1. What is USMLE ?

The USMLE is the United States Medical Licensing Examinations. It is a set of qualifying examinations for medical graduates for the purpose of licensing and to obtain eligibility for US residency. A pass in USMLE means the candidate has the required competency for legally practising medicine in the US and the medical training is comparable to American standards.

2. What is the exam process ?

USMLE has 3 Steps:

  • The Step 1 exam essentially tests Basic Sciences knowledge.
  • Step 2 is on Clinical Knowledge (CK) and Clinical Skills (CS).
  • Step 3 is the requirement for licensing.

3. The ECFMG (Education Commission for Foreign Medical Graduates)

The ECFMG is a body that conducts the USMLE exam steps for foreign medical graduates.

4. What is ECFMG certification ?

A pass in USMLE Steps 1 and 2, CK and CS will confer ECFMG certification. With this certification, candidates will be eligible to apply for the US residency. Step 2 is usually done in the clinical years.

5. What is the value of this licensing (step 3) exam ?

To be eligible for US residency and for practice in the US.

6. Who can take this exam ?

Any medical student or a medical graduate with the approval of the Medical School Dean.

7. What is the step 1 & step 2 ck exam format ?

The Step 1 and Step 2 CK exam is a computer-based test taken in a single day over an 8 or 9-hour period. It’s a multiple choice question test that includes several sections of 46 questions each for a total of 300+ questions. One hour is allotted for each of the 7 or 8 sections. It is an average of 1 minute and 18 seconds per question.


Test takers are allowed 45 minutes during the test for personal breaks. If candidates finish any section before the allotted hour is up, they can add that time to the personal break total. Several breaks are allowed in between the test.


During the test, candidates are only allowed to bring soft foam earplugs into the examination room. Nothing else is allowed – no bags, electronics, phones, or even jackets are allowed.


The test is usually conducted all over the world at different Prometric Test centres.

8. What is the step 1 syllabus ?

Step 1 covers mainly basic scientific principles including anatomy, behavioral sciences, biochemistry, microbiology, pathology, pharmacology, and physiology. Interdisciplinary topics covered include genetics, aging, nutrition, immunology, molecular and cell biology, epidemiology, and medical ethics.


Some questions test your understanding of basic facts and definitions. But the majority deal with your ability to solve problems using basic scientific principles. For example, you will be asked to interpret graphs, identify gross and microscopic pathology and normal specimens, and apply concepts and principles relevant to individual organ systems.

9. When is the ideal time to take the USMLE steps ?

Most people take Step 1 between their second and third year in medical school, after finishing basic science courses and before a clinical clerkship. Many have success taking it within two months of finishing their basic courses because the material is still fresh in their minds, combined with an extra month or two of studying. Step 2 exams are taken during or after the clinical years.

10. Can I retake my exam if I am not happy with my scores ?

Only if a student fails the exam can they re-take the test. If they pass the exam with low scores, they cannot re-take the test. The scores are tagged to the student for 7 years. They can re-take the test after 7 years.

11. What is the limit on number of test attempts ?

Any number of attempts are allowed within the 7 year period. The more attempts, the less will be the chances for a medical graduate to get into a residency.

12. How is the exam scored ?

Ideally, the exam is pass or fail. But with increasing competition for getting into residency, the scores matter most. Currently the Steps have 3 digit scores. The Step 1 Pass scores range anywhere from 192 to a maximum of 260. Prior to 2013 there were additional 2 digit scores and before 1999, there was percentile grading.


The pass score is exam dependent. Any student with scores of 220 and above is generally considered excellent.

13. How does a student prepare for these steps ?

Option 1: No Preparation done, the student goes and attempts the Steps. It’s a high risk here. Low scores mean they cannot re-sit and improve their scores for 7 years. Except for geniuses, it is quite difficult to excel in the Steps without preparation.


Option 2: Self preparation, online free materials/books/peer support: Hard working students can achieve a good score. There are plenty of free prep materials online. Many of them may give false information. Students may not be able to take mock tests. No options for seeking guidance from experts. The scores will certainly be better with formal preparation.


Option 3: Attending commercial prep courses, online prep courses, buying USMLE prep books, practising questions, going through the learning materials: This is most often done worldwide. There are many vendors available online for USMLE prep guidance. Many are good, some are fake/not reliable. Going through the prep courses will definitely be useful and can get higher scores. The courses can be expensive. A Step 1 course for 4-6 months could be almost RM 6000-8000.


