Complete Guide: How to prepare for the USMLE

The dream of practicing medicine in the United States, with its wide range of healthcare opportunities, attracts doctors from all over the world. To make this dream a reality, the The USMLE (United States Medical Licensing Examination) is one of the biggest challenges to overcome. This exam, made up of three steps, assesses the medical knowledge and clinical reasoning skills of candidates and is a prerequisite for obtaining a medical license in the United States. Given the complexity and importance of the exam, many Brazilian doctors ask themselves: “How can you prepare for the USMLE effectively and increase your chances of success?”..

Doctor approved for EB-2 NIW visa in 8 months: Testimonial about the whole process

In this exclusive article from D4U Immigration, you’ll find a Complete Guide, with valuable tips and essential information about the USMLE to help you achieve your goal of working as a doctor in the United Statescovering topics such as:

• The structure of the USMLE: Understand the stages of the exam, the content covered in each stage and the importance of each stage to your success.
• How to prepare: Discover the best study strategies, available resources and how to create a personalized study plan.
• The importance of English: Learn how to master the English language, both in the written and oral parts, in order to perform better in the exam.
• The role of immigration advice: Understand how a specialized advisory can help you throughout the journey, from preparing for the USMLE to obtaining a work visaoptimizing your time and increasing your chances of success.

By the end of this reading, you’ll be better prepared to face the challenges of the USMLE and take an important step towards realizing your dream. Check it out!

What is USMLE?

The first step in preparing for the USMLE(United States Medical Licensing Examination) is to understand that it is a exam divided into three stageswhich assesses the knowledge and skills of future doctors with a Brazilian degree in the United States.

Each step (step) of the USMLE has a specific focus and assesses the professional at different stages of medical practice, as we will see below.

USMLE steps: Step 1, Step 2 CK and Step 3

To know how to prepare for the USMLE, it is essential to know what each of the steps of the USMLE exam, as well as knowing the content, format, number of questions and average duration for each exam.

To facilitate your understanding and put you one step ahead in this process, the D4U Immigration brings you the main information about the Step 1 content, Step 2 CK content e Step 3 content listed on the official USMLE website below:

USMLE – Step 1

O Step 1 of the USMLE assesses whether you have mastered basic medical knowledgesuch as anatomy, physiology, biochemistry, pharmacology, pathology, microbiology and immunology.

Structure of Step 1 of the USMLE

• Formatting: Multiple choice questions.
• Duration: 8 hours, divided into 7 blocks of 60 minutes.
• Content: Questions about body systems (such as cardiovascular, respiratory) and biological processes (such as inflammation, metabolism).
• Number of questions: Approximately 280 multiple choice questions.

The aim of Step 1 is to see if you can apply these concepts in clinical situations.

USMLE – Step 2 CK (Clinical Knowledge)

O USMLE Step 2 CK assesses knowledge in areas such as internal medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry and family medicine.

USMLE Step 2 CK structure

• Formatting: Multiple choice questions and clinical cases.
• Duration: 9 hours, divided into 8 blocks of 60 minutes.
• Content: Questions on various areas of medicine, such as internal medicine, surgery, pediatrics, obstetrics and gynecology, psychiatry and family medicine.
• Number of questions: Approximately 318 multiple choice questions.

This stage focuses on your ability to diagnose diseases e plan treatments under the supervision of a more experienced doctor.

USMLE – Step 3

O Step 3 of the USMLE is the final step in obtaining a license to practice medicine without supervision in the United States and assesses the physician’s ability to practice independent medical practicewith a focus on the application of medical knowledge in an outpatient setting, such as clinics and offices.

Structure of Step 3 of the USMLE

Step 3 is divided into two days and assesses different aspects of medical practice.

In general, the structure of Step 3 of the USMLE is:

• Outpatient medical practice: Assesses the ability to provide comprehensive medical care to patients in an outpatient setting.
• Decision-making: Checks the ability to make independent and safe clinical decisions.
• Formatting: Multiple choice questions, clinical cases and computer simulations.

The exam is written by medical specialists and reflects common clinical situations faced by general practitioners.

USMLE Step 3 – Day 1: Fundamentals of Independent Practice (FIP)

• Duration: Approximately 7 hours
• Content: Assesses essential skills for medical practice, such as exam interpretation, correlation between basic and applied sciences, communication, ethics, etc.
• Number of questions: Around 232 multiple-choice questions, divided into six 60-minute blocks.

