United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. The exam is sponsored by the Federation of State Medical Boards and the National Board of Medical Examiners. USMLE is taken by persons who intend to practice medicine in the United States or might be taken to assess the possibility of practicing medicine in the Unites States. As common with United States exams, all steps of the USMLE require a lot of hard work and studies to be successful. All three steps of the USMLE exam must be passed before a physician with an M.D. degree is eligible to apply for an unrestricted license to practice medicine in the United States.
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 1 is constructed according to an integrated content outline that organizes basic science material along two dimensions: system and process.
Step 1 is a one-day examination. It is divided into seven 60-minute blocks and administered in one 8-hour testing session The number of questions per block on a given examination form will vary, but will not exceed 40. The total number of items on the overall examination form will not exceed 280.
The USMLE Content Outline provides a common organization of content across all USMLE examinations. In addition, the USMLE Physician Tasks/Competencies, outline lists tasks and competencies assessed throughout the sequence of USMLE.
The USMLE Content Outline organizes content according to general principles and individual organ systems. Test questions are classified in one of 18 major areas, depending on whether they focus on concepts and principles that are important across organ systems or within individual organ systems.
Sections focusing on individual organ systems are subdivided according to normal and abnormal processes, including principles of therapy. Each Step 1 examination covers content related to the following traditionally defined disciplines:
biostatistics and epidemiology
The Step 1 examination also covers content related to the following interdisciplinary areas:
molecular and cell biology
Currently, students receive a three-digit score following sitting for the Step 1 examination. In 1999, the USMLE phased out the use of a percentile-based system in favor of a three-digit and two-digit scaled scoring system. In October 2011, two-digit scaled scores were no longer reported to any parties besides the examinees. In April 2013, the two-digit score was eliminated completely from the score report.
While the USMLE program does not disclose how the three-digit score is calculated, Step 1 scores theoretically range from 1 to 300, most examinees score in the range of 140 to 260, the passing score is 194 and the national mean and standard deviation are approximately 229 and 20, respectively. Rise in the national mean Step 1 score has been observed with time, as shown in the table below. According to the National Resident Matching Program, the mean score for U.S. allopathic seniors who matched to residency programs in 2016 was 233.2
The USMLE score is one of many factors considered by residency programs in selecting applicants. However, at present, this test is the only standardized measure of all applicants. The median USMLE Step 1 scores for graduates of U.S. Medical Schools for various residencies are charted in Chart 6 on page 9 of “Charting Outcomes in the Match” available through NRMP Website
Many residency programs use a “cutoff” score for Step 1, below which applicants are unlikely to be considered, although in some cases individuals with significantly higher Step 2 CK scores may still receive further consideration. The NRMP Residency Program Director survey contains more information, both overall and by specialty, regarding “cutoff” scores (i.e., scores below which programs generally do not grant interviews).
The eligibility to write USMLE steps are different for Step 1& 2 and Step 3. (Click here to read our comprehensive summary sheet on USMLE steps and requirements)
Step One & Two: For Nigerians, any medical student officially enrolled in, or a graduate of a medical school that is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements, and that meets other eligibility criteria of the ECFMG.
To be eligible:
- You must be enrolled as a medical student in Nigeria.
- The medical school must be listed in the World Directory of Medical Schools (as a school which has met the ECFMG eligibility)
- The medical school must meet other eligibility criteria of ECFMG
The good news therefore is that most of the medical students in Nigeria can write Step One of the USMLE.
Currently (as at August 2018) on World Directory of Medical Schools, students of 37 Nigerian medical schools can write USMLE. The list is below:
Medical School Name City Name
Abia State University Faculty of Medicine Uturu
Afe Babalola University College of Medicine and Health Sciences Ado Ekiti
Ahmadu Bello University Faculty of Medicine Zaria
Ambrose Alli University College of Medicine Ekpoma
Bayero University Faculty of Medicine Kano
Benjamin S. Carson School of Medicine, Babcock University Ilishan Remo
Benue State University College of Health Sciences Makurdi
Bingham University College of Health Sciences Karu
Bowen University College of Health Sciences Iwo
Chukwuemeka Odumegwu Ojukwu University College of Medical Sciences Uli
Delta State University College of Health Sciences Abraka
Ebonyi State University College of Health Sciences Abakaliki
Ekiti State University College of Medicine Ado Ekiti
Enugu State University of Science and Technology College of Medicine Enugu
Gombe State University College of Medical Sciences Gombe
Imo State University College of Medicine Owerri
Kaduna State University Faculty of Medicine Kaduna
Ladoke Akintola University of Technology (LAUTECH) Osogbo
Lagos State University College of Medicine Ikeja
Madonna University College of Medicine Elele
Niger Delta University College of Medical Sciences Amassoma
Nnamdi Azikiwe University College of Health Sciences Nnewi
Oba Okunade Sijuade College of Health Sciences, Igbinedion University Benin
Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Ago Iwoye
Obafemi Awolowo University College of Health Sciences Ile-Ife
University of Abuja College of Health Sciences Abuja
University of Benin School of Medicine Benin
University of Calabar College of Medical Sciences Calabar
University of Ibadan College of Medicine Ibadan
University of Ilorin College of Health Sciences Ilorin
University of Jos Faculty of Medical Sciences Jos
University of Lagos College of Medicine Idi-Araba
University of Maiduguri College of Medical Sciences Maiduguri
University of Nigeria Faculty of Medicine Enugu
University of Port Harcourt College of Health Sciences Port Harcourt
University of Uyo College of Health Sciences Uyo
Usmanu Danfodiyo University College of Health Sciences Sokoto
The USMLE Step 1 and Step 2 CK exams are taken at Prometric test centers worldwide. Prometric is the testing agency for USMLE. In Africa, the Prometric test centers are in Ghana, Kenya, South Africa, and Uganda. A test center used to be available in Nigeria but was discontinued due to the high level of irregularities. The closest test center for Nigerian applicants is currently Ghana.
The Step 2 CS and the Step 3 can only be taken in the United States. There is no fee for taking the test in the United States and in Canada. (Click here to read our comprehensive summary sheet on USMLE guidelines and requirements)