In the United States, after you finish your medical school and get your MD degree, there is only one more step to becoming an independent practitioner of medicine and getting your permit. That step is passing the United States Medical Licensing Examination, or USMLE in short. Passing the USMLE will grant you medical licensure, which is one of the requirements to apply for a practice permit. In order to do better at the USMLE, you should know two things – first of all, what the USMLE is, and secondly, how the examination is graded and what score is satisfactory.
What is the USMLE?
While the format stays more or less the same through the years, the material used for the exam changes every year, as it is prepared by examination committees around the United States. The exam always has three parts, and you will have to pass all of them in order to get a satisfactory grade for the entire USMLE.
The first part of the United States Medical Licensing Examination is taken on a single day. The test is divided into seven components, each taking 60 minutes, so prepare for 7 long hours of hard work. You will have 45 minutes of break time, during which you can eat something or use the bathroom. There is also a 15-minute tutorial that explains the examination in greater detail. The first part of the USMLE consists solely of multiple-choice questions – however, these questions can have as many as 10 answers, so choose wisely! The total number of questions for Part I changes every year, but there is a maximum limit of 40 questions per segment – so, in the worst scenario, you can expect a total of 280 questions for the entire examination.
The second part of the USMLE, Step 2, is itself divided into two parts. The parts are named, respectively, Clinical Knowledge and Clinical Skills. The Clinical Knowledge, or CK, is very similar to the first part of the USMLE – a one-day test with 8 blocks, 60 minutes each. You will be also faced with similar multiple-choice questions. The Clinical Exam, or CE, is a bit different – you will go through stations, performing physical examinations, and using the gathered data to communicate with the patient and other doctors. The examiners will test your ability to gather information from patients and interact with them in a professional manner.
The third – and last – step of the USMLE will check your knowledge and skills of patient management and ambulatory settings. The final step takes two days to finish and features 233 multiple-choice questions. Apart from the 7 hours of testing on the first day and 9 hours of testing on the second, you will have to go through 13 case simulations with a strict time limit. As you can see, this last part is quite hard!
How is the USMLE scored?
Sadly, the USMLE program does not disclose specific scores for each task to the participants. However, for Step I of examination, you will get a three-digit score that represents how well you did. Theoretically, this score ranges from 1 to 300. The passing score is 194, and the national mean of Step 1 is 229 points. However, it was announced that in 2022, USMLE Step 1 would transition to a simple pass/fail scoring system. More details are yet unknown.
Similarly to Step 1, the Clinical Knowledge part of Step 2 is scored in 3 digit scores between 1 and 300. The exact minimum score to pass changes, but usually is somewhere between 200 and 210, based on the difficulty of the exam. Typically, you will need between 55% and 65% of correct answers to pass. Grading of the Clinical Skills part is based on a pass/fail system, without any numerical score assigned. There are three components on which you will be graded: Communication and Interpretation Skills, Spoken English Proficiency, and Integrated Clinical Encounter. To pass Step 2 CS – you will need to pass every individual component.
During Step 3, your performance on the simulations will affect the overall score, along with points for the multiple-choice questions. The details are not known, but the scale is similar to Step 1 and Step 2 of the USMLE. To pass Step 3, you need a total of 193 points, combined between MCQ and simulations.