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MEDICAL SCIENCE EXAMINATION

ECFMG requires a passing score on both a basic medical science test and a clinical science test to meet the medical science examination requirement for ECFMG Certification. Step 1 (basic medical) and Step 2 CK (clinical) of the United States Medical Licensing Examination™ (USMLE™) are the exams currently administered that meet this requirement. If you apply for examination, you are required to read the USMLE Bulletin of Information for complete information on the USMLE. The Bulletin of Information is available on this website and on the USMLE website at www.usmle.org.

When USMLE Step 2 CS is implemented in mid-2004, it will replace the ECFMG CSA as the exam that satisfies the clinical skills requirement for ECFMG Certification. After implementation of Step 2 CS, Step 1 and Step 2 CK (the current Step 2 exam) will continue to satisfy the medical science examination requirement for ECFMG Certification. Unless otherwise indicated, the policies and procedures described in this section refer to Step 2 CK. Refer to New for 2004 and Clinical Skills Assessment for additional information and important resources on Step 2 CS that you should monitor closely as the implementation of Step 2 CS approaches.

The United States Medical Licensing Examination

The United States Medical Licensing Examination is a single, three-step exam for medical licensure in the United States. The USMLE provides a common system to evaluate applicants for medical licensure. The USMLE is sponsored by the Federation of State Medical Boards of the United States, Inc. (FSMB) and the National Board of Medical Examiners® (NBME®). The USMLE is governed by a committee consisting of representatives of FSMB, NBME, ECFMG, and the American public.

For descriptive information about the content of Step 1 and Step 2 CK, refer to The Three Steps of the USMLE on page 1 and Examination Content on page 6 of the USMLE Bulletin of Information. For information on the format of these exams, refer to Format of the Exams in this publication and to Test Lengths and Formats on page 9 of the USMLE Bulletin of Information. Sample test materials for Step 1 / Step 2 CK are available on this website, the USMLE CD and on the USMLE website at www.usmle.org.

Registration Entity and Test Delivery Entity

Step 1 and Step 2 CK

ECFMG serves as the registration entity for international medical students / graduates taking Step 1 and Step 2 CK. This means that ECFMG processes your application and payment, determines your eligibility, and notifies you of the outcome of your application. The NBME serves as the registration entity for students / graduates of medical schools in the United States and Canada that are accredited by the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association (AOA).

You can take Step 1 and Step 2 CK in either order, provided that you meet the respective eligibility requirements for these exams. If ECFMG determines that you are eligible, ECFMG will forward your registration information to NBME. After receiving this information, NBME will send your Step 1 or Step 2 CK scheduling permit. Although your scheduling permit will be sent by NBME, you should contact ECFMG by e-mail at permits@ecfmg.org or by telephone or fax (see General Inquiries) if you have questions or concerns about this document. The scheduling permit is your authorization to schedule your testing appointment.

Prometric provides scheduling and test centers for USMLE Step 1 and Step 2 CK. Prometric serves as the test delivery entity for students / graduates of both international medical schools and U.S. / Canadian medical schools accredited by the LCME and AOA.

ECFMG is not responsible for errors or any associated computer problems that may occur in generating the scheduling permits or delivering the exams. These functions are the responsibility of NBME and / or Prometric.

Step 3

The FSMB serves as the registration entity for both international medical graduates and graduates of LCME- and AOA-accredited medical schools applying for Step 3. In addition to passing Step 1 and Step 2 CK, international medical graduates must be certified by ECFMG before applying for Step 3. If you have not met these requirements, as well as the other Step 3 eligibility requirements (refer to Eligibility on page 3 of the USMLE Bulletin of Information), your application for Step 3 will not be accepted. For detailed information and application procedures for Step 3, contact the individual medical licensing authorities (see Communicating About USMLE on page 26 of the USMLE Bulletin of Information) or the Federation of State Medical Boards, PO Box 619850, Dallas, TX 75261-9850 USA; Telephone: (817) 868-4041; Internet: www.fsmb.org.

When USMLE Step 2 CS is implemented in mid-2004, it will become an additional requirement for Step 3 eligibility. Although the ECFMG CSA will not be administered after implementation of Step 2 CS, the ECFMG CSA will fulfill the clinical skills requirement for Step 3 eligibility. International medical graduates who have passed the CSA will not be required to pass Step 2 CS for Step 3 eligibility.

Eligibility

The eligibility requirements for Step 1 and Step 2 CK differ depending on whether you are a medical school student or a medical school graduate.

IMPORTANT NOTE: If your eligibility for an exam changes after you apply but before you take the exam, you are required to inform ECFMG immediately of this change in your status.

Medical School Students

To be eligible for Step 1 and Step 2 CK, you must be officially enrolled in a medical school located outside the United States and Canada that is listed in the International Medical Education Directory (IMED) of the Foundation for Advancement of International Medical Education and Research (FAIMER), both at the time that you apply and at the time you take the exam. In addition, the "Graduation Years" in IMED for your medical school must be listed as "Current" at the time you apply and at the time you take the exam. Your Medical School Dean, Vice Dean, or Registrar must certify your current enrollment status on the application. This certification must be current; the official must have signed the application within four months of its receipt by ECFMG. As soon as you graduate and receive your medical diploma, you must send two photocopies of your medical diploma and one full-face photograph to ECFMG (see Provision of Credentials and Translations). The photograph that you send must be current; it must have been taken within six months of the date that you send it. A photocopy of a photograph is not acceptable.

