The United States Medical Licensing Examination (USMLE) is the entry point to begin practicing medicine in the U.S. With this guide, you will learn about everything you need to prepare for the USMLE following your MBBS degree completion abroad: eligibility criteria, study materials, preparation strategies, and available career options.
What is the USMLE?
The United States Medical Licensing Exam (USMLE) is a three-part exam that assesses our qualifications to safely and effectively care for patients. The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) evaluate whether someone has the knowledge and skills necessary to treat patients in a physician’s practice.
If you want to become a physician after completing your MBBS degree outside the U.S., then you must understand how the USMLE is structured and what you must do to pass it. Depending on when you take your exam, it can take several years to complete. As such, you will need to be dedicated to developing a solid plan for success and put forth the necessary time and effort during your medical education.
Eligibility Requirements for International Medical Graduates
Before starting your preparation for the USMLE, if you earned your MBBS abroad, you must check that you meet all of the eligibility requirements. Your medical school should be listed in the World Directory of Medical Schools and also meet the ECFMG certification requirements. This certificate is required if you are an international medical graduate and want to apply to residency programs.
Individuals can begin taking Step 1 or Step 2 Clinical Knowledge while in medical school or after they have graduated from medical school. However, to be able to take Step 3, you must have already received your MBBS degree and obtained your ECFMG certification.
The Three Steps of USMLE Explained
- USMLE Step 1: Basic Medical Sciences
Step 1 is designed to evaluate your understanding of the basic sciences of medicine, as well as the basic concepts of medicine. Recently, the USMLE has switched to a pass/fail scoring system for Step 1 so that candidates no longer have to be concerned with obtaining a specific score, which can sometimes be anxiety-inducing. Instead, this system allows candidates to focus on mastering the material instead of stressing over how well they will be able to “play the system” to obtain a specific score.
Step 1 tests multiple components within 18 core subjects. Anatomy, biochemistry, microbiology, pathology, pharmacology, physiology, and behavioral sciences are all core subjects included on Step 1. Questions are presented through the use of integrated clinical simulated cases, which require you to use your basic science background to answer the questions.
- USMLE Step 2 Clinical Knowledge (CK)
Step 2: CK assesses your capacity to use the knowledge and principles of clinical science in the provision of individual patient care. Step 2: CK places emphasis on how well you can diagnose, treat, and provide care for a patient in a supervised environment. Therefore, with Step 2: CK, you demonstrate your clinical abilities instead of your theoretical knowledge.
Typically, International Medical Graduates complete Step 2: CK during their internship year or shortly after completing MBBS. Step 2: CK is designed to assess the clinical reasoning capabilities of candidates through the use of patient scenarios covering areas such as Internal Medicine, Surgery, Pediatrics, OB/GYN, and Psychiatry.
- USMLE Step 3: Independent Practice Assessment
The third step of the licensing sequence is known as step three, which examines if you are prepared to independently practice medicine without supervision. During two days, you may take the test only after successfully passing both step one and step two of the CK and receiving ECFMG certification.
You can begin testing at step three once again at any time after you are finished with your residency. The assessment examines your clinical abilities to treat patients in non-urgent ambulatory settings and your knowledge of the biomedical and clinical sciences required to practice unsupervised in the field of medicine. To maximize their clinical experience and further enhance their readiness for Step Three, numerous international medical graduates take this step in their first year of residency training.
Creating a Study Schedule
Creating a study schedule is critical after MBBS training abroad as part of Step One preparation. The majority of successful candidates schedule a minimum of six to twelve months to prepare for the USMLE (step one) and four to seven months to prepare for CK (step two). Although these timeframes may seem like they are taking too long to prepare for, the difficulty of the examination continues to rise each year, as well as the level of performance requirements that residency programs are expecting from applicants.
Preparing well in advance allows you time for any unforeseen circumstances and gives you the opportunity for another study period in case you do not feel as comfortable with your knowledge yet. Many candidates will typically underestimate the length of time required for preparation compared to the timeframes of candidates who were previously registered for the same exam in the past ten years, when these tests were performed less rigorously. One very important thing to remember is that you cannot retake Step One or Step Two after you have passed the exam because the residency program can see how many times you took the examination; they often disregard candidates who have taken multiple attempts.
Essential Study Resources and Materials
The materials you choose to use while preparing for the USMLE after completing an MBBS overseas have a significant impact on how effectively you prepare for the exam and how well you perform on it.