USMLE Step 3 – Day 2: Advanced Clinical Medicine (ACM)

• Duration: Approximately 7 hours
• Content: Assesses medical knowledge of diseases and patient management, as well as the ability to make clinical decisions.
• Number of questions: Approximately 232 multiple choice questions on Essential skills for medical practice on Day 1 (FIP) and approximately 180 multiple choice questions + 13 simulations on Clinical knowledge and decision making on Day 2 (ACM).

Test Duration – Average time for each USMLE Step

Knowing the approximate time it will take to take each test is fundamental to preparing for the USMLE.

The average time it takes to take each USMLE exam is key information in the process of preparing for the USMLE exam. For this reason, D4U Immigration provides an overview of the duration of the USMLE exams:

• Step 1: Approximately 8 hours. The exam consists of several blocks of questions, with a set time for each block.
• Step 2 CK: Approximately 9 hours. The format is similar to Step 1, with a greater number of questions and blocks.
• Step 3: Approximately 7 hours for each of the two days.

It’s important to note:

• Breaks: During the tests, short breaks are allowed between blocks of questions so that candidates can rest and eat.
• Total time: The total time of the test includes not only the solving of the questions, but also the time for the initial instructions and the completion of the test.
• Concentration: The length of the tests requires a high level of concentration and physical and mental stamina.

How do I register for the USMLE?

To register, you need to access the official ECFMG website (Educational Commission for Foreign Medical Graduates) and follow the instructions. You need to create an account and provide personal, academic and financial information.

In summary, registration for the USMLE requires:

• Create an OASIS (On-line Application Status Information System) account: You will need to create an account on the ECFMG’s online system to complete your application and follow the process.
• Payment of fees: USMLE fees are high and must be paid for each stage.
• Scheduling your test: After registration and payment, you will be able to schedule your test at one of the authorized test centers.
• Required documents: On the day of the exam, you will need to present valid identification documents.

For more information on how to apply or even how to prepare for the USMLE, contact contact D4U Immigration.

USMLE Prices and Fees

A very common question about how to prepare for the USMLE is the cost of taking the exams. After all, the costs involved are a fundamental part of planning for doctors with a Brazilian degree who wish to work in the USA.

USMLE fees are usually considerable and include:

• Registration: Fee to register for each stage of the exam.
• Scheduling the test: Fee for scheduling the test at a test center.
• Additional services: Fees for services such as transcript requests, document checks, etc.

Saving tip: Some institutions or organizations offer scholarships for USMLE applicants. The best way to get the latest and exact USMLE fees is to visit the official ECFMG website or contact US immigration specialists.

Doctor with business plan for the USA approved in EB-2 NIW

USMLE Passing Scores

The minimum scores required to pass each stage of the USMLE are not fixed and may vary over time.

In addition, the score required to get a place in a residency program is usually higher than the minimum passing score.

USMLE Step 1 score:

• Minimum score to pass: 196
• From 2022: The score will be reported as “Pass/Fail”.
• Recommendation: Even with the change to Pass/Fail, it is highly recommended to get a score above 230 to increase the chances of getting a residency place.

USMLE Step 2 CK score:

• Minimum score for approval: 209
• Recommendation: The higher your score, the better your chances of getting a residency place.
• Preparation time: The Medical Boards Study Academy (MBSA) recommends at least 4 months of dedicated study for this exam.

7 Tips on how to prepare for the USMLE

Preparing for the USMLE requires dedication, planning and the right strategies. Some important tips include:

1. Start early: Preparing for the USMLE and organizing the documentation takes time. Therefore, preparation should be started well in advance.
2. Translation and authentication of documents: If your documents are in another language, they will need to be translated and authenticated by a sworn translator.
3. Pay attention to deadlines: Each stage of the process has specific deadlines. Don’t leave it to the last minute to send in your documentation.
4. Create a study plan: Organize your studies efficiently by setting goals and deadlines.
5. Do mock exams: Do mock exams regularly to familiarize yourself with the format of the exam and identify your areas of difficulty.
6. Manage stress: Use relaxation techniques to deal with anxiety.
7. Seek support: Study in a group, talk to other candidates and seek out a mentor if you need one.
8. Time management: Practice with mock exams to develop an effective time management strategy.

1. Breathing and relaxation: Use breathing and relaxation techniques to stay calm during the exam.
2. Read the questions carefully: Read each question carefully to avoid mistakes due to inattention.
3. Eliminating alternatives: If you’re not sure of the answer, eliminate the most unlikely alternatives.

Tip: the USMLE website has some materials on how to prepare for the USMLE, detailing each Step at:

• Content Outline and Specifications
• Examples of Test Questions
• Test Question Formats
• USMLE Practice Session
• Common questions

Preparing for the USMLE is a challenging process, but with dedication and the right strategies, you can achieve your goals. This is where the importance of a Specialized immigration advice. D4U Immigration offers personalized support at every stage of the immigration journey, from the initial assessment to the approval of the American visa and your integration into the American job market.

