International student’s cell INTERNATIONAL STUDENT CELL

Dr. Vithalrao Vikhe Patil Foundation’s Medical College & Hospital Opp. Govt. Milk Dairy, M.I.D.C., Vadgaon Gupta, Ahmednagar-414111 Ph. No.(0241) 2778041/ 2777059 Fax no. (0241) 2779782 [email protected] Website :www.vpfmch.org. Email- principal [email protected]

1/02/2018

International student’s cell

Committee members

Sr.no.

Name & designation Position Contact number

1. Dr. Sunil N. Mhaske, Dean Chairman 8554990221 2. Dr. Sandeep Kadu Member 8421388444 3 Dr. Sunita Nighute Member 7057022893 4 Dr. Sushil Kachewar Member 9921160357 5 Dr. Ninad Salastekar Member From

USA +1(404)988-4654

6 Dr. Boralkar Kalyani Member From USA

+1(6050)603-1949

7 Dr. Shreepad Joshi Member From Germany

+4515213694663

8 Dr. Nitin Bhalerao Secretary 9545738938

Dr.Sunil Natha Mhaske

Dean

INTERNATIONAL STUDENT CELL

Objectives :

To constitute the international student cell committee

International Student Cell Committee is constituted with a purpose to take utmost care of

International students during their stay, from the time of their admission to completion of

their study.

To promote cordial student-student and student-teacher relationship.

The committee would work to ensure support and integrate international students in

various events of the institution.

To guide students for preparation of different International examination for post-

graduation course.

Standard operating procedure

The international student’s cell will provide necessary guidance for admission to

students for international exams USMLE, PLAB etc.

All correspondence related to students admission should be addressed to the

office of international student’s cell of this institution.

Cell refers to the updated UGC guidelines for Admission of International Students

periodically.

Students holding passports issued by foreign countries including people of Indian

origin (PIO) who have acquired citizenship of foreign countries can apply for

admission.

Nonresident Indians students who have passed the qualifying examinations (12th

standard/ NEET) from schools or colleges situated in foreign countries and

Students of Indian citizens whose immediate family members like parents,

grandparents or siblings are an NRI also can apply for admission in this institute.

Student admitted under this category cannot be given change of status during the

study period if the status of the sponsor is changed.

Cell will conduct two/three meetings in a year in to cater to student’s grievances.

Integration of International students into the college premises and activities

without any obstacles.

To provide the Students with information about the local customs, language and

civic facilities.

Admission of all the international students will be done through the International

Student’s cell of VIMS University.

All international students wishing to undertake any research work or join a Ph.D.

programs will have to obtain prior security clearance from the Ministry of Home

Affairs and the approval of Department of Secondary &Higher Education,

Ministry of Human Resource Development, and Government of India.

Eligibility criteria:

1. A candidate should have completed 17 years of age on or before 31st

December.

2. Candidates seeking admissions to medical program must have studied the

subjects of Physics, Chemistry, Biology and English in Grades 11and 12.

3. Under this category only students who have studied and passed the

qualifying examination from a school located in a foreign country shall be

considered. This will be include the student studying in a school and/or

college situated in a foreign country, even if the concerned school /

college is affiliated to any board of secondary education or a University in

India.

4. In case of any school that follows the American system of education, the

candidate must have studied physics, Chemistry and biology at “Advanced

Placement” level and must have minimum C grade in these subjects.

5. The candidate should get equivalence certificate from the association of

Indian University (AIU), New Delhi.

Mode of Contact

Drop boxes have been installed at various places in the campus and hospital

to facilitate the students report complaints, grievances as well as their

suggestions.

International students are provided with contact numbers of the committee

members to facilitate 24/7 assistance in case of emergency and also

encouraged to directly contact the Member Secretary in case of grievance.

Once the grievance is received the issue will be resolved under the guidance

of Dean and if necessary, relevant committees would also be involved. On

redressal of the issue, the information will be communicated to the

concerned student and University

Opportunities for Doctors in the US

Ninad Salastekar, MBBS, MPH

Introduction

● Graduated in 2010

● Master of Public Health (MPH) 2012-2014

● Research Fellow - Harvard Medical School 2014-2016

● Internship - Metrowest Medical Center 2016-2017

● Residency in Diagnostic Radiology 2017- Present

Different Paths

● Clinical

○ Residency

○ Fellowship in the US after residency/PG in India

● Non-Clinical

○ Scientific roles/fields - MPH, MS, MSPH, PhD

○ Administrative/ Management/ Consulting

○ Something else

Clinical Path

● Residency in the US

● Fellowship in the US after residency/PG in India

Residency in the US

● Requirements:

○ United States Medical Licensing Examination

(USMLE) Step 1, 2CK, 2CS, 3

○ Educational Commission for Foreign Medical

Graduates (ECFMG) certification

○ Application and Interviewing

○ Residency Match

Residency in the US

Total cost:

Minimum: $9000/Rs 6,12,000

Realistic: $10,000 - $12,000= Rs. 6,80,000 - 8,16,000

Exchange Rate $1 = Rs 68

Residency in the US

● IMG Friendly Specialties:

○ Internal Medicine (MD Medicine)

○ Family Medicine

○ Pediatrics

○ Neurology

○ Psychiatry

○ Pathology

● More Competitive Specialties:

○ General Surgery

○ OBGYN

Residency in the US

● Most Competitive Specialties:

○ Dermatology

○ Orthopedics

○ Ophthalmology

○ Plastic Surgery

○ Neurosurgery

○ Radiology

○ Radiation Oncology

Residency in the US

● Why?

● How?

● What are my chances?

Residency in the US

Residency in the US

● ECFMG registration

● Step 1

● Step 2 CK

● Step 2 CS

● Step 3

Residency in the US

● Step 1

○ MCQ type questions, 9 Hours

○ India Prometric Centres

○ Anatomy, Physiology, Biochemistry, Pathology,

Genetics, Microbiology, Pharmacology, Behavioral

Sciences, Epidemiology and Statistics

○ Time to prepare: 12-18 months (typically)

Residency in the US

● Step 1 Resources

○ Kaplan Notes and Videos, First Aid, UWorld Qbank

○ Physiology: BRS

○ Biochemistry, Genetics, Immunology: Kaplan

○ Pathology: Pathoma, Goljan

○ Microbiology: First Aid

○ Pharmacology: First Aid, BRS

○ Behavioral Sciences, Epidemiology: Kaplan

Residency in the US

● Step 1 Preparation:

○ Read > Solve Qs > Take Notes in FA > Revise

Repeat! > Until you score >65 to 70% on Random, Timed

○ Take NBME test (Predictive of actual score)

○ If NBME score >230, take Step 1

UWorld: Start with tutor mode - Q followed by Ans.

Best resource for Step 1 > UWorld!

Residency in the US

● Step 2 CK:

○ MCQ type questions, 9 hours

○ India - Prometric Centres

○ Medicine, Surgery, OBGYN, Pediatrics, Epidemiology

○ Diagnosis and Work-Up

○ Time to prepare: 6-8 months

Residency in the US

● Step 2 CK Resources:

○ Kaplan Notes, Step Up CK/ Medicine, UWorld

○ Master the Boards (would not recommend)

○ First Aid for Step 2 CK (would not recommend)

Preparation Strategy:

Kaplan/ Step Up - use as supplemental material

UWorld - Primary resource. Same strategy as Step 1.

Residency in the US

● Step 2 CS:

○ Standardized Patient Encounters

○ Only in the US

○ Most IMGs fail this step: Language and cultural

barriers are the main culprits

○ Solution: Practice, practice and practice!

○ Resources: UWorld, CSV videos, First Aid for CS

○ Time for preparation: 1-6 months!

Residency in the US

● Step 3:

○ Not required to Apply

○ Required if applying for H1 Visa

○ MCQ and Case Simulations, 9 hours, 2 days

○ Only in the US

Resources: UWorld, Step Up Medicine

Score is much less important. Pass/ Fail.

Residency in the US

● Observerships/Clerkships:

○ Best done before graduation

○ Free ones > Paid University > Paid Private

○ Target institution

● Research:

○ Only accepted posters, published papers matter

○ Networking

Residency in the US

● Community Vs. University Hospitals:

○ Different places, different purposes

○ IMG friendly hospitals

○ Visa

○ Fellowships

○ Supply - Demand Rule

○ Realistic Expectations

Residency in the US

● Job prospects: Excellent for Primary Care physicians

● Visas complicate matters

○ J visa 2 year rule

○ J visa Waiver - Primary care Vs Specialists

○ H visa issues

○ Green Card - types, wait time

● Compensation data available online, caution advised

● Can practice in other countries after graduation

Different Paths

● Clinical

○ Residency


● Non-Clinical



○ Something else

Fellowships

● Clinical fellowships are an equivalent of DM/MCh

● Typical fellowships after IM/ MD Medicine:

○ Cardiology, GI, Hematology/Oncology, ID, etc.

○ Cards/GI/HO= 3 years

○ ID/Endocrine/Critical Care= 1 or 2 years

● Different sub-specializations

● Cardiology (3 years) -> Interventional Cardiology (1 or

2 years) OR Electrophysiology EP (1 or 2 years)

Fellowships

● Most competitive fellowships are IM:

○ GI

○ Cardiology

○ Hematology/ Oncology

○ Pulmonary/ Critical Care

● Less competitive:

○ Infectious Diseases, Endocrine, Rheumatology,

Nephrology, Palliative Care, Immunology

Fellowships

● MUST do residency in IM in the US in order to do a

fellowship

● Exceptions: Non-ACGME accredited fellowship

○ Rare

○ Probably sub-standard training

○ Cannot practice in the US after completion

● Alternative Pathway - Radiology

Jobs

● Primary Care Physician (PCP) - Outpatient

● Hospitalist - Inpatient

● Intensivist - ICU

● Consultant (Cards, GI, ID, etc.) - Outpatient/Inpatient

➢ Abundance of PCP and hospitalist jobs

➢ Harder to find Consultant jobs in desirable cities

Jobs / Salary

Consultant > Intensivist > Hospitalist > PCP

GI/Cards > Hem/Onc = Pul/CC > ID, Endocrine

Ranges of starting salaries:

PCP - $150,000 to $180,000

Hospitalist - $200,000 to 250,000

Consultants - $250,000 to $350,000

Jobs / Salary

● Factors affecting salary:

○ Specialization

○ Working hours (No. of hours, Day/Night, Call)

○ Location

■ Rural > Urban

■ Less desirable cities > popular cities

○ Visa

○ Employee vs. Partner

Jobs / Salary

Remember this slide?