Effective February 1, 2004, there will be an additional medical education credential requirement for ECFMG Certification. In addition to the final medical school diploma, graduates must submit a final medical school transcript. You should send two photocopies of the transcript as soon as you graduate. A photograph, as described above, must accompany the copies of the transcript; this photograph is in addition to the photograph you must submit with the copies of your diploma. For complete information, refer to Provision of Credentials and Translations.

In addition to being currently enrolled as described above, to be eligible for Step 1, you must have completed at least two years of medical school. This eligibility requirement means that you must have completed the basic medical science component of the medical school curriculum by the beginning of your eligibility period for Step 1.

In addition to being currently enrolled as described above, to be eligible for Step 2 CK, you must be within twelve months of completion of the full didactic curriculum by the beginning of your eligibility period for Step 2 CK.

ECFMG reserves the right to re-verify with the medical school the eligibility of medical school students who are registered for Step 1 and Step 2 CK. If ECFMG requests re-verification of your student status with your medical school, ECFMG will release your score report for USMLE Step 1 and / or Step 2 CK only after re-verification of your status has been received by ECFMG.

Medical School Graduates

To be eligible for Step 1 and Step 2 CK, you must be a graduate of a medical school located outside the United States and Canada that is listed in the International Medical Education Directory (IMED) of the Foundation for Advancement of International Medical Education and Research (FAIMER). Your graduation year must be included in the medical school's IMED listing. You must have had at least four credit years (academic years for which credit has been given toward completion of the medical curriculum) in attendance at a medical school that is listed in IMED. The signature of the official who certifies your status as a graduate on the application must be current; the official must have signed the application within four months of its receipt by ECFMG.

You must also submit two photocopies of your medical diploma at the time of application if you have not sent the diploma to ECFMG previously. The name on your medical diploma must match exactly the name in your ECFMG record. If the names do not match exactly, you must submit legal documentation that verifies the name on your medical diploma is (or was) your name. (See Name of Applicant.) One full-face photograph must accompany the copies of your diploma. The photograph that you send must be current; it must have been taken within six months of the date that you send your application. A photocopy of a photograph is not acceptable. If your medical diploma has not yet been issued, you must submit with the application a current photograph and a letter signed by your Medical School Dean, Vice Dean, or Registrar that confirms you graduated from medical school, have met all requirements to receive your medical diploma, and states the date (month and year) that your medical diploma will be issued. You must then send the photocopies of your medical diploma to ECFMG as soon as your diploma is issued. (See Provision of Credentials and Translations.)

Effective February 1, 2004, there will be an additional medical education credential requirement for ECFMG Certification. In addition to the final medical school diploma, graduates must submit a final medical school transcript. If you are a graduate, you should send two photocopies of your final medical school transcript at the time of application. You are not required to submit your final medical school transcript at the time of application; however, since the final medical school transcript becomes an additional requirement for ECFMG Certification effective February 1, 2004, you should send the transcript as soon as possible. A photograph, as described above, must accompany the copies of the transcript; this photograph is in addition to the photograph you must submit with the copies of your diploma. For complete information, refer to Provision of Credentials and Translations.

Application and Scheduling

Each of these steps is discussed in detail below.

Decide When and Where You Want to Take the Exam:
Your Eligibility Period and Testing Region

Step 1 and Step 2 CK are offered on a regular basis throughout the year. If you meet the eligibility requirements for these exams, you can apply at any time. However, you should consider the following factors when planning the timing of your application.

Eligibility Period

When you apply for Step 1 or Step 2 CK, you must choose a three-month period, such as January-February-March, February-March-April, etc., during which you would like to take the exam. This three-month period is referred to as your eligibility period.

You must take the exam during the eligibility period assigned to you. You can take the exam on any day that it is offered during your assigned eligibility period, provided that there is space available at the test center that you choose. If you apply for Step 1 and Step 2 CK at the same time, you can choose the same eligibility period for both Step 1 and Step 2 CK, or you can choose a different eligibility period for each exam.

When choosing your eligibility period, remember that: Prometric test centers are closed on major local holidays; USMLE is not offered during the first two weeks in January; and the busiest testing times in the United States / Canada testing region are May through July and November through December. Your eligibility period will not be adjusted to compensate for dates when USMLE is not available.

When to Apply

ECFMG must receive your complete application at least one month in advance of the eligibility period you select. If you apply on-line, both the on-line part of the application and the completed Certification Statement must be received at least one month in advance of the eligibility period you select. Refer to the following table for the specific date by which ECFMG must receive your complete application. Keep in mind that delays or interruptions in postal service may delay delivery of your application to ECFMG.

If your application is not received in time to assign the eligibility period you select, you will be assigned to the next eligibility period. The eligibility period assigned to you will be listed on your scheduling permit.

