2010
Bulletin of
Information
A Joint Program of the Federation of State
Medical Boards of the United States, Inc.,
and the National Board of Medical Examiners®
TABLE OF CONTENTS
OVERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Purpose of the USMLE . . . . . . . . . . . . . . . . . . . . . . . . . 1
The Three Steps of the USMLE . . . . . . . . . . . . . . . . . . 2
Examination Committees. . . . . . . . . . . . . . . . . . . . . . . . 2
Ownership and Copyright of
Examination Materials . . . . . . . . . . . . . . . . . . . . . . . 2
Computer-Based Testing (CBT) . . . . . . . . . . . . . . . . . . 2
USMLE Step 2 Clinical Skills (CS) . . . . . . . . . . . . . . . 2
The Comprehensive Review of USMLE . . . . . . . . . . . 3
ELIGIBILITY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Step 1, Step 2 CK, and Step 2 CS . . . . . . . . . . . . . . . . . 4
Step 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Who Is Required to Take Step 2 CS? . . . . . . . . . . . . . . 4
Graduates of Unaccredited Medical Schools
in the United States and Canada . . . . . . . . . . . . . . . 5
Sequence of Steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Time Limit and Number of Attempts Allowed
to Complete All Steps . . . . . . . . . . . . . . . . . . . . . . . . 6
Retakes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Official Performance of Record for Examinees
Retaking a Previously Passed Step . . . . . . . . . . . . . 7
Formerly Administered Examinations . . . . . . . . . . . . . 8
Change in Eligibility Status . . . . . . . . . . . . . . . . . . . . . . 8
EXAMINATION CONTENT . . . . . . . . . . . . . . . . . . . . 9
Step 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Step 2 Clinical Knowledge (CK) . . . . . . . . . . . . . . . . . 10
Step 2 Clinical Skills (CS) . . . . . . . . . . . . . . . . . . . . . . 11
Step 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
PREPARING FOR THE TEST . . . . . . . . . . . . . . . . . 14
Sample Test Materials . . . . . . . . . . . . . . . . . . . . . . . . . 14
Test Lengths and Formats . . . . . . . . . . . . . . . . . . . . . . 14
Practicing with the Software . . . . . . . . . . . . . . . . . . . . 14
Practice at Prometric Test Centers. . . . . . . . . . . . . . . 14
APPLYING FOR THE TEST AND SCHEDULING
YOUR TEST DATE . . . . . . . . . . . . . . . . . . . . . . . . 16
Application Materials. . . . . . . . . . . . . . . . . . . . . . . . . . 16
Applying for Step 1, Step 2 CK, and Step 2 CS. . . . . 16
Applying for Step 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Examinees Who Require Personal Items in the
Testing Room . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Examinees with Disabilities Requesting Test
Accommodations . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Obtaining an Eligibility Period
for Step 1 and Step 2 CK . . . . . . . . . . . . . . . . . . . . 17
Obtaining an Eligibility Period for Step 2 CS . . . . . . 18
Obtaining an Eligibility Period for Step 3 . . . . . . . . . 18
Scheduling Step 1, Step 2 CK, and Step 3 . . . . . . . . . 18
Scheduling Step 2 CS . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Summary of Process. . . . . . . . . . . . . . . . . . . . . . . . . . . 22
TESTING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Testing Regulations and Rules of Conduct . . . . . . . . 23
Personal Items. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Admission to the Test . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Step 1, Step 2 CK, and Step 3 . . . . . . . . . . . . . . . . . . . 25
Step 2 CS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
SCORING AND SCORE REPORTING . . . . . . . . . . 29
Examination Results and Scoring. . . . . . . . . . . . . . . . 29
Minimum Passing Scores. . . . . . . . . . . . . . . . . . . . . . . 30
Examinee Score Reports . . . . . . . . . . . . . . . . . . . . . . . 30
Score Rechecks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Score Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Official USMLE Transcripts and Providing
Scores to Third Parties . . . . . . . . . . . . . . . . . . . . . . 32
Electronic Residency Application Service
(ERAS®) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
INDETERMINATE SCORES AND
IRREGULAR BEHAVIOR . . . . . . . . . . . . . . . . . . 34
Validity of Scores . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Irregular Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
COMMUNICATING ABOUT USMLE . . . . . . . . . . . 36
Application and Registration Inquiries . . . . . . . . . . . 36
Scheduling and Test Center Inquiries . . . . . . . . . . . . 37
Test Administration Problems/Inquiries . . . . . . . . . . 37
General Inquiries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Step 3 and Medical Licensure Inquiries. . . . . . . . . . . 37
Copyright © 2009 by the Federation of State Medical Boards of the United States, Inc., and the National Board of Medical
Examiners® (NBME®). The USMLE is a joint program of the Federation of State Medical Boards of the United States, Inc.,
and the National Board of Medical Examiners.
OVERVIEW
INTRODUCTION
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®).
The Composite Committee, appointed by the FSMB
and NBME, establishes policies for the USMLE program.
Membership includes representatives from the
FSMB, NBME, Educational Commission for Foreign
Medical Graduates (ECFMG®), and the American
public.
Changes in the USMLE program may occur after the
release of this bulletin. If changes occur, information
will be posted at the USMLE website. You must
obtain the most recent information to ensure an accurate
understanding of current USMLE rules. If you
are unable to access updated USMLE information via
the Internet, you may contact the USMLE Secretariat
in writing (see page 37) for updated information.
PURPOSE OF THE USMLE
In the United States and its territories ("United States"
or "US"), the individual medical licensing authorities
("state medical boards") of the various jurisdictions
grant a license to practice medicine. Each medical
licensing authority sets its own rules and regulations
and requires passing an examination that demonstrates
qualification for licensure. Results of the USMLE are
reported to these authorities for use in granting the initial
license to practice medicine. The USMLE provides
them with a common evaluation system for applicants
for medical licensure.
The USMLE assesses a physician's ability to apply
knowledge, concepts, and principles, and to demonstrate
fundamental patient-centered skills, that are important in
health and disease and that constitute the basis of safe
and effective patient care. Each of the three Steps complements
the others; no Step can stand alone in the
assessment of readiness for medical licensure. Because
individual medical licensing authorities make decisions
regarding use of USMLE results, you should contact the
jurisdiction where you intend to apply for licensure to
obtain complete information. Also, the FSMB can provide
general information on medical licensure.