Ranges of starting salaries:

PCP - $150,000 to $180,000 (Works 50 hours per week, no nights, most patients not seriously ill)

Hospitalist - $200,000 to 250,000 (Works 12 hour shifts, nights, patient are acutely ill)

Consultants - $250,000 to $350,000 (Works 70 hours or more per week, nights, high risk of lawsuits, most patients are very ill)

Jobs / Salary

● PCP in a rural area > Cardiologist in a big city

● Cost of living

● NEVER convert in Rupees

● NEVER pick a specialty based only on salary

● Don’t believe online salary data

Most important point of this lecture:

If only becoming rich is your goal for doing a US residency, then you will be most certainly disappointed!

Different Paths

● Clinical

○ Residency


● Non-Clinical



○ Something else

Non-Clinical Scientific Roles● MPH : Master of Public Health

○ Epidemiology, Biostatistics, Global Health, Health

Policy, Behavioral Health

○ 2 year programs (MSPH/MPH)

○ Cost varies from $30,000 to $75,000

○ Jobs - Epidemiologist, Analysts, Clinical Research,

Government, Non-Profits, Biostatistician, Health

Administration

Non-Clinical Scientific Roles● PhD

○ Clinical Research, Epidemiology, Biostatistics, Global

Health, Health Policy, Behavioral Health,

○ Molecular Biology, Genetics, Pharmacology, etc.

○ 5-7 years


○ 2 years of Masters will count towards PhD

○ Funding dependent

Non-Clinical Scientific Roles● PhD

○ Academic Jobs:

■ Post Doctorate (2 years +) > Faculty

■ Grants/ Funding/ Publications

○ Industry Jobs:

■ Pharma, Health Foundations, Consulting

■ Twice as much pay as Academic jobs

■ Not necessarily as prestigious/impactful

Non-Clinical Scientific Roles● MS : Master of Science

○ Clinical Research, Biostatistics, non-biology related

○ 2 year programs


○ Jobs - Analysts, Clinical Research, Government,

Non-Profits, Biostatistician, Consulting

○ Similar to MPH, but more technical

Non-Scientific Roles● MHA : Master of Health Administration

○ Like an MBA in healthcare administration, but less

competitive

○ 2 year programs


○ Jobs - Hospital administration (non-executive)

○ Similar to MPH, but more specific to administration/

management

Non-Scientific Roles● MBA : Master of Business Administration

○ Healthcare Administration, Finance, Strategy, etc.

○ 2 year programs


○ Jobs - Hospital administration (non-executive or

executive), Consulting, Investment Banking

○ Health Admin: MBA>MHA/MPH

Which one to Choose?● MS/MPH - If residency is your main goal

● MS>MPH - If you don’t feel too sure about residency

● MBA>MS/MPH - If you’re sure you don’t want to do

residency OR you want to do something other than

Medicine/ Science / Biology

● MBA> MHA/MPH - Hospital Administration

● Most value* for money - MBA

● Best job prospects (non-clinical) - MBA

Should you do an MS/MPH?● NOT necessary to get into a residency program

● Not of much intrinsic value in a residency application

● Then why do it?

○ Networking

○ Acclimatization

○ Future value

● Alternatives - Apply for research assistantships

Research● If you don’t publish in an indexed journal, then any

research is useless

● Original Research > Abstract/Poster/Case Report

● US Journals > International Journals > Indian Journals

● If Step 1 score >240, nominal research or no research

for internal medicine

● If you don’t have good scores, no amount of research

will help you

VISA● Most residency and fellowship programs - J1 visa

● Few programs sponsor H1B visa

● J visa○ 7 years, renewed each year○ 2 year home residency* requirement○ J waiver

● H1B ○ 6 years○ More expensive for both resident and hospital○ Cap vs. Non-capped

VISA

● Green Card types: EB1, EB2, EB3

● Wait times for EB2 NIW - 8 to 10 years and increasing

● Changes with US politics

● Costs upto $10,000

● Travel restrictions

Summary● Clinical and Non-Clinical opportunities for in the US

● Residency programs in IM, Pediatrics, Neurology,

Psychiatry, Pathology are IMG friendly

● Visa will dictate your early career

● Money should not be a big motivator

● Step 1 score>>Step 2 score>>Observerships/Research

● Do not pick a specialty based on compensation/salary

Summary● MS, MPH, PhD, MBA are alternative degrees that will

allow you to live and work in the US

● Can be healthcare related or completely different

● MS Clinical Research/ MPH best ->residency

● MBA best value for money, best job prospects

● GRE for MS/MPH/MHA, GMAT for MBA

● Visa is again the main obstacle

Thank you

Questions?

E-Book available on Amazon

A Joint Program of the FEDERATION OF STATE MEDICAL BOARDS OF THE

UNITED STATES, INC., and the NATIONAL BOARD OF MEDICAL EXAMINERS®

2019 Bulletin of Information

www.usmle.org 2019 Bulletin of Information

OVERVIEW 10

ELIGIBILITY FOR THE USMLE 13

APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE 16

EXAMINATION DAY AND TESTING 18

SCORING AND SCORE REPORTING 23

IRREGULAR BEHAVIOR 26

CONTACT US 28

▫ Eligibility for the USMLE Steps 5 ▫ Applying and Scheduling 6 ▫ Examination Day and Testing 7 ▫ Scoring and Score Reporting 8 ▫ Irregular Behavior 9

▫ Purpose and Mission of the USMLE 10 ▫ Why is the USMLE Important? 10 ▫ Examination Committees 10 ▫ How to Prepare 10 ▫ How to Register 10 ▫ Where is the USMLE Administered? 11 ▫ The USMLE: Purpose, Test Format, and Test Lengths 11 ▫ Ownership and Copyright of Examination Materials 12

▫ Who is Eligible to Take the USMLE? 13 ▫ Change in Eligibility Status 14 ▫ Graduates From Unaccredited Medical Schools in the US or Canada 14 ▫ Sequence of Steps 14 ▫ Number of Attempts and Time Limits 14 ▫ Retaking Failed Examinations 14 ▫ Retaking Previously Passed Steps 15 ▫ Previously Licensed Physicians 15

▫ Application Materials 16 ▫ Examinees With Disabilities Requesting Test Accommodations 16 ▫ Examinees Who Require Additional Break Time 16 ▫ Personal Item Exceptions (PIE) 16 ▫ Applying for and Scheduling Your Test 17

▫ Testing Regulations and Rules of Conduct 18 ▫ Personal Belongings – What You Can Bring Into the Testing Room 19 ▫ Admission to the Test 19 ▫ Break Time 21 ▫ Starting and Completing the Test 21

▫ Examination Results and Scoring 23 ▫ Score Reporting 23 ▫ Score Rechecks 24 ▫ Score Validity 25 ▫ Anomalous Performance 25

▫ Irregular Behavior Defined 26 ▫ Examples of Irregular Behavior 26 ▫ Irregular Behavior – Investigation Process 27

LIST OF ABBREVIATIONS 30

TABLE OF CONTENTSQUICK FACTS

Page #5

2

WELCOME


Reading this Bulletin of Information (BOI) is your first step in preparing to take the United States Medical Licensing Examination® (USMLE®) series. We are confident that this guide will help you succeed with this important examination sequence.

At the time you apply for the USMLE, you will be asked to certify that you agree to comply with the policies and procedures within this USMLE BOI. If you are a returning examinee, you must read the USMLE BOI each time you register. It is subject to change, and the version applicable to you is the version in effect at the time of your examination.

As you may already know, the USMLE is composed of Step 1, Step 2 Clinical Skills (CS), Step 2 Clinical Knowledge (CK), and Step 3. Each Step gets you closer to achieving your goal of obtaining a license to practice medicine in the US.

The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®) work together to co-sponsor the USMLE. We know that taking the USMLE Step exams is an important part of medical training. Passing each Step marks a milestone as you begin the next phase in your education.

As leaders of the USMLE program we are committed to helping you achieve your goals. Our teams are here as resources for you. This guide is updated each year to answer your questions and serve as a reference as you begin your journey to licensure.

Please visit the USMLE website or the NBME or FSMB websites to see everything we have to share. And don’t forget to follow us on Facebook, Twitter, and LinkedIn for the most up-to-date news and information. We are always interested in improving your experience, and supporting you on your journey. Feel free to touch base with us at any time.

Congratulations on all of your achievements to date. We wish you the very best as you embark on your medical career!

Sincerely,

3

David Johnson, M.A. Senior Vice President, Assessment Services Federation of State Medical Boards

Lisa Rawding, MBASenior Vice President, Assessment ProgramsNational Board of Medical Examiners


Copyright © 2018 by the Federation of State Medical Boards of the United States, Inc. (FSMB), and the National Board of Medical Examiners® (NBME®). All rights reserved.

The United States Medical Licensing Examination® (USMLE®) is a joint program of the FSMB and the NBME.

CAUTIONS You must become familiar with the information referenced in this Bulletin if you are an applicant with

an eligibility period in 2019. If your eligibility period crosses into the next calendar year (ie, 2020), please note that you are responsible for reading and abiding by the policies and procedures described in both years’ editions of the USMLE BOI.

If your eligibility period extends into 2020 and you test in 2020, you must become familiar with and will be subject to the policies and procedures in the 2020 BOI.

If changes in the USMLE program occur after the release of this BOI, they will be effective when posted on the USMLE website. You are responsible for checking the USMLE website for updates and changes to the USMLE policies and procedures.