If the eligibility period you want ends in the next calendar year, you must use the next year's application materials.

EXAMPLE: An applicant decides in May 2004 that he wants to apply to take Step 2 CK during the November-December-January eligibility period. Since the last month of the eligibility period desired by the applicant (January) falls within the year 2005, the applicant must apply using the year 2005 application materials.

The USMLE application materials specify a date after which you cannot use them and after which you must use the next year's application materials. You should check for this date before you apply.

Eligibility Period Extension

If you are unable to take the exam during the three-month eligibility period assigned to you, you may request an extension. You may extend your eligibility period only through the next, contiguous eligibility period, i.e., the next eligibility period that does not overlap with your originally-assigned eligibility period.

EXAMPLE: An applicant's eligibility period is April-May-June 2004. The eligibility period may be extended only through July-August-September 2004.

You may request an extension on-line using ECFMG's Interactive Web Application (IWA) or by completing a Request to Extend a USMLE™ Eligibility Period (Form 176) and submitting it to ECFMG. You can access IWA on this website. Form 176 is available on this website and from ECFMG, upon request. Payment of the appropriate fee must be submitted with the request. You may request an extension of your eligibility period only once for each exam registration. You may request an extension of your eligibility period only after your eligibility period has begun. Requests received at ECFMG more than twenty-five days after the end of the originally-assigned eligibility period will not be processed. For specific information on the timing of your request, refer to IWA or Form 176.

Additionally, you must continue to be eligible to take the exam during the extended eligibility period (i.e., you must still be officially enrolled in a medical school located outside the United States and Canada that is listed in the International Medical Education Directory [IMED] and the "Graduation Years" for your medical school must be listed as "Current," or you must be a graduate of such a medical school and your graduation year must be included in the school's IMED listing). See Eligibility.

If your eligibility period is extended, NBME will send you a letter notifying you of the extension. The NBME will not send another scheduling permit. You must bring your original scheduling permit and acceptable identification to the test center on the date of your exam.

If you have a scheduled appointment during your originally-assigned eligibility period and need to cancel and reschedule the appointment for your extended eligibility period, you must contact Prometric before 12:00 noon (local time at the Regional Registration Center for your testing region) at least five business days before your scheduled appointment to avoid a rescheduling fee. Requesting an extension of your eligibility period does not cancel a scheduled appointment. See Rescheduling Your Testing Appointment.

If you are unable to take the exam during your extended eligibility period or you are unable to extend your originally-assigned eligibility period, you must reapply, including payment of the appropriate fee(s), to take the exam.

Testing Region

Prometric's test centers are grouped into distinct testing regions. Within each region, Prometric has a central scheduling office known as the Regional Registration Center to contact for scheduling test dates.

When you apply for the exam, you must choose the region where you want to take the exam. If you apply for both Step 1 and Step 2 CK at the same time, you can choose the same testing region for both Step 1 and Step 2 CK, or you can choose a different testing region for each exam. Although you need to choose a testing region when you apply, you do not need to choose a particular test center until you contact Prometric to schedule your testing appointment. A list of the Prometric testing regions and test centers expected to be available for eligibility periods ending in 2004 is located on this website. Although this list was current at the time of publication, the test centers available for USMLE are subject to change. You are strongly encouraged to visit the Prometric website at www.prometric.com or to follow instructions on the scheduling permit for contacting Prometric to obtain current information on test centers in specific testing regions.

You must take the exam in your assigned testing region. You can take the exam at any test center in your testing region that offers USMLE, provided there is space available on the date you choose. Once your testing region has been assigned, it cannot be changed. If you cannot take the exam in your assigned testing region, you will lose your payment for the exam, and you will need to reapply, including payment of all applicable fees, to take the exam. See Reexamination and Reapplication.

Complete the Application

To apply for Step 1 and / or Step 2 CK:

• Submit an on-line application using ECFMG's Interactive Web Application (IWA). You can access IWA on this website. ECFMG typically processes on-line applications within ten calendar days of receipt of the completed Certification Statement, or



• Complete a paper application (Form 104S) and send it to ECFMG by mail (or courier service). You can download Form 104S from this website or request a photocopy from ECFMG (see How To Obtain This Publication). Processing time for paper applications is approximately four weeks.

You may not register using a letter, postcard, or e-mail message. All photographs, signatures, and seals / stamps on the application must be original. You cannot register by faxing your application or sending photocopies of the completed application to ECFMG.

Detailed application instructions are included with the application. Follow these application instructions carefully and answer all questions completely. You should review these instructions before you begin working on the application. Some of the necessary items require advance planning. These items include photographs, official signatures, and additional documentation, such as copies of your medical diploma if you are a medical school graduate. If your application is not complete, it will be rejected.

ECFMG will notify you when your application is received. If you provide an e-mail address when you apply, ECFMG will send this notification by e-mail. If you do not provide an e-mail address, ECFMG will send this notification by mail. You can check the status of your exam application on-line using OASIS.

ECFMG will process your application and payment and determine your eligibility to take the exam(s) you requested. Once your application has been processed, ECFMG will notify you of the outcome of your application by mail. For eligible applicants, ECFMG will also send important information about scheduling and taking the exams.

