United States Medical Licensing Examination
United States Medical Licensing Examination
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United States Medical Licensing Examination

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United States Medical Licensing Examination

The United States Medical Licensing Examination (USMLE) is a three-step examination program for medical licensure in the United States sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). Physicians with a Doctor of Medicine (MD) degree are required to pass the USMLE for medical licensure. However, those with a Doctor of Osteopathic Medicine degree (DO) are required to take the COMLEX-USA (COMLEX) exams but may also sit for the USMLE as well.

States may enact additional testing and/or licensing requirements.

The USMLE was created in the early 1990s. The program replaced the multiple examinations, including the NBME Part Examination program and the FSMB's Federation Licensing Examination (FLEX) program, that offered paths to medical licensing in the medical profession.

The examination was originally imparted using pencil and paper. In 1999, computerized examination delivery was included.

In 2004, an examination with standardized patients to assess clinical-skills was added to Step 2 of the USMLE (Step 2 Clinical Skills), and required for licensure beginning with the medical school graduating class of 2005. During the COVID-19 pandemic, USMLE Step 2CS was initially suspended and later discontinued.

A review of the program was enacted in 2009. USMLE claimed it was done with the intention of orienting the examination to support the licensing decisions made by medical boards, transitioning the exam to a competencies schema and emphasizing the importance of scientific foundations of medicine throughout the examination sequence. They also aimed to continue the assessment of clinical skill and interpretation of clinical information.

USMLE announced a move to a pass/fail model on February 12, 2020, along with other changes. They claimed this was done in an attempt by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) to balance focus between exams and actual coursework. The change became effective in 2022.

The United States Medical Licensing Examination (USMLE) is required for medical licensure in the United States by all graduates of M.D.-granting American medical schools as well as all graduates of international medical schools. It consists of three examinations:

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