If you are a student or graduate of a medical school outside the United States or Canada with an eligibility period in 2019, in addition to becoming familiar with this BOI, you must also be familiar with the contents of the 2019 Information Booklet published by the Educational Commission for Foreign Medical Graduates® (ECFMG®).

If you are a student or graduate of a medical school outside the United States or Canada and your eligibility period extends into 2020 and you test in 2020, you must become familiar with and will be subject to the policies and procedures in the ECFMG 2020 Information Booklet.

The ECFMG Information Booklet is available on the ECFMG website. Students and graduates of medical schools outside the United States and Canada are responsible for monitoring the ECFMG website to ensure they understand current ECFMG policies and procedures.

4


STEP COMPONENT REQUIREMENTS ADDITIONAL INFORMATION

STEPS 1, 2 CK, AND 2 CS • Officially enrolled in, or a graduate of, a US orCanadian medical school leading to the MD degree(LCME accredited), OR

• Officially enrolled in, or a graduate of, a USmedical school leading to the DO degree (AOAaccredited), OR

• Officially enrolled in, or a graduate of, a medicalschool outside the US and Canada listed in theWorld Directory of Medical Schools as meetingECFMG eligibility requirements; and meet otherECFMG criteria

• Must meet eligibility requirementsat time of application AND on testday

• If you are dismissed or withdraw(n)from medical school, you are noteligible for the USMLE, even if youare appealing the school’s decisionor are otherwise contesting yourstatus

STEP 3 • Possess the MD degree (or its equivalent) or theDO degree from an LCME- or AOA-accredited USor Canadian medical school or from a medicalschool outside the US and Canada listed in theWorld Directory of Medical Schools as meetingECFMG eligibility requirements, AND

• Pass Step 1, Step 2 CK, and Step 2 CS, AND• If you are a graduate of a medical school

outside the US and Canada possess theECFMG certification

• Must meet eligibilityrequirements prior to submittingyour application AND on the dayof testing

If you meet the eligibility requirements, you may take Step 1, Step 2 CK, and Step 2 CS in any sequence.

Please see pages 13-15 for more information regarding eligibility requirements.

RETAKES

You may take the same examination no more than three times within a 12-month period. Your fourth and subsequent attempts must be at least 12 months after your first attempt at that examination and at least six months after your most recent attempt at that examination.

If you have passed an examination, you are not permitted to retake a Step or Step Component, except to comply with certain requirements as approved by the USMLE governance committee (see page 15).

ATTEMPT AND TIME LIMITS

You are ineligible to retake a Step or Step Component if you have made six or more prior attempts to pass that Step or Step Component, including incomplete attempts, regardless of when the examinations were taken.

Many state medical boards require that all Steps of the USMLE be successfully completed within a certain time frame, usually seven years.

Information regarding specific state requirements can be obtained on the FSMB website.

QUICK FACTS: Eligibility for the USMLE Steps

If you are dismissed or withdraw(n) from medical school, you are not eligible for the USMLE, even if you are appealing the school’s decision to dismiss you or are otherwise contesting your status. If you are on a leave of absence, please check with the organization that would register you for your examination before submitting your application; or if you have already registered, check before testing. Failure to notify the organization that registered you for your examination of your changed status may result in a determination of irregular behavior and a permanent annotation on your score reports and transcripts.

5


STEP COMPONENT APPLICATION AND SCHEDULING PROCESS ADDITIONAL INFORMATION

STEPS 1 AND 2 CK • Students/graduates of LCME- or AOA-accredited programs should apply via theNBME Application website

• Students/graduates of medical schoolsoutside the US/Canada should apply viathe ECFMG Application website

• During the application process, select athree-month eligibility period duringwhich you prefer to test

• You will receive an e-mail notifying youthat your scheduling permit is available

• Visit the Prometric website toschedule your test date

• You may be able to schedule your test dateup to six months in advance

• If you are unable to test within your eligibilityperiod, contact the organization thatregistered you for your examination (NBMEor ECFMG) to inquire about a one-timeeligibility period extension; a fee is chargedfor this service

• If you do not take the examination withinyour eligibility period, you must reapply witha new application and fee

• Your application fee is nonrefundable

STEP 2 CS • Students/graduates of LCME- or AOA-accredited programs should apply viathe NBME Application website

• Students/graduates of medical schoolsoutside the US/Canada should apply viathe ECFMG Application website

• You will be assigned a 12-montheligibility period, which begins uponacceptance and verification of yourapplication

• You will receive an e-mail notifying youthat your scheduling permit is available

• Visit the USMLE website to schedule yourtest date

• Once assigned, your eligibility periodcannot be changed

• If you do not take the examination withinyour assigned eligibility period, you mustsubmit a new application and fee


STEP 3 • All graduates should apply for Step 3 viathe FSMB website

• During the application process, selecta three-month eligibility period duringwhich you prefer to test

• You will receive an e-mail notifying youthat your scheduling permit isavailable

• Visit the Prometric website toschedule your test dates

• You may be able to schedule your testdates up to six months in advance

• If you are unable to test within your eligibilityperiod, contact the FSMB to inquire about aone-time eligibility period extension; a fee ischarged and restrictions may apply. Visit theFSMB website for more information

• If you do not take the examination withinyour eligibility period, you must reapply witha new application and fee


QUICK FACTS: Applying and Scheduling

For information about how to request test accommodations for documented disabilities or for permission to bring medically necessary items with you on exam day, see page 16 of the Applying for the Test and Scheduling Your Test Date section of this BOI.

6


Review the USMLE Rules of Conduct prior to takingyour examination

Follow all test center staff instructions onthe day of your examination

Remember to bring a copy of your schedulingpermit (electronic or paper) and requiredidentification (see below); you will not bepermitted to test without them

Arrive 30 minutes prior to your testingappointment (computer-based examinations); forStep 2 CS, arrive at the time listed on yourconfirmation notice

Confirm that your headphones are working, eitherbefore the examination begins or during thetutorial (computer-based examinations)

Use personal items only when on an authorizedbreak; you are not permitted to access yourlocker during unauthorized breaks (computer-based examinations)

Ensure you’ve completed all sectionsof the examination

Feel compelled to test if you are ill, under unusual stress, or unprepared for the examination; to reschedule, contact the organization that registered you for your examination

Bring family and friends to the testcenter; instead, arrange to meet themafter the examination ends

Bring unauthorized items to the testing room: forcomputer-based examinations, only soft-foamearplugs are allowed; for Step 2 CS, only yourwhite lab coat and stethoscope are allowed

Write on laminated note boards prior to enteringyour Candidate Identification Number (CIN) andstarting your test session (computer-basedexaminations) or write on anything other thanthe laminated note boards

Work past the announcements instructing you tostop

Access your locker or use your cell phone onan unauthorized break

Please see pages 18-22 for more information regarding examination day rules and regulations.

Identification Required on Exam Day

You must present valid (unexpired) identification with: Your photo Your name as it appears on your permit Your signature

Your name, as it appears on your scheduling permit, must match the name on your identification exactly. If the name listed is not correct, contact the organization that registered you for your examination immediately.

Acceptable forms of unexpired identification include: Passport Driver’s license with photograph National Identity Card Other form of government-issued identification*

Security Procedures on Exam Day

During check-in, you will: be scanned with a handheld or walk-through metal

detector (computer-based examinations) be asked to empty your pockets and turn them inside

out place your personal belongings in bins that are

inaccessible for the duration of the examination(Step 2 CS)

have your photo identification checked* have your fingerprint captured using biometric

technology (computer-based examinations; not available at all locations)

write your unique CIN as shown on your scheduling permit on one of the laminated note boards provided (computer-based examinations)

be asked to repeat much of this process each time you return to the testing room after a break.

*See pages 19–20 for detailed identification requirements.

QUICK FACTS: Examination Day and Testing

DO DON’T

7


WHAT HAPPENS WHILE YOU WAIT FOR YOUR SCORES? STEPS 1, 2 CK, AND 3 STEP 2 CS

After testing, the examination data are deliveredelectronically to the NBME

Examinee responses are converted into a rawscore (the sum of the points earned fromcorrect responses)

The raw score is converted into a three-digit score Analyses are performed to detect aberrant

examinee response behavior. Candidates who areidentified by these analyses as having an aberrantscore pattern may be asked to provide anexplanation for their testing behaviors

Final quality assurance procedures are performedto verify the accuracy of the scores

Score reports are then posted to the securewebsite of the organization that registered youfor your examination (NBME, ECFMG, or FSMB)and made available to examinees

Examinee test dates are batched into scoringcohorts that are usually eight weeks long

Each day, after testing ends, the testing centerperforms quality control measures on theexamination data before the information isdelivered to the NBME

Standardized patient rating scales are converted toscores and patient notes are assigned to speciallytrained patient note raters

When the test administration period for the cohortends, the performance from the entire cohort isused to generate the data needed to ensure scorecomparability (across sites and administrations)and to report outcomes

The results go through a final quality controlprocess involving computation of statistical qualitycontrol measures

Once results are verified and approved for release,the scores are made available as shown inthe Step 2 CS Score Reporting Schedule

How Long Does it Take to Get Results?

Results for computer-based examinations (Steps 1, 2 CK, and 3) are typically available within three to four weeks after your test date. However, delays are possible for various reasons. In selecting your test date and inquiring about results, you should allow at least eight weeks to receive notification that your score report is available. For more specific information about potential scoring delays, please visit the Announcements section of the USMLE website.

For Step 2 CS, refer to the Step 2 CS Score Reporting Schedule.

When you are notified that your score is available, follow the instructions in the e-mail to access your USMLE score report. The report will remain available for approximately 120 days from the date of the e-mail notification. After 120 days, your scores will be provided to you only in the form of an official USMLE transcript, which is available for a fee.

How Do I Receive/Send Transcripts?

To obtain your USMLE transcript or have it sent to a third party, you must contact the organization that registered you for your examination; there is a fee for this service.

Please visit the USMLE website to determine which organization to contact to request your transcript and the fees associated with the service.

