ECFMG and USMLE: How Can Foreign Medical Graduates and Doctors Practice in the US?

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Photo of Ian Hawes Written by Ian Hawes
Published on January 24, 2022
10 minute read
  1. Step 1

    The first exam tests how the medical student applies basic scientific knowledge and concepts in a clinical setting. It's a multiple-choice paper, and the examinee should mark the correct answer among the given choices.

  2. Step 2 (CK Exam)

    The Step 2 test involves two separate exams, comprising a multiple-choice paper that assesses one's Clinical Knowledge (CK) and a second one that tests the examinee's practical Clinical Skills (CS).

  3. Step 2 (CS Exam)

    The CS exam is a hands-on test designed to evaluate the examinee's practical skills in a clinical scenario. It assesses their ability to apply their clinical knowledge and communication skills in handling patients. The key areas include gathering information from a standardized patient, conducting a physical exam, communicating the results to the patient, and writing a patient medical note. 

  4. Step 3

    Also a multiple-choice exam, Step 3 is the last test toward ECFMG licensing. It examines the doctor's ability to apply medical knowledge and understanding of biomedical and clinical sciences when providing healthcare services in an unsupervised setting. It primarily focuses on patient management in ambulatory scenarios.


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