Examinees with Documented Disabilities

Reasonable accommodations will be made for USMLE examinees with disabilities who are covered under the Americans with Disabilities Act (ADA). International medical students / graduates must submit official requests and documentation to ECFMG. ECFMG forwards these requests to NBME for processing. The NBME processes requests for test accommodations in accordance with USMLE policies and procedures and renders a decision. Once your request has been processed, NBME will inform you of the outcome of your request. If you take USMLE Steps with test accommodations, your score reports and transcripts may indicate that such accommodations were provided.

The procedures for requesting test accommodations vary, depending on whether you have been granted test accommodations for a previous Step.

• If you have never received test accommodations for a USMLE Step, refer to the Test Accommodations information available on the USMLE website at www.usmle.org. These guidelines include a comprehensive description of how to document a need for accommodations to assist you in compiling complete and comprehensive documentation. Follow all instructions on the USMLE website, including the requirement to complete the Questionnaire for USMLE Step 1 and 2 Applicants Requesting Test Accommodations, and mail the Questionnaire, with all supporting documentation, to the designated address at the same time that you apply for the exam.



• If you have received test accommodations for a previous USMLE Step and would like the identical accommodations, you must complete the Form for Requesting Subsequent Test Accommodations and mail the form to the address indicated at the same time that you apply for the exam.



• If you have received test accommodations for a previous USMLE Step but are requesting a change in accommodations, follow the instructions listed above for new requests.

The Questionnaire for USMLE Step 1 and 2 Applicants Requesting Test Accommodations and Form for Requesting Subsequent Test Accommodations are available on the USMLE website at www.usmle.org or from ECFMG, upon request. All requests and accompanying documentation must be in English. You must send your official request / documentation to the ECFMG Test Accommodations Coordinator at the address indicated in the Test Accommodations information on the USMLE website at the same time that you apply for the exam. If you apply on-line, you must send your official request / documentation at the same time you submit your completed Certification Statement. To protect your privacy, do not send your request for test accommodations to the same address or in the same envelope as your application / Certification Statement.

Include Full Payment

You must pay all fees at the time of application. If you do not pay all fees, your application will be rejected. If you apply for Step 1 and Step 2 CK at the same time, you must pay all fees for both exams at the time of application. See Payment.

Fees

The total fee for Step 1 or Step 2 CK consists of the examination fee plus the appropriate international test delivery surcharge, if applicable.

• Examination Fee. The examination fee for 2004 eligibility periods is $675 for each exam. All examinees must pay the examination fee.



• International Test Delivery Surcharge. If you choose a testing region other than the United States / Canada, you must also pay the international test delivery surcharge for the international testing region that you choose. These surcharges represent the additional cost of offering Step 1 and Step 2 CK by computer outside the United States and Canada. If you choose to take the exam in the United States or Canada, you do not need to pay a surcharge. Refer to the list of Prometric testing regions and test centers or to the USMLE application materials for the international test delivery surcharges that apply to eligibility periods ending in 2004.

If your application is rejected, any payment received with that application will be credited to your ECFMG financial account and will be used for future exam applications or services.

Receive Your Scheduling Permit

Once ECFMG determines that you are eligible, ECFMG will also notify NBME of your eligibility. The NBME will send your scheduling permit within two weeks of this notification. However, if the beginning of your assigned eligibility period is more than six months away, your scheduling permit will not be sent until approximately six months before the beginning of your assigned eligibility period. You can check the status of your scheduling permit on-line using OASIS. Although your scheduling permit will be sent by NBME, you should contact ECFMG by e-mail at permits@ecfmg.org or by telephone or fax (see General Inquiries) if you have questions or concerns about this document.

Scheduling Permit

The scheduling permit is your authorization to schedule your testing appointment with Prometric. Your scheduling permit is a very important document, and you should be careful not to lose it. You cannot schedule your testing appointment or take the exam without it. The scheduling permit contains the following information:

• Your name and mailing address;



• The exam for which you registered-either Step 1 or Step 2 CK (If you register for both Step 1 and Step 2 CK, you will receive two separate scheduling permits, one for Step 1 and one for Step 2 CK.);



• Your eligibility period-the three-month period during which you are eligible to take the exam; and



• Your testing region-the geographical region in which you will take the exam.

It also contains two important numbers:

• Your Scheduling Number-you must provide this number when you contact Prometric to schedule your testing appointment; and



• Your Candidate Identification Number (CIN)-you must enter your CIN into the computer at the test center to start the exam and to initiate each block of the exam. You must keep this number confidential. For your own protection, do not share your CIN with anyone.

Your scheduling permit tells you how to contact Prometric to schedule a testing appointment. The contact information included on the scheduling permit varies, depending on whether you register for the United States / Canada testing region or an international testing region. The information included for both cases is summarized below.

Contact Information Included on Scheduling Permit

Replacement Scheduling Permits

If you lose your scheduling permit, you should contact ECFMG immediately by e-mail at permits@ecfmg.org or by telephone or fax (see General Inquiries) to request a replacement. There may be a fee for this service. ECFMG will notify NBME that you need a replacement scheduling permit, and NBME will send the replacement to you. If you would like your replacement scheduling permit sent by a courier service, you must pay for delivery. Although your replacement scheduling permit will be sent by NBME, you should contact ECFMG if you have questions or concerns about this document.