1
Note: You must become familiar with the
information in this bulletin if you are an
applicant with an eligibility period in 2010. If
your eligibility period extends into 2011 and
you test in 2011, you must become familiar
with and will be subject to the policies and
procedures detailed in the 2011 Bulletin of
Information. Eligibility periods are explained on
pages 17–18. To apply for the USMLE, you must
contact the appropriate registration entity (see
page 36).
http://www.usmle.org
Visit the USMLE website for
up-to-date information.
USMLE Mission Statement
The United States Medical Licensing Examination
(USMLE) program supports medical licensing
authorities in the United States through its leadership
in the development, delivery, and continual
improvement of high quality assessments across the
continuum of physicians' preparation for practice.
Goals:
q To provide to licensing authorities meaningful
information from assessments of physician
characteristics—including medical knowledge,
skills, values, and attitudes—that are important to
the provision of safe and effective patient care.
q To engage medical educators and their
institutions, licensing authority members, and
practicing clinicians in the design and
development of these assessments.
q To assure fairness and equity to physicians
through the highest professional testing standards.
q To continue to develop and improve assessments
for licensure with the intent of assessing
physicians more accurately and comprehensively.
OVERVIEW
THE THREE STEPS OF THE USMLE
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 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.
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.
EXAMINATION COMMITTEES
Examination committees composed of medical educators
and clinicians prepare the examination materials.
Committee members broadly represent the teaching,
practicing, and licensing communities across the
United States. At least two of these committees critically
appraise each test item or case. They revise or
discard any materials that are in doubt.
OWNERSHIP AND COPYRIGHT OF
EXAMINATION MATERIALS
The examination materials used in the USMLE are
copyrighted. If you reproduce and/or distribute any
examination materials, by any means, including
memorizing and reconstructing them, without explicit
written permission, you are in violation of the
rights of the owners. In addition to actions described
on pages 34–35, every legal means available to protect
USMLE copyrighted materials and secure
redress against those who violate copyright law may
be pursued.
COMPUTER-BASED TESTING (CBT)
Parts of the USMLE are administered by computer.
Prometric™ provides scheduling and test centers for
the computer-based components of USMLE. Step 1
and Step 2 CK are given around the world at Prometric
Test Centers (PTCs). USMLE Step 3 is given at PTCs
in the United States and its territories only.
USMLE STEP 2 CLINICAL SKILLS (CS)
Implementation of the clinical skills examination
began in June 2004. The clinical skills examination is
a separately administered component of Step 2 and is
referred to as Step 2 Clinical Skills, or Step 2 CS.
The computer-based, multiple-choice component of
Step 2 is referred to as Step 2 Clinical Knowledge, or
Step 2 CK.
USMLE Step 2 CS is administered at five regional
test centers (CSEC Centers) in the United States.
2
OVERVIEW
3
The Comprehensive Review of USMLE
Background
The USMLE examination program was designed in the late 1980s and introduced during the period 1992 to
1994. The program replaced the NBME Part Examination program and the Federation Licensing Examination
(FLEX) program, which were the widely accepted medical licensing examination programs at that time. While
the content and design for the USMLE Step examinations have been continuously reviewed and refreshed, there
had been no in-depth review of overall program design and structure since the sequence was first conceived. In
2004, the USMLE Composite Committee called for a comprehensive review of the entire USMLE program to
determine if the mission and purpose of USMLE are effectively and efficiently supported by the current design,
structure, and format of the USMLE.
The primary responsibility for this review was given to the Committee to Evaluate the USMLE Program
(CEUP), reflecting perspectives of students, residents, fellows, Deans and Associate Deans, basic science and
clinical faculty, international medical graduates, state medical boards, practicing physicians, and the public.
To inform CEUP, staff members used surveys and focus groups to gather information about the impact and relevance
of the USMLE program from a wide range of individuals and organizations, including representatives
from the medical licensing authorities, the US undergraduate and graduate education communities, and institutional
and national leaders from the international medical education community.
Current Status
The CEUP report and the implications of its recommendations were carefully reviewed by the staff and governing
bodies of ECFMG, FSMB, and NBME. In 2009, the proposal for changes to the USMLE was approved.
Research, planning, and implementation have begun. Up-to-date information on the current status of this
process is posted at the USMLE website.
ELIGIBILITY
STEP 1, STEP 2 CK, AND STEP 2 CS
To be eligible, you must be in one of the following
categories at the time of application and on the test
day:
q a medical student officially enrolled in, or a
graduate of, a US or Canadian medical school
program leading to the MD degree that is
accredited by the Liaison Committee on Medical
Education (LCME),
q a medical student officially enrolled in, or a
graduate of, a US medical school leading to the
DO degree that is accredited by the American
Osteopathic Association (AOA), or
q a medical student officially enrolled in, or a
graduate of, a medical school outside the United
States and Canada and eligible for examination
by the ECFMG.
If you have been dismissed from medical school, you
are not eligible for USMLE, even if you are appealing
the school’s decision to dismiss you.
STEP 3
To be eligible for Step 3, prior to submitting your
application, you must:
q obtain the MD degree (or its equivalent) or the
DO degree,
q pass Step 1, Step 2 CK, and, if required based
upon the rules referenced below, Step 2 CS,
q obtain certification by the ECFMG or
successfully complete a "Fifth Pathway" program
(see Special Notice Regarding the Fifth
Pathway Program on page 5) if you are a
graduate of a medical school outside the
United States and Canada, and
q meet the Step 3 requirements set by the medical
licensing authority to which you are applying.
WHO IS REQUIRED TO TAKE STEP 2 CS?
In order to be eligible to register for USMLE Step 3, the
current examination requirements for graduates of
LCME-accredited medical school programs or AOAaccredited
medical schools include passing Step 1 and
Step 2. Such individuals must have passed Step 2 CS as
part of the examination requirements for Step 3 if they:
(a) have medical school graduation dates in 2005 or
4
Note: The USMLE program recommends that for
Step 3 eligibility, licensing authorities require the
completion, or near completion, of at least one
postgraduate training year in a program of graduate
medical education accredited by the
Accreditation Council for Graduate Medical
Education (ACGME) or the AOA. You should
contact the FSMB for state-specific eligibility
requirements for Step 3. These requirements for
sitting Step 3 are similar, but not always identical,
to requirements for licensure in that jurisdiction.
Note: A physician who received his or her basic
medical degree or qualification from a medical
school outside the United States and Canada may
be eligible for certification by the ECFMG if the
medical school and graduation year are listed in
the International Medical Education Directory
(IMED) of the Foundation for Advancement of
International Medical Education and Research
(FAIMER®). This applies to citizens of the
United States who have completed their medical
education in schools outside the United States and
Canada but not to foreign nationals who have
graduated from medical schools in the United
States and Canada. Specific eligibility criteria for
students and graduates of medical schools outside
the United States and Canada to take Step 1 and
Step 2 are described in the Information Booklet
provided by the ECFMG.