Your USMLE transcript includes: biographical information, complete examination history, and, if applicable, information regarding findings of irregular behavior and actions reported to the FSMB Physician Data Center.

QUICK FACTS: Scoring and Score Reporting

The USMLE does not provide scores or outcomes by telephone, e-mail, or fax to anyone. The scoring process is not expedited or accelerated for any individual or group.

8

www.usmle.org 9 2019 Bulletin of Information

DO DON’T Put all personal belongings, including your cell

phone and study materials, in the locker provided Access your personal belongings only when

on an authorized break Verify that your computer displays an authorized

break screen before leaving the examinationroom for a break

Contact the USMLE program via theUSMLE website if you have evidence thatsomeone may have violated a USMLE rule

Ask for or share content (items, cases) from anyof the examinations, by any means, including butnot limited to face-to-face conversation, webforums, or social media

Provide examination content to others, includingtest preparation companies or other entities

Change any information on score reports,transcripts, or any other USMLE-relateddocuments

Write on your skin, tissue, or any surface otherthan the laminated note board provided to you bytest center staff on your examination day

Apply and/or sit for an examination if you are nota current student or a graduate of a medicalschool program, even if you are appealing yourschool’s decision to withdraw or dismiss you

You are responsible for reading the USMLE Bulletin of Information in its entirety; contact the USMLE Secretariat's office with questions or concerns.

Please see pages 26-27 for more information regarding irregular behavior.

STOP! THINK BEFORE YOU ACT! The USMLE program takes examination security seriously. Irregular behavior includes, but is not limited to: • Registering for or taking an exam when ineligible• Seeking, providing, or obtaining unauthorized access

to exam content, including solicitation via socialmedia or web forums

• Altering exam scores or other official USMLEinformation

• Having unauthorized items in the testing area• Having or attempting to have someone else take your

exam• Writing on anything other than the laminated note

boards provided

The penalties for irregular behavior may include: • Cancelation of your exam scores• Ban on future testing• Permanent annotation of your USMLE transcript• Report to the FSMB’s Physician Data Center and

legitimately interested entities• Possible legal action

If you have information concerning activities or behavior that may threaten the security or integrity of the USMLE, please contact us via the USMLE website.

QUICK FACTS: Irregular Behavior


OVERVIEW This BOI provides you with the information needed to complete each of the Steps of the USMLE. Please read it carefully and regularly check the USMLE website for announcements. By using this guide and our website, you will learn what to expect from each USMLE Step.

PURPOSE AND MISSION OF THE USMLE

The USMLE is a three-Step examination for medical licensure in the United States. It is sponsored by the FSMB and the NBME. The USMLE program supports medical licensing authorities and physicians in the United States through development, delivery, and continual improvement of high-quality assessments across the continuum of physicians’ preparation for practice.

WHY IS THE USMLE IMPORTANT?

The USMLE assesses an examinee's ability to apply knowledge, concepts, and principles and to demonstrate fundamental patient-centered skills. These skills constitute the basis of safe and effective patient care. Health care consumers throughout the nation enjoy a high degree of confidence that doctors who have passed all three Steps of the USMLE have met a common standard.

EXAMINATION COMMITTEES

Examination committees, composed of medical educators and clinicians, create the examination materials. Committee members broadly represent the teaching, practice, and licensing communities across the United States. At least two committees of experts critically appraise each test question or case and revise or discard any materials that are outdated or inconsistent with current medical practice.

HOW TO PREPARE

Sample items are available free of charge on the USMLE website under the section titled Practice Materials. You may also purchase an at-home online self-assessment by visiting the Students & Residents section of the NBME website. Practice materials and self-assessments are available to all USMLE examinees.

HOW TO REGISTER

To apply for USMLE examinations, you must submit an application through the appropriate organization. Appointments at some test centers fill up quickly. Examinees are encouraged to schedule at their preferred test center as soon as they have received their scheduling permit. More information about scheduling is on pages 16 and 17 of this guide.


WHERE IS THE USMLE ADMINISTERED?

The Step 1, Step 2 Clinical Knowledge (CK), and Step 3 examinations are computer-based tests that are administered at Prometric Centers, which are located around the world. Visit the Prometric website to find the test center closest to you. The Step 2 Clinical Skills (CS) examination is administered at six testing centers across the US. More information about CS centers can be found on the Clinical Skills Evaluation Collaboration (CSEC) website.

THE USMLE: PURPOSE, TEST FORMAT, AND TEST LENGTHS

STEP & PURPOSE FORMAT LENGTH (including breaks)

ADDITIONAL INFORMATION

STEP 1 assesses the examinee’s understanding of and ability to apply important concepts of the basic sciences to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy

Approximately 280 multiple- choice questions, divided intoseven 60-minute blocks Computer-based

examinations areadministered at Prometrictest centers around the world

One-day testsession

-Approximatelyeight hours

For more information on Step 1, including applications, practice materials, and updates, visit the USMLE website

STEP 2 assesses the examinee’s ability to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision, with an emphasis on health promotion and disease prevention

Clinical Knowledge (CK) Approximately 316 multiple-

choice questions, divided intoeight 60-minute blocks Computer-based

examinations areadministered at Prometrictest centers around the world

One-day testsession-Approximatelynine hours

For more information on Step 2 CK, including applications, practice materials, and updates, visit the USMLE website

The Clinical Skills examination is a separate component of STEP 2 that uses standardized patients to test the examinee’s ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues

Clinical Skills (CS) 12 patient cases: 15 minutes for

each patient encounter plus 10minutes to record each patientnote Administered at six test centers

in the US – Atlanta, Chicago,Houston, Los Angeles, andPhiladelphia (2) Composed of three

subcomponents:Communication andInterpersonal Skills (CIS),Integrated Clinical Encounter(ICE), and Spoken EnglishProficiency (SEP). For moreinformation, see pages 10and 11 of the Step 2 CS ContentDescription and General

One-day testsession

-Approximatelyeight hours

For more information on Step 2 CS, including applications, practice materials, and updates, visit the USMLE website

OVERVIEW


STEP & PURPOSE FORMAT LENGTH (including breaks)

ADDITIONAL INFORMATION

STEP 3 assesses the examinee’s ability to apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings

Day 1: FOUNDATIONS OF INDEPENDENT PRACTICE (FIP) assesses the examinee’s knowledge of basic medical and scientific principles essential for effective health care

Day 2: ADVANCED CLINICAL MEDICINE (ACM) assesses the examinee’s ability to apply comprehensive knowledge of health and disease in the context of patient management and the evolving manifestation of disease over time

Day 1 FIP: Approximately 233 multiple-

choice test questions, divided into six 60-minute blocks, each containing approximately 40 questions

Computer based, administered at Prometric test centers in the US

Day 2 ACM: Approximately 180 multiple-

choice test questions, dividedinto six 45-minute blocks, eachcontaining approximately 30questions

Thirteen computer-based casesimulations (CCS). Eachsimulation is allotted amaximum of 10 or 20 minutes ofreal time

Computer based,administered at Prometrictest centers in the US

One-day testsession-Approximatelyseven hours

One-day testsession-Approximatelynine hours

For more information on Step 3, including applications, practice materials, and updates, visit the USMLE website

OWNERSHIP AND COPYRIGHT OF EXAMINATION MATERIALS

The examination materials in the USMLE are the confidential, copyrighted property of the USMLE program. If you reproduce and/or distribute any examination materials, by any means, including by memorizing and reconstructing them, you are violating the legal rights of the USMLE program. The USMLE program will use every legal means available to protect the copyrighted materials and secure redress against those who violate copyright law.

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Stay up to date by following USMLE on Twitter, Facebook, and LinkedIn.

OVERVIEW


ELIGIBILITY FOR THE USMLE STEPS WHO IS ELIGIBLE TO TAKE THE USMLE?

Step 1, Step 2 CK, and Step 2 CS To be eligible, you must be in one of the following categories at the time you apply AND on the day of your examination:

• a medical student officially enrolled in, or a graduate of, a US or Canadian medical school programleading to the MD degree that is accredited by the Liaison Committee on Medical Education (LCME),OR

• a medical student officially enrolled in, or a graduate of, a US medical school leading to the DO degreethat is accredited by the American Osteopathic Association (AOA), OR

• a medical student officially enrolled in, or a graduate of, a medical school that is outside the US andCanada, listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements,and that meets other eligibility criteria of the ECFMG

Step 3 To be eligible for Step 3, before submitting your application, you must:

• obtain the MD degree (or its equivalent) or the DO degree from an LCME- or AOA-accredited US orCanadian medical school, or from a medical school outside the US and Canada that is listed in theWorld Directory of Medical Schools as meeting ECFMG eligibility requirements, AND

• pass Step 1, Step 2 CK, and Step 2 CS, AND If you are a graduate of an international medical school,

• obtain certification by the ECFMG

The USMLE program recommends that, for Step 3 eligibility, applicants should have completed, or be near completion of, at least one postgraduate training year in an accredited US graduate medical education program that meets state board licensing requirements.

Individuals who passed Step 2 prior to the implementation of Step 2 CS are not permitted to take Step 2 CK, except under the specific exceptions to the retake policy approved by the Composite Committee (see page 15). These individuals are permitted to take Step 2 CS, provided they meet all other eligibility requirements.

Individuals who were not required to pass Step 2 CS for Step 3 eligibility but who elect to take Step 2 CS and fail the examination are not eligible for Step 3 until they have passed Step 2 CS (most recent administration) and meet all other Step 3 requirements.

If you are dismissed or withdraw(n) from medical school, you are not eligible for the USMLE, even if you are appealing the school’s decision to dismiss you or are otherwise contesting your status. If you are on a leave of absence, please check with the organization that registered you for your examination before submitting your application; if you have already registered, check before testing. Failure to notify the organization that registered you for your examination of your changed status may result in a determination that you engaged in irregular behavior and placement of a permanent annotation on your score reports and transcripts.