Schedule Your Testing Appointment With Prometric

You must have your scheduling permit before you can schedule your testing appointment.

Before you contact Prometric to schedule your appointment, you should choose several dates when you could take the exam. The dates that you choose must fall within your assigned eligibility period. You should also choose the test center(s) where you could take the exam. The test centers that you choose must fall within your assigned testing region. A list of the test centers expected to be available for USMLE eligibility periods ending in 2004 is available on this website. The current list of centers is also available on Prometric's website at www.prometric.com.

Once you receive your scheduling permit for Step 1 or Step 2 CK, you may contact Prometric at any time to schedule your testing appointment. You can schedule your testing appointment with Prometric up to six months in advance of the beginning of your eligibility period. You must contact Prometric before 12:00 noon (local time at the Regional Registration Center for your testing region) at least five business days prior to the exam date that you want. Testing appointments are scheduled on a first-come, first-served basis. To increase your chances of getting the test date and location that you want, you should contact Prometric as soon as possible after receiving your scheduling permit.

If you are registered for an international testing region and do not have access to a telephone, you can contact Prometric by fax or mail. Prometric's fax number and mailing address are listed on your scheduling permit. Simply make a photocopy of the Form to Schedule an Appointment by Fax or Mail that appears on your scheduling permit and send it to Prometric. When scheduling by fax or mail, be sure to copy the form that appears on your scheduling permit. Do not send your original scheduling permit to Prometric. When copying the form, be sure not to copy your confidential Candidate Identification Number that appears below the form. You must send a clear copy; illegible copies or faxes may delay or prevent scheduling.

When you contact Prometric to schedule, you will need to give the Scheduling Number listed on your scheduling permit. Prometric will let you know what dates are available at the location(s) you have chosen. When you make your appointment, Prometric will confirm with you the date and time of your exam. Prometric will give you the address and telephone number of the Prometric test center you selected. You will also receive your Prometric Confirmation Number. Be sure to write all of this information in the spaces provided on your scheduling permit. If you need to reschedule your testing appointment with Prometric, you will need your Prometric Confirmation Number. Do not write anything else on your scheduling permit. If you schedule by telephone, you will not receive a written confirmation.

Rescheduling Your Testing Appointment

If you are unable to keep your testing appointment on the scheduled date or at the scheduled location, you may change your date or test center by contacting Prometric. Your new test date and center must fall within your assigned eligibility period and testing region, respectively. You will need to provide your Prometric Confirmation Number when you reschedule.

To reschedule your appointment, follow the instructions for contacting Prometric on your scheduling permit. If you are testing in the United States / Canada, you can reschedule on-line by visiting the Prometric website at www.prometric.com. To avoid a rescheduling fee, you must request to reschedule your appointment at least five business days before your appointment. If you are testing in the United States or Canada, you must make your request by 12:00 noon, Eastern Time, at least five business days before your scheduled appointment. If you are testing outside the United States / Canada, you must make your request by 12:00 noon, local time at the Regional Registration Center for your testing region, at least five business days before your scheduled appointment. If telephoning, you must speak with a Prometric representative. Leaving a voice mail message does not satisfy the requirement to provide advance notice. If you give notice of less than five business days, you must pay Prometric a rescheduling fee when you arrange your new appointment. If you give notice of less than five business days, Prometric may require additional time to process your request.

If you cannot take the exam during your assigned, three-month eligibility period, you may request an extension. See Eligibility Period Extension for additional information. However, you must still contact Prometric to cancel a scheduled testing appointment, as described above, if you cannot keep the appointment. Requesting an extension of your eligibility period does not cancel a scheduled testing appointment.

Preparation

Format of the Exams

Step 1 and Step 2 CK are each one-day, multiple-choice exams. Step 1 has approximately 350 multiple-choice questions, divided into seven sixty-minute blocks, administered in one eight-hour testing session. Step 2 CK has approximately 370 multiple-choice questions, divided into eight sixty-minute blocks, administered in one nine-hour testing session. The computer will keep track of how much time you have left in each block and for the entire exam. Once you begin a block of the test, no breaks are provided during the block. Once you exit the block or the time allotted for the block runs out, you cannot go back to the questions in that block.

You can take breaks, including a lunch break, between blocks of questions. You will have at least 45 minutes of break time for the entire testing day. This break time can be divided in any manner, according to your preference. If you finish one or more blocks early, you can take this extra time as break time. If you are already familiar with the tutorial and choose to exit from it early, you can use this extra time for breaks. See Test Lengths and Formats on page 9, Completing the Test on page 19, and How Break Time Works on page 19 of the USMLE Bulletin of Information.

IMPORTANT NOTE: These test descriptions, including test length and number of test items, are subject to change. Notice of any changes will be posted on the USMLE website at www.usmle.org.