Application and other requests for services will
not be processed if it is determined that doing so
would be violative of any applicable federal laws
or regulations.
ELIGIBILITY
later, or (b) graduated from medical school prior to 2005
but did not pass the CK component of Step 2 taken on or
before June 30, 2005. Note: After June 30, 2012, all
graduates of LCME- and AOA-accredited medical
schools will be required to take and pass Step 2 CS in
order to be eligible for Step 3.
Step 2 CS replaced the Clinical Skills Assessment
(CSA®) formerly administered by the ECFMG.
Effective June 14, 2004, Step 2 CS became a
requirement for ECFMG certification of international
medical graduates who have not passed the CSA.
To register for Step 3, ECFMG certificate holders
must have taken and passed either the CSA or the
Step 2 CS.
In order to register for Step 3, eligible Fifth Pathway
participants must have taken and passed either the
CSA or the Step 2 CS (see Special Notice).
Individuals who have passed Step 2 prior to the
implementation of Step 2 CS are not permitted to
take Step 2 CK, except under the specific exceptions
to the retake policy approved by the Composite
Committee (see page 7), but are permitted to take
Step 2 CS, provided they meet all other eligibility
requirements.
Individuals who are not required to pass Step 2 CS
for Step 3 eligibility but elect to take Step 2 CS and
fail the examination are not eligible for Step 3 until
such time as the individual’s Step 2 CS performance
of record (i.e., most recent performance) is a pass and
the individual meets all other Step 3 requirements.
GRADUATES OF UNACCREDITED MEDICAL
SCHOOLS IN THE UNITED STATES AND
CANADA
If you are eligible for licensure by a US medical
licensing authority but are not in one of the eligibility
categories listed on page 4, you may take the
USMLE only upon specific request by that medical
licensing authority. A licensing authority may sponsor
you to take Step 1 and Step 2, followed by Step 3 if
Step 1 and Step 2 are passed, if all the following conditions
apply to you:
q You are a graduate of an unaccredited medical
school program in the United States or Canada;
q You are an applicant for initial medical licensure
in the jurisdiction of the sponsoring licensing
authority; and
q The sponsoring licensing authority certifies
that you have met all of the requirements for
licensure in the jurisdiction except for the
examination requirement.
If these conditions apply to you, the medical licensing
authority should submit the request to sponsor you to the
USMLE Secretariat at the address shown on page 37 in
advance of your application for the Step.
5
Special Notice Regarding the Fifth Pathway
Program
In November 2007, the American Medical
Association (AMA) determined that it would
withdraw its support of the Fifth Pathway program.
Per the AMA, the last Fifth Pathway program
class to be supported will be the January
2009 entering class, which will be supported until
its completion in December 2009.
The USMLE Composite Committee and the USMLE
parent organizations (FSMB and NBME) have determined
that the USMLE program will cease acceptance
of Fifth Pathway certificates issued after
December 31, 2009 for the purpose of meeting
Step 3 eligibility requirements. For valid Fifth
Pathway certificates issued through December 31,
2009, the USMLE program has not yet determined
whether they will be accepted indefinitely for purposes
of meeting Step 3 eligibility criteria or whether a
cutoff date will be imposed. Individuals holding Fifth
Pathway certificates that are not accepted by the
USMLE program for purposes of meeting Step 3 eligibility
will be required to obtain ECFMG certification
in order to be eligible for Step 3.
Information and updates about the Fifth Pathway
program and USMLE will be posted on the
USMLE website (
http://www.usmle.org).
ELIGIBILITY
SEQUENCE OF STEPS
If eligibility requirements are met (see page 4), you
may take Step 1, Step 2 CK, and Step 2 CS in any
sequence.
TIME LIMIT AND NUMBER OF ATTEMPTS
ALLOWED TO COMPLETE ALL STEPS
Although there is no limit on the total number of
times you can retake a Step or Step Component you
have not passed, the USMLE program recommends
to medical licensing authorities that they:
q require the dates of passing the Step 1, Step 2,
and Step 3 examinations to occur within a
seven-year period; and
q allow no more than six attempts to pass each
Step or Step Component without demonstration
of additional educational experience acceptable
to the medical licensing authority.
For purposes of medical licensure in the United
States, any time limit to complete the USMLE is
established by the state medical boards. Most, but not
all, use the recommended seven years as the time
limit for completion of the full USMLE sequence.
While medical schools may require students to pass
one or more Steps for advancement and/or graduation,
you should understand the implications for
licensure. For states that establish a time limit for
completion of all three Steps, the "clock" starts running
on the date the first Step or Step Component is
passed or, in some cases, on the date of the first
attempt at any Step. General information regarding
state-specific requirements for licensure can be
obtained from the FSMB (
http://www.fsmb.org). For definitive
information, you should contact directly the
licensing authority in the jurisdiction in which you
intend to seek licensure.
Special Notice for MD/PhD Candidates
The common pathway for MD/PhD students involves
completing the first two years of medical school and
then moving to graduate school studies and research
for a three- or four-year period. Following completion
of PhD course work and all or most of their
research projects, these students return to complete
their two clinical years, thus completing the medical
degree in seven to nine years after first matriculating.
The USMLE program recognizes that the recommended
seven-year time limit may pose problems for
medical licensure for some candidates with a combined
degree (i.e., MD/PhD). It is for this reason that
the USMLE program recommends to licensing jurisdictions
that they be willing to consider exceptions to
the seven-year limit for MD/PhD candidates who
meet certain narrow requirements. The recommended
requirements are as follows:
1. The candidate has obtained both degrees in
an institution or program accredited by the
LCME and regional university accrediting body.
2. The PhD studies should be in a field of biological
sciences tested in the Step 1 content. These fields
include but are not necessarily limited to
anatomy, biochemistry, physiology, microbiology,
pharmacology, pathology, genetics, neuroscience,
and molecular biology. Fields explicitly not
included are business, economics, ethics, history,
and other fields not directly related to biological
science.
3. Candidates seeking an exception to the sevenyear
rule should be required to present a
verifiable and rational explanation for the fact
that he or she was unable to meet the seven-year
limit. Although these explanations will vary
considerably, each licensing jurisdiction will
need to decide on its own which explanation
justifies an exception.