CHANGE IN ELIGIBILITY STATUS

If your eligibility for a Step or Step Component changes after you submit your application but before your scheduled test date(s), you must promptly notify the organization that registered you for your examination. Failure to notify the organization that registered you for your examination of your change in status may result in a finding that you engaged in irregular behavior. If you take a Step or Step Component for which you are not eligible, results for that examination may not be reported or, if previously reported, may be canceled, at the discretion of the USMLE program.

GRADUATES FROM UNACCREDITED MEDICAL SCHOOLS IN THE US OR CANADA

If you graduated from an unaccredited medical school in the US or Canada and are eligible for initial licensure as a physician by a US medical licensing authority, you may take the USMLE only upon specific request by that medical licensing authority. The medical licensing authority should submit the request to sponsor you to the USMLE Secretariat in advance of your application for each Step.

SEQUENCE OF STEPS

If you meet the eligibility requirements, you may take Step 1, Step 2 CK, and Step 2 CS in any sequence. You may take Step 3 only after passing Step 1, Step 2 CK, and Step 2 CS.

NUMBER OF ATTEMPTS AND TIME LIMITS

An examinee may not take the same Step or Step Component more than six times, including incomplete attempts. All attempts at a Step or Step Component are counted toward the limit, regardless of when the examinations were taken.

Information regarding state-specific requirements for licensure can be obtained on the FSMB website. Note: combined degree (e.g., MD PhD) students should reference the USMLE website for more specific information regarding exceptions to time limits.

RETAKING FAILED EXAMINATIONS

You may not take the same Step or Step Component more than three times within a 12-month period. Your fourth and subsequent attempts must be at least 12 months after your first attempt at that examination and at least six months after your most recent attempt at that examination. This includes incomplete attempts.

ELIGIBILITY FOR THE USMLE


ELIGIBILITY FOR THE USMLE

RETAKING PREVIOUSLY PASSED STEPS

If you pass a Step or Step Component, you are not allowed to retake it, except to comply with a time limit imposed by a US physician licensing authority for completion of all Steps or by another authority recognized by the USMLE program. Visit the USMLE website for more information. If you have not yet passed Step 3 and need to retake a previously passed Step 1 or Step 2 examination in order to meet a time limit imposed by a US physician licensing authority or another authority recognized by the USMLE program, you should understand that if you fail a retake, you will no longer be eligible to take Step 3. In order to meet the examination requirements for Step 3 eligibility, you must have achieved a passing performance on the most recent administration of the examinations intended to meet those requirements.

PREVIOUSLY LICENSED PHYSICIANS

If you have already been granted a physician license by a US medical licensing authority based on other licensure examinations, such as the Federation Licensing Examination (FLEX), the NBME certifying examinations, or National Board of Osteopathic Medical Examiners COMLEX-USA, you may not be eligible to take the USMLE. Please contact the appropriate registration organization with questions about your eligibility (see page 28).


APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE APPLICATION MATERIALS

Step 1, Step 2 CK, and Step 2 CS Students and graduates of LCME- or AOA-accredited programs should apply for Step 1, Step 2 CK, and Step 2 CS by following the instructions on the NBME website. Students and graduates of medical schools outside the US and Canada should apply for Step 1, Step 2 CK, and Step 2 CS by following the instructions on the ECFMG website.

Step 3 Graduates with an MD or DO degree from an LCME- or AOA-accredited medical school, and graduates of medical schools outside the US and Canada that are listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements, should apply for Step 3 by following the instructions on the FSMB website.

EXAMINEES WITH DISABILITIES REQUESTING TEST ACCOMMODATIONS

The USMLE program provides reasonable accommodations for examinees with disabilities under the Americans with Disabilities Act (ADA). If you are an individual with such a disability and require test accommodations, visit the USMLE website before you apply for each Step or Step Component for information regarding test accommodations, including procedures and documentation requirements.

EXAMINEES WHO REQUIRE ADDITIONAL BREAK TIME

Examinees with physical or health conditions who require additional break time should complete the request form and submit it with a letter from a qualified health care professional documenting the medical need. Examples include lactation (to express breast milk) and diabetes (to monitor/treat blood glucose). Requests for additional break time should be made prior to, or at the same time as, registration for a Step examination.

PERSONAL ITEM EXCEPTIONS (PIE)

Unauthorized possession of personal items while you are in the secure areas of the testing center is prohibited. Exceptions to this policy may be made in certain limited circumstances. A list of approved personal items that may be permitted in the secure testing area, subject to inspection by test center staff, is available at the USMLE website.

If you are dismissed or withdraw(n) from medical school, you are not eligible for USMLE, even if you are appealing the school’s decision or are otherwise contesting your status.

You should not feel compelled to test on a particular day if you are ill, under unusual personal stress, unprepared for the examination, or otherwise not ready to test. Contact the organization that registered you for your examination for further details regarding rescheduling your examination.


APPLYING FOR THE TEST AND SCHEDULING YOUR TEST DATE

APPLYING FOR AND SCHEDULING YOUR TEST

STEP COMPONENT OBTAINING AN ELIGIBILITY PERIOD AND

SCHEDULING YOUR TEST DATE ADDITIONAL INFORMATION

STEPS 1 AND 2 CK • When applying for the examination, youmust select a three-month eligibility periodduring which you wish to test (e.g., January –March).

• Once your registration is complete, ascheduling permit with your eligibilityperiod will be issued. You will receive ane-mail with instructions for accessing yourpermit.

• After obtaining the scheduling permit, youmay visit the Prometric website to schedule atest date. Scheduling may not be availablemore than six months in advance.

• You are permitted to reschedule within your eligibility period; you must pay a fee if you make a change during the 30 calendar days before your scheduled appointment.

• If you are unable to test within your eligibility period, contact the organization that registered you for your examination to inquire about a one-time contiguous eligibility period extension. A fee is charged for this service.

• If you do not take the examination within your original or extended eligibility period, you must reapply by submitting a new application and fee(s). Fees are nonrefundable and nontransferable .

STEP 2 CS • When you apply for Step 2 CS, you areassigned a 12-month eligibility period thatbegins when your application is acceptedand your eligibility is verified.

• Once your registration is complete, ascheduling permit with your eligibilityperiod will be issued. You will receive ane-mail with instructions for accessing yourpermit.

• After obtaining the scheduling permit, youmay visit the USMLE website to scheduleyour test date.

• Once your eligibility period is assigned, itcannot be changed or extended.

• Please check the Step 2 CS ScoreReporting Schedule before scheduling atesting appointment if you need your resultsby a specific deadline. Test centers fill quickly.Scheduling at least six months in advanced isadvisable.

• You are permitted to reschedule within youreligibility period; you must pay a fee if youmake a change during the 14 calendar daysbefore your scheduled appointment.

• If you do not take the examination withinyour eligibility period, you must reapply bysubmitting a new application andexamination fee. Fees are nonrefundable andnontransferable.

STEP 3 • When applying for an examination, you mustselect a three-month eligibility period duringwhich you wish to test (e.g., January –March).

• Once your application is processed, ascheduling permit with your eligibilityperiod will be issued. You will receive ane-mail with instructions for accessing yourpermit.

• After obtaining the scheduling permit, youmay visit the Prometric website to scheduleyour test dates.

• You are permitted to reschedule within youreligibility period; you must pay a fee if youmake a change during the 30 calendar daysbefore your scheduled appointment.

• If you are unable to test within your eligibilityperiod, contact FSMB to inquire about a one- time contiguous eligibility period extension. Afee is charged for this service. Visit the FSMBwebsite for more information on eligibilityperiod extensions.

• If you do not take the examination withinyour original or extended eligibility period,you must reapply by submitting a newapplication and fee(s). Fees arenonrefundable and nontransferable.


EXAMINATION DAY AND TESTING TESTING REGULATIONS AND RULES OF CONDUCT

Administrations of the USMLE Steps are monitored by test center staff, in person and through audio and visual recording. Test center staff are required to report any violations of the USMLE or test center rules. You must follow instructions from test center staff throughout the examinations; failure to do so may result in a finding that you have engaged in irregular behavior and a permanent annotation of your transcript. Test center staff are not authorized to answer questions regarding registration, examination content or format, or testing software, scoring, or retesting.

RULES OF CONDUCT

When you submit your application to take the USMLE, you agree to the following: 1. You are the person named on the scheduling permit for the examination.2. You will not seek, provide, or obtain any form of unauthorized assistance at any time, including during

the examination or during breaks.3. You will not have prohibited materials, including formulas, study materials, notes, papers, or electronic

devices of any kind, in your possession while you are in the secure areas of the test center.4. You will place in a locker or cubicle all personal belongings, including cell phones, watches, pagers,

tablet PCs, iPods/media players, fitness and tracking monitors, any device with transmitting orreceiving capabilities (e.g., Bluetooth), formulas, study materials, notes, papers, pens/pencils, and yourpurse and/or wallet, before you enter the testing room (or “orientation room” for Step 2 CS).

5. During computer-based testing (Steps 1, 2 CK, and 3), you will leave your testing station for breaks onlywhen the break screen is visible on your monitor. It is a violation of the Rules of Conduct if you indicateon the test center log that your break screen is visible when it is not.

6. During computer-based testing (Steps 1, 2 CK, and 3), you may use a telephone or othercommunication device only when outside the secure testing area and during an authorized break.During Step 2 CS, you will not use a personal telephone at any time while you are in the testing center.

7. You will not remove examination content from the test center by any means.8. You will maintain the confidentiality of the materials, including, but not limited to, the multiple-choice

items and the case content for Step 2 CS and Primum CCS. You will not reproduce or attempt toreproduce examination materials through recording, memorization, or any other means. Also, you willnot provide information relating to examination content to anyone, including those who may be takingor preparing others to take the examination. This includes postings regarding examination contentand/or answers on the Internet.

9. You will not write on anything other than the laminated note boards (computer-based examinations)or scrap paper (Step 2 CS) provided.

