The United States Medical Licensing Examination (USMLE) is a multi-part professional exam sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). Physicians with an M.D. degree are required to pass this examination before being permitted to practice medicine in the United States of America; see below for requirements of physicians with a D.O. degree.
All three steps of the USMLE exam must be passed before a physician with an M.D. degree is eligible to apply for an unrestricted license to practice medicine in the United States. U.S. osteopathic medical school graduates are permitted to take the USMLE for medical licensure, which they can also obtain by passing the multi-part Comprehensive Osteopathic Medical Licensing Examination (COMLEX) professional exam. Students who have graduated from medical schools outside the US and Canada must pass all three steps of the USMLE to be licensed to practice in the US, regardless of the title of their degree. Overall pass rates for first time USMLE Step 1 test takers are: 94% for U.S. M.D. medical school graduates, 89% for U.S. D.O. osteopathic medical school graduates, and 73% for international medical school graduates. First-time USMLE Step 2 CK test taker pass rates are: 97% for U.S. M.D. medical school graduates and 93% for U.S. D.O. medical school graduates. First-time USMLE Step 2 CS test taker pass rates are: 98% for U.S. M.D. medical school graduates and 88% for U.S. D.O. medical school graduates. Overall pass rates for first time USMLE Step 3 test takers are: 97% for U.S. M.D. medical school graduates, 94% for U.S. D.O. medical school graduates, and 78% for international medical school graduates. (In these statistics, "U.S. M.D. medical school graduates" includes graduates of Canadian M.D. programs.
The USMLE first started out as a paper examination, converting to a computer based multiple choice examination. The test can be taken at parametric test centers worldwide. However, the Step 2 CS and the Step 3 can only be taken in the USA