How are foreign doctors assessed before practising in the US?

The United States Medical Licensing Examination (USMLE)

Before practising in the US, The United States Medical Licensing Examination (USMLE) assesses any physician’s ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills.

3 steps in this exam:

The 1st 2 steps are different depending on the medical school where you studied or certified: Students and graduates of U.S. or Canadian medical school programs register with the National Board of Medical Examiners (NBME), although all others do by the Educational Commission for Foreign Medical Graduates (ECFMG),
But step 3 is common to all graduates.

Newcomers to US or Canada:

ECFMG assesses your ability for medical care under supervision and your readiness to enter residency or fellowship programs in the United States, although you graduated in medical schools outside the United States and Canada.
Contact: info@ecfmg.org.

Step 1 and Step 2: Clinical Knowledge, and Clinical Skills

Applicants for ECFMG Certification must satisfy both the medical science examination Clinical Knowledge (CK), and Clinical Skills (CS) requirements.

Parts of the USMLE are computer-based:

Step 1 and Step 2 CK include only single questions with one best answer and are given around the world at Prometric Test Centers (PTCs),
Although Step 2 CS covers common and important situations that a physician is likely to encounter (with people trained to portray real patients),and is therefore administered at five regional test centers (CSEC Centers) in the United States only.

Clinical Knowledge (CK) prior to Clinical Skills (CS)...

You can take Step 1 or Step 2 CK in either order

But you must pass both Step 1 and Step 2 CK (Clinical Knowledge) within a specified period of time (7 years).

Before you are eligible to Step 2 CS (Clinical Skills)

Both Step 2 CK and CS before Initial License to practise

Results of the USMLE are reported to the 70 state medical boards authorities for use in granting the initial license to practice medicine and patient care under supervision.

Beware of different decisions made by any of these, we recommend you should contact the jurisdiction where you intend to apply for licensure to obtain complete information.

Step 3:

Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care. It is common to all medical school graduates who have passed Step 1 and Step 2, whatever way.

Step 3 is given in the United States and its territories only.

Pass Step 3 once you have:

passed Step 1 and both CK and CS Step 2, and are certified by ECFMG
and have met all other eligibility requirements for step3, such as complete at least one postgraduate training year in a program of accredited graduate medical education.

For more inquiries about Step 3, see the Federation of State Medical Boards of the United States (FSMB).
Contact: usmle@fsmb.org

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