USMLE PRACTICE MATERIALS

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About the USMLE
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The United States Medical Licensing Examination, or USMLE, is a three-step examin
ation,
which is accepted by all licensing authorities in the United States as meeting t
heir
examination requirements for initial licensure to practice medicine in the Unite
d States
and is co-sponsored by the Federation of State Medical Boards (FSMB) and the Nat
ional
Board of Medical Examiners (NBME). Students and graduates of US or Canadian medic
al
school programs leading to the MD degree that are accredited by the Liaison Comm
ittee
on Medical Education (LCME) or leading to the DO degree that are accredited by t
he
American Osteopathic Association (AOA) register for Step 1 and Step 2 with the N
BME.
Students and graduates of medical schools outside the United States and Canada r
egister
for Step 1 and Step 2 with the Educational Commission for Foreign Medical Gradua
tes
(ECFMG). Graduates of medical schools in and outside the United States and Canada
register for Step 3 with the FSMB.
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About the USMLE registration entities and sponsoring
organizations
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The ECFMG is a private, non-profit organization founded in 1956. The ECFMG promo
tes
quality health care for the public by certifying international medical graduates
for entry
into US graduate medical education, and by participating in the evaluation and
certification of other physicians and health-care professionals. In conjunction
with its
Foundation for Advancement of International Medical Education and Research (FAIM
ER), and
other partners, it actively seeks opportunities to promote medical education
through programmatic and research activities. Through its program of certificati
on, the
ECFMG assesses the readiness of international medical graduates to enter residen
cy or
fellowship programs in the United States that are accredited by the Accreditatio
n Council
for Graduate Medical Education (ACGME).
The FSMB is a national non-profit association with membership consisting of 70 m
edical
licensing authorities in 50 American states, the District of Columbia, Guam, Pue
rto Rico,
the Commonwealth of the Northern Mariana Islands and the US Virgin Islands. It i
s the
Federation's goal to provide services to its members to help them carry out the
responsibilities mandated by state law. The FSMB was founded in 1912, as the res
ult of a
merger between the National Confederation of State Medical Examining and Licensi
ng Boards
(established in 1891) and the American Confederation of Reciprocating Examining
and
Licensing Boards (established in 1902). Its mission includes continual improveme
nt in the
quality, safety, and integrity of health care through the development and promot
ion of
high standards for physician licensure and practice.
The NBME is an independent, not-for-profit organization that provides high quali
ty
examinations for the health professions. Protection of the health of the public
through
state-of-the-art assessment is the mission of the NBME, along with a major commi
tment to
research and development in evaluation and measurement. The NBME was founded in
1915
because of the need for a voluntary, nationwide examination that medical licensi
ng
authorities could accept as the standard by which to judge candidates for medica
l
licensure. Since that time, it has continued without interruption to provide hig
h quality
examinations for this purpose and has become a model and a resource of internati
onal
stature in testing methodologies and evaluation in medicine.
For more information about the USMLE registration entities and sponsoring organi
zations,
visit the ECFMG website at www.ecfmg.org, the FSMB website at www.fsmb.org, the
NBME
website at www.nbme.org, and the USMLE website at www.usmle.org.
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Purpose of these practice materials
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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 yo
u are not
registered and would like more information on the examination or how to apply, v
isit the
USMLE website. All applicants must review and become familiar with the current U
SMLE
Bulletin of Information, available at the USMLE website (www.usmle.org), before
completing
applications for USMLE Step 1, Step 2 (CK and CS), or Step 3.
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Software description
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The software you install has more than 100 practice test items for each Step exa
mination.
Some practice items may include multimedia files, such as video or audio clips.
There are
six sample case simulations for Step 3. All Step 3 applicants must review the Pr
imum 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.
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Obtaining practice materials
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All USMLE practice materials are available for download from the USMLE website
(http://www.usmle.org).
Instructions are included below to assist in downloading from the web, installin
g the
files that have been downloaded, running the practice software,
watching the video, and reading the documentation in portable document format (P
DF).