Students who pursue both degrees should understand
that while many states' regulations provide specific
exceptions to the seven-year rule for dual-degree candidates,
others do not. Students pursuing a dual
degree are advised to check the state-specific requirements
for licensure listed by the FSMB.
6
ELIGIBILITY
Special Notice for International Medical Students
and Graduates
ECFMG policy requires that applicants pass those
USMLE Steps or Step Components required for
ECFMG certification within a seven-year period.
(You should refer to ECFMG’s Information Booklet
for complete details, as some exceptions may apply.)
This policy applies only to ECFMG certification.
The USMLE program recommends, although not all
jurisdictions impose, a seven-year limit for completion
of the three-Step USMLE program. You should
contact the FSMB or the medical licensing authority
of the jurisdiction where you plan to apply for licensure
for state-specific requirements.
RETAKES
If you fail or do not complete a Step or Step
Component and want to retake it, you must reapply
by submitting a new application and fee.
q For the computer-based examinations (Step 1,
Step 2 CK, Step 3), you may take the failed or
incomplete examination no more than four
times within a 12-month period.
q For Step 2 CS, you may take the failed or
incomplete evaluation no more than three times
within a 12-month period.
If you pass a Step or Step Component, you are not
allowed to retake it, except to comply with the time
limit of a medical licensing authority for the completion
of all Steps or a requirement imposed by another
authority recognized by the USMLE program for this
purpose. The medical licensing or other authority
must provide information indicating that you are
applying to retake the passed Step or Step Component
in order to comply with its requirement. If you are
repeating a Step or Step Component because of a time
limit, you may apply to retake the examination only
after the applicable time limit has expired.
An exception to the policy of requiring the time limit
to expire before applying to retake a previously
passed Step or Step Component can be granted if, at
the time of application and testing:
q you are currently enrolled in an LCME- or AOAaccredited
medical school program leading to the
MD or DO degree;
q you have previously passed Step 1 and/or Step 2
but have not passed Step 3;
q you are expected to graduate from the medical
school program six or more years after the date
you first passed Step 1 and/or Step 2; and
q you are otherwise eligible to retake the
examination.
The number of attempts allowed to pass each Step or
Step Component and the time allowed to complete all
Steps vary among jurisdictions. To obtain specific
information, you should contact the medical licensing
authority in the jurisdiction where you intend to
apply for medical licensure or the FSMB for eligibility
requirements for Step 3.
OFFICIAL PERFORMANCE OF RECORD FOR
EXAMINEES RETAKING A PREVIOUSLY
PASSED STEP
In order to meet the examination requirements for
Step 3 eligibility, you must achieve a passing
performance on the most recent administration of the
examinations intended to meet those requirements.
If you have not yet passed Step 3 and wish to retake
a previously passed Step 1 or Step 2 examination in
order to meet a time limit imposed by a medical
licensing or other recognized authority, you should
7
See pages 36–42 for information on how to
contact the FSMB and medical licensing authorities.
ELIGIBILITY
understand the implications for Step 3 eligibility of a
failing performance on a retake. Specifically, if a failing
performance on a retake is the most recent
administration of that examination, that failing score
will preclude Step 3 eligibility.
FORMERLY ADMINISTERED EXAMINATIONS
The NBME certifying examinations, Part I, Part II, and
Part III, and the Federation Licensing Examination
(FLEX) Components 1 and 2 are no longer administered.
Use of the former NBME Parts or FLEX Components to
fulfill eligibility requirements for Step 3 is no longer
accepted. If you have passed all or a portion of these
examinations and have never been granted a medical
license by a US medical licensing authority, you may
take any Step(s) for which you are otherwise eligible.
CHANGE IN ELIGIBILITY STATUS
If your eligibility for a Step or Step Component
changes after you submit your application but before
your scheduled test date(s), you must notify your registration
entity promptly. Failure to notify your registration
entity that you may no longer be eligible to
take the examination may result in a determination of
irregular behavior (see pages 34–35). If you take a
Step or Step Component for which you are not eligible,
scores for that examination may not be reported
or, if previously reported, may be revoked.
8
EXAMINATION CONTENT
STEP 1
Step 1 includes test items in the following content
areas:
q anatomy,
q behavioral sciences,
q biochemistry,
q microbiology,
q pathology,
q pharmacology,
q physiology,
q interdisciplinary topics, such as nutrition,
genetics, and aging.
Step 1 is a broadly based, integrated examination.
Test items commonly require you to perform one or
more of the following tasks:
q interpret graphic and tabular material,
q identify gross and microscopic pathologic and
normal specimens,
q apply basic science knowledge to clinical
problems.
Step 1 classifies test items along two dimensions:
system and process, as shown in Table 1.
9
http://www.usmle.org
Sample Step 1 test materials and further
information on Step 1 test content are
available at the USMLE website.
Table 1: USMLE Step 1 Specifications*
System**
40%–50% General principles
50%–60% Individual organ systems
• hematopoietic/lymphoreticular
• nervous/special senses
• skin/connective tissue
• musculoskeletal
• respiratory
• cardiovascular
• gastrointestinal
• renal/urinary
• reproductive
• endocrine
Process
30%–50% Normal structure and function
30%–50% Abnormal processes
15%–25% Principles of therapeutics
10%–20% Psychosocial, cultural,
occupational, and environmental
considerations
* Percentages are subject to change at any time.
See the USMLE website for the most up-to-date
information.
** The general principles category includes test
items concerning those normal and abnormal
processes that are not limited to specific organ
systems. Categories for individual organ systems
include test items concerning those normal and
abnormal processes that are system specific.
EXAMINATION CONTENT
STEP 2 CLINICAL KNOWLEDGE (CK)
Step 2 CK includes test items in the following
content areas:
q internal medicine,
q obstetrics and gynecology,
q pediatrics,
q preventive medicine,
q psychiatry,
q surgery,
q other areas relevant to provision of care under
supervision.
Most Step 2 CK test items describe clinical situations
and require that you provide one or more of the
following:
q a diagnosis,
q a prognosis,
q an indication of underlying mechanisms
of disease,
q the next step in medical care, including
preventive measures.
Step 2 CK is a broadly based, integrated examination.
It frequently requires interpretation of tables and
laboratory data, imaging studies, photographs of
gross and microscopic pathologic specimens, and
results of other diagnostic studies. Step 2 CK classifies
test items along two dimensions: disease category
and physician task, as shown in Table 2.
Please note that much of the content that addresses
normal growth and development and general principles
of care is also related to the individual organ
systems categories, so that the number of questions
that deal solely with normal growth and development
and general principles of care is relatively small.
