All you should know about USMLE Steps

what is residency ?

Residency is what we call post graduate training in India or simply PG.
In Order to practice in US one should need  to get state license which requires at least 2-3 yrs of "Accredited American Graduate medical education"(RESIDENCY).

and if u r Board Certified it adds to authenticity and value ...!

Basically to practice in US one need NOT ! be BOARD CERTIFIED.
"If a doctor is "licensed to practice medicine" does that mean he/she is certified?

No. Obtaining a medical license and being certified as a medical specialist by an ABMS Member Board are two different and separate processes. A license, legally required in order to treat patients, is issued and required by the state or territory in which a doctor practices medicine. A specialty certificate is issued by a medical specialty certifying board, which is valid nationwide. Although certification is not required for an individual physician to practice medicine, most hospitals and managed care organizations require that at least a certain percentage of their staff be, " board certified." Today, approximately 89% of licensed physicians are certified by one or more ABMS Member Boards."

What is USMLE?

The United States Medical Licensure Exam (USMLE)  commonly called “the Boards,” is a standardized test that assesses a med student’s ability to apply UG medical Skills  to the practice of medicine. The entire exam has three steps. Students generally take Step 1 following their second year of medical school. 

who conducts this test?

The test is administered by the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB).

what is the pattern of Step 1?

The Step 1 exam is a computer-based test taken in a single day over an eight hour period. It’s a multiple choice question test that includes seven sections of 46 questions each for a total of 322 questions. One hour is allotted for each of the seven sections. That’s an average of one minute and 18 seconds per question.

Is there any breakup(relaxation) time during exam?

Test takers are allowed 45 total minutes during the test for personal breaks. 

If you finish any section before the allotted hour is up, you can add that time to your personal break total. Six breaks total are allowed. There is an optional 15 minute tutorial period at the beginning of the exam. If you choose to skip the tutorial you can add the 15 minutes to your total break time.

 what are the precautions one should observe during exam?  During the test, you are only allowed to bring soft foam earplugs into the examination room. Nothing else is allowed – no bags, electronics, phones, or even jackets are allowed. Be sure to check with the exam monitor prior to entering the test room for complete details.

How do I apply for Step 1?

Students or graduates of medical schools outside of the U.S. or Canada register with the Educational Commission for Foreign Medical Graduates (ECFMG). Tests are administered by appointment year round.
How much does the step 1 test cost? 

As of 2015, Step 1 costs $1000.

 I passed Step 1 but am not thrilled with my score. Can I retake it to raise my score?

 No.

 I didn’t pass the first time. Can I retake the exam?

Yes. You may take the USMLE Step 1 exam a maximum of three times within a 12-month period. Your fourth attempt must be at least 12 months after your first attempt, and at least six months after your most recent attempt.

what is the syllabus for step 1 exam?  Step 1 mainly covers basic scientific principles including anatomy, behavioral sciences, biochemistry, microbiology, pathology, pharmacology, and physiology. Interdisciplinary topics covered include genetics, aging, nutrition, immunology, molecular and cell biology, epidemiology, and medical ethics.

What is the pattern of questions?  the majority deal with your ability to solve problems using basic scientific principles. For example, you’ll be asked to interpret graphs, identify gross and microscopic pathology and normal specimens, and apply concepts and principles relevant to individual organ systems.

when is the ideal time to take step 1 exam?  within two months of finishing basic courses because material is still fresh in their minds, combined with an extra month or two of studying.

what is the pass mark in step 1?   A score of 192 is needed to pass the Step 1 exam. The average score in 2013 was 228 with a standard deviation of 21.

When do I get my USMLE test results? Scores for Step 1 are released each Wednesday. It usually takes three to four weeks for scores to be released. You will receive an email from the entity you registered with (NBME or ECFMG) when your score is available. It will also be posted to that entity’s website. If you don’t receive an email within two months, it’s recommended that you contact the registration entity directly. The current pass rate is about 85%.

How much total fees costs for international medical graduates for all steps? 

the student can apply online- ( http://www.ecfmg.org ).

• Application for ECFMG Certification : 65$ .access the Application for ECFMG Certification through Interactive Web Applications (IWA) on the ECFMG website.(http://www.ecfmg.org/2014ib/application-ecfmg-certification.html). You must have your USMLE/ECFMG Identification Number before you can begin the Application for ECFMG Certification. You must complete an Application for ECFMG Certification before you can apply to ECFMG for examination.
• for step1  exam fee + exam center in india surcharge = 865 $ + 150 $
• step2 -CK  exam fee + exam center in india surcharge = 865 $ + 165 $
• Step2 CS exam fee  = 1505 $

Roughly the total USMLE  exams costs around $5000, including airfare for Step 2 CS).

note: for complete details of various types of fees plz see - http://www.ecfmg.org/fees/index.html

                                                       Few more clarifications:

Is it compulsory for an IMG to do a clinical elective or extern-ship  in the USA in order to secure a residency position? 

Compulsory no, Advisable yes. 

The match rate in USMLE for IMGs is declining. This year only close to 50% IMGs matched. 

So unless you have a decent CV and score, and/or someone to recommend you , its definitely advisable to do electives. 

Is it really that difficult for an IMG to get residency even after he/she gets good scores in the USMLE?

It's getting more difficult each year. As number of applicants is increasing, competition is very high. The point is, scores are still the biggest factor, but you need to have a complete application from every aspect. Having US clinical attachments or externship and research experience is gaining more and more importance. 

Another factor is having contacts. Believe me, it matters too. 

It requires a lots of patience and time to build a good application to fetch a good number of interviews. Compromising any part will decrease the chances. 

And with all these things, if you have good communication skills, you'll be through. 

Are the Post Graduate Medical Degrees from UK, US and Canada Recognised in India?

Since april 2009,India has recognized Post graduation MD/MS degrees from  5 countries including US,UK,Canada,Australia and New Zealand.

During the tenure of Anbumani Ramadoss as Union Health Minister of India, govt of India has taken a unilateral decision to recognise postgraduate degrees in medicine obtained from foreign institutes in UK, USA, Canada and New Zealand. This would mean that Indian doctors who have obtained their postgraduate qualifications from these countries would be able to legally practice in India as a specialist in their areas of post graduate qualification.