If you violate these Rules of Conduct, you may be directed to leave the test center before completing your examination. Also, evidence of violation of any test administration rule, including these Rules of Conduct, will result in actions being taken under the United States Medical Licensing Examination USMLE Policies and Procedures Regarding Irregular Behavior. If you are found to have engaged in irregular behavior, your score report and transcripts will include this finding, you may be barred from taking the USMLE in the future, and your score may be canceled.


EXAMINATION DAY AND TESTING

PERSONAL BELONGINGS – WHAT YOU CAN BRING INTO THE TESTING ROOM

Personal items are prohibited in the secure areas of the testing center. For computer-based examinations (Step 1, Step 2 CK, and Step 3), the only items you are allowed to bring into the testing room are soft-foam earplugs without strings. Earplugs must be removed from the packaging and be ready for inspection by test center staff during check-in and must remain at your workstation during all breaks. Earplugs are prohibited for Step 2 CS. Visit the USMLE website for more information.

For Step 2 CS, the entire test center, including the orientation room and the restrooms, is considered a secure testing area. The only items you are allowed to bring into the secure testing area are your white lab coat (pockets must be empty) and your stethoscope (should you forget to bring one, there are a limited number available at the test center). All other equipment, including pens, gloves, writing paper, and other medical equipment, is provided by the test center. Visit the USMLE website for more information regarding the Step 2 CS examination experience and test center regulations.

For all Steps, if you bring personal items to the test center, you must store them in a small designated locker outside the secure testing area or in the designated storage area for Step 2 CS; electronic devices must be turned off. Turning down the volume is not sufficient. All personal items are subject to inspection.

ADMISSION TO THE TEST

Check-in Procedures Step 1, Step 2 CK, Step 3 You should arrive at the test center approximately 30 minutes prior to your scheduled testing appointment. If you arrive after your appointment time, you may not be admitted. If you arrive more than 30 minutes after your scheduled testing appointment, you will not be admitted and must pay a fee to reschedule your test. Your rescheduled test date(s) must fall within your eligibility period.

Step 2 CS You should arrive at the test center at the time listed on the confirmation notice you printed after scheduling your appointment. There will be an on-site orientation to demonstrate the equipment available for you to use in the examination rooms and to review examination rules and procedures. If you arrive during the on-site orientation, you may be allowed to test after signing a Late Admission Form. If you arrive after the on-site orientation, you will not be allowed to test and must pay a fee to reschedule your test. Your rescheduled test date must fall within your eligibility period.

All Steps When you arrive at the test center, you must present a paper or electronic copy of your scheduling permit and a government-issued unexpired photo identification. Please review your scheduling permit for additional identification requirements. Acceptable forms of unexpired identification include:

▫ Passport▫ Driver’s license with photograph▫ National Identity Card▫ Other form of unexpired, government-issued identification



Your name, as it appears on your scheduling permit, must exactly match the name on your form(s) of identification. Your identification must contain both your signature and a recent photograph. Please review your scheduling permit for details and limited exceptions. If the name listed on your scheduling permit is not correct, contact the organization that registered you for your examination immediately.

If you do not bring your scheduling permit on paper or electronically (e.g., via smartphone) and acceptable identification on each day of your exam, you will not be admitted to the test and will be required to pay a fee to reschedule your test. Your rescheduled test date(s) must fall within your eligibility period.

Security Procedures For Step 1, Step 2 CK, and Step 3 ONLY

During check-in, test center staff will scan you with a metal detector (handheld or walk-through) and ask you to empty your pockets and turn them inside out before entering the testing room to confirm that you have no prohibited items. You will be asked to repeat this process each time you return to the testing room after a break. Additionally, your photo ID and fingerprint may be scanned electronically, and you must sign the test center log each time you enter or exit the test room.

Before you enter the test room, test center staff will give you laminated writing surfaces and markers to use for making notes and/or calculations during the testing session. You will be instructed to write your name and CIN, as shown on your scheduling permit, on one of the laminated writing surfaces provided. Writing surfaces and markers should be used only at your assigned testing station and only after you have entered your CIN in the computer to start your test session. If you have filled the laminated writing surfaces and need additional space for making notes, raise your hand to ask test center staff for a replacement. You must return laminated writing surfaces to test center staff at the end of the testing session. Do NOT write on anything (e.g., skin, clothing, tissue) other than the laminated writing surface. Failure to comply may result in a finding that you engaged in irregular behavior.

Test center staff will escort you to your assigned testing station and provide brief instructions on use of the computer equipment. You must enter your CIN to start the examination. A brief tutorial is available before each examination. You must run the sound check for the audio headphones either before the examination begins or during the tutorial, so that problems can be resolved before you start the examination.

For Step 2 CS ONLY During check-in, in addition to having your photo ID scanned electronically, you will be asked to place your personal belongings (e.g., pens, study materials, cell phones) in small bins, which are inaccessible for the duration of the examination day. Any personal belongings that you may need during breaks or during the examination, including your lab coat and stethoscope, can be placed at your seat in the orientation room. Please note that every area of the testing center is under video surveillance at all times; examinees are escorted by proctors at all times, with the exception of restroom breaks.



All Steps There are no facilities available for family and friends to wait at the center while you test; plan to meet them elsewhere after the examination ends. All examinees will be required to remove eyeglasses for close visual inspection by the test center administrator. These inspections will take a few seconds and will be done at check-in and upon your return from breaks. Jewelry, except for wedding and engagement rings, is prohibited. Hair accessories such as hats, ornate clips, combs, barrettes, or headbands are subject to inspection.

BREAK TIME

Step 1, Step 2 CK, and Step 3 Your test session is scheduled for a fixed amount of time, and the computer keeps track of the time allocated for each block and for breaks. At the start of the testing session, you have a total of 45 minutes of break time for authorized breaks and for computer transitions between blocks. Authorized breaks include any time you spend between test blocks, whether you remain at your seat or leave the testing room. If you complete the tutorial or other testing blocks early, the remaining time will be added to your total break time.

Once you begin a testing block, you may not leave the room (except in the event of an emergency). If you leave the room for a personal emergency and you are not on an authorized break, the block and daytime clocks will continue to run, and the test center will report the incident to the USMLE program. Additionally, the unauthorized break screen, described in the examination tutorial, will appear on the monitor after a defined period of inactivity. After the unauthorized break screen appears, you will need to enter your CIN to continue with the examination. Each time you leave the testing room, you are required to sign out and sign in when you return. You must present your identification each time you sign in.

If you exceed your allocated or accumulated break time, the excess will be deducted from your total testing time. Use the time summary feature (explained in the tutorial on your test day) to keep track of your time.

Step 2 CS Your Step 2 CS administration will include 12 patient encounters. The examination session lasts approximately eight hours. Examinees get a minimum of 45 minutes of break time, which includes a 30-minute lunch period. During lunch, a light meal will be served. The test center is unable to accommodate special meal requests. However, you may bring your own food, provided that no refrigeration is required. The frequency and length of breaks, other than the lunch break, will vary slightly by testing center. Smoking and/or the use of any tobacco products is prohibited throughout the centers.

STARTING AND COMPLETING THE TEST

Step 1, Step 2 CK, and Step 3 After you start taking an examination, you cannot cancel or reschedule that examination. If you experience a computer issue during the test, notify test center staff immediately. The testing software is designed to restart the test at the point that it was interrupted, without loss of time.

The test session ends when you have started and exited all blocks or the total test time expires. You will receive a notice during checkout that you have appeared for the test. If your test is scheduled for multiple days, be sure to bring a copy of your scheduling permit with you each day or you may not be permitted to test.



In the rare event that a technical problem occurs that does not permit you to complete your examination, please send a written description of the incident to Test Administration Services at the NBME. Test Administration Services must receive your notice within 10 days of your testing date or it may not be possible to fully investigate your concerns. Your correspondence should include your name, your USMLE ID number, the examination name (Step 1, 2 CK, 2 CS, or 3), the date of administration, and a message with a detailed description of the difficulty experienced. Please allow at least 15 business days for your report to be investigated and evaluated. You will receive written notification of the investigation results.

If you start the examination but do not complete it for reasons other than a technical problem or expiration of time, you should promptly write to Test Administration Services explaining, in detail, the reasons you did not finish the examination. The attempt may appear as an incomplete on your USMLE transcript.

For more information on how to report a test administration problem, visit the USMLE website.

Step 2 CS Once you enter the secure area of the test center, which includes the orientation area, you may not leave the area until the examination has been completed. All examinees taking the Step 2 CS examination are required to type the patient note portion of the exam. You are permitted to handwrite your patient note only if you were approved to receive an accommodation for a disability or if technical difficulties occur that make the patient note-typing program unavailable.

You may not solicit information about cases or discuss the cases with anyone, including other examinees, at any time (before, during, or after your examination). This includes any activity on the Internet, including on social media. All conversation at the testing center among examinees must be in English.

The USMLE program may prohibit an examinee from completing the exam and/or may impose conditions on retesting if the examinee appears to represent a health or safety risk to the standardized patients or test center staff. Such circumstances include, but are not limited to, an examinee performing careless or hazardous acts during the physical examination, exhibiting signs of illness (e.g., persistent coughing or sneezing) during the examination, or showing visibly open skin lesions or active bleeding.

If you do not feel well on the day of your test, we strongly encourage you to consider rescheduling your examination. If you become ill during your exam, inform a proctor promptly.

The USMLE makes every effort to ensure that your registration information is properly processed and that the Step examinations are properly prepared, administered, and scored. In the unlikely event that an error occurs in the preparation, processing, administration, or scoring of your USMLE examination or in the reporting of your USMLE scores, the USMLE program will make reasonable efforts to correct the error, if possible, or permit you either to retest at no additional fee or to receive a refund of the examination fee. These are the exclusive remedies available to examinees for errors in the registration process; in preparing, processing, or administering exams; or in determining or reporting scores.


SCORING AND SCORE REPORTING EXAMINATION RESULTS AND SCORING

The USMLE program provides a recommended pass or fail outcome on all Step examinations. Recommended performance standards for the USMLE are based on a specified level of proficiency. As a result, no predetermined percentage of examinees will pass or fail the examination. The recommended minimum passing level is reviewed periodically and may be adjusted at any time. Notice of such review and any adjustments will be posted at the USMLE website.. On the examinations containing multiple-choice items, the percentages of correctly answered items required to pass varies from form to form. However, examinees typically must answer 60 to 70 percent of items correctly to achieve a passing score.

