Completing the United States Medical Licensing Examinations (USMLE) is prerequisite for medical licensure in the US. The test measures your ability to apply essential knowledge, skill and principles central to health care that are important when treating patients. Researchers and students who will not interact with patients usually do not have to complete the USMLE.

The USMLE is a three-step examination. These steps should be completed within a period of 7 years, if possible. Step 1, Step 2 CK and Step 3 are administered at a computer test center. Step 2 CS involves patients. They do not have to be taken in order: you are allowed to complete the Step 2 exam before the Step 1 exam.


Step 1

Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, including health care, diseases and modes of therapy.


Step 2 Clinical Knowledge

You need to have completed at least 2 years of medical school or a similar education before you can take Step 2 CK This exam assesses your ability to apply medical knowledge when treating patients.


Step 2 Clinical Skills

Step 2 CS assesses the ability of a medical assistant in diagnosing patients, and in communicating their findings to patients and colleagues in English. Step 2 examinations are administered year-round at ECFMG test centers in Philadelphia, Atlanta, Houston, Chicago, and Los Angeles. You will receive your results 6 weeks after examination by mail. Try to take this test as early in the process as possible if you want to be eligible for a Match. Testing dates fill up fast when the deadlines approach

The results of the Step 2 CS are valid for three years. After completing the ACGME accredited program in the US, your results will remain valid indefinitely.


Step 3

The Step 3 examination takes two days and assesses whether you are able to apply your medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings.



Students applying for Step 1 and Step 2 examinations can submit their preferred test dates within a period of three months – the eligibility period – when registering. Once the ECFMG has submitted permission in writing, the exam can be scheduled within the eligibility period. It is possible to take the exams at Prometic. Students can register at Prometric. All applicants have to register at least one month before their desired eligibility period.  

International candidates for the Step the 1 and Step 2 exams need to be enrolled at – or have a degree from – a medical school that is included in the International Medical Education Directory.

Candidates for the Step 3 exam are must have an MD or equivalent, should have completed the Step 1 and Step 2 programs successfully, and have to be ECFMG certified to be eligible to register for this examination. We recommend starting the registration process at least 6 months before your intended examination date. Individual State Medical boards can help you find more information.



Step 1                      $895 + $185 surcharge for Europe

Step 2 CK               $895 + $210 surcharge for Europe

Step 2 CS               $1550



Several practice books are available to purchase. Some of the more popular editions are Rypins Basic, and Clinical Medical Review, published by Frohlich Publishers.