10
http://www.usmle.org
Sample Step 2 CK test materials and further
information on Step 2 CK test content are
available at the USMLE website.
Table 2: USMLE Step 2 CK Specifications*
Normal Conditions and Disease Categories
q Normal growth and development and general
principles of care
q Individual organ systems or types of
disorders
• immunologic disorders
• diseases of the blood and blood-forming
organs
• mental disorders
• diseases of the nervous system and
special senses
• cardiovascular disorders
• diseases of the respiratory system
• nutritional and digestive disorders
• gynecologic disorders
• renal, urinary, and male reproductive
systems
• disorders of pregnancy, childbirth, and
the puerperium
• disorders of the skin and subcutaneous
tissue
• diseases of the musculoskeletal system
and connective tissue
• endocrine and metabolic disorders
Physician Task
15%–20% Promoting preventive medicine
and health maintenance
20%–35% Understanding mechanisms
of disease
25%–40% Establishing a diagnosis
15%–25% Applying principles of management
* Percentages are subject to change at any time.
See the USMLE website for the most up-to-date
information.
EXAMINATION CONTENT
STEP 2 CLINICAL SKILLS (CS)
Step 2 CS assesses whether you can demonstrate the
fundamental clinical skills essential for safe and
effective patient care under supervision. There are
three subcomponents of Step 2 CS (see Table 3):
Integrated Clinical Encounter (ICE), Communication
and Interpersonal Skills (CIS), and Spoken English
Proficiency (SEP).
Step 2 CS uses standardized patients, i.e., people
trained to portray real patients. You are expected to
establish rapport with the patients, elicit pertinent historical
information from them, perform focused physical
examinations, answer questions, and provide counseling
when appropriate. After each interaction with a
patient, you will record pertinent history and physical
examination findings, list diagnostic impressions, and
outline plans for further evaluation, if necessary. The
cases cover common and important situations that a
physician is likely to encounter in common medical
practice in clinics, doctors’ offices, emergency departments,
and hospital settings in the United States.
The cases that make up each administration of the
Step 2 CS examination are based upon an examination
blueprint. An examination blueprint defines the
requirements for each examination, regardless of
where and when it is administered. The sample of
cases selected for each examination reflects a balance
of cases that is fair and equitable across all examinees.
While the set of cases administered on a given
day will differ from the set of cases administered on
another day, each set of cases is comparable.
The intent is to ensure that examinees encounter a
broad spectrum of cases reflecting common and
important symptoms and diagnoses. The criteria that
are used to define the blueprint and create individual
examinations focus primarily on presenting complaints
and conditions. Presentation categories
include, but are not limited to, cardiovascular, constitutional,
gastrointestinal, genitourinary, musculoskeletal,
neurological, psychiatric, respiratory, and
women's health. Examinees will see cases from
some, but not all, of these categories. The selection
of cases is also guided by specifications relating to
acuity, age, gender, and type of physical findings presented
in each case.
STEP 3
Step 3 is organized along two principal dimensions:
clinical encounter frame and physician task (see
Table 4). Step 3 content reflects a data-based model
of generalist medical practice in the United States.
Encounter frames capture the essential features of
circumstances surrounding physicians' clinical activity
with patients. They range from encounters with
patients seen for the first time for nonemergency
problems, to encounters with regular patients seen in
the context of continued care, to patient encounters in
(life-threatening) emergency situations. Encounters
occur in clinics, offices, skilled nursing care facili-
11
Table 3: The Subcomponents of Step 2 CS
Integrated Clinical Encounter (ICE)
• Data gathering – patient information
collected by history taking and physical
examination
• Documentation – completion of a patient
note summarizing the findings of the patient
encounter, diagnostic impression, and initial
patient workup
Communication and Interpersonal Skills (CIS)
• Questioning skills
• Information-sharing skills
• Professional manner and rapport
Spoken English Proficiency (SEP)
• Clarity of spoken English communication
within the context of the doctor-patient
encounter
http://www.usmle.org
Further information on Step 2 CS
is available at the USMLE website.
EXAMINATION CONTENT
ties, hospitals, emergency departments, and on the
telephone. Each test item in an encounter frame also
represents one of the six physician tasks. For example,
initial care encounters emphasize taking a history
and performing a physical examination. In contrast,
continued care encounters emphasize decisions
regarding prognosis and management.
High-frequency, high-impact diseases also organize
the content of Step 3. Clinician experts assign clinical
problems related to these diseases to individual clinical
encounter frames to represent their occurrence in
generalist practice.
Primum® Computer-Based Case
Simulations (CCS)
Step 3 examinees test using two formats: multiplechoice
questions and Primum computer-based case
simulations (CCS), a testing format that allows you
to provide care for a simulated patient. You decide
which diagnostic information to obtain and how to
treat and monitor the patient's progress. The computer
records each step you take in caring for the patient
and scores your overall performance. This format
permits assessment of clinical decision-making skills
in a more realistic and integrated manner than other
available formats.
In Primum CCS, you may request information from
the history and physical examination; order laboratory
studies, procedures, and consultants; and start
medications and other therapies. Any of the thousands
of possible entries that you type on the "order
sheet" are processed and verified by the "clerk."
When you have confirmed that there is nothing further
you wish to do, you decide when to reevaluate
the patient by advancing simulated time. As time
passes, the patient's condition changes based on the
underlying problem and your interventions; results of
tests are reported, and results of interventions must
be monitored. You suspend the movement of simulated
time as you consider next steps. While you cannot
go back in time, you can change your orders to
reflect your updated management plan.
The patient's chart contains, in addition to the order
sheet, the reports resulting from your orders. By
selecting the appropriate chart tabs, you can review
vital signs, progress notes, patient updates, and test
results. You may care for and move the patient
among the office, home, emergency department,
intensive care unit, and hospital ward.
12
Table 4: USMLE Step 3 Specifications*
Clinical Encounter Frame
20%–30% Initial care
50%–60% Continued care
15%–25% Emergency care
Physician Task
8%–12% Obtaining history and performing
physical examination
8%–12% Using laboratory and diagnostic
studies
8%–12% Formulating most likely diagnosis
8%–12% Evaluating severity of patient's
problems
8%–12% Applying scientific concepts and
mechanisms of disease
45%–55% Managing the patient
• health maintenance
• clinical intervention
• clinical therapeutics
• legal and ethical issues
* Percentages are subject to change at any time.
See the USMLE website for the most up-to-date
information.
http://www.usmle.org
Sample Step 3 test materials and further
information on Step 3 test content
are available from the FSMB
and at the USMLE website.