For Step 3, your performance on the case simulations will affect your Step 3 score and could affect whether you pass or fail. The proportional contribution of the score on the case simulations is no greater than the amount of time you are allowed for the case simulations.

For up-to-date information on minimum passing scores, examination performance data, and general scoring methodology, please visit the USMLE website.

SCORE REPORTING

Score Availability Results for computer-based examinations (Step 1, Step 2 CK, and Step 3) are typically available three to four weeks after your test date. However, a number of factors may delay score reporting. When selecting your test date and inquiring about results, you should allow at least eight weeks to receive notification that your score report is available. For Step 2 CS results, you should refer to the Step 2 CS Score Reporting Schedule. For more specific information about potential scoring delays, please visit the Announcements section on the home page of the USMLE website.

When your score is available, you will receive an e-mail notification from the organization that registered you for your examination. Your score report will remain available on the website of the organization that registered you for your examination for approximately 120 days from the date of the e-mail notification. After the score report is removed from the website, your scores will be provided to you only in the form of an official transcript, for a fee, through the organization that registered you for your examination. Visit the USMLE website for more details, including how to request a transcript for yourself or for a third party.

Reporting to Third Parties The NBME reports the results of the USMLE to LCME- and AOA-accredited medical school programs for their students and graduates. For Step 1, Step 2 CK, and Step 2 CS, if you do not want your results reported to your medical school, you must send a request from your e-mail account of record to [email protected], at least 10 business days before your scheduled test date. A separate request must be submitted for each examination administration. For Step 3, you must specify your reporting preference on your application.

You must pass all three subcomponents of Step 2 CS (ICE, CIS, SEP) in a single administration to obtain the overall designation of passing on Step 2 CS.


SCORING AND SCORE REPORTING

The ECFMG may provide the results of the USMLE to international medical schools for their students and graduates. For Step 1, Step 2 CK, and Step 2 CS, if you do not want your results reported to your medical school, you must submit a request for each examination administration, via ECFMG’s Interactive Web Applications (IWA), at least 10 business days before your scheduled test date.

Examination data (including performance information and recorded patient encounters) may be used by the USMLE program or made available to third parties for research and other purposes that are disclosed to or authorized by you, as appropriate. In all instances, the data will be confidential, and individual examinees will not be identifiable in any publication. If you do not wish your examination data to be made available for such purposes, you must advise the USMLE Secretariat via e-mail at [email protected] no later than 30 days before your administration.

Incomplete Scores If you do not open every block of your Step 1, Step 2 CK, or Step 3 examination, your examination may not be scored and the attempt may be reported as incomplete on your USMLE transcript.

For Step 2 CS, if you leave the test early or otherwise fail to carry out one or more of the cases, your performance may be assessed on those cases you completed. If, based on the performance of the completed cases, a pass/fail outcome cannot be determined, the attempt may be recorded as incomplete on your USMLE transcript.

For privacy purposes, the USMLE program does not provide scores or outcomes by telephone, e-mail, or fax to anyone. Additionally, the scoring process is not expedited or accelerated for any individual or group.

SCORE RECHECKS

For all Steps and Step Components, a rigorous process is used to ensure the accuracy of scores, including a double scoring method involving independent scoring systems. Therefore, a change in your score or in your pass/fail outcome based on a recheck is an extremely remote possibility. To date, the score recheck process has not resulted in a score change. However, if you wish to request a score recheck, submit a request and service fee to the organization that registered you for your examination. Your request must be received no later than 90 days after your result was released to you.

REGISTRATION ORGANIZATION TO REQUEST A SCORE RECHECK, VISIT NBME http://examinee.nbme.org/interactive ECFMG http://www.ecfmg.org/forms/steprchk.pdf FSMB http://www.fsmb.org/step-3

For Steps 1, 2 CK, and 3, when a request for a score recheck is received, the original response record is retrieved and rescored using a system that is outside of the normal processing routine. The rechecked score is then compared with the original score.

For Step 2 CS, the ratings received from the standardized patients and from the physician note raters are retrieved, re-summed, and reconverted into final scores to verify the accuracy of the original outcome. Encounters and patient notes are not re-rated, and videos are not reviewed during the recheck.


SCORING AND SCORE REPORTING

SCORE VALIDITY

The performance of examinees is monitored and may be analyzed to detect aberrancies that raise questions about the validity of scores. The USMLE program reserves the right to cancel scores that are at or above the passing level if the USMLE program has a good faith basis for questioning whether they represent a valid measure of knowledge or competence as sampled by the examination. Questions about score validity may result from irregular behavior (please refer to the Irregular Behavior section of this BOI, pages 26–27) or other factors. If there are questions related to the validity of your score, your score report may be delayed or withheld pending completion of further review and/or investigation. You will have an opportunity to provide information that you consider relevant.

After review and analysis of all available information, scores will be classified as either valid and reported or invalid and canceled. If your score is canceled, an annotation of “score not available” will appear on your record next to the date of your examination. If your score is canceled, you will be notified and advised of the options for retaking the examination.

ANOMALOUS PERFORMANCE

Anomalous performance and/or unusual testing history may impact your access to the USMLE. If your performance raises concerns about your readiness to test or your motivation to pass, the USMLE program reserves the right to restrict your future access to its examinations and/or to impose conditions on future access. Do not test if you are not able or not ready on your scheduled test date.

Taking a Step examination to familiarize yourself with the examination format, or for any reason other than to pass, is prohibited and may result in restrictions on your future access to the USMLE.


IRREGULAR BEHAVIOR IRREGULAR BEHAVIOR DEFINED

Irregular behavior includes any action by applicants, examinees, potential applicants, or others that could compromise the validity, integrity, or security of the USMLE process.

EXAMPLES OF IRREGULAR BEHAVIOR

Specific examples of conduct that may be deemed to be irregular behavior include, but are not limited to, the following: seeking, providing, and/or obtaining unauthorized access to examination materials, including but not

limited to in-person or online unauthorized reproduction by any means, including, but not limited to, reconstruction

through memorization and/or dissemination of examination materials by any means, includingvia the Internet

communicating (including online and via social media) or attempting to communicate about testitems, cases, and/or answers with another examinee, potential examinee, or formal or informaltest preparation group at any time before, during, or after an examination

providing false information or making false statements on or in connection with application forms,scheduling permits, or other USMLE-related documents

taking or attempting to take an examination for which you are not eligible taking an examination for someone else or engaging someone to take an examination for you seeking, providing, or obtaining unauthorized assistance during the examination or attempting to do so making notes of any kind while in the secure areas of the test center, except on the writing

materials provided at the test center for this purpose failing to adhere to any USMLE policy, procedure, or rule, or instructions of the test center staff verbal or physical harassment of test center staff or other examination staff or other disruptive or

unprofessional behavior during the registration, scheduling, or examination process possessing any unauthorized materials, including, but not limited to, photographic equipment,

communication or recording devices, fitness and tracking monitors, and cell phones in the securetesting areas

altering or misrepresenting examination scores or outcomes making violent, threatening, or unprofessional comments to USMLE or test center staff failing to cooperate fully in an investigation concerning a possible violation of the USMLE rules

If you have information that an examinee or other person or entity has, or may have, compromised the security of the USMLE or intended to do so, please immediately contact or call the USMLE Secretariat.


IRREGULAR BEHAVIOR

IRREGULAR BEHAVIOR – INVESTIGATION PROCESS

The USMLE program will conduct an investigation if it receives information that an individual may have engaged in irregular behavior. During this time, anyone alleged to have engaged in such activity will be prohibited from registering for additional exams; previously unreleased scores, if any, may be withheld; and pending examination appointments will be canceled. If the evidence suggests that the alleged irregular behavior affects score validity, the score will also be reviewed as described in the Scoring and Score Reporting section of this BOI, pages 23–25.

If you are the subject of a USMLE investigation, you will be advised of the matter and will have an opportunity to provide information that you consider relevant. Individuals who are the subject of an investigation must cooperate fully with the investigation, including providing all requested documentation and truthfully answering all questions posed during investigative interviews conducted on behalf of the USMLE program. If requested, individuals who are the subject of an investigation shall provide a signed release authorizing the USMLE program to obtain information and records from educational institutions and other third parties. Failing to cooperate with an investigation or providing misleading or untruthful information in the course of an investigation will constitute irregular behavior that may be the basis of separate proceedings or other actions by the USMLE program.

If it is determined that you engaged in irregular behavior, information regarding this determination will become part of your permanent USMLE history. Your score report (if applicable) and USMLE transcript will contain a notation of the finding of irregular behavior. The USMLE program will provide information about the irregular behavior to third parties that receive or have received your USMLE transcript and may also report to other legitimately interested entities, as determined by the USMLE program. You may be barred from taking future examinations, and/or special administrative procedures or conditions may be implemented for your future examinations. The USMLE program also reserves the right to take such action when information regarding irregular behavior on predecessor examinations suggests that such actions may be appropriate to ensure the security of the USMLE.

Test preparation courses and materials are available from individuals and companies not associated with the USMLE. It is unlawful for any test preparation service or program to use, disclose, distribute, or solicit content from recent test takers or to otherwise provide access to questions or answers from actual USMLE examinations. If there is evidence that you enrolled in, participated in, or used any test preparation program or service that distributes, provides access to, or uses USMLE content (questions or answers) or provides a forum for others to share such information, your registration and/or testing may be canceled, your scores on the USMLE may be withheld or canceled, and you may be subject to further sanctions.


CONTACT US APPLICATION AND REGISTRATION INQUIRIES

Contact the appropriate organization (see below) for information on how to apply for the USMLE, obtain application materials, and receive information on the status of your application and scheduling permit.