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System requirements
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* WindowsXP, Vista(), or Windows 7 with administrator privileges where applicable
* Intel Pentium or higher processor recommended
* 1 GHz or higher
* 512 MB RAM or higher
* 100 MB available on the hard drive
* Mouse
* Microsoft Internet Explorer 6.0 or higher
* Windows Media Player
* Adobe Reader
* Adobe Flash Player, 8.0 or higher
* Color display set to 24-Bit or higher or True Color
* Resolution set to a minimum of 1024 x 768
Please note: MacIntosh (Mac) and Linux are not supported, and you may be unable
to download
practice materials onto a notebook due to limited screen resolution.
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Instructions to download materials from the USMLE website
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* 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 aski
ng 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).
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Installing downloaded files
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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.
Please note: If you have any previous version of the USMLE practice materials in
stalled on
your computer, you may be asked to remove them when installing newer versions.
* During installation, if you see a menu asking if you want to modify, repair or
remove
components, this means that the installation program has detected a previous
installation.
* Select REMOVE to uninstall any component currently on your machine and then ru
n the
installation program again to install the component you want to use.
* Double click on the file on your desktop (or navigate to the location where yo
u 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 ".ex
e").
* If you receive a security warning "authenticode signature not found," click 'Y
es' to
continue the installation.
* Dialog boxes will appear on your screen to guide you through the rest of the i
nstallation.
* When installation is complete you should see a folder(s) on your desktop with
icon(s)
for the practice materials you selected. If the desktop folder(s) containing p
ractice
materials do not appear, click on your desktop area and press F5 to refresh yo
ur screen
or right-click and select Refresh from the pop-up menu.
Please note: the video does not need to be installed, just unzipped. Please se
e
"Watching the Step 2 Clinical Skills (CS) Video" below.
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Running the Step 1, Step 2 CK, and Step 3 tutorials,
practice multiple-choice questions ("Test Items"), and
Primum computer-based case simulations (CCS)
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* Download and/or install the portion of the practice software that you want to
use.
* To view items you must set your screen resolution to 1024 x 768 or higher. Ple
ase use
your manual or system's Help if you need assistance changing these settings.
* Once your resolution is set, open the USMLE folder on your desktop and double
click on
the practice software that you want to use. The multiple choice items are foun
d in the
NBME Test Delivery Software. Primum CCS cases may be run from the NBME Test De
livery
Software or from the icon for Step 3 CCS.

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Watching the Step 2 Clinical Skills (CS) Video
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The video is provided in windows media file format, which works best with Window
s Media
Player, although other players may be used. Windows Media Player can be obtained
from the
Microsoft website (http://www.microsoft.com).
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Reading the Step 2 CS Content Description and General
Information Booklet
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You must use Adobe Acrobat Reader to view and print the booklet. Acrobat Reader
can be
installed on your computer free from the Adobe website (http://www.adobe.com).
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Technical support
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If you have problems that you cannot resolve, visit the USMLE website for freque
ntly asked
questions, send your inquiry to USMLEtech@nbme.org, or call (215) 590-9700 from
8:30 AM to
4:00 PM Eastern Time in the United States, Monday to Friday.
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Copyright information
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The United States Medical Licensing Examination is a joint program of the Federa
tion of
State Medical Boards of the United States, Inc. and the National Board of Medica
l
Examiners. The practice package includes proprietary information and materials t
hat are
licensed by the National Board of Medical Examiners or owned and copyrighted by
the Federation
of State Medical Boards and the National Board of Medical Examiners. As to the m
aterials that are
owned and copyrighted by the NBME and FSMB: Copyright 1998-2014 the Federation o
f State
Medical Boards of the United States, Inc. and the National Board of Medical Exam
iners, except for
the following: Copyright 2006-2014 National Board of Medical Examiners as to the
computer
program test driver. Primum Computer-based Case Simulation Software Version 8.3,
Copyright 1988-2014 the National Board of Medical Examiners. Runtime library por
tions of the
software included with permission from Versant Corporation, Copyright 1996. All
rights reserved.
Portions of Step 2 CS practice materials reproduced with permission from the Edu
cational
Commission for Foreign Medical Graduates (ECFMG) Clinical Skills Assessment (CSA)
Candidate
Orientation Manual, Copyright 2002 by the ECFMG. Microsoft PowerPoint Viewer, incl
uded 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 indivi
duals who are
registered to take the examinations, and further reproduction, distribution, tra
nsmission, or
other uses are prohibited without permission from the copyright holders.