*********************************************************

2005 USMLE� ORIENTATION MATERIALS

*********************************************************
The United States Medical Licensing Examination�, or USMLE,
is a three-step examination for medical licensure in the
United States and is sponsored by the Federation of State
Medical Boards (FSMB) and the National Board of Medical
Examiners� (NBME�). Students and graduates of US or Canadian
medical school programs leading to the MD degree that are
accredited by the Liaison Committee on Medical Education (LCME)
or leading to the DO degree that are accredited by the American
Osteopathic Association (AOA) register for Step 1 and Step 2
with the NBME. Students and graduates of medical schools
outside the United States and Canada register for Step 1 and
Step 2 with the Educational Commission for Foreign Medical
Graduates (ECFMG�). Graduates of medical schools in and outside
the United States and Canada register for Step 3 with the FSMB
or a medical licensing authority in the United States.

These materials are intended to help orient individuals registered

to take Step 1, Step 2 Clinical Knowledge (CK) and Clinical
Skills (CS), and Step 3 of the USMLE. If you are not registered
and would like more information on the examination or how to apply,
visit the USMLE website (http://www.usmle.org). All applicants
must review and become familiar with the USMLE Bulletin of
Information, available at the USMLE website, before completing
applications for USMLE Step 1, Step 2 (CK and CS), or Step 3.

*********************************************************
System Requirements
*********************************************************
Windows� 98, 2000, Me, XP, or NT 4.0 with administrator
privileges where applicable
Intel� Pentium� or higher processor recommended
733 MHz or higher
128 MB RAM or higher
100 MB available on the hard drive
8x or higher CD-ROM drive(if using the CD)
Mouse
Microsoft� Internet Explorer 6.0 or higher
Windows� Media Player
Adobe� Reader�
Color display set to 24-Bit or True Color

See below for additional information about downloading,

installing, and/or using the software and for information
on screen resolutions needed for different software versions.

*********************************************************
CBT Software Versions
*********************************************************
At present, the CBT software used to deliver Step 1, 2 CK,
and 3 is provided by Prometric, a division of Thomson
Learning, Inc. The NBME is developing new software for
delivery of the USMLE Steps as well as tests for other
programs. The NBME software, known as FRED�, will replace
the Prometric software in USMLE during 2004 and 2005.
The software you install has over 100 practice test items for
each Step examination. There are five sample case simulations
for Step 3. The FRED software has the same practice test items
as the Prometric software for each Step. See below and the
USMLE website to decide which software to use in running the
sample items for the Step you are taking. Monitor the home
page at the USMLE website (http://www.usmle.org) to check for
information regarding changes in test delivery software.

Note to Step 3 examinees:

The NBME software (FRED), will replace the Prometric
software in USMLE Step 3 in the fall of 2004. Installation
of FRED for USMLE Step 3 will be phased in over several
weeks in October 2004. If you schedule to take the Step 3
with a test date during the month of October, you should
familiarize yourself with both the Prometric test delivery
software and FRED.

All Step 3 applicants must review the Primum CCS tutorial

and practice with all the practice cases well in advance
of the testing day to have a thorough understanding of how
Primum CCS works.

Note to Step 2 CK examinees:

Migration of Step 2 USMLE to the FRED software will occur
after the Step 3 transition in October 2004. Please monitor
the USMLE website to check for changes in test delivery
software.

Note to Step 1 examinees:

Migration of Step 1 USMLE to the FRED software will occur
sometime in 2005. Please monitor the USMLE website to check
for changes in test delivery software.

*********************************************************
Obtaining Orientation Materials
*********************************************************
The 2005 USMLE Orientation materials are provided to all
registered examinees on a CD. They are also available for
download from the USMLE website (http://www.usmle.org).
Instructions are included below to assist in downloading
from the web, installing the files that have been downloaded,
installing from the CD, running the practice software, watching
the video and reading the documentation in portable document
format (pdf).

*********************************************************
Instructions to Start the CD
*********************************************************
Insert the CD into your CD drive. If your computer has the CD
autorun feature enabled, the CD will start automatically. If
the autorun feature is not enabled, open the Windows Start
menu and select Run. Type X:\menu.htm (substitute the letter of
your computer�s CD drive for X). Click OK. A menu will appear
on your screen with links to all of the software.

*********************************************************
Installing from the CD
*********************************************************
Please note: IF YOU HAVE ANY PREVIOUS VERSION OF THE USMLE
PRACTICE MATERIALS INSTALLED, YOU MUST REMOVE
THEM BEFORE CONTINUING

The menu that appears on the screen will indicate which

portions of the enclosed practice materials must be
installed.
* Click the link for the portion that you want to install.
* Depending on the configuration of your computer, you may
see a dialog box asking whether you want to �Open� or
�Save�. Choose �Open�.
* Dialog boxes will appear on your screen to guide you
through the rest of the installation.

When installation is complete you should see a folder

on your desk top with icon(s) for the practice materials
you selected. If the desktop folder does not appear, press
F5 to refresh your screen.

