United States Medical Licensure Examination

The United States Medical Licensing Examination® (USMLE®) is a three-step examination for medical licensure in the United States and is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®). Physicians with an M.D. degree are required to pass this examination before being permitted to practice medicine in the United States; see below for requirements of physicians with a D.O. degree.

The USMLE assesses a physician's ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care. Examination committees composed of medical educators and clinicians from across the United States and its territories create the examination materials each year. At least two committees critically appraise each test item or case, revising or discarding any materials that are in doubt.

Students and graduates of U.S. or Canadian medical school programs accredited by either the Liaison Committee on Medical Education (LCME), leading to the Doctor of Medicine (M.D.) degree, or by the American Osteopathic Association (AOA), leading to the Doctor of Osteopathic Medicine (D.O.) degree, register for Step 1 and Step 2 of the USMLE with the NBME. Students and graduates of medical schools outside the United States or Canada listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements register for Step 1 and Step 2 with the Educational Commission for Foreign Medical Graduates (ECFMG). Graduates of medical schools in and outside the United States and Canada register for Step 3 with the FSMB or with a medical licensing authority in the United States. Each of the three steps of the USMLE examination complements the other; no step stands alone in the assessment of readiness for medical licensure.

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. U.S. osteopathic medical school graduates are permitted to take either the USMLE or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) exam for medical licensure. Students who have graduated from medical schools outside the US and Canada must pass all three steps of the USMLE to be licensed to practice in the US, regardless of the title of their degree.

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