Step 1 assesses the examinee’s understanding and ability to 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. It is unlike any examination that Dutch medical students are exposed to during their medical educations in the Netherlands. Step 1 is a one day examination; the exam consists of seven 60-minutes blocks of 44 questions on various topics, often formulated in a different manner than the Dutch test formats. Step 1 is regarded as being the most challenging USMLE exam. Your Step 1 test score is a critical determinant when applying for a residency program in the US.
The Educational Commission for Foreign Medical Graduates (ECFMG), through its program of certification, assesses whether international medical graduates (IMGs) are ready to enter residency or fellowship programs in the US. The examination requirements for ECFMG Certification include passing Step 1 and Step 2 of the USMLE.
In order to take a USMLE examination, you will first need to establish an ECFMG account and apply for ECFMG certification through the Interactive Web Application (IWA) at the ECFMG website (https://secure2.ecfmg.org/emain.asp?app=iwa).
To be eligible for Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical Skills (CS), mediscal students must be officially enrolled in a medical school located outside the United States and Canada that is listed in the World Directory of Medical Schools (World Directory: all Dutch medical faculties are enlisted) during the application period and at the time of your exam. In addition to being currently enrolled as described above, to be eligible for Step 1, Step 2 CK, and Step 2 CS, a medical school student must have completed at least two years of medical school. This eligibility requirement means that the student must have completed the basic medical science component of the medical school curriculum by the beginning of his/her examination eligibility period. We at USMLE SOS advise that you have obtained your bachelor degree (BSc) in Medicine, before applying for any of the USMLE exams.
An authorized official of the student’s medical school must certify his/her current enrollment status; instructions are provided at the time of application for examination. It is important that you contact the appropriate official at your faculty, not all service employees are registered by ECFMG. Also medical graduates will need confirmation from a registered official at the graduate’s medical school in order to apply for the USMLE.
In order to register for a USMLE exam as a foreign medical student/graduate, you must have your USMLE/ECFMG Identification Number and on-line services password. To obtain this, you will first need to establish an ECFMG account and apply for ECFMG certification through the Interactive Web Application (IWA) at the ECFMG website (https://secure2.ecfmg.org/emain.asp?app=iwa). You will need to confirm that you are officially enrolled in (or graduated from) a medical school located outside the USA and Canada.
After receiving your ECFMG Identification Number, you can apply for USMLE examination through IWA. There are two parts to the exam application:
Below, you can find a table showing an example of the total costs of obtaining your ECFMG Certificate (consisting of USMLE Step 1, Step 2 Clinical Knowledge and Step 2 Clinical Skills).
|
Fee(s) in US dollars |
Application for ECFMG Certification |
65 |
Step 1 |
865 |
Step 2 CK |
865 |
Step 2 CS |
1505 |
Translation of medical credentials after graduation of foreign medical school |
200 |
Test preparation books (e.g. USMLE First Aid books, Master The Boards, Biochemistry) |
250 |
30 day Q bank of UWorld (for both step 1 and step 2 CK) |
258 |
American-style doctors’ coat |
40 |
Additional test prep material for Step 2 CS (e.g. DVD with cases, 3 day Step 2 CS prep course in NYC) |
1150 |
|
|
Cumulative |
5198 |
If you want to apply for residency training (or part of) in the US, your score is important. Several specialties are considered to be highly competitive and require you to have a near perfect score. The score needed for a specific residency differs between international medical graduates (IMG) and US medical graduates but also on the institution where you apply. Although these scores are not set in stone, they can be considered as guidelines. You can find the latest score requirements and other score statistics in the link below:
USMLE exams are offered at Prometric test centers located worldwide. Visit the Prometric website (https://www.prometric.com/en-us/clients/usmle/Pages/landing.aspx) to look for a test center in your area. In the Netherlands, the nearest test center is located in Amsterdam, about a 10 minute walk from Amsterdam Central Station (Westerdoksdijk 215). For the USMLE Step 2 CS one needs to travel to one of the 5 test centers in the US (Atlanta, Chicago, Philadelphia, Los Angeles and Houston).