*********************************************************
Instructions to Download from the USMLE website
*********************************************************
All downloadable files are zipped.
* Click the link for the portion that you want to download.
* Make a note of the name of the file.
* Depending on the configuration of your computer, you may
see a dialog box asking whether you want to �Open� or �Save�
the file. Choose �Save�.
* Save this file to your desktop (or make a note of the
path where you save the file).

*********************************************************
Installing Downloaded Files
*********************************************************
Files downloaded from the web are zipped. If you do
not have a utility to unzip a file, you can obtain an
evaluation copy from http://www.winzip.com/downwzeval.htm.

* Double click on the file on your desktop (or navigate

to the location where you saved the downloaded file and
double click).
* Unzip the file to your desktop (or make a note of the
location where the file is saved).
* Make a note of the file name � it will end in �.exe�.
* Double click on the unzipped file on your desktop (the
one that ends with �.exe�).
* If you receive a security warning �authenticode signature
not found,� click 'Yes' to continue the installation.
* Dialog boxes will appear on your screen to guide you
through the rest of the installation.

When installation is complete you should see a folder

on your desk top with icon(s) for the practice materials
you selected. If the desktop folder does not appear, press
F5 to refresh your screen.

Please note: videos do not need to be installed. Please

see �Watching a Step 2 Clinical Skills (CS) Video� below.
s

*********************************************************
Running the Step 1, Step 2 CK, and Step 3 Tutorials,
practice Multiple-Choice Questions ("Test Items"),
and Primum� Computer-based Case Simulations (CCS)
*********************************************************
Download and/or install the portion of the practice software
that you want to use.
t

To view items in the Prometric version you must set your

screen resolution to 800 x 600 in order to run the
computer-based testing (CBT) sample test materials after
installing them on your computer. You must set font size
to small fonts. Please use your manual or system's help
if you need assistance changing these settings.
i

To view items in the FRED version you must set your screen
resolution to 1024 x 768. Please use your manual or system's
help if you need assistance changing these settings.
h

Once your resolution is set, open the folder on your desktop

and double click on the practice software that you want to use.
a

*********************************************************
Watching a Step 2 Clinical Skills (CS) Video
*********************************************************
The videos are provided in windows media file format which
works best with Windows Media Player, although other players
may be used. Windows Media Player can be obtained from the
Microsoft� website(http://www.microsoft.com).
M

If you are using the CD:

* Insert the CD and click the appropriate link. The video
will play directly from the CD.

If you have downloaded from the web:

* double click on the downloaded file to unzip it. Double
click on the unzipped file to play the video.

*********************************************************
Reading the Step 2 CS Content Description and
General Information Booklet
*********************************************************
You must use Adobe� Reader� to view and print the booklet.
Reader can be installed on your computer free from the
Adobe website (http://www.adobe.com).
A

If you are using the CD:

* Insert the CD and click the appropriate link. Adobe
Reader will open and display the file for you.

You do not need to download the booklet in order to read it:

* Go to http://www.usmle.org/orientation/menu.htm.
Click the link for the booklet.

*********************************************************
Technical Support
*********************************************************
If you have problems that you cannot resolve, visit the
USMLE website for frequently asked questions, send your
inquiry to USMLEtech@nbme.org, or call (215) 590-9502
from 8:30 AM to 4:00 PM Eastern Time in the United States,
Monday to Friday.
M

*********************************************************
Copyright Information
*********************************************************
The United States Medical Licensing Examination is a joint
program of the Federation of State Medical Boards of the
United States, Inc. and the National Board of Medical
Examiners. This orientation package includes proprietary
information and materials that are owned and copyrighted by
the Federation of State Medical Boards, the National Board
of Medical Examiners, and Prometric, a division of Thomson
Learning, Inc.
L

Copyright � 2004 the Federation of State Medical Boards of

the United States, Inc. and the National Board of Medical
Examiners, except for the following: Copyright � 1999-2004
Prometric, a division of Thomson Learning, Inc., as to the
computer presentation of practice test materials delivered
by the Prometric test driver. Copyright � 2000-2004 National
Board of Medical Examiners as to the computer presentation
of practice test materials delivered by the NBME test
driver (FRED�). Primum� Computer-based Case Simulation
Software Version 8.2, Copyright � 1988-2004 the National
Board of Medical Examiners. Runtime library portions of the
software included with permission from POET Software
Corporation, Copyright � 1996. Portions of Step 2 CS
orientation materials reproduced with permission from the
Educational Commission for Foreign Medical Graduates (ECFMG�)
Clinical Skills Assessment (CSA�) Candidate Orientation Video
and Candidate Orientation Manual, Copyright � 2002 by the ECFMG.
Microsoft� PowerPoint� Viewer, included in this software, is a
product of Microsoft� Corporation. Permission to use this
software and the other materials installed with it is limited
to exam preparation or practice by individuals who are registered
to take the examinations, and further reproduction or other uses
are prohibited without permission from the copyright holders.
a