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.
The exam is a 9-hour single-day computer-based test composed of eight question sets with no more than 40 questions per set. Each section is one hour long. The test taker is permitted 45 minutes, in total for the whole day, for the purpose of breaks that can only be taken between sections. There is a 15-minute tutorial at the beginning of the exam, which the test-taker can choose to skip, and have the time added to the break time. If the taker finishes any section before the allotted 1 hour time limit, the remainder of the time is added to break time. The test is administered at the Prometric testing sites around the world.
Step 2 CK includes test items in the following content areas: internal medicine, obstetrics and gynecology, pediatrics, preventive medicine, psychiatry, surgery, 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: diagnosis, a prognosis, an indication of underlying mechanisms of disease, 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.
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
Scoring is reported in 3 digit scores. Scores fall between 1 and 300, with the mean score of 240 and the standard deviation of 18 for first-time takers from accredited medical schools in the United States and Canada for the 2013/14 and 2014/15 academic years. Every three to four years the Step Committees are asked to complete an in-depth review of standards, and they may schedule more frequent reviews. At its May 2014 meeting, the Step 2 Committee conducted a review for USMLE Step 2 Clinical Knowledge (CK). As a result of its review, the Step 2 Committee decided to raise the Step 2 recommended minimum passing score to 209 for students taking the test after July 1, 2014. A more recent review in May 2018 maintained the passing score of 209.
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
Abia State University Faculty of Medicine
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)