EXAMINATION CONTENT
The cases used in the CCS portion of the Step 3
examination are based upon a CCS examination blueprint.
The blueprint defines the requirements for CCS
examination forms. The CCS blueprint is used to
construct CCS examination forms focusing primarily
on presenting symptoms and presenting locations.
Presenting symptoms relate to the Step 3
Problem/Disease List and are associated with the
central nervous system, eye/ear/nose/mouth/throat,
respiratory system, circulatory system, digestive system,
behavioral/emotional disorders, musculoskeletal
system, skin/subcutaneous tissue, endocrine/nutrition/
metabolic disorders, kidneys/urinary tract, reproductive
system, pregnancy/childbirth, neonate/childhood
illnesses, blood and blood-forming organs,
infectious/parasitic diseases, injuries/wound/toxic
effects/burns, and health maintenance issues.
Presenting locations include the outpatient office,
emergency department, inpatient unit, intensive care
unit, and the patient's home.
You will see cases related to some, but not all, of
these problem/disease and location categories. The
intent is to ensure that all examinees encounter a
broad range of cases reflecting common and important
symptoms and diagnoses. The selection of cases
is also guided by specifications relating to age and
gender. Each CCS examination form is structured to
reflect a balance of cases that is fair and equitable for
all examinees.
13
PREPARING FOR THE TEST
SAMPLE TEST MATERIALS
The best preparation for the USMLE is a general,
thorough review of the content reflected in the examination
descriptions on pages 9–13. You should also
review further information on the examination content
and test formats available on the USMLE website or
from your registration entity and run the sample test
materials available on the USMLE website or on the
2010 USMLE compact disc (CD). The 2010 USMLE
CD is available through your registration entity.
There are no test preparation courses affiliated with
or sanctioned by the USMLE program. Information
on such courses is not available from the ECFMG,
FSMB, NBME, USMLE Secretariat, or medical
licensing authorities.
TEST LENGTHS AND FORMATS
q Step 1 has approximately 336 multiple-choice
test items, divided into seven 60-minute blocks,
administered in one eight-hour testing session.
q Step 2 CK has approximately 352 multiple-choice
test items, divided into eight 60-minute blocks,
administered in one nine-hour testing session.
q Step 2 CS has 12 patient cases. You will
have 15 minutes for each patient encounter and
10 minutes to record each patient note. If you do
not use the entire 15 minutes for the patient
encounter, the remaining time will be added to
the time you have to record the patient note. The
testing session is approximately eight hours.
q Step 3 has approximately 480 multiple-choice
test items, divided into blocks of 35 to 50 items.
You will have 45 to 60 minutes to complete each
of these blocks. There are approximately nine
computer-based case simulations (see page 12),
with one case in each block. You will have a
maximum of 25 minutes to complete each of
these blocks. Step 3 is administered in two eighthour
testing sessions.
For Step 1, Step 2 CK, and Step 3 multiple-choice
sections, during the defined time to complete the
items in each block, you may answer the items in any
order, review your responses, and change answers.
After you exit the block, or when time expires, you
can no longer review test items or change answers.
Step 2 CS cases and Step 3 case simulations must be
taken in the order presented. After you exit the case
or session, or when time expires, you can no longer
review test items or cases, change answers, or collect
additional information.
PRACTICING WITH THE SOFTWARE
For Steps 1, 2 CK, and 3, you should acquaint yourself
with the test software well before your test
date(s). Practice time is not available on the test day,
and test center staff are not authorized to provide
instruction on use of the software. A brief tutorial on
the test day provides a review of the test software,
including navigation tools and examination format,
prior to beginning the test. It does not provide an
opportunity to practice. Step 3 examinees should
review the Primum CCS orientation materials and
practice with all of the sample cases well in advance
of the testing day to have a thorough understanding
of how the software works.
Sample test materials to practice with the software
(both multiple-choice questions and Primum CCS
cases) are available at the USMLE website.
PRACTICE AT PROMETRIC TEST CENTERS
If you wish to experience some of the conditions of
test administration for Step 1, Step 2 CK, or Step 3,
you may schedule time to review sample test materials
at a Prometric Test Center for a fee. Although
shorter than an actual USMLE examination and containing
the same sample test materials provided at the
14
http://www.usmle.org
Note: The test descriptions provided here, including
test length and number of test items or cases,
may be changed at any time. Notice of any
changes will be posted at the USMLE website.
PREPARING FOR THE TEST
USMLE website, this option allows you to experience
USMLE sample test materials in the same environment
as your actual test. After your registration
for a Step or Step Component is complete and you
have obtained your Scheduling Permit, you may register
for a practice session for that examination by
following the instructions at the USMLE website.
15
Note: If you register for the practice session, you
will be issued a separate Scheduling Permit
specifically for the practice session. You must
have this Permit before you can contact Prometric
to schedule the practice session. You should allow
seven business days for issuance of your practice
session Scheduling Permit.
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
APPLICATION MATERIALS
If you meet the eligibility requirements on page 4,
you can apply for Step 1, Step 2 CK and CS, or Step
3. Applications are available from the appropriate
registration entity. You must use current application
materials to apply.
APPLYING FOR STEP 1, STEP 2 CK, AND
STEP 2 CS
Students and graduates of LCME-accredited programs
and AOA-accredited medical schools should
apply for Step 1, Step 2 CK, and Step 2 CS by following
the instructions at the NBME website
(
http://www.nbme.org). Review and follow the application
instructions, complete your application, and
submit it to the NBME.
Students and graduates of medical schools outside the
United States and Canada should apply for Step 1,
Step 2 CK, and Step 2 CS by following the instructions
at the ECFMG website (
http://www.ecfmg.org).
Review and follow the application instructions, complete
your application, and submit it to the ECFMG.
If you have been dismissed from medical school, you
are not eligible for USMLE, even if you are appealing
the school’s decision to dismiss you.
APPLYING FOR STEP 3
To request information on Step 3 eligibility requirements
and application procedures, follow the instructions
at the FSMB website (
http://www.fsmb.org), or
contact the FSMB or the medical licensing authority
to which you wish to apply.
Application procedures for Step 3 vary among jurisdictions.
You should begin inquiries at least three
months in advance of the dates on which you expect
to take the test.
After you obtain application materials, review and
follow the application instructions to complete your
application and submit it to the medical licensing
authority or the FSMB as directed in the instructions.