USMLE STEP TYPE OF APPLICANT ORGANIZATION CONTACT INFORMATION

STEPS 1, 2 CK, AND 2 CS Students and graduates of medical schools in the US or Canada

NBME 3750 Market Street Philadelphia, PA 19104-3102 Website: http://www.nbme.org Telephone: (215) 590-9700 E-mail: [email protected]

STEPS 1, 2 CK, AND 2 CS Students and graduates of medical schools outside the US and Canada

ECFMG 3624 Market Street Philadelphia, PA 19104-2685 Website: http://www.ecfmg.org Telephone: (215) 386-5900 E-mail: [email protected]

STEP 3 All medical school graduates who have passed Step 1 and Step 2 (CK and CS)

FSMB Assessment Services 400 Fuller Wiser Road Euless, TX 76039-3856 Website: http://www.fsmb.org Telephone: (817) 868-4041 E-mail: [email protected]

SCHEDULING AND TEST CENTER INQUIRIES

For Steps 1, 2 CK, and 3, your scheduling permit includes instructions on how to contact Prometric to schedule your appointment to test. Inquiries about your appointment, such as a request to reschedule an appointment within your eligibility period, must be directed to Prometric. Visit the Prometric website for information on test center locations.

To schedule an appointment for Step 2 CS, follow the instructions provided on your scheduling permit. To check test center availability and to schedule or reschedule an appointment, visit the USMLE website.

If you receive a scheduling permit but experience a problem scheduling your appointment that Prometric or Clinical Skills Evaluation Collaboration (CSEC) scheduling staff are unable to resolve, you may contact the organization that registered you for your examination.


CONTACT US

TEST ADMINISTRATION INQUIRIES

For questions and concerns about your administration, contact the NBME Test Administration office.

Attention: Test Administration National Board of Medical Examiners 3750 Market Street Philadelphia, PA 19104-3102 Telephone: (215) 590-9700 E-mail: [email protected]

SECURITY CONCERNS

USMLE encourages you to provide information about cheating, violations of the USMLE rules and other activities of which you are aware that may compromise the security and integrity of the USMLE. Please visit the USMLE website to report such information.

GENERAL INQUIRIES

Complete information about the USMLE is available on the USMLE website. General inquiries regarding the USMLE or inquiries for the USMLE Secretariat may be directed to:

Attention: USMLE Secretariat National Board of Medical Examiners 3750 Market Street Philadelphia, PA 19104-3102 Telephone: (215) 590-9700 E-mail: [email protected]

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Stay up to date by following USMLE on Twitter, Facebook, and LinkedIn.


LIST OF ABBREVIATIONS ACM Advanced Clinical Medicine ADA Americans with Disabilities Act AOA American Osteopathic Association CCS Computer-based Case Simulations CIN Candidate Identification Number CIS Communication and Interpersonal Skills CK Clinical Knowledge CS Clinical Skills CSEC Clinical Skills Evaluation Collaboration ECFMG Educational Commission for Foreign Medical Graduates FLEX Federation Licensing Examination FSMB Federation of State Medical Boards FIP Foundations of Independent Practice ICE Integrated Clinical Encounter LCME Liaison Committee on Medical Education NBME National Board of Medical Examiners PIE Personal Item Exception SEP Spoken English Proficiency USMLE United States Medical Licensing Examination

BOOK LIST FOR USMLE PREPARATION

First Aid for the USMLE Step 1

If you're taking Step 1 this year, get this book, the next edition will come out in December. If

you don't have this book, BUY IT NOW! Do not even think about preparing for Step 1 without

First Aid. They call it FIRST Aid for a reason. This book covers all subjects from Anatomy to

Path. It is very concise and high yield. Some people only use First Aid, and although I don't

recommend doing this, it shows how important this book is to your score.

Kaplan Med Essentials

This book is in table format, which makes the material easier to memorize. However, many

people recommend it and new edition just came out in 2009. In my opinion, this book can be

one of the most useful books if used properly. If you are going to buy the Kaplan Videos, I

STRONGLY advise you to use Kaplan med Essentials over the Kaplan lecture notes.

Unfortunately, I didn't think of this until AFTER I finished watching all the Kaplan videos. This

book is basically a summary of the 6 huge books in the Kaplan Lecture notes series. It has all of

the high yield figures that are in the Kaplan Lecture Notes. If you're going to watch the Kaplan

videos, save yourself the time and money required for the Kaplan Lecture Notes and buy

yourself a copy of medEssentials instead!

Kaplan Lecture Notes

These require a great deal of time to work through. However, many people have recommended

using these during your basic science classes to help you identify high yield information from

each subject. I usually don't recommend using the Kaplan notes unless you have enough time or

need a thorough review book for each subject. Kaplan does an excellent job of covering the

basics, and they do so in great detail (relative to the USMLE's focus, at least). The set of Kaplan

notes usually sells for over $500, so this is something you'll want to consider as well. Perhaps

borrow a used set of books from a friend or snatch it on the rare occasion that it is available for a

lower price.

Physiology

Kaplan book

Adequate for most sections. Sometimes further explanations are needed. I studied some sections

from BRS.

BRS physiology

This is a great book. It takes longer to get thorugh this than the Kaplan book, but it is great

review and covers many topics that the Kaplan book fails to cover.

Pathology

Rapid Review Pathology (Goljan)

Next to First Aid, this is the most useful book for Step 1! It contains a lot of high yield

information, concise explanations, and many integrations and correlations. This is a book that I

will say you MUST BUY. The only 2 books that I think you absolutely must have for step 1 are

First Aid and Rapid Review Pathology. 90% of the questions that will be on your exam will be

from these 2 books alone. Goljan knows what he's doing. He's been taught USMLE review

courses for years. Buying this book will boost your score! You will definitely regret not buying

this book. The link above is for the 3rd edition. I actually own the 2nd edition, which is

excellent. The 3rd edition has more images and updated content and structure. If you already

have the 2nd edition, you'll be fine, if you don't, buy the 3rd edition.

Webpath

This website has tons of pathology images and even a few Radiology images for select diseases.

If you have time, you could go through the images quickly. If you don't have a lot of time left,

this is too low yield for you.

Robbins and Cotran Review of Pathology

It has 1100+ questions divided by chapter and go along perfectly with Rapid Review Pathology.

Some questions were more detailed than necessary, but this was a great way to nail the facts into

my brain after reviewing each chapter in Rapid Review Pathology.

Pharmacology

*First aid has all of the drugs you need to know.

*Kaplan book explains mechanisms in more detail. Some chapters are low yield.

*Brenner's Pharmacology Flashcards: excellent flash cards. What I did was put them in the

washroom and went through a few each day.

Lange Pharmacology cards: I haven't tried these but I put up the link because many people like

them.

Microbiology and Immunology

Kaplan book

This is the only resource I used for micro, but I must say I'm not very satisfied with it. It could

have been organized better into a more efficient and concise review, but oh well, what are you

going to do.

MMRS (Microbiology Made Ridiculously Simple)

This is a good book but I think it's too detailed for Micro. It's pictures and mnemonics are great

though. I skimmed through the mnemonics and pictures, but didn't have time to read all the text.

Anatomy, Neuroanatomy, Embryology

Kaplan book: sufficient for these low yield subjects.

Netter's Anatomy: Don't try to go through the whole atlas! Only use as a supplement.

High Yield Anatomy, HY Neuroanatomy, HY Embryology

Don't waste your time by reading everything in these books. The images in High Yield

Neuroanatomy are excellent and well worth the price of the book.

Biochemistry

Kaplan book: Excellent review for Biochem. Very high yield and well worth your time.

Lippincott's Biochemsistry: I used this book during my Biochemistry coursework, it's a great

book. If you've used this book during your course and are comfortable with it, go ahead and use

it for Step 1 review, but only to annotate First Aid. Just make sure not to get bogged down in

some of the details in this book. Review questions are okay, but not in typical USMLE format.

High Yield Cell and Molecular Biology: After taking the exam, I felt this book was a waste of

time. It's too detailed in some areas, and all of the important facts in it are found in First Aid. I

don't recommend this book.

UCV Biochemistry: this book is AMAZING! The way the metabolic deficiencies are presented

in clinical scenerios helped me grasp these concepts very well. This has made Biochemistry so

easy for me.

Behavioral Science:

Kaplan book: concise, to the point, and high yield. I wouldn't recommend anything else over it.

UCV Behavioral Science: This book contains about 100 clinical cases that you read about in

Behavioral Science. It is great for consolidating the incomplete concepts you gain while

reviewing this subject. I used it because Behavioral Science is one of my weak areas.

USMLE Medical Ethics: If you keep getting those ethics questions wrong in practice questions,

get this book. It shows you what the USMLE wants you to say. For the USMLE you should

always think in terms of "the best ethical standards", and not what is actually done by physicians

in the US.

High Yield Biostatistics: Biostatistics was my weakest area in Basic sciences. This book is

concise and I got through it in 2 days. It is an excellent review book for anyone who struggles

with Biostatistics. This was a life-saver for me!

Usmle World: I will be starting this in a month, I will put up my review of it then.

Kaplan Step 1 Qbook: provides blocks that you can do to assess your strengths and weaknesses.

Some questions are way too detailed, so don't get bogged down by them.

First Aid Q&A for the USMLE Step 1: haven't gotten to this yet. Will post review soon.\

First Aid Cases for the USMLE Step 1: haven't gotten to this yet. Will post review soon.

USMLE Step 1 Recall: Buzzwords for the Boards (the CD not the book): Great audio review

for Step 1. It's in Q & A format and has about an hour of review for each subject.

Best Books for PLAB 1 Exam

1. Read Me – Topics to Cover

2. GMC Sample Questions

3. 1700 – Unsolved Questions

4. 1700 – Solved Questions (no explanations)

5. 1700 by Dr. Khalid – Fully Revised (2nd version)

6. Unity Notes – Subject wise

7. Unity Notes – Unanswered

8. Other Notes

9. Mocks Made from 1700

10. Clinchers

11. Recalls (2014 – 2017)

12. 1700 Subject Wise

Documents

International student’s cell INTERNATIONAL STUDENT CELL