To practise medicine in USA, you must pass the USMLE exam. The USMLE exam is co-sponsored by the FSMB (Federation of State Medical Boards) and NBME (National Board of Medical Examiners).

The USMLE is a three-step exam that evaluates candidate's capacity to apply the knowledge, concepts and patient-centred abilities that form the cornerstone of safe and efficient treatment is assessed by. It is crucial to understand every aspect of the USMLE exam.

The Changes

There are three components to the changes.

• First, there are now just four allowed attempts each USMLE exam rather than the former six. (   (The new policy applies to all applications received on or after July 1, 2021.)
• Second, you must pass Step 1 before taking Step 2CS.
• Third, and this is the most important, USMLE Step 1 will henceforth be graded on a pass-fail basis.

Why Does This Matter?

The most challenging and stressful exam a doctor has ever taken was USMLE Step 1. For many IMGs or students from foreign medical schools, this is fantastic news.

Why did this happen?

The choice was made primarily to enhance student wellbeing and facilitate a smoother transition from medical school to residency. With the test becoming Pass/Fail, the board anticipates less stress and worry for students as well as a decrease in some of the repercussions on their mental health.

What Does All of This Mean?

Clearly, Step 2CK will take the place of Step 1 in terms of relevance.   The bad news is that if you botched Step 1, you frequently have a second shot to impress residency adcoms by passing Step 2CK. But if you fail Step 2CK right away, you won't have a second chance to redeem yourself.

Did you know that other aspects of your residence application are significantly more crucial?The most significant and heavily weighted component is those letters of recommendation. However, it differs from specialized to specialty.

Additionally, research will become more significant. Therefore, you should search for medical schools that emphasize research-based learning. One such medical school in the Caribbean is AUB, School of Medicine, where research is an essential component of the the medical sciences education. Many of its graduates have secured residencies at prestigious teaching hospitals and top medical facilities  across the United States.

A brief overview of USMLE step exams

Passing the first two exams, STEP 1 and STEP 2, will allow you to practise medicine under supervision and submit a residency application. You can practise medicine in the US without supervision after passing STEP 3, which can be taken before or during residency.

To be qualified to take the USMLE STEP 1 exam, IMGs must obtain the Educational Commission for Foreign Medical Graduates (ECFMG) certification.

• STEP 1 is an eight-hour multiple-choice test that covers foundational medical sciences.
• STEP 2 CK (clinical knowledge) is a nine-hour multiple-choice test places a strong emphasis on clinical knowledge. It focuses on both the root cause of an illness and how to recognize and treat a patient. The passing mark is 209/300.

IMGs who pass these two exams are eligible for a J1 visa.

• The STEP 3 exam, which lasts for two days, covers the application of both clinical and basic science. It is computer-based and multiple choice. The current passing score is 198/300.

While STEP 3 is not required prior to residency, it does improve your chances of being granted an H1B visa.

Eligibility Requirements

There are prerequisites for each step of the examination.

Criteria for Steps 1, 2 CK:

• You must be a graduate of a medical school in Canada or the United States or be enrolled in an MD program that has been accredited by the Liaison Committee on Medical Education (LCME)

If you are planning on studying outside the US, Caribbean will be just the perfect location - aesthetically and financially. But do consider fully accredited medical schools since they are recognized as comparable to LCME by the US Department of Education. In fact, according to the ECFMG, medical graduates from Caribbean medical schools that are not CAAM-HP approved won't be eligible to practise in the US starting in 2023. Check out American University of Barbados (AUB), School of Medicine in Barbados - it is fully accredited and among the top universities of the Caribbean.

• You must be a medical student who has received official recognition of enrolment or graduation from a medical school that is not located in Canada or the US and is listed in the World Directory of Medical Schools.

Criteria for USMLE Step 3:

• Aspirants must pass Steps 1 and 2 CK of the USMLE to qualify for Step 3.
• Aspirants should have MD degrees from Canadian or American medical schools that are LCME or COCA certified.
• Aspirants with MD degrees from medical school outside of the United States and Canada that is listed in the World Directory of Medical Schools

Hopefully, you found the information useful. Your grasp of USMLE has improved now that you are equipped with some professional counsel.