How to Get a Medical Licence in USA?


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If you want to Practice medicine in United States of America, you will be needing a licence for medical practice by the licensing board of the state where you want to practice medicine. Every doctor, from the USA or an international applicant must clear a standardised test sequence decided for the medical aspirants.

USMLE Exam for USA

USMLE– United States Medical Licensing Exam is the licencing exam for the students who are willing to practice unsupervised medicine- outside medical schools. It is not a memory based test, but a problem solving test, to assess candidate’s ability to practice medicine independently.

There is a sequence of four exams that are taken. The candidate must clear each of them in order to get the medical licence. Both international and US students are scored equally and assessed equally, too. The sequence of the tests and Exam pattern for USMLE Exam are given below:

  1. USMLE Step-1
  2. USMLE Step-2 CK
  3. USMLE Step-2 CS
  4. USMLE Step-3

USMLE Step 1

USMLE Step 1 is computerised MCQ type examination that assess the knowledge of subjects that candidates learn in the first two years of Medical Schools. This should be the first examination candidate should be taking. It is Basic Medical Science Exam that Assesses Basic knowledge of medical science in patient care.

Exam Pattern USMLE Step 1:

Duration Total Questions Blocks No. of Question in each Block
8 Hours 280 7 40

Break Duration: 45 Minutes.


USMLE Step 2 CK (Clinical Knowledge) is computerised MCQ type examination that tests knowledge of subjects candidates learn in the last years of Medical Schools. This Exam should be taken after the completion of USMLE Step 1.  This test is assessment of solving basic practical medical problems under medical supervision. It focuses and emphasise in internal medicine.

Exam Pattern USMLE Step 2 CK:

Duration Total Questions Blocks No. of Question in each Block
9 Hours 318 8 40

Break Duration: 45 Minutes.


USMLE Step 2 CS (Clinical Skills) is a “practical” exam with standardised patients. Standardised patients are people who are trained to behave as a patient. It is an assessment of candidate’s interpersonal, communication and clinical skills. Along with spoken English, it is also exam to check candidate’s ability to perform medical exam, questioning, and patient notes while interacting with the patient. The exam can only be taken in the USA, and international students need to book for the exam. It is scored three dimensionally:

  1. Integrated Clinical Encounter (ICE)
  2. Communication/Interpersonal skill (CIS)
  3. Spoken English proficiency (SEP)

Along with that, Standardised patients score the candidates as per a prepared checklist, and the whole process is videotaped to ensure reliability.

Exam Pattern USMLE Step 2 CS:

Questions Block
12 Patients 15 Minutes Each

After every patient encounter, 10 minutes are given to the candidate for patient notes.

USMLE Step 2 CS Test Centres:

State City
Georgia Atlanta
‎Illinois Chicago
Texas Houston
California Los Angeles
Pennsylvania Philadelphia


USMLE Step 3

USMLE Step 3 is a combination of multiple-choice questions and other clinical cases questions on computer. It is also an assessment of candidate’s patient management and ability to practice medicine independently. Only candidates who have cleared medical schools give this exam.

Exam Pattern USMLE Step 3:

USMLE Step 3 Duration Total Questions Blocks No. of Question in each Block
USMLE Step 3-Day 1 7 hours 260 6 44
USMLE Step 3-Day 2 9 hours 200 6 (30-45 minutes each) 33

(13 case stimulations)


USMLE Step 3 Exam Centres:

Just like USMLE Step 2 CS examination, the candidates will have to travel to the USA to appear for the exam. Here is the list to the states and territories in USA to appear for USMLE Step 3:

Test Centres
1.    American Samoa
2.    Guam
3.    Northern Mariana Islands
4.    Puerto Rico
5.    United States of America (All the States)
6.    Virgin Islands (U.S)


USMLE Scores:

There are no specific scores declared to qualify. However, latest scores are as follows:

Step 1: 194
Step 2 CK: 209
Step 3: 196

For USMLE Step 2 CS, there is no scoring scale. The results are simply declared as Pass / Fail for USMLE step 2 CS.


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