the United States.

The purpose of the USMLE is to assess a physician's ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care. Examination committees composed of medical educators and clinicians from across the United States and its territories create the examination materials each year. At least two committees critically appraise each test item or case, revising or discarding any materials that are in doubt.

USMLE Step 1

Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning. Step 1 is constructed according to an integrated content outline that organizes basic science material along two dimensions: system and process.

For more information on step 1 content, visit: http://usmle.org/Examinations/step1/step1.html

USMLE Step 2

Step 2 assesses whether you can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine.

For more information on step 2 content, visit: http://usmle.org/Examinations/step2/step2.html

Step 2 Clinical Knowledge (CK)
Step 2 CK consists of multiple-choice questions prepared by examination committees composed of faculty members, teachers, investigators, and clinicians with recognized prominence in their respective fields. Committee members are selected to provide broad representation from the academic, practice, and licensing communities across the United States and Canada. Test questions focus on the principles of clinical science that are deemed important for the practice of medicine under supervision in postgraduate training. The examination is constructed from an integrated content outline that organizes clinical science material along two dimensions: Normal Conditions and Disease categories (Dimension 1) and Individual disorders subdivided according to Physician Task (Dimension 2).

More on step 2 CK: http://usmle.org/Examinations/step2/step2ck_content.html

Step 2 Clinical Skills (CS)
Step 2 CS uses standardized patients, i.e., people trained to portray real patients. The cases cover common and important situations that a physician is likely to encounter in clinics, doctors’ offices, emergency departments, and hospital settings in the United States

More on step 2 CS: http://usmle.org/Examinations/step2/step2cs.html

USMLE Step 3

Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care. A principal organizing dimension for Step 3 design is normal conditions and disease categories. Second and third organizing dimensions are the clinical encounter frame and physician tasks. Step 3 content reflects a data-based model of generalist medical practice in the United States.

For more information on step 2 content, visit: http://usmle.org/Examinations/step3/step3.html

Also read: Understanding medical exams

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