USMLE Exam Quick Summary
The USMLE is a three-step, computer-based licensing exam taken at Prometric test centers. Step 1 and Step 2 CK can be taken worldwide, while Step 3 is offered only in the US. Step 1 is pass/fail, Step 2 CK needs 218, and Step 3 needs 200. Since January 2026, IMGs register for Step 1 and Step 2 CK through the FSMB.
What is the USMLE exam?
The United States Medical Licensing Examination (USMLE) is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). It assesses a doctor's ability to understand and apply medical knowledge, clinical concepts, and fundamental patient-centered skills, and US state medical boards use the results to make licensing decisions. For international medical graduates (IMGs), passing Step 1 and Step 2 CK is also the first part of ECFMG Certification, which is required to start an accredited US residency program.
The three USMLE Steps
For a side-by-side look at each Step's content and timing, see our guide to what the three USMLE Steps are like.
USMLE test formats
All three Steps are closed-book, computer-based exams taken at Prometric test centers. Most questions are single best answer: a patient vignette followed by four or more options, sometimes with images or audio findings. Unanswered questions count as wrong. Step 3 also includes computer-based case simulations (CCS), in which you manage virtual patients in real time. Since May 2026, Step 1 and Step 2 CK are delivered in 30-minute blocks of up to 20 questions, so all three Steps now use 30-minute blocks.
Where can I take the USMLE?
USMLE passing scores
How IMGs register for the USMLE
- Confirm your medical school is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements.
- Apply for Step 1 or Step 2 CK through the FSMB via the USMLE website. Since January 12, 2026, the FSMB handles exam registration, scheduling permits, and score reports for IMGs.
- Choose your eligibility period and testing region, then book a date at a Prometric test center.
- Complete your ECFMG Certification requirements with ECFMG, which continues to handle certification and credential verification.
- Take Step 3 in the US once you have passed Step 1 and Step 2 CK and hold a valid ECFMG Certificate.
Doctors from Pakistan can check our USMLE eligibility requirements for Pakistani doctors.
Frequently asked questions
> What does USMLE stand for?
United States Medical Licensing Examination. It is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME).
> Can I take the USMLE outside the United States?
Yes for Step 1 and Step 2 CK, which are offered at Prometric test centers worldwide. Step 3 is offered only in the United States and its territories.
> What is the passing score for the USMLE?
It depends on the Step: Step 1 is pass/fail, Step 2 CK requires 218, and Step 3 requires 200.
> Do IMGs still register for the USMLE through ECFMG?
No. Since January 12, 2026, IMGs register for Step 1 and Step 2 CK through the FSMB via the USMLE website. ECFMG still handles ECFMG Certification and credential verification.
> What types of questions are on the USMLE?
Mostly single-best-answer multiple-choice questions built around patient vignettes. Step 3 also includes computer-based case simulations (CCS), in which you manage virtual patients.
Preparing for Step 1 or Step 2 CK?
Join our live online USMLE course, taught in small groups by experienced medical teachers.
Explore the USMLE Course