EXAMINEES WHO REQUIRE PERSONAL
ITEMS IN THE TESTING ROOM
As more fully explained on page 23, unauthorized
possession of personal items while you are in the
secure areas of the testing center is prohibited.
However, in certain limited circumstances, exceptions
to this policy may be made for medical reasons,
provided that permission is granted in advance of test
administration. If you believe that you have a medical
condition that requires you to use medication, an
external appliance, or electronic device in the secure
areas of the test center, please submit a written
request via e-mail to PIE@nbme.org, via fax to 215-
590-9422, or via mail to Personal Item Exception
Coordinator, 3750 Market Street, Philadelphia, PA,
19104 at least four weeks prior to your anticipated
test date. You will need to explain the necessity for
the exception and provide documentation from your
medical professional substantiating your need to use
the item(s) during test administration. Professional
documentation must be typewritten on the professional’s
letterhead. Examples of appliances and
devices to which this policy applies include insulin
pumps, inhalers, medications, TENS units, breast
pumps, hearing aids, electronic or digitally amplified
or otherwise enhanced non-standard stethoscopes (for
Step 2 CS), wheelchairs, canes, crutches and casts.
This list is not exhaustive; if you are unsure whether
you should request an exception, please contact the
Personal Item Exception Coordinator via e-mail at
PIE@nbme.org.
You are not required to obtain advance permission to
wear eyeglasses or contact lenses during testing, or to
consume food or medication on authorized breaks.
All personal items, including those permitted as an
exception under this policy, are subject to inspection
16
Note: See page 36 for information on how to
contact your registration entity to apply for a Step
or Step Component.
Note: See pages 37–42 for information on how to
contact medical licensing authorities.
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
at the test center. If you bring an item, including an
appliance or device, to your test administration without
obtaining permission in advance, you may not be
permitted to test, you may be required to relinquish
the item, you may be investigated for irregular
behavior, and/or your score may be held until you
provide adequate documentation from your medical
professional.
EXAMINEES WITH DISABILITIES
REQUESTING TEST ACCOMMODATIONS
The USMLE program provides reasonable accommodations
for examinees with disabilities who are covered
under the Americans with Disabilities Act as
amended (ADA). If you are a disabled individual
covered under the ADA and require test accommodations,
the following guidelines apply to you:
q You must obtain information regarding
procedures and documentation requirements in
advance of applying for each Step or Step
Component. This information is available from
the USMLE website.
q Your application and your request for accommodations
and accompanying documentation must
be submitted at the same time to the appropriate
addresses. All documentation received with your
request will be audited, and you will be contacted
if additional information is needed. Processing
may take up to eight weeks from the date
sufficient documentation of the impact of your
reported impairment is received.
q When test accommodations are granted for
USMLE Steps and Step Components, score
reports and transcripts may include an annotation
that an accommodation was granted. Score
recipients who inquire about the annotation will
be provided with information about the nature of
the accommodation only.
OBTAINING AN ELIGIBILITY PERIOD FOR
STEP 1 AND STEP 2 CK
When applying for Step 1 or Step 2 CK, you must
select a three-month period, such as January-
February-March or February-March-April, during
which you prefer to take the examination. A
Scheduling Permit with instructions for making an
appointment at a Prometric Test Center will be issued
to you after your registration entity processes your
application and determines your eligibility. The
Scheduling Permit specifies the three-month eligibility
period during which you must complete the examination.
During peak periods, allow up to approximately
four weeks for processing of your application.
After obtaining your Scheduling Permit, you are able
to contact Prometric immediately to schedule a test
date.
Prometric schedules testing appointments for
Steps 1 and 2 CK up to six months in advance. If your
application is submitted more than six months in
advance of your requested eligibility period, it will be
processed, but your Scheduling Permit will be issued
no more than six months before your assigned eligibility
period begins.
If you are unable to take the test within your eligibility
period, contact your registration entity to inquire about a
one-time contiguous three-month eligibility period
extension. A fee is charged for this service. Visit your
registration entity’s website for more information. If you
do not take the test within your original or extended eligibility
period and wish to take it in the future, you must
reapply by submitting a new application and fee(s).
17
http://www.prometric.com
Use the Prometric website for
up-to-date information on the locations
of Prometric Test Centers and to schedule
an appointment.
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
OBTAINING AN ELIGIBILITY PERIOD FOR
STEP 2 CS
Step 2 CS is offered regularly throughout the year;
however, there may be occasional, brief periods when
all centers are closed. In planning the timing of your
application, see below for information on how Step 2
CS eligibility periods are assigned. You should be
aware that demand for test dates/centers at certain
times during the year may exceed the number of testing
spaces available.
When you apply for Step 2 CS you are assigned a 12-
month eligibility period that begins when processing
of your application is completed. A Scheduling
Permit with instructions for making a testing appointment
will be issued to you.
Your eligibility period will be listed on your
Scheduling Permit. You must take the exam during
your eligibility period. You can schedule a testing
appointment for any available date in your eligibility
period. Once your eligibility period is assigned, it
cannot be changed. If you do not take the exam within
your eligibility period, you must reapply to take
the exam, including payment of the examination fee.
Although you cannot change your assigned eligibility
period, you can reschedule a scheduled testing
appointment within your eligibility period (see
Rescheduling). A fee is charged if a change is made
during the 14 days before your scheduled appointment.
OBTAINING AN ELIGIBILITY PERIOD FOR
STEP 3
Step 3 eligibility periods are assigned immediately
once your application has been processed and
approved. Time for processing will vary depending
on the particular medical licensing authority and the
volume of applications. Check the FSMB website
for more detailed information on processing times.
Upon complete processing of your Step 3 application
and confirmation of eligibility, a Scheduling
Permit will be issued to you with instructions for
making an appointment at a Prometric Test Center.
On receipt of your Scheduling Permit, you should
contact Prometric immediately to schedule the test
dates. The Scheduling Permit specifies the eligibility
period (beginning immediately and extending for
approximately 90 calendar days) during which you
must complete the examination. If you are unable to
take the test within your eligibility period, contact
the FSMB to inquire about a one-time contiguous
three-month eligibility period extension. A fee is
charged for this service, and some restrictions may
apply. Visit the FSMB website (
http://www.fsmb.org)
for more detailed information. If you do not take the
test within your original or extended eligibility period
and wish to take it in the future, you must reapply by
submitting a new application and fee(s). The USMLE
Step 3 fee is non-refundable and non-transferable
from one eligibility period to another or from one
application to another.
SCHEDULING STEP 1, STEP 2 CK, AND STEP 3
Testing Regions
Step 1 and Step 2 CK are administered in the United
States and Canada and in more than 50 other countries.
