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United States Medical Licensing Exam (USMLE)

At the competition of the basic sciences curriculum in Aruba, Aureus students are eligible and required to take the USMLE Step 1 exam. USMLE Step 2 and Step 3 exams are administered during clinical rotations in the United States.

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.

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, 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two committees of experts critically appraise each test question or case and revise or discard any materials that are outdated or inconsistent with current medical practice.

Step 1

This Step assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning. Step 1 is constructed according to an integrated content outline that organizes basic science material along two dimensions: system and process.

Step 2

This Step assesses an examinee’s ability to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes an emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine under supervision.


Applicants who pursue one of the ECFMG Pathways are required to attain a satisfactory score on the Occupational English Test (OET) Medicine to satisfy the communication skills requirement for ECFMG Certification. All Pathways applicants, regardless of citizenship or native language, must satisfy this requirement.


The Mini-CEX is a well-studied workplace-based assessment tool used to evaluate an individual’s clinical skills in a variety of clinical settings. Using ECFMG’s Mini-CEX for Pathway 6, your physician evaluators will assess your clinical skills during real, in-person clinical encounters.

Step 3

This Step assesses whether you can 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. It is the final examination in the USMLE sequence leading to a license to practice medicine without supervision. The examination material is prepared by examination committees broadly representing the medical profession. The committees comprise recognized experts in their fields, including both academic and non-academic practitioners, as well as members of state medical licensing boards. Step 3 content reflects a data-based model of generalist medical practice in the United States. The test items and cases reflect the clinical situations that a general, as-yet undifferentiated, physician might encounter within the context of a specific setting. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care.

Practice materials, which include Sample Test Items (PDF) and web-based Tutorial and Practice Test Items, as well as other informational materials, are available at the USMLE website.