usmle exam syllabus

USMLE Exam Syllabus & Pattern

USMLE has been designed to provide a license to practice medicine in the United States. Read on to find out the latest USMLE Exam Syllabus and Pattern in 2023.

June 15, 2022

The purpose of the U.S Medical Licensing Exam (USMLE) is to provide a license to practice medicine in the United States. This USMLE exam is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME).

In this article, we provide the latest USMLE Exam Syllabus and Pattern for 2022. Let’s get started with our free USMLE practice test to pass your actual exam with a high score on your first attempt.

usmle exam syllabus

USMLE exam 2022

The aspirants wishing to practice medicine in the United States need to qualify for the entrance exam. Check below to find out what is the USMLE exam details:

Name of the examThe U.S Medical Licensing Examination
Commonly Known asUSMLE
PurposeObtaining a license in order to practice the medicine in the United States area
Sponsoring organizationthe National Board of Medical Examiners (NBME) along with the Federation of State Medical Boards (FSMB)
USMLE Stepsthe USMLE exam consists of the total of three steps:
Step 1
Step 2: Clinical Skills along with Clinical Knowledge
Step 3
Mode of USMLE examStep 1, Step 2 Clinical Knowledge, and Step 3: computer-based 
Step 2 Clinical Skills: Offline
ResultThe National Board of Medical Examiners (NBME) will declare results for all Steps
RetakesNo more than 3 times of taking the USMLE exam within a 12-month period
Number of attemptsAn examinee can not take a USMLE Step or Step Component more than six times
Mode of ApplicationOnline

Who Is Eligible for The USMLE Exam?

To prevent being rejected, candidates must check the eligibility conditions before applying for the test. Aspirants must fulfill a specified requirement for each step of the test. Candidates can take USMLE Step 1 and 2 Clinical Skills, as well as Step 2 Clinical Knowledge, in any sequence. To appear for Step 3, candidates must first complete USMLE Step 1 and 2. The following are the USMLE eligibility criteria:

Eligibility Criteria For USMLE Step 1, 2 Clinical Knowledge, And 2 Clinical Skills

  • Medical students must be officially enrolled in, or a graduate of, a Canadian or the United States medical school program leading to the MD degree that is accredited by the Liaison Committee on Medical Education. Or,
  • A medical student officially enrolled in, or a graduate of, a United States medical school leading to the DO degree accredited by the American Osteopathic Association. Or,
  • A medical student officially enrolled in, or a graduate of, a medical school that is outside the United States and Canada can apply.

Eligibility Criteria For Taking The USMLA Step 3 Exam

  • Aspirants must have passed Steps 1, 2, and 2 Clinical Knowledge and Clinical Skills.
  • Candidates having an MD degree or DO degree from an LCME- or AOA-accredited United States or Canadian medical school. Or,
  • The equivalent of the MD degree from a medical school outside the United States and Canada is listed in the World Directory of Medical Schools.

USMLE Exam Pattern

Computer-based assessment will be used for USMLE Step 1, Step 2 Clinical Knowledge, and Step 3. Candidates will be guided by the USMLE exam pattern in terms of the exam format, test duration, and the purpose of each Step and Step Component. The exam pattern can be used to assist the candidate’s test preparation. Below is the USMLE exam pattern:

USMLE Step 1 Pattern 


Knowledge of and ability to apply critical ideas from the basic sciences to medical practice, with a focus on the principles and processes underlying health and illness, as well as treatment modalities.


280 multiple-choice questions, divided into seven 60-minute blocks.

This computer-based exam is given by Prometric test centers around the world.


One-day test session. Approximately eight hours.

USMLE Step 2 Clinical Knowledge Pattern 


This exam assesses the examinee’s ability to use medical skills, knowledge, and clinical science understanding to provide supervised patient care with a focus on health promotion and illness prevention and management.


There are approximately 318 multiple-choice questions spread throughout eight 60-minute blocks. Prometric test centers administer the computer-based exam.


One-day test session. Approximately nine hours.

USMLE Step 2 Clinical Skills Pattern 


STEP 2 includes a unique and distinct component called the Clinical Skills Test.  It is the second component of the STEP 2 exam. It evaluates the examinee’s abilities to get information from patients, conduct physical exams, and explain their results to both patients and colleagues using standardized patients.


There are 12 patient cases to complete, with each patient visit lasting 15 minutes and an additional 10 minutes to document each patient encounter., the exam was offered in six different locations. Cities in the United States include Chicago, Atlanta, Los Angeles, Houston, and Philadelphia.

