USMLE Examination Guide Part 1

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Note: This article is for international medical graduates (IMGs) the United States Medical Licensing Examination (USMLE) is a three-step test for medical licensure. It is mandatory for every doctor who wants to practice in the US.

United States Medical Licensing Examination (USMLE) is a three-step test for medical licensure. It is mandatory for every doctor who wants to practice in the US.



The examination is conducted in three steps. Step 1 and Step 2 must be cleared to match for a residency, however, Step 3 can be attempted during the residency.

  • Step 1 tests the foundational aspects of the medical knowledge.
  • Step 2 tests the clinical knowledge and clinical skills of a doctor. Hence it is divided into the clinical knowledge (CK) and clinical skills (CS) parts.

It is not necessary that you attempt Step 1 before Step 2. In this article, we will discuss strategies to decide which step to attempt first.



Make sure that you have the following links saved:



Here is the list of actions items for you:

  • Register with to obtain an identifier (ID).
  • Decide which Steps examination you want to take first.
  • Apply to take the Step.
  • Prepare for the examination.
  • Request an extension if needed.
  • Attempt the examination.
  • Receive score.
  • Apply for matching (when both steps are passed)
  • Obtain a visa –once matched– to a residency program.
  • Travel to the US and join your job.
  • Be an amazing doctor!







Here is the link that lists the required documents and data you need to complete the application:

Dr. Mobeen’s advice for deciding a Step to attempt:

  • If you spend the first four years studying foundational courses (physiology, pharmacology, pathology, etc.) and you are in one of these four years then attempt the step 1 first.
  • If you are in the final year (studying medicine and surgery) then attempt the step 2 first.
  • It is counterintuitive to attempt step 1 in the final year (imagine having to simultaneously study all four years of subjects and the final year’s subjects.) Chances are that you won’t be able to ace any of the two categories of subjects.
  • If you’re already a doctor – an HO or MO, etc., then my suggestion is to attempt step 2 first. The reason is that you’re more in tune with the clinical subjects and practices. Trying to recall step 1 material and ace it will frustrate you. Once you ace step 2, you will have enough confidence to take some time off to ace the step 1.
  • In my next articles and on our site ( I will propose some schedules that you can either follow as is or adjust according to your situation.
  • I will also outline exam prep material in the next articles of this series.


      My recommendation is that you book a date for the exam once you have done at least two reviews of your course material, however, make sure you have registered to obtain your identifier before you are ready to appear for the exam.
    • To apply for a step go to this link:
    • At the time of writing this article, the fee for Step 1 is $895.00 (US Dollars.) You may also have to pay the international test delivery surcharge. See the page on the following link for further details:
    • At the time of writing this article, the fee for Step 2 CK is $895.00 (US Dollars), and fee for the step 2 CS is $1550.00 (US Dollars). These fees exclude the international test delivery surcharge.
    • There is a fee for rescheduling/extending your date. Again, take a look at the fees page for details:


      • Your readiness means that you can review course material within a few days. To reach this point, a general suggestion is to study the material at least three times.
      • For Step 1, buy First Aid for USMLE and get it ring bound. Use a binder big enough to add new pages to take notes from other books, videos, and questions.
      • For Step 2, buy Ace The Boards from Kaplan and get it ring bound.
      • For your first review, go over the material in First Aid. If you feel that you need to clarify a concept then study from a bigger book (text book) to grasp the concept. Make notes on a page and add this page to First Aid. Indicate the page number and, if possible, the concept number on the notes page. This will help you correlate the notes to the concepts in the future. This phase should not be more than six months.
      • Your second review will be from this “new book” you have created during your first review. My recommendation is to use UW or Kaplan QBank with your second review. Make notes again from these resources and add them to this book you are making. Two months are sufficient for this phase.
      • Once finished with this review take  National Board of Medical Examiners (NBME) if necessary. Four to six weeks are sufficient for this phase.
      • The point to reduce the duration of review is to make sure that your recall has improved and your reflexes are built to answer questions rapidly. If you are not able to review your course within a few weeks then you are not ready yet.

In the next article, we will discuss the topics to study, reference books/videos/qbanks, study schedule; additionally we will also discuss strategies for studying.




5 Simple Steps to Ace Your Next Exam

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Setting Goals and Expectations

The first thing you need to know is what the minimum score is to pass and your intention to score way above that mark. Be honest with yourself and where your current knowledge level is. Once you know what level you currently stand, it will be much easier to dig in and learn what you need to master in the timeliest fashion. What do you want to score? Do you have a study plan? How long do you intend to study? What tools have you set out to use? What specialty do you want to practice? Set your goals and expectations early and you’ll find that your roadmap to success will be much easier to follow.


Study Agenda

Start looking at study material as you prepare for your school courses early. Sometimes the lecturer will cover outside material in order to cover the intended material for the class, but not emphasize information taught heavily for board preparation. By cross correlating between your lecture material and your board study prep, you fill in the gaps and critical information isn’t left behind. You’ll also have extensive notes already written for the critical period of time allocated for your exam.


If you set out a schedule for your studying, you’ll find that you aren’t reviewing material when you should be working on new material and vice versa. You’ll also have time for exercise, sleep, and down time. Some people are disorganized and as a result “study” for 10 years but yield very little retainable information at the end of the day. I know this because I was disorganized at the beginning.

Example: 3 hours for Anatomy, with 10 minute breaks every 50 minutes. Followed by 1 hour of focused questions. Review the answers and write down the solutions of why you got answers correct and more importantly, why you got answers incorrect. Then take a break. Work out, watch a show, and eat something. Focus on when your next session will start.



Questions vs. Reading

Some students focus heavily on questions for their studying. This is a good strategy once you have some background material. Think about it like mining for gold. You have to go through a lot of coal (data) to get the nuggets you need. If you go straight to the questions, it’s likely you’ll miss big picture concepts and the ability to sift through it properly. Questions are key. Incorporate them into your study schedule. Allocate sets of questions that are topic based so that once you finish a section of study, you reinforce the concepts with focused questions on that topic. Once you’ve completed all subject topics, now you can randomize your bank of questions to simulate the actual exam. You want to reinforce study material, but you also want to have unused questions to simulate the exam as you prepare. Keep in mind that research has shown that it is better to write out your notes than to type them out.

Getting into a Flow

Flow is also known as “the zone”, and is the mental state of operation in which a person performing an activity is fully immersed in a feeling of energized focus, full involvement, and enjoyment in the process of the activity. Basically, when you are in the flow state, you are undistracted and totally absorbed. Interestingly, flow enhances learning due to dopamine release. Getting into a flow state requires concentration, a challenging task at hand, and total immersion. You likely have experienced flow before. Have you ever jumped into a task that felt like you were busy for only 5 minutes, only to find that you have been working on it for 4 hours? That’s the flow state. More and more business executives and educators are working on cracking the code of the flow state. Use it to your advantage.