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2002 USMLE Bulletin
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 following organizations:
Federation of State Medical Boards (FSMB)
National Board of Medical Examiners (NBME)
The Composite Committee, appointed by the FSMB and NBME, governs the USMLE. The
Composite Committee establishes rules for the USMLE program. Membership includes
representatives from the following:
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.
Purpose of the USMLE
In the United States and its territories, 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 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.
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 undergirding 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 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 that undergird 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 prominent 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 problem.
They revise or discard any materials that are in doubt.
The USMLE parent organizations, the FSMB and NBME, own the examination materials
used in the USMLE. The examinations are copyrighted. If you reproduce and/or
distribute any examination materials by any means, including memorizing and
reconstructing them, without explicit written permission from the parent
organizations, you violate the rights of the FSMB and NBME. In addition to
actions described under Irregular Behavior, the FSMB and NBME will use every
legal means available to protect USMLE copyrighted materials and impose
penalties on those who violate copyright law.
Computer-Based Testing (CBT)
The USMLE is administered by computer. Prometric, Inc.®, a subsidiary of
Thomson Learning™, provides scheduling and test centers for the USMLE. Step 1
and Step 2 are given around the world at Prometric Test Centers (PTCs). Step 3
is given at PTCs in the United States and its territories.
ELIGIBILITY
Step 1 and Step 2
To be eligible for Step 1 or Step 2, you must be in one of the following
categories at the time of application and on the test day:
* A medical student officially enrolled in, or a graduate of, a US, Puerto
Rican, or Canadian medical school program leading to the MD degree that is
accredited by the Liaison Committee on Medical Education (LCME)
a medical student officially enrolled in, or a graduate of, a US medical school
that is accredited by the American Osteopathic Association (AOA)
* A medical student officially enrolled in, or a graduate of, a medical school
outside the United States, Puerto Rico, and Canada and eligible for examination
by the ECFMG for its certificate
Step 3
To be eligible for Step 3, prior to submitting your application, you must meet
the Step 3 requirements set by the medical licensing authority to which you are
applying, obtain the MD degree (or its equivalent) or the DO degree, obtain
passing scores on Step 1 and Step 2, and obtain certification by the ECFMG or
successfully complete a "Fifth Pathway" program if you are a graduate
of a medical school outside the United States, Puerto Rico, and Canada.
Note: A physician whose basic medical degree or qualification
was conferred by a medical school outside the United States, Puerto Rico, and
Canada may be eligible for certification by the ECFMG if the medical school is
listed at the time of graduation in the World Directory of Medical Schools,
published by the World Health Organization. Citizens of the United States who
have completed their medical education in schools outside the United States,
Puerto Rico, and Canada are included in this category, while foreign nationals
who have graduated from medical schools in the United States, Puerto Rico, and
Canada are not. Specific eligibility criteria for students and graduates of
medical schools outside the United States, Puerto Rico, and Canada to take Step
1 and Step 2 are described in the Information Booklet provided by the ECFMG.
Note: A physician whose basic medical degree or qualification
was conferred by a medical school outside the United States, Puerto Rico, and
Canada may be eligible for certification by the ECFMG if the medical school is
listed at the time of graduation in the World Directory of Medical Schools,
published by the World Health Organization. Citizens of the United States who
have completed their medical education in schools outside the United States,
Puerto Rico, and Canada are included in this category, while foreign nationals
who have graduated from medical schools in the United States, Puerto Rico, and
Canada are not. Specific eligibility criteria for students and graduates of
medical schools outside the United States, Puerto Rico, and Canada to take Step
1 and Step 2 are described in the Information Booklet provided by the ECFMG.
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 or the individual licensing authority
for complete information on Step 3 eligibility requirements in the state where
you plan to be licensed.
A "Fifth Pathway" program* is an academic year of
supervised clinical education provided by an LCME-accredited medical school, and
is available to persons who meet all of the following conditions:
A. Have completed, in an accredited US college or university,
undergraduate premedical work of the quality acceptable for matriculation in an
LCME-accredited US medical school;
B. Have studied medicine in a medical school located outside the
United States, Puerto Rico, and Canada that is listed in the World Directory of
Medical Schools (published by the World Health Organization) and that requires
an internship and/or social service after completing the school's academic
requirements and before receiving the final medical credential;
C. Have completed all of the formal requirements of the non-US
medical school except internship and/or social service. (Those who have
completed all of these requirements for graduation are not eligible.)
Students who have completed the academic curriculum in residence at a non-US
medical school and who meet the above conditions may be offered the opportunity
to substitute, for an internship and/or social service required by a non-US
medical school, an academic year of supervised clinical training in a medical
school accredited by the LCME.
Any medical school accredited by the LCME can provide Fifth Pathway education.
As of the release of this bulletin, the only medical school known to provide
such education is New York Medical College in Valhalla, New York.
*Source: Graduate Medical Education Directory, 2001/2002, American
Medical Association.
Graduates of Unaccredited Medical Schools in the United States and Canada
If you are eligible for licensure by a medical licensing authority but are not
in one of the eligibility categories listed on page 3, you may take the USMLE
only upon specific request by that 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 of the following conditions apply to you:
You are a graduate of an unaccredited medical school in the United States,
Puerto Rico, or Canada.
You are an applicant for initial medical licensure in the jurisdiction of the
sponsoring licensing authority.
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 in advance of your
application for the Step.
Sequence of Steps
If you meet the eligibility requirements to take Step 1 and/or Step 2, you may
take either Step first. You may apply for Step 3 only after passing both Step 1
and Step 2.
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
you have not passed, the USMLE program recommends to medical licensing
authorities that they require successful completion of Steps 1, 2, and 3 within
a seven-year period, beginning when you first pass a Step; and allow no more
than six attempts to pass each Step without demonstration of additional
educational experience acceptable to the medical licensing authority.
If you pass a Step, 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. The
medical licensing or other authority must provide information indicating that
you are applying to retake the passed Step in order to comply with its
requirement. If you are repeating a Step because of a time limit, you may apply
to retake the Step only after the applicable time limit has expired.
The number of attempts allowed to pass each Step 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.
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, you may take the Step(s) corresponding
to the passed examination(s) only to comply with a time limit or other
requirement established by the USMLE program, a medical licensing authority, or
other authority recognized by the USMLE program.
Retakes
If you fail or do not complete a Step and want to retake it, you must reapply by
submitting a new application and fee. You may take the failed or incomplete Step
no more than three times within a 12-month period.
For Step 1 and Step 2, you may retake the Step no earlier than the first day of
the month 60 days after your previous test date. When you reapply to retake Step
3, the FSMB will assign an eligibility period to you that begins no earlier than
60 days after your previous test dates.
Change in Eligibility Status
If your eligibility for a Step 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 Step may result in a determination of irregular behavior.
If you take a Step for which you are not eligible, scores for that Step will not
be reported or, if previously reported, will be revoked.
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