USMLE – Frequently Asked Questions
Find important information about USMLE eligibility, Steps, application process, fees, exam centres in India and ECFMG Certification requirements.
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Who Takes USMLE?
The United States Medical Licensing Examination (USMLE) is a three-Step examination system used in the medical licensing pathway in the United States. International medical students and graduates may take the relevant USMLE Steps as part of the pathway toward ECFMG Certification and U.S. medical residency.
Who Is Eligible for USMLE?
International medical students and graduates must meet the applicable eligibility requirements. For ECFMG Certification, the medical school must meet the applicable requirements in the World Directory of Medical Schools, including an appropriate ECFMG Sponsor Note.
- Students must be officially enrolled in an eligible medical school when applying as a student.
- Graduates must have graduated from an eligible medical school.
- Applicants must meet the applicable ECFMG Certification requirements.
- Required medical education credentials are subject to verification.
Eligibility should always be checked against the current official requirements before applying.
What Are the USMLE Steps?
The USMLE consists of three Steps:
- Step 1 – Assesses understanding and application of important concepts of the basic sciences to medicine.
- Step 2 CK – Assesses the ability to apply medical knowledge and clinical science to patient care under supervision.
- Step 3 – Assesses the ability to apply medical knowledge and clinical science for unsupervised practice of medicine.
Important: Step 2 CS is no longer administered and is not part of the current USMLE examination system.
Where Can I Take USMLE in India?
USMLE Step 1 and Step 2 CK are administered through Prometric testing centres. Available centres and appointment dates can change, so candidates should check the official Prometric scheduling system when selecting a test centre.
What Is the Procedure to Apply for USMLE?
From January 12, 2026, USMLE Step examination services for students and graduates of international medical schools are managed through the Federation of State Medical Boards (FSMB). ECFMG continues to manage the ECFMG Certification process.
- Check whether your medical school meets the applicable eligibility requirements.
- Complete the applicable ECFMG Certification requirements.
- Apply for the relevant USMLE Step through the current FSMB process.
- Pay the applicable examination and testing-region fees.
- Receive the scheduling information and schedule your examination through Prometric.
What Is the Duration of USMLE Exams?
| Exam | Duration |
|---|---|
| Step 1 | Approximately 8 hours |
| Step 2 CK | Approximately 9 hours |
| Step 3 | Two-day examination |
What Is the USMLE Exam Format?
Step 1
Step 1 has approximately 280 multiple-choice questions. From May 14, 2026, the updated testing software uses 14 blocks of 30 minutes in an approximately 8-hour testing session.
Step 2 CK
Step 2 CK has approximately 318 multiple-choice questions. From May 7, 2026, the updated testing software uses 16 blocks of 30 minutes in an approximately 9-hour testing session.
Step 3
Step 3 is a two-day examination consisting of multiple-choice questions and computer-based case simulations.
What Are the USMLE Passing Scores?
Step 1 is reported as Pass/Fail only.
For Step 2 CK, the current passing standard is 218 for examinations taken on or after July 1, 2025.
Passing standards are determined by the USMLE program and may be reviewed or changed.
What Subjects Are Covered in USMLE Step 1?
Step 1 focuses on understanding and applying concepts of the basic sciences to medicine. The examination uses an integrated content outline covering scientific concepts across systems and processes.
Major areas include:
- Anatomy
- Physiology
- Biochemistry and Molecular Biology
- Microbiology
- Pathology
- Pharmacology
- Immunology
- Genetics
- Behavioral Sciences
- Biostatistics and Epidemiology
What Comes After Step 1 and Step 2 CK?
For international medical graduates, passing Step 1 and Step 2 CK is part of meeting the medical science examination requirement for ECFMG Certification. IMGs must also meet the applicable clinical and communication skills requirements for certification.
After meeting the relevant requirements, eligible candidates can pursue the U.S. graduate medical education and residency application process.
Are Letters of Recommendation Important for US Residency?
Yes. Letters of Recommendation can be an important part of a residency application. Their importance and requirements can vary by specialty and residency program.
Applicants should check the individual requirements of the residency programs they plan to apply to.
When Should Medical Students Do Clinical Electives?
Clinical electives and other U.S. clinical experiences may be useful for international medical students, depending on their eligibility and the requirements of the institution offering the rotation.
Students should check the individual requirements of each hospital or medical school before planning an elective.
Which Visa Is Used for U.S. Residency?
International physicians entering U.S. graduate medical education may use the visa category for which they qualify. The J-1 visa is commonly used for international physicians participating in U.S. graduate medical education through the applicable sponsorship process.
Visa eligibility and requirements are separate from USMLE examination eligibility and should be checked with the appropriate authorities and sponsoring organization.
More USMLE FAQs
Is Step 1 still scored numerically?
No. Step 1 is reported as Pass/Fail only.
Is USMLE Step 2 CS still conducted?
No. Step 2 CS is no longer administered.
Can Indian medical students take USMLE?
Yes. Eligible students and graduates of medical schools outside the United States can pursue the USMLE pathway subject to the applicable requirements.
Can USMLE Step 1 and Step 2 CK be taken in India?
Yes. Step 1 and Step 2 CK are administered through Prometric testing centres, including available centres in India.
Where do international medical graduates apply for USMLE in 2026?
From January 12, 2026, USMLE Step examination services for international medical students and graduates are managed through FSMB. ECFMG continues to manage ECFMG Certification.
What is the current Step 2 CK passing score?
The current Step 2 CK passing standard is 218.
What is the USMLE Step 1 exam duration?
Step 1 is an approximately 8-hour, one-day examination.
How many questions are in Step 1?
Step 1 has approximately 280 multiple-choice questions.
How many questions are in Step 2 CK?
Step 2 CK has approximately 318 multiple-choice questions.
Is Step 3 required for ECFMG Certification?
No. The medical science examination requirement for ECFMG Certification is met by passing Step 1 and Step 2 CK. Step 3 is a separate USMLE Step.
What is the ECFMG Certification application fee?
The current ECFMG Certification application fee is $580. Additional credential verification and other applicable fees may apply.
Does ECFMG verify medical credentials?
Yes. Verification of required medical education credentials is part of the ECFMG Certification process.
Official Sources for USMLE Information
USMLE:
Official USMLE Website
ECFMG:
Official ECFMG Website
Prometric:
USMLE Test Centre Information