In order to practice clinical medicine in an unsupervised setting (i.e. outside postgraduate training programs), all physicians (international graduates and domestic graduates in USA) must be licensed by the medical licensing board of the state where they plan to practice.
The United States Medical Licensing Examination (USMLE) consists of three steps designed to assess a physician’s ability to apply a broad spectrum of knowledge, concepts, and principles to evaluate the physician’s basic patient-centered skills.
This exam is designed to test how well the examinee applies basic, integral science concepts to clinical scenarios.
The Step 2 Clinical Knowledge (CK) is a multiple-choice exam designed to determine whether the examinee possesses the medical knowledge and understanding of clinical science considered essential for the provision of patient care under supervision. The Step 2 Clinical Skills (CS) is a separate “hands-on” exam that tests the examinee’s clinical and communication skills through his/her ability to gather information from standardized patients, perform a physical examination, communicate the findings to the patient, and write a patient note.
This exam assess the examinee’s ability to apply medical knowledge and the understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings.
International Medical Graduates (IMG) must be certified by the Educational Commission for Foreign Medical Graduates (ECFMG). To become certified by ECFMG, an IMG must pass USMLE Step 1, Step 2 CK and Step 2 CS. Doctors can take these exams in any order, but we strongly recommend the order listed. Once a doctor receives ECFMG certification, he/she may apply for a hospital residency.
Step 3 is always taken LAST in the series of medical licensing exams because International Medical Graduates must be ECFMG Certified to be eligible to take Step 3. Some states allow doctors to take Step 3 prior to obtaining a residency. Many doctors perceive that having passed Step 3 enhances their chance of obtaining a residency. This may be true in some cases, but high scores on the Steps 1 and 2 and a strong application are the most important factors in attaining residency. Step 3 must be passed if a student wishes to qualify for an “H” visa.
International Medical Graduates seeking licensure in the United States will have to go through the following sequence to obtain a Post Graduate Medical Residency Training position.
(Electronic Residency Application Service – ERAS / National Residency Matching Program – NRMP)
3-8 years depending on the speciality that the International Medical Graduate is seeking. This is paid post graduate training where all participating residents receive a salary for their training at the US hospital. Typical 1st year resident salaries are approximately $45,000 USD.