The most widely accepted study aid for both Step 1 and all of the other steps of the USMLE is First Aid for the
USMLE Step 1.
Written by successful test-takers, continually updated, and reviewed by medical professionals, this comprehensive guide provides information on all topics studied in Step 1. Organizing the information by subject allows students to use memory aids, charts, and lists of high-yield items as they study.
The teaching techniques developed by Dr. Sattar allow medical students to digest difficult pathophysiological concepts so that they become easier to understand and remember.
The Kaplan USMLE Step 1 Lecture Notes are comprised of seven distinct volumes and supply the learner with a broad overview of anatomy, behavioral science, biochemistry, microbiology, pathology, pharmacology, and physiology, with well-illustrated sections containing color illustrations and clinically related information that integrates basic science with clinical practice.
Step 2 CK Resources
First Aid for the USMLE Step 2 CK has a good amount of information regarding clinical topics but does not have the same amount of thoroughness that First Aid for Step 1 has. The primary focus of the book will be to serve as a resource in addition to other forms of question banks and actual clinical rotations.
Step-Up to Medicine is an excellent resource to find clinical pearls and ways to approach the management of the most common clinical conditions. As such, this resource is presented in the manner of providing practical clinical knowledge for the management of patients.
The Master’s Guide to the Boards (Step 2 CK) uses algorithms, charts, and pathways for diagnostic approaches in the management of different patient scenarios. This resource is not comprehensive enough to be your sole source of study materials, but it provides a quick reference to the most common clinical presentations.
Developing an Effective Study Plan
A properly constructed study blueprint serves to guide you on your quest to achieve success in your examinations.
- Phase 1: Building a Strong Foundation
Your first step should consist of reviewing all of the subjects in a thorough manner, focusing on comprehending and mastering the basic concepts rather than memorizing definitions or other facts. A good way to accomplish this is by systematically reading all of the textbooks for each of your subjects in the order you have chosen and taking good notes, making flashcards, and studying the material that is of the highest yield. Spend more of your time working on the areas of difficulty or where you feel that your knowledge is weakest.
Most students spend approximately two to three months of time doing their foundational review, making sure they comprehend the foundational principles prior to practicing with the question banks of practice questions. In this stage, you will have established the basis for knowledge that you will use in the clinical vignettes and case scenario questions.
- Phase 2: Active Learning through Question Banks
After completing your fundamental review, focus on studying using a question-based learning approach. One of the best ways to study is to use question banks such as UWorld as your main form of study. When working with question banks, look at every question as an educational opportunity, spending the time necessary to fully understand each and every answer explanation, regardless of your accuracy in answering the question, since answers provided by question banks generally have a good deal of additional high-yield educational information that can be of value. As you study the question banks, identify the areas in which you need improvement that were identified in the incorrect answers. To improve these identified weak areas, return to your textbooks and/or video lectures to study and work on the identified weak areas. You should set up a systematic plan for regularly reviewing the questions that were missed, making sure you know and understand the reasons for your incorrect answers, and improving your future approach to responses to similar types of questions.
- Phase 3 - Integration and Evaluation
Once your exam is imminent, focus on combining concepts from different areas and taking full-length practice tests. These practice exams will help you increase your stamina for an 8-hour exam and provide you with the opportunity to identify your areas of weakness and develop strategies to improve those areas before your actual test.
Make sure to schedule your practice exams under actual testing conditions (e.g., in one sitting without taking long breaks). Once you take your exam, take a thorough review of your performance and determine why you missed specific questions. This will help you understand what patterns of thought exist that need to be revised.
- Phase 4 - Wrap-Up and Finalization
In the last few weeks leading up to your exam, focus on reviewing the highest-yield topics and going over questions that you previously struggled with. Many candidates create a sheet of key concepts that will help them quickly review the information in the days leading up to their exam. Try not to introduce any new materials during this time frame; rather, reinforce what you already know by repeatedly reviewing high-yield material. Have confidence in the preparation you have done in the past and continue to maintain mental clarity.
EOCL India
EOCL India Consultancy is considered one of the most trusted website resources for those medical students wanting to follow their dreams of taking the USMLE examinations and actually practicing medicine in America. They offer a personal approach with their counsel and are equipped with extensive knowledge regarding all aspects of the medical school experience. This knowledge allows EOCL India Consultancy’s counselors to create custom strategies that will increase the chances of success for each student from India and other international medical graduates throughout the entire world.