This component of the USMLE Exam is divided into three subcomponents:

The Integrated Clinical Encounter (ICE) includes components such as Integrated Clinical Encounter (ICE), Communication and Interpersonal Skills (CIS), and Spoken English Proficiency (SEP)). 


One-day test session. Approximately nine hours 

USMLE Step 3 Pattern 


This exam assesses the examinee’s ability to apply medical understanding and knowledge of biological and clinical science to carry out unsupervised medical practice while also evaluating their communication skills.

Day 1: The principles of the performance

The examinee’s ability to comprehend the fundamentals of medicine and scientific concepts needed for efficient healthcare services is assessed by FIP.

Day 2: Testing your advanced clinical experience

The American College of Medicine (ACM) assesses the examinee’s ability to use a broad knowledge of health and illness in the context of patient care, as well as the changing presentation of disease throughout time.


Day 1 FIP: 

There will be approximately 232 multiple-choice questions split out over six 60-minute blocks. Prometric test centers across the country offer computer-based exams.

Day 2 ACM:

There will be 180 multiple-choice questions spread out over six 45-minute periods. This study used thirteen computer-based case simulations (CCS). Depending on the complexity of the simulation, each simulation is given a maximum of 10 or 20 minutes of actual time.

Prometric test centers across the United States offer computer-based exams.


Day 1 FIP: It is a one-day test session that lasts approximately seven hours.

Day 2 ACM: It is a one-day test session that lasts approximately nine hours.

USMLE Exam Syllabus

What is the USMLE test syllabus? Students who are currently enrolled in or have just graduated from a medical school recognized by the World Directory of Medical Schools are eligible to apply for USMLE.

USMLE Step 1 Syllabus

The USMLE Step 1 Syllabus covers the majority of the subjects addressed in the first two years of medical school. The following is information on the subjects and their weight ranges for each subject:

USMLE Step 1 subjects distribution is as follows

The Foundational Science's General Principles15% - 20%
1. Multisystem Disorders & Processes15% - 20%
2. Biostatistics & Epidemiology
3. Population Health
4. Social Sciences
1. Immune System60%-70%
2. Special Nervous & Senses System 
3. Skin & Subcutaneous Tissue
4. Respiratory System
5. Pregnancy, Childbirth along with the Puerperium
6. Female Reproductive & Breast
7. Male Reproductive
8. Endocrine System
9. Blood & Lymph reticular System
10. Cardiovascular System
11. Musculoskeletal System
12. Behavioural Health
13. Gastrointestinal System
14. Renal & Urinary System


Abnormal Processes55% - 60%
Normal Processes10% - 15%
Principles of Therapeutics15% - 20%
Other10% - 15%

USMLE Step 2 Syllabus

usmle exam syllabus

Step 2 in the USMLE exam focuses on patient care under medical supervision. It is an examination of the candidate’s clinical science skills and knowledge, which are required for patient care under supervision and disease prevention. It applies basic clinical science principles and patient-centered skills to provide safe and competent practice of medicine.

Step 2 Clinical Knowledge is a one-day examination, just like the Step 1 exam. The test will last 9 hours, with each block lasting 60 minutes. The total number of USMLE step 2 questions will be 350, with no more than 40 questions in each block. The questions on the USMLE Step 2 Clinical Knowledge test will be in the same MCQ format as the Step 1 test.

Candidates will encounter standardized patients who have been trained to portray real patients in Step 2 Clinical Skills. This is an assessment of their clinical knowledge and patient communication skills. Candidates need to listen to patients, communicate with them, treat them professionally, identify their medical issues, and answer their medical questions.

The USMLE Step 2 test is divided into three sections:

  • Integrated Clinical Encounter
  • Communication Skills as well as the Interpretation Skills
  • Spoken English Proficiency

For Step 2 Clinical Knowledge, the following information regarding the subjects and their weightage ranges is given:

Foundational Science's General Principles1% - 3%
1. Biostatistics/Population Health & Epidemiology1% - 5%
2. The Medical Literature Interpretation
1. Immune System85% - 95%
2. Multisystem Processes & Multisystem Processes Disorders
3. Lymph Blood Reticular Systems
4. Endocrine System
5. Behavioural Health
6. Male Reproductive System
7. Female Breast & Reproductive System
8.  Special Nervous & Senses System
9. Renal & Urinary Systems
10. Skin & Subcutaneous Tissue
11. Gastrointestinal System
12. Musculoskeletal System
13. Respiratory System
14. Cardiovascular System

USMLE Step 3 Syllabus

While candidates who have enrolled in or graduated from medical school take the Step 1 and Step 2 exams, those who have completed the program take Step 3. Students from Canada, and the United States, as well as international medical graduates, have graduated from a medical school recognized in the World Directory of Medical Schools.

