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USMLE Exam Pattern 2024 - USMLE 1, 2 and 3 Test Pattern, Format, Length

USMLE Exam Pattern 2024 - USMLE 1, 2 and 3 Test Pattern, Format, Length

Edited By Porishmita Paul | Updated on Apr 15, 2024 09:59 AM IST | #USMLE

USMLE Exam Pattern 2024 - USMLE has a different USMLE syllabus and pattern for each step. It is because each USMLE step has been designed to evaluate a different skill set and ability. For example, the USMLE pattern and syllabus in Step 1 assesses the candidate's understanding of and ability to apply important concepts of basic sciences to the practice of medicine. As a result, the applicant must differentiate the USMLE exam pattern 2024 for the step they are taking. By checking the exam pattern of USMLE 2024, the applicant will get to know the details of each step, the disciplines covered, the exam format, and the test length.

USMLE Exam Pattern 2024  - USMLE 1, 2 and 3 Test Pattern, Format, Length
USMLE Exam Pattern 2024 - USMLE 1, 2 and 3 Test Pattern, Format, Length

Where To Take USMLE?

The USMLE 2024 is a three-step examination.

  1. USMLE Step 1 and Step 2 CK can be taken at Prometric centres across the world.

  2. Step 3 has to be taken at designated centres in the USA.

Step 1 and Step 2 Clinical Knowledge (CK) can be taken in any sequence. But Step 3 can be taken only after completion of Steps 1 and 2 (CK).

USMLE Exam Pattern 2024

USMLE pattern is different for the USMLE step 1 pattern, step 2 & step 3. The below format consists of the USMLE step 1 exam pattern, step 2, and step 3. In the USMLE step 1 pattern, step 1 is a one-day exam and the USMLE step 1 format is divided into 60-minute blocks around 8 hours time length. Similarly, the USMLE paper pattern is the same for all the USMLE step 1 paper patterns, step 2, step 3, etc.

USMLE Pattern- For Step 1, 2,3

Step and purpose




Evaluates applicant's understanding of and ability to apply important concepts of the basic sciences to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy

Around 280 MCQs, divided into seven 60-minute blocks

Computer-based tests administered at Prometric test centres across the world

Single day test


eight hours


Tests the examinee’s ability to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision, with an emphasis on health promotion and disease Prevention.

Clinical Knowledge (CK)

Around 318 MCQs, divided into eight 60-minute blocks

Computer-based tests are administered at Prometric test centres.

One-day test



nine hours


Assesses the ability of the examinee to apply medical knowledge and understanding of biomedical and clinical science essential to carry out the unsupervised practice of medicine, while emphasising patient management in ambulatory settings.


Assesses the examinee’s knowledge of basic medical and scientific principles essential for effective health care


Assesses the examinee’s ability to apply comprehensive knowledge of health and disease in the context of patient management and the evolving manifestation of disease over time

Day 1 FIP:

Approximately 232 MCQs, divided into six 60-minute blocks.

Computer-based tests administered at Prometric test centres in the US

Day 2 ACM:

Approximately 180 MCQs, divided into six 45-minute blocks

Thirteen computer-based case simulations (CCS). Each simulation is allotted a maximum of 10 or 20 minutes of real-time.

Computer-based test, administered at Prometric test centres in the US

One-day test



seven hours

One-day test



nine hours

There is no negative marking in USMLE. Hence the candidate can focus on attempting the exam at full length.

USMLE Exam syllabus

The syllabus for the USMLE exam varies at each step. In the USMLE step 1 syllabus, the test questions are classified in one of 18 major areas. The knowledge of the normal processes is evaluated for the candidate in the context of disease process or pathology.

USMLE Step 1 Syllabus - Disciplines Covered



Behavioural sciences


Biochemistry & Nutrition


Biostatistics and epidemiology




Histology and cell biology

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The Step 1 syllabus consists of MCQs that measure basic science knowledge. So, while preparing the USMLE part 1 syllabus, candidates should develop a good understanding of the concepts and principles of basic science.

USMLE Exam Syllabus - Step 2 Disciplines Covered


Obstetrics & Gynecology





USMLE step 2 syllabus is about Clinical Knowledge, focusing on individual organ systems, and principles of therapy.