Sample Test Materials

ECFMG provides sample test materials to registered applicants. The same sample test materials are also available on the USMLE website at www.usmle.org. The Step 1 / Step 2 CK sample test materials will help you become familiar with the types of questions and exam software that you will encounter on the date of your exam.

It is recommended that you practice with the exam software before taking the exam. One way to do this is to run the Step 1 / Step 2 CK sample test materials on the USMLE CD. ECFMG sends the USMLE CD to applicants when they are registered for Step 1 or Step 2 CK. You should also review the additional information on examination content and test format available on the USMLE website at www.usmle.org.

If you do not have extensive experience with computers, you may be concerned about taking a computer-based exam. The NBME has conducted field trials to determine the effect of prior computer experience on examinee performance on computer-based exams. These field trials show that experience with computers generally does not affect how examinees score on computer-based, multiple-choice exams.

Practice Session at a Prometric Test Center

If you have already received your scheduling permit for Step 1 or Step 2 CK, you can register to take a practice session for this exam at a Prometric test center. You must pay a fee to Prometric for this service. You should know that the materials used for the practice sessions at Prometric test centers are the same sample test materials available on the USMLE website and on the USMLE CD. No new material will be presented during the Prometric practice sessions.

If you would like to take a practice session at a Prometric test center, you must register for the practice session to obtain a practice session scheduling permit. You can register for a practice session on the USMLE website at USMLE website. Information on the fee for the practice sessions is also available at this site. If you do not have access to the Internet, you can call ECFMG at (215) 386-5900 for assistance.

When you register for a practice session, you will be asked for the Scheduling Number and Candidate Identification Number from your Step 1 or Step 2 CK scheduling permit. Once you are registered for a practice session, your practice session scheduling permit will be sent to you.

Taking the Exam

On the date of your testing appointment, you should arrive at the Prometric test center thirty minutes before your scheduled start time. You must bring both your original scheduling permit and acceptable identification, as described below. If you requested a change in the name on your scheduling permit, you must also bring to the test center the document from NBME notifying you of the change.

If you need directions to the test center, you should contact Prometric in advance of your test date. If you are testing in the United States / Canada, call the test center using the telephone number that Prometric provided when you scheduled your appointment. If you are testing outside the United States / Canada, contact the Regional Registration Center for your testing region using the contact information on your scheduling permit. If you arrive late, you may not be allowed to take the exam. If you arrive more than thirty minutes late or do not have both the scheduling permit and acceptable identification, you will not be allowed to take the exam. If you are not allowed to take the exam for these reasons, you will need to reschedule your testing appointment and pay Prometric a rescheduling fee. Your rescheduled testing appointment must fall within your assigned eligibility period.

Before beginning the exam, you will be asked to: present your scheduling permit and identification, sign in, have your photograph taken, and store all of your personal belongings in a locker.

A proctor will lead you to a computer in the testing area. To begin your exam, you must enter your CIN into the computer. The exam will begin with a brief tutorial. The tutorial will help you become familiar with how the computer and test software work. The answers that you choose during the tutorial do not contribute to your score on the exam.

When your testing appointment is over, you will sign out, and a proctor will give you a notice indicating that you appeared for the exam. This notice does not include your score. Before leaving the test center, you must turn in the portion of your scheduling permit that contains your CIN.

Acceptable Identification

Your name as it appears on your scheduling permit and your form(s) of identification must match exactly. Since your name on the scheduling permit appears in the Latin alphabet, i.e., in "English language letters," the name on your identification must also appear in the Latin alphabet. The spelling of the name on your scheduling permit must match exactly the spelling of the name on the form(s) of identification you present at the test center. If the names do not match as described above, you will not be allowed to take the exam. Refer to Name of Applicant.

The form of identification you present must be one of the forms of unexpired, government-issued identification listed below that contains your name in the Latin alphabet, your signature, and your photograph. The following forms of identification are acceptable, only if they meet all of these requirements:

• Passport;
• Driver's license;
• National identity card; or
• Other form of unexpired, government-issued identification that meets all of these requirements.

If your unexpired, government-issued form of identification contains your name in the Latin alphabet and your photograph but not your signature, you can use another form of unexpired identification that contains your signature, such as a student / employee identification card or a credit card, to supplement your photo-bearing, government-issued identification.

If you do not have acceptable identification, as described above, that contains your name in the Latin alphabet, you can apply for an ECFMG Identification Card (EIC). You may use a valid EIC in place of one of the forms of identification listed above to gain admittance to the test center on the date of your exam. To receive an EIC, you must complete an ECFMG Identification Card Request Form (Form 180) for each exam for which you are applying and submit the form(s) to ECFMG with your exam application. If you apply on-line, you must submit the form(s) with your completed Certification Statement. Complete information and Form 180 are available on this website. Each EIC is valid for one testing appointment only and will be collected at the test center at the end of your testing appointment.

IMPORTANT NOTE: The purpose of the EIC is to provide acceptable identification for examinees who do not have identification that contains their name in the Latin alphabet. Do not request an EIC if you already have identification that meets all of the requirements listed above. Exam applications accompanied by an EIC request form will require additional processing time. Requesting an EIC may delay the processing of your exam application up to four weeks beyond the normal processing time.