Step 3 evaluates whether or not the candidate is capable of providing unsupervised medical practice. Candidates who pass USMLE Step 3 obtain the final license to practice medicine.

The Step 3 exam lasts two days. As follows, this exam is divided into two subcategories:

  • Foundations of the Independent Practice
  • Advanced Clinical Medicine

The following table summarizes the various competencies and their weight on the USMLE Step 3 exam.

CompetencyFoundations of the Independent PracticeAdvanced Clinical Medicine
Professionalism & Communication 8% - 12%NA
Scientific Concepts along with Medical Knowledge18% - 22%NA
Systems-based Practice/Patient Safety as well as Practice-based Learning22% - 27%NA
Patient Care: Diagnosis40% - 45%NA
1. History/Physical Examination
2. Laboratory/Diagnosis Studies
3. Diagnosis
Prognosis/OutcomeNA20% - 25%
Patient Care: ManagementNA75% - 80%
1. Health Maintenance & Disease Prevention
2. Pharmacotherapy
3. Mixed Management
4. Surveillance for the Disease Recurrence
5. Clinical Interventions

USMLE Scores and Results

USMLE Scores

There are no fixed scores for passing the exam. The higher your score, however, the better programs will be waiting for you. Below listed are the latest USMLE Step 1 passing scores, USMLE Step 2 Scores, and Step 2 Clinical Skills results, with USMLE Step 3 Scores required:

USMLE TestsLatest Qualifying USMLE Scores
Step 1194
Step 2 Clinical Knowledge209
Step 3196

USMLE Results

The USMLE Step 1 results are released within 3 to 4 weeks every Wednesday. It will be delivered to you by the entity you registered with, either NBME or ECFMG. And also, it will be posted on their respective website. 

USMLE Step 2 Clinical Knowledge results are declared within four weeks of the exam. USMLE Step 2 Clinical Skills results are not a particular number, they are declared simply as pass/fail. 

Similarly, USMLE Step 3 Results take three to four weeks as well.

FAQs – USMLE Exam Details

The following are some frequently asked questions regarding USMEL Steps 1, 2, and 3:

Is there a limit to the number of times you can take Steps?

Candidates who have tried to pass a Step or Step Component six times or more are eligible to take that Step or Step Component.

Is there a minimum age to apply for the USMLE?

No, the officials have not set an age limit for the applicants.

Where can I apply for the USMLE Step 3?

You must apply for USMLE Step 3 on the FSMB’s official website.

What happens if I fail USMLE?

You can retake the test twice within a year after your first failed attempt.

Is USMLE a hard exam?

One of the most stressful and challenging exams you will take during your medical school career is the USMLE Step 1. Your performance on this exam will largely determine if you are successful or unsuccessful in the residency match process.

What is the hardest exam in the world USMLE?

Step 3 is the most difficult. It’s a 16-hour exam spread out over 2 days, with tests scheduled within 8 hours. There are a total of 454 multiple-choice questions (256 on the first day and 198 on the second), with candidates receiving a maximum of 1 hour of break per day.

What is a resident doctor’s salary in the USA?

How much can a Resident Doctor make? In the United States, the national average salary for a Resident Doctor is $62,608.

What countries accept USMLE?

Medical licensing authorities accept the USMLE program in the United States, New Zealand, Israel, UAE, and Qatar. These countries accept the USMLE scores and exempt candidates from other eligibility requirements.


The USMLE Exam aims to assess students’ ability to apply comprehensive knowledge in the context of patient care. It focuses on determining how diseases have evolved over time and how professionals have perceived them.

Through Step 1, Step 2, and Step 3, the candidates would be assessed for basic to advanced levels of their understanding of medical sciences.

The candidate’s knowledge of history and physical examination, diagnosis, and diagnostic investigation application will also be tested. As a result, this article will aid you in better understanding the USMLE exam syllabus requirements so that you can prepare for the exam.

Don’t forget to take our free USMLE practice test at Medtutor to get familiarized with the format as well as the questions of the actual exam to strengthen your knowledge and skills, as a result, enhancing your chance to pass the USMLE exam with a high score on your first attempt. Good luck to you!