Option 4: Medical school assisted USMLE prep programme. There are very few medical schools that are doing this. The advantage is that the prep courses blend through the medical curriculum and helps the students identify the USMLE Step learning through their medical years. The medical school faculty and the prep programme experts can be there to guide students when needed.

14. What if I appear for USMLE test without enroling for any prep programmes ?

See options 1 and 2 above. Prep programmes are not mandatory. Students may pass the Steps. But higher scores can be achieved with suitable preparation. For FMGs, scores matter most. High scores mean better chances of getting desired residency programme.

15. Can any prep programmes guarantee high scores ?

No. Prep programmes will only assist students with additional teaching-learning materials, recorded lecture videos, live virtual lectures, mock tests, practice questions, feedback on assessments, etc.


The key mantra for success is “hard work”.

16. How do medical school worldwide assist students for the USMLE steps ?

Most medical schools do not assist students in USMLE preparation. The students have to prepare by themselves and take the Steps. The medical schools in and around US (like Caribbean) where all students are mandated to sit the USMLE Steps, their curricular would prepare the students for the USMLE exams only.


The medical school dean needs to approve the student application for eligibility to sit for the USMLE Steps.

17. Is IMU assessment different from the USMLE Step exams ?

Yes. Assessments in IMU are linked to the IMU learning outcome domains and prepares a student to achieve this. The pattern of assessment tools can be different. In IMU we have MCQs, essays, OSPE and OSCE assessments. USMLE Steps have MCQs based on clinical scenarios and linked to graduate outcomes for US.

18. Why is IMU providing parallel USMLE prep material for medical students ?

It is an advantage for any student to be familiar with the USMLE Step 1 preparation during the early medical school years. The prep materials will be additional teaching learning resource for students helping them to prepare for USMLE.


Preparing for Step 1 exams during Phase 1 (Medical Sciences) will give students more confidence as similar subjects are taught in the curriculum. Preparing for Step 1 exams after graduation or during the clinical years may require students to put in more efforts in terms of time and money.


Preparing and passing the USMLE Steps will allow students to be ECFMG-certified and allow them to be eligible for US residency programmes. IMU is providing this opportunity for our medical graduates (local and PMS track) so that they will have additional pathways to pursue post-graduation from US if the students are ECFMG certified.

19. What is the provided USMLE prep material ?

The materials include learning resources like text material, recorded video lectures, opportunity for some live online lecture sessions, question bank, mock tests, etc. The duration of access will depend on the option chosen.

20. How is the USMLE prep course linked to IMU different from other available online courses ?

The online USMLE prep materials will allow students to learn alongside the IMU curriculum. The students can have the opportunity to discuss and get feedback from IMU faculty when needed. There will be opportunities to take customised tests based on what students learn in the IMU curriculum.

21. Will enrolling the USMLE prep courses guarantee better grades ?

To achieve better grades, students need to work hard and make the best use of the facility. With quality prep materials and good preparation during the medical course, students can achieve better scores.

22. Can I take the prep course and not sit the Step 1 exam ?

Yes. The course is for a student to be familiar with the USMLE assessment process. But, it is advisable for students to take the Step 1 exams while they are in Phase 1 as the curriculum is similar. Taking tests later either during clinical years or after graduation may need more additional preparation.

23. When is the prep course most likely be made available for IMU students ?

All students from the August 2017 Intake will have this opportunity free of charge.

24. What about existing IMU students? Do they have opportunities to enrol into the prep course ?

Existing IMU students in BJ campus, clinical campuses, IMU graduates either through our own IMU MBBS or IMU – PMS can enrol into the USMLE Step 1 course. The course tenure and the costs will be different.

25. What is the Fee Structure?

There are three options for the fee structure you can undertake, with different benefits:


Option 1: RM 1,500

  • 30-hour Live Online Integrated Cases Class
  • 12 months of access to Becker’s full USMLE Step 1 Guide MD resources (interactive ebook series, question bank, diagnostics and simulated exams.

Option 2: RM 2,500

  • 30-hour Live Online Integrated Cases Class
  • 24-months of access to Becker’s full USMLE Step 1 Guide MD resources (interactive ebook series, question bank, diagnostics and simulated exams)

Option 3 RM 4,500

  • Step 1 Comprehensive Live Virtual Review (300 hours) with text books.