Scoring and Score Reporting

Minimum Passing Scores

For ECFMG Certification, you must obtain at least the USMLE-recommended minimum passing scores for Step 1 and Step 2 CK. These USMLE-recommended minimum passing scores are reviewed periodically and may be adjusted at any time. Notice of such adjustments will be posted on the USMLE website at www.usmle.org. (See Minimum Passing Scores on page 21 of the USMLE Bulletin of Information.)

Reporting of Scores

Score reports for Step 1 and Step 2 CK include a pass / fail designation, numerical scores, and graphical performance profiles, which summarize areas of strength and weakness to aid in self-assessment. These profiles are developed as assessment tools for the benefit of examinees only.

Although most scores typically will be available in time to mail your report within three to four weeks after your test date, delays are possible for various reasons. In selecting your test date and inquiring about scores, you should allow at least six weeks after your test date to receive your score report. Once your score is available, ECFMG will mail it to your ECFMG address of record. You can check the status of your score report on-line using OASIS. To avoid misinterpretation and to protect the privacy of examinees, ECFMG will not provide scores by telephone, fax, or e-mail to anyone, including examinees.

Please note that the reporting of scores may be delayed if additional data and / or analyses are required to assure the validity of the test scores. Additionally, ECFMG reserves the right to re-verify with the medical school the eligibility of medical school students who are registered for Step 1 and Step 2 CK. If ECFMG requests re-verification of your student status with your medical school, ECFMG will release your score report for USMLE Step 1 and / or Step 2 CK only after re-verification of your status has been received by ECFMG.

If you do not receive your Step 1 or Step 2 CK score report or you receive a damaged score report, you must send a written request for a duplicate score report to ECFMG. ECFMG will honor requests for duplicate scores received up to ninety days after the score report release date. If more than ninety days have passed since your score report was released, scores will be reported to you only in the form of a USMLE transcript.

Except as otherwise specified below, to receive a score, you must begin every block of the test. (See Format of the Exams for more information on test blocks.) If you do not begin every block, no final results are reported, and the "incomplete examination" attempt appears on your USMLE transcript. If you register for but do not take a Step, no record of the test will appear on your transcript.

If your examination is incomplete, you may request that a score be calculated and reported, with all missed test items scored as incorrect. This score is likely to be lower than the score you would have achieved had you completed all sections of the examination. If you decide to request calculation and reporting of your score, the score will appear on your USMLE transcript as though it were complete. It will remain the permanent score for the examination administration. If your exam is incomplete, you will be notified in writing by NBME. You will have forty-five days from the date of this notification to request the exam to be scored as described above.

See Scoring and Score Reporting on page 20 of the USMLE Bulletin of Information.

Score Rechecks

Standard procedures ensure that the scores reported for you are an accurate reflection of the responses recorded by the computer on the exam date. A change in score based on a recheck is an extremely remote possibility. However, a request for a recheck will be honored if you submit a Request for Recheck of Score on USMLE™ Step 1 and Step 2 CK (Form 265) and the fee for this service to ECFMG. Form 265 and additional information are available on this website and from ECFMG, upon request. Your request must be received at ECFMG no later than ninety days after your score report release date.

USMLE Transcripts

To request official copies of your USMLE scores, you must contact the appropriate registration entity. You must contact the Federation of State Medical Boards if: you are registered for or have taken Step 3, and/or you want to send your transcript to a medical licensing authority. In all other cases, submit your transcript request to ECFMG by sending a completed Request for Official USMLE™ Transcript (Form 172) and the appropriate fee to ECFMG. Form 172 and additional information are available on this website and from ECFMG, upon request. You can check the status of your USMLE transcript request on-line using OASIS. For a description of the information provided in USMLE transcripts, see Official USMLE Transcripts and Providing Scores to Third Parties on page 22 of the USMLE Bulletin of Information.

If you apply to residency programs through the Electronic Residency Application Service (ERAS), you may request electronic transmittal of your USMLE transcript to these programs. For additional information, refer to the ERAS applicant information available on this website. Information on requests for electronic transmittal of USMLE transcripts via ERAS is not available through OASIS.

Testing Conditions, Validity of Scores, and Irregular Behavior

Testing Conditions

Policies and procedures to govern the administration of the exams have been established to ensure that no examinee or group of examinees receives unfair advantage on the exam, inadvertently or otherwise. If the integrity of the examination process is jeopardized, the USMLE parent organizations reserve the right to invalidate all or any part of an exam. If information indicates that continued testing would jeopardize the security of the examination materials or the integrity of scores derived from the exam, the USMLE parent organizations reserve the right to suspend or cancel test administration. Refer to Testing on page 16 of the USMLE Bulletin of Information.

Validity of Scores

To ensure the integrity of the examination system, the validity of scores reported for USMLE Steps is assured by every means available to the USMLE program. The performance of all examinees is monitored and may be analyzed statistically to detect aberrancies that may result in a classification of scores as indeterminate. To designate a score as indeterminate means that the score achieved may not represent a valid measure of the examinee's knowledge or competence as sampled by the exam, based upon statistical analyses or otherwise. To ensure the meaningfulness of ECFMG Certification, a score that has been classified as indeterminate will not be reported. Refer to Validity of Scores on page 24 of the USMLE Bulletin of Information.