International testing locations are distributed
among defined international testing regions. There is
an additional international test delivery surcharge.
Your Scheduling Permit
Your Scheduling Permit will be issued to you when
the processing of your application is complete. You
should verify the information on your Scheduling
Permit before scheduling your appointment. Your
Scheduling Permit includes the following:
q your name (see Important Note, page 25),
q the examination for which you registered,
q your eligibility period,
q your testing region,
q your Scheduling Number,
q your Candidate Identification Number (CIN).
18
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
Scheduling Test Dates
When applying for the USMLE Steps 1, 2 CK, and 3
or scheduling test dates, please keep the following in
mind:
q You must have your Scheduling Permit before you
contact Prometric to schedule a testing appointment.
Appointments are assigned on a "first-come,
first-served" basis; therefore, you should contact
Prometric to schedule as soon as possible after
you receive your Scheduling Permit.
q You may take the test on any day that it is
offered during your assigned eligibility period,
provided that there is space at the Prometric Test
Center you choose.
q Prometric Test Centers are closed on major
local holidays.
q USMLE Steps 1, 2 CK, and 3 are not available
during the first two weeks of January.
q The busiest testing times in the Prometric testing
network in the United States and Canada are May
through July and November through December.
q Some, but not all, Prometric Test Centers are
open on weekend days. When you schedule your
Step 3 test dates, the two days on which you take
the test must be consecutive, unless the center
is closed on the day that follows your first
day of testing. In that event, Prometric will
assign you to the next day the center is open for
your second day of testing. In all other cases, you
must take Step 3 on two consecutive days at the
same test center.
Your Scheduling Permit includes specific information
for contacting Prometric to schedule your test date(s)
at the test center of your choice.
You will be required to provide information found
only on your Scheduling Permit. When you schedule
your appointment, you will receive the following
specific information:
q the confirmed test day(s), date(s), and time;
q the address and telephone number of the
Prometric Test Center where you will test; and
q your Prometric Confirmation Number(s).
After you schedule your testing appointment, you can
print a confirmation of your appointment from the
Prometric website. Scheduling a testing appointment
for a specific date at a Prometric Test Center is not a
guarantee that the scheduled test time or location will
remain available. The Prometric Test Center at which
you are scheduled may become unavailable after you
have scheduled your appointment. In that event,
Prometric will attempt to notify you in advance of
your scheduled testing appointment and to schedule
you for a different time and/or center. However, on
rare occasions, rescheduling your appointment for a
different time or center may occur at the last minute.
To avoid losses you would incur as a result, you
should try to maintain flexibility in your travel
arrangements. You are encouraged to confirm your
testing appointment one week prior to your test date.
Rescheduling Test Dates
If you are unable to keep your testing appointment on
the scheduled date(s) or at the scheduled location, you
19
http://www.prometric.com
Use the Prometric website for up-to-date
information on the locations of Prometric Test
Centers and to schedule your test.
Note: You will not be able to take the test if
you do not bring your Scheduling Permit to
the test center.
Note: Your Scheduling Number is needed when
you contact Prometric to schedule test dates. It
differs from your Candidate Identification
Number (CIN), which is your private key, and is
needed to test. Prometric does not have access to
your CIN.
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
may change your date(s) or center by following the
instructions on your Scheduling Permit for contacting
Prometric. You will need to provide your Prometric
Confirmation Number when you reschedule.
To avoid a rescheduling fee, you must cancel or
reschedule your appointment at least five business
days before your appointment. If you are testing in
the United States or Canada, you must cancel or
reschedule by noon Eastern Time at least five business
days before your appointment. If you are testing
outside the United States or Canada, you must cancel
or reschedule by noon local time of the Regional
Registration Center for your testing region at least
five business days before your appointment. If you
provide less than five business days' notice,
Prometric will charge you a fee to reschedule your
test date(s). Your rescheduled test date(s) must fall
within your assigned eligibility period.
SCHEDULING STEP 2 CS
Step 2 CS is administered at five test centers: Atlanta,
Georgia; Chicago, Illinois; Houston, Texas; Los
Angeles, California; and Philadelphia, Pennsylvania.
Your Scheduling Permit
After your registration for Step 2 CS is complete, your
registration entity will issue you a Scheduling Permit.
The Scheduling Permit contains the following:
q your name (see Important Note, page 25),
q your USMLE identification number, and
q your eligibility period.
Scheduling Test Dates
Follow the instructions on your Scheduling Permit to
schedule your test date(s) at the test center of your
choice. To browse available test dates in your eligibility
period at each of the five test centers, you can
use on-line Step 2 CS Calendar and Scheduling.
Before accessing Step 2 CS Calendar and
Scheduling, you should review the important information
in How Test Dates Become Available.
A schedule for reporting Step 2 CS results is available
on the USMLE website. Please refer to this calendar
before scheduling a testing appointment if you
need your results by a specific deadline.
After you confirm your testing appointment, you will
be able to print a confirmation notice from the scheduling
system. The confirmation notice includes your
scheduled test date, arrival time, test center, and other
important information. If you lose the confirmation
notice, you can reprint it by accessing Step 2 CS
Calendar and Scheduling on the website of your registration
entity.
How Test Dates Become Available
q Testing appointments are available on a “firstcome,
first-served” basis (although some
scheduling restrictions may be imposed). It is
possible that you will not be able to obtain a
testing appointment for the first time period
and/or center you prefer.
q The availability of testing appointments will
change frequently as a result of examinee
scheduling and rescheduling.
q It is possible that testing appointments will
become available for a time period and/or center
that you prefer after you have scheduled an
appointment for a different time period and/or
center. In this event, you can change your
scheduled test date and/or center. See page 21
for rescheduling fees.
q Although you can monitor available test
dates for your preferred time period and test
center, availability is not guaranteed. You must
take the exam during your eligibility period;
if the exam is not taken during the eligibility
period, you must reapply and pay the full exam
fee in order to take the examination.
Rescheduling Test Dates
If you have a scheduled testing appointment and are
unable to take the exam on your scheduled test date
or at your scheduled test center, you can cancel your
scheduled testing appointment and reschedule for a
20
APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE
different date and/or center, subject to availability. A
fee may be charged for this service depending on
how much notice you provide when canceling your
appointment. To cancel or reschedule, follow the
instructions on your Scheduling Permit for accessing
Step 2 CS Calendar and Scheduling.
Before canceling and/or rescheduling a scheduled
testing appointment, you will hav
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