USMLE Syllabus - Step 3 Disciplines Covered

General Principles of Foundational Science

Respiratory System

Immune System

Gastrointestinal System

Blood & Lymphoreticular System

Renal & Urinary System

Behavioral Health

Pregnancy, Childbirth, & the Puerperium

Nervous System & Special Senses

Female Reproductive & Breast

Skin & Subcutaneous Tissue

Male Reproductive

Musculoskeletal System

Endocrine System

Cardiovascular System

Multisystem Processes & Disorders

Biostatistics & Epidemiology/Population Health, & Interpretation of the Medical LiteratureSocial Sciences
Human Development-

Download the USMLE syllabus E-book for detailed information.

USMLE Pattern - Scoring

USMLE total score is reported on a 3-digit scale. The USMLE total marks are different for each section. The candidate would have to reach the USMLE score of the prescribed minimum cutoff mark in the respective Step or Step Component to qualify for the exam.

The minimum passing USMLE 2024 scores are as follows:


Minimum Scores Required

Step 1

196 (Reported as Pass/Fall)

Step 2 CK


Step 3


Scores of USMLE Step 1

The USMLE step 1 total mark is 300. The questions in the USMLE exam are in multiple-choice format. The step 1 exam is conducted in a single day and its duration is 8 hours, where there are seven blocks each 60 minutes long.

USMLE Step 2 Scores

Candidates need to score at least 214 out of 300 to pass the USMLE Step 2 CK. It means that a candidate must get a minimum of two-thirds of the total marks of USMLE Step 2 CK to achieve a passing score.

USMLE Exam Details for Indian students

How to register for the USMLE exam? Indian applicants applying for USMLE can register by following the below steps:

  • Create an ECFMG account.

  • Fill out the USMLE Step 1 application.

  • Fill and notarize the "Certificate of Identification"

  • Wait to receive the scheduling permit.

  • Book a test date at a Prometric Centre.

USMLE Admission Guide
This ebook gives you a detailed insight on the exam, its various steps, eligibility, exam pattern, syllabus, and much more.
Download Now

USMLE Preparation Tips:

Apart from the routine and study plans, candidates can follow some special strategies and preparation tips for a better USMLE score. Here are some of the preparation tips for USMLE-

  • Develop a strong understanding of the format and content of each USMLE step.
  • Analyse the official website of the USMLE resources
  • Candidates are advised to supplement their learning with additional resources
  • Practice answering questions
  • Set realistic goals and track your progress.
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Frequently Asked Question (FAQs)

1. Is USMLE very tough for Indian students?

Yes, USMLE may be challenging for Indian students. However, Indian candidates can overcome the difficulty level level of the exam through dedicated preparation and a solid foundation in medical knowledge. Extensive content, unfamiliar format, and time constraints are some of the major challenges that are combined to make the USMLE syllabus challenging. With USMLE-specific study materials, practice exams, and mentorship, candidates can easily get higher scores.

2. Is USMLE only for MBBS students?

No, the USMLE is not only for MBBS students. USMLE exam is open to international medical graduates (IMGs). Candidates must have some specific eligibility criteria for appearing in the exam. These criteria include graduating from a World Directory of Medical School listed medical school and passing ECFMG certification steps.

3. Who is eligible for the USMLE exam?

Candidates must fulfil all the eligibility criteria for appearing in the USMLE exam. These eligibility criteria include:

  • Officially enrolled in, or a graduate of, a U.S. or Canadian medical school 

  • Graduate from a medical school listed in the World Directory of Medical Schools (WDOMS) 

  • Successfully pass the ECFMG certification process.

  • Demonstrate good moral character and professionalism.

  • Meet the English language proficiency requirements.

4. How hard is the USMLE exam?

Yes, USMLE exam is considered to be difficult. The passing rate of the exam varies between between 95% for US/Canadian students and 77% for international students. Extensive content, unfamiliar format, and time constraints are some of the major challenges that are combined to make the USMLE syllabus challenging.

5. What is the total cost of USMLE in India?

The total cost of the USMLE for Indian students varies depending on individual circumstances. However, the overall cost ranges between 15-20 lakh INR. This includes:

  • Exam fees: Approximately 5-7 lakh INR 

  • Preparation materials: 4-6 lakh INR ECFMG certification: 2-3 lakh INR for fees and related expenses.

