2022 USMLE Registration Guide to US Medical Licensing

• USMLE Step 1costs around $965
• Was a numerical score test, starting Jan 2022, changed to pass/fail test
• Passing score 196 instead of 194 in the past
• Needs about 7-month preparation and study
• Test important concepts of basic science preclinical knowledge, as microbiology, anatomy physiology, Parasitology, and biochemistry
• Exam duration: One day test, 8 hours, 7 blocks each block 40 questions total 280 questions

• For more information about eligibility, application, test dates, resources, you can check 2022 Bulletin of information offered by official USMLE website

• You apply through online ECFMG registration.
• USMLE Step 2 costs around $965
• Assesses your ability to apply medical clinical knowledge and skills in different medical specialties as: OB GYN, internal medicine, pediatrics, surgery, and some basic sciences as well.
• Testing foundation aims at ensuring the candidates’ ability to apply all medical required knowledge and skills under supervision to ensure patients’ safety and optimum medical care.
• Numerical test results, the higher, the better your chances are in matching.
• About 5-month average preparation time
• Exam duration: One day test, 9 hours, 8 blocks each 60 min, total 318 questions, one-hour break as step 1.

• Used to cost $1600
• Suspended by the USMLE program early 2020 due to COVID outbreak.
• Used to be the way to assess clinical and communication skills.
• ECFMG offered alternative pathway, OET is replacing step 2 CS till further notice.

• It is now a requirement to obtain ECFMG Certification for candidates aiming at 2022 match.
• OET costs $587 AUD / $455 USD
• Test assesses ability of candidate to communicate with physicians in clinical health care matters competently using medical English terms.
• Available in Paper and Computer delivery methods
• All applicants must satisfy the required score, whatever their nationality or native language is.
• Required minimum score of 350 (Grade B) to pass, in each of the 4 subtests, all in one test administration.
• Subtests are Listening, Reading, Writing, and Speaking.
• You can retake the test as many times as needed, no limits.
• Taking a course to prepare would be a great idea, saving you time and money instead of retaking the test.

• ECFMG (Educational Commission For Foreign Medical Graduates).
• It helps international medical graduates (IMGs) practice medicine in the US.
• Application cost $145
• Acquiring this certificate means you are as prepared as American medical graduates for medical training.
• Requirements for 2022 certification: Step 1 & Step 2 CK score, OET and Medical degree from your home country.
• You need to pass all exams required for ECFMG Certification within a seven-year period.

• Application costs $85.
• NRMP contacts ECFMG regularly to confirm the IMG candidate has passed certification requirements and is eligible to apply for residency programs.

• ERAS Application costs $130
• ERAS is a separate organization that requires separate registration, you need to register in both ERAS & NRMP to be able to access services offered by them.

• ECFMG certification.
• Professional medical experience (US and home country experience)
• Volunteer experience
• Research experience, especially team research is recommended, not required, but still is very essential for competitive programs such as surgery.
• Personal statements: Expressing yourself, telling your life story, why you would prefer this specialty or this specific program, write about your motivation and your ultimate goals, discuss your future plans, etc.
• LOR (Letter of recommendation):
• US or home country LOR written by a specialist or attending vouching for your skills, professionalism and your communication skills.
• US LOR are more valuable, you can get them by doing clinical rotations in the US.
• Maximum 4 LOR in one application.

• MSPE (Medical school performance evaluation).

• Medical school transcripts: your grades in different exams during medical school.

• About 4 months.
• From October to January.
• Winning interviews relies upon programs liking your application.
• Candidates take flying trips to meet with the Interview committee which usually consists of 3 individuals: Program director, chief resident & a professor.
• They test your English, medical skills and personality to make sure you fit in their program.
• Programs choose candidates based on their scoring and other qualifications.

• In February.
• Programs and applicants make their ROL, each program ranks their applicants, and each applicant lists their most favorable programs in order.

• Match date, often in March.
• Costs between $4200-$4800.
• Algorithms match applicants and programs.
• Monday to Friday, Monday candidates know if matched or not, Friday they know which program they got accepted into.
• If unmatched on Monday, apply for SOAP (supplemental offer and acceptance program).
• If you are matched to a program, you get to start and complete your residency there.

• USMLE costs $895
• It is the last exam in the USMLE sequence, finishing it would mean you are ready to practice medicine unsupervised, and would qualify you to become a licensed general medical practitioner.
• Not required for matching, you can do it after, but it would increase your chances to match if you have done it.
• A Two-day exam:

■ First day: Foundations of Independent Practice (FIP)

MCQs, total 7 hours long, 6 blocks exam total 232 questions with 1-hour break

■ Second day: Advanced Clinical Medicine (ACM)

• MCQs and computer based simulations
• About 9 hours, 6 blocks of multiple choice items total 180 MCQs then,
• 13 case simulations, each 10-20 min, testing ability of history taking, physical examination and delivering patient care.

• Short training pathways in the USA, 3-5 years training in residency instead of 5-10 years in the UK. You would probably favor the shorter pathway. Mid-twenties to early thirties are valuable years when you would mostly need to start a family, save for a house or have a social life in general.
• After completing training years, you have full autonomy to change your schedule whenever it fits you, freedom indeed, you would be able to do that a few years earlier in the US than in the UK
• Huge difference in salaries: US attending doctors make twice or three times more money than UK consultant or attending, regardless of short training years in the favor of the US

• Be aware of deadlines.
• Don’t take too much time to prepare.
• No guarantees, you can do everything by the book and still don’t match, or you can get accepted for one unique point you have as your personality or English proficiency.
• Boost your CV, make it more appealing, fill it with variant experiences.
• Search for information regarding the visa required for each program you apply for.
• Total cost of US pathway: from $17000-$20000. It would be wise to start financial planning.