What’s more, among our differentials, we offer a specialist for each stage and reapplication at no extra cost.

Check out some of our Success Stories, with approved clients, and our services and solutions for the immigration process.

Frequently Asked Questions (FAQ) about the USMLE

In order to clarify all the points, we have highlighted the main doubts about how to prepare for the USMLE, which we have received from countless doctors and candidates assisted by D4U Immigration in this process. Check them out below:

1 Which language is the USMLE in?

The USMLE is conducted exclusively in English (the official language of medicine in the United States), from registration to taking the exams. English is used in all medical literature, research and communication between professionals in the field.

D4U Immigration offers English, Spanish and Portuguese courses in the online classes and with native teachers to help you open doors on your professional journey!

2. Can I take the USMLE in my home country?

Yes, the USMLE is offered in several test centers around the world.

For more information, consult the official USMLE website or contact us directly at D4U Immigration via WhatsAppvoted Best Immigration Consultancy in the United States and Latin America by the Legal Awards in 2021, 2022 and 2023.

3. How many times can you do the USMLE?

The maximum number of times you can do each USMLE step has changed over the years. Currently, you can redo Step 1 up to 4 times.

4. How long does it take to receive the USMLE results?

The time it takes to receive the results of the USMLE can vary, but it usually takes a few weeks.

The best way to get accurate information about the waiting time for USMLE results is to consult the official ECFMG website. Lá você encontrará um cronograma estimado e poderá acompanhar o status da sua inscrição.

5. Is there no more USMLE Step 2 CS?

USMLE’s Step 2 CS (Clinical Skills) has been officially discontinued due to the COVID-19 pandemic. With social distancing measures and travel restrictions, it has become impossible to carry out the test safely and effectively.

Furthermore, a more in-depth analysis of the format of the exam and the needs of medical practice led to the conclusion that Step 2 CS could be eliminated without compromising the quality of the assessment of future doctors.

What does this mean for the candidates?

• Simplification of the process: With the elimination of Step 2 CS, the process of obtaining a medical license in the United States has become simpler and less bureaucratic.
• Focus on other aspects: Candidates can focus on preparing for Step 1, Step 2 CK and Step 3, which assess theoretical and practical knowledge more comprehensively.
• Adapting to the new realities of medical practice: The discontinuation of Step 2 CS reflects the evolution of medicine and the growing importance of skills such as teamwork, virtual communication and the use of information technologies.

The elimination of Step 2 CS does not mean that the skills assessed by this exam are any less important. Medical schools and residency programs continue to emphasize the importance of developing these skills, which are essential for safe and effective medical practice.

6. Is there no longer USMLE Step 3 as it was previously known?

What happened was a rethink of the exam. The old Step 3 was split into two parts:

• USMLE Step 3This new version of Step 3 focuses on clinical evaluation and decision-making in an outpatient setting.
• CCS (Clinical Skills Examination)This is a new assessment that evaluates the candidate’s practical clinical skills in a simulated environment.

Why this change?

This reformulation aimed to align the USMLE with changes in medical practice and ensure that future doctors are prepared for the challenges of modern clinical practice.

How important is it to know about this change?

It is essential that you are aware of these changes so that you can prepare properly for the exam. When looking for study materials and information about the USMLE, make sure they are up to date and refer to the new exam structure.

7. Is it difficult to pass the USMLE?

The difficulty of passing the USMLE varies greatly from person to person and depends on several factors. There is no single answer to this question, as what is challenging for one candidate may be easier for another.

The main factors influencing the difficulty of the USMLE exam are:

• English level: A command of the English language is essential, both to understand the questions and to answer them properly.
• Knowledge base: A solid foundation in basic and clinical sciences is essential for good performance.
• Clinical reasoning skills: The USMLE assesses not only the memorization of facts, but also the ability to apply knowledge in clinical situations.
• Time management: The exam requires you to solve a large number of questions in a limited amount of time.
• Study strategy: A good study strategy, including choosing suitable study materials and creating an efficient timetable, can make all the difference.

Why do many find the USMLE challenging?

• Competitiveness: Each year, a large number of applicants compete for a limited number of residency places.
• Extensive content: The content of the USMLE covers a wide range of medical topics.
• Pressure: The exam is considered one of the most important for a medical career, which creates a lot of pressure on the candidates.

In short, the USMLE is a challenging exam, but it’s not impossible to pass. With dedication, planning and the right strategies, you can significantly increase your chances of success.