  • Travel and accommodation: 3-4 lakh INR 

  • Other expenses: 1-2 lakh INR for visa fees, medical exams, and miscellaneous costs.

6. What is the USMLE exam pattern?

Each Step of the USMLE has a different exam pattern. Most of the questions asked in the USMLE are in the MCQ format. The 

  • Step 1 exam is a 1 day exam of 8 hours duration
  • Step 2 is a 1-day exam of 9 hours  duration 
  • Step 3 is a 2-day examination of 7 hours duration for day 1 and 9 hours duration for day 2.

Each Step exam is divided into several blocks with a specific number of questions. A total break of 45 minutes is given during the exam for 1 day.


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Questions related to USMLE

Have a question related to USMLE ?
Hi aspirant
See, what you've asked about, are the entrance exams conducted at an international level.
Once you give complete your graduation i.e MBBS. You might want to pursue PG in India. For that you'll have to give NEET PG entrance examination. Now you might also want to settle abroad or pursue specialization abroad. In that case such exams like PLAB and USMLE are conducted.

PLAB is Professional and Linguistic Assessment Board. It is a licensing examination conducted for foreign medical  graduates who wish to practice medicine in the UK . PLAB is undertaken by the General Medical Council (UK) in several countries across the globe.
There are two parts of the PLAB exam

Part  1 :  180 single best answer questions.
Part 2 comprises  of  18 scenarios, each lasting eight minutes

Candidate are selected according to their score.

Now USMLE is United States The United States Medical Licensing Examination
It is a necessary medical license to practice in the United States of America (USA).
The FSMB (Federation of State Medical Boards) and NBME (National Board of Medical Examiners) are co-sponsors of this exam.
It is took by the students who wish to study and practice in the US.

Hope this helps
All the best:)

Hello aspirant,

India and Phillipines are  the best country.

Every year plenty of Indian students apply for USMLE, though everyone should understand that among those many of the students are students studying/studied in foreign medical colleges from various countries. So, when we question whether it is easy to crack USMLE if the student study in local/Indian medical colleges or in Foreign medical colleges, which require a thorough understanding of all the criteria including the student’s individual interest impacting most of their performance.

USMLE—the United States Medical Licensing Examination is the most popular PG entrance examination in the world where all the world’s medical graduates dream to get a chance to qualify and enter into those prestigious institutions to study PG or Residency.

The United States Medical Licensing Examination—USMLE is the licensure cum medical PG entrance examination to obtain a medical license as well to study their Post-Graduation in various US medical colleges. USMLE is co-sponsored by the National Board of Medical Examiner—NBME and the Federation of State Medical Boards—FSMB together.


A MBBS physician's capacity to put knowledge into practical medical practise is evaluated by the United States Medical Licensing Examination (USMLE). Contains Steps 1 and 2. If you take it, you'll be able to practise medicine in the US. After earning 6 Cr and prudently investing 3 Cr over the course of 60 months, you are free to return to India.

List of colleges you can choose for doing MBBS which will allow you to appear for USMLE :-

  • AIIMS, New Delhi
  • CMC, Vellore
  • Osmania Medical College, Hyderabad
  • King George Medical University, Lucknow and many more.

Thank You


You can obviously practice medicine in United States of America. But you need to take the screening test called U.S.M.L.E exam which is The United States Medical Licensing Examination.

To know more about U.S.M.L.E exam, please take a look the below link.

Students whoever want to do medicine in United States of America, you can take U.S.M.L.E exam. The first year of training after medical school is called an internship, or more commonly it is called first year of residency or PGY-1 (Post-Graduate-Year-1). The following years are called PGY-2, PGY-3, etc. The training that is done after a residency (in a subspecialty) is usual called a fellowship.

All the best for your career!!!

Thank You.

Hello Aspirant,

Yes, you can definitely take the U.S.M.L.E exam to practice medicine in U.S. The medical universities of Russia are well recognized all over the world. The Students are eligible for U.S.M.L.E exam after completing their studies from N.S.M.U.

To know what is U.S.M.L.E exam and its updates take a look in the below link.

All the Best for your future!!!

Thank You.

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