Irregular Behavior

Irregular behavior includes all actions on the part of applicants, examinees, potential applicants, or others when solicited by an applicant and / or examinee, that subvert or attempt to subvert the examination process. All USMLE exams at Prometric test centers are monitored through use of audio and video monitors and recording equipment and by test center staff. Failure to adhere to the instructions of test center staff during the exam may result in a determination of irregular behavior and annotation of your USMLE record and transcripts. If you are observed engaging in a possible violation of test administration rules or other forms of irregular behavior during an exam, you will not necessarily be told of the observation by a proctor at the time of the exam. See Irregular Behavior on pages 61-63 of the USMLE Bulletin of Information for detailed information.

Falsification of the exam application, submission of any falsified documents to ECFMG, submission of any falsified ECFMG documents to other agencies, or the giving or receiving of aid in the examination as evidenced either by observation at the time of the examination or by statistical analysis of an examinee's answers and those of one or more other participants in that examination, or engaging in other conduct that subverts or attempts to subvert the examination or ECFMG Certification process, may be sufficient cause for ECFMG to bar an individual from the examination, to terminate participation in the examination, to withhold and / or invalidate the results of the examination, to withhold a certificate, to revoke a certificate, or to take other appropriate action.

In all cases when the ECFMG Committee on Medical Education Credentials or the CSA Committee on Irregular Behavior has taken an action with respect to an examinee, an annotation will be included in the ECFMG Status Report and ECFMG Certification Verification Service (CVS) Report.

Representative Examples of Irregular Behavior

Reexamination and Reapplication

For the purpose of ECFMG Certification, there is no limit on the number of times you can take a Step until you have passed that Step. Once you pass a Step, you may not repeat it, and you will have seven years to pass the other Step. If you do not pass the other Step within a maximum of seven years, your previous passing score will no longer be valid for the purpose of ECFMG Certification, and you must repeat the entire process.

ECFMG policy requires that applicants pass those USMLE exams required for ECFMG Certification (currently Step 1 and Step 2 CK) within a seven-year period. After implementation of USMLE Step 2 CS in mid-2004, applicants must pass Step 1, Step 2 CK, and Step 2 CS within a seven-year period for ECFMG Certification. Refer to Requirements for ECFMG Certification and New for 2004 for additional information and important resources on Step 2 CS that you should monitor closely as the implementation of Step 2 CS approaches.

IMPORTANT NOTE: These policies apply only to ECFMG Certification. The USMLE program has made specific recommendations to state medical licensing authorities regarding the time to complete all three Steps and the number of attempts allowed to pass each Step. If you are taking the Steps for the purpose of licensure, refer to Time Limit and Number of Attempts Allowed to Complete All Steps, Formerly Administered Examinations, and Retakes on page 5 of the USMLE Bulletin of Information for more information. You should also contact the medical licensing authority of the jurisdiction where you plan to apply for licensure or the Federation of State Medical Boards, since licensure requirements vary among jurisdictions.

If you fail or do not complete an exam, you may retake it, but you must reapply, including payment of the appropriate fee(s). You may not retake a Step within sixty days of your last attempt on that same Step. As a result, if you reapply for Step 1 or Step 2 CK, you must select an eligibility period that begins at least sixty days after your last attempt on the same Step. Additionally, you cannot take the same Step more than three times in any twelve-month period.

If you do not take the exam, you must reapply, including payment of the appropriate fee(s) if you wish to take the exam. In this event ECFMG cannot process a subsequent application for this exam until two weeks after the end of the eligibility period for the exam you did not take.

Formerly-Administered Medical Science Examinations Acceptable for ECFMG Certification

ECFMG accepts a passing performance on former medical science examinations for the purpose of ECFMG Certification. Those formerly administered by ECFMG are:

• ECFMG Examination
• Visa Qualifying Examination (VQE)
• Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS)
• Part I and Part II Examinations of the National Board of Medical Examiners (NBME)

Combinations of exams are also acceptable. Specifically, if you have passed only part of the former VQE, FMGEMS, or the NBME Part I or Part II, you may combine a passing performance on the basic medical science component of one of these exams or USMLE Step 1 with a passing performance on the clinical science component of one of the other exams or USMLE Step 2 CK, provided that the components are passed within the period specified for the exam program.

Additionally, ECFMG accepts for the purpose of its certification a score of 75 or higher on each of the three days of a single administration of the former Federation Licensing Examination (FLEX), if taken prior to June 1985.

IMPORTANT NOTES:

• In mid-2004, USMLE Step 2 CS will replace the ECFMG CSA as the exam that satisfies the clinical skills requirement for ECFMG Certification. Applicants for Step 2 CS must have passed USMLE Step 1. Passing performance on former basic medical science examinations will not satisfy the examination prerequisite for Step 2 CS.
• Use of the former NBME Parts or FLEX Components to fulfill eligibility requirements for Step 3 is no longer accepted. You should contact the FSMB or the licensing authority of the jurisdiction where you plan to apply for licensure for information on licensure requirements.