Tags: USMLE® & COMLEX® Test Strategies
Consensus opinion provided by Dan Mountcastle, MD; Phillip Hynes, MD; and Nick Lorenzo, MD
What Are The Common USMLE® and COMLEX® Question Types?
The question types and difficulty level varies from USMLE®/COMLEX® 1 to 3. The entire exam is based on single-time questions. Generally, a patient clinical vignette is followed by four or more choices, options A, B, C, D, and sometimes E.
Questions may include the need to interpret laboratory values and/or a graphic image. Often, more than one answer is partially correct, but the candidate should select the single best answer.
How Do You Apply For The USMLE® and COMLEX® Steps?
To Apply for USMLE® Step 1-3 examinations, review the USMLE® Bulletin and apply.
To Apply for the COMLEX® Step 1-3 examinations, review NBOME®️ requirements and apply.
How Do You Apply For The USMLE® and COMLEX® Steps?
The cost of the USMLE® and COMLEX® examination changes from year to year and may be higher outside the United States. Current information is available at the USMLE® or COMLEX® website.
How Do You Prepare For The USMLE® or COMLEX®?
The USMLE® or COMLEX® does not sanction any preparation program. The medical licensing boards recommend no test preparation course of study.
- Candidates for USMLE® or COMLEX® Steps 1-3 should review the content reflected in the examination descriptions.
- USMLE® - Practice exams and self-assessments
- COMLEX® - Practice exams and self-assessments
- Registered examinees may become familiar with the Prometric test center environment by paying a fee and completing a CBT Practice Session.
Students who want to achieve high scores on the USMLE® or COMLEX® should consider studying for each Step for at least six months. Students interested in examination preparation by doing practice questions have several options, including review books and a variety of online resources, for example:
BoardVitals® Kaplan® StatPearls® UWorld®
S1. #MCQ/6M ~3250/$189 2900/$249 17000/$99 3800/$419
S2. #MCQ/6M ~1350/$209 2900/$249 19000/$199 3800/$419
S3. #MCQ/6M ~1450/$209 900/$179 13000/$199 1600/$419
Where Can I Find The USMLE® or COMLEX® Bulletin Information?
Obtain the USMLE® Bulletin online or download a PDF file or obtain the COMLEX® Bulletin online or downloading a PDF file.
How Do I Update USMLE® Or COMLEX® Information?
Go to the registration entity website to submit a name change or contact information request.
- Supporting documentation is required for a name change request
- Name change forms and documentation must be received and processed by your registration entity seven business days before the testing appointment.
- If a scheduling permit has been obtained, a revised permit will be issued with the new name. Bring the new permit for admittance to the test center, or you will not be admitted.
What Are the USMLE® Or COMLEX® Disability Accommodations?
If the documented disability is covered under the Americans with Disabilities Act (ADA) and requires accommodations, obtain information regarding procedures and documentation requirements from the USMLE® or COMLEX® accommodation sections. Submit the application for the USMLE® or COMLEX® Step examination and request accommodations with required documentation at the same time.
When Do the USMLE® Or COMLEX® Steps Need To Be Taken?
- Complete USMLE® Step 1 and 2 before Step 3. One and 2 may be taken in any order.
- LCME-accredited Medical Schools: Usually USMLE® Step 1 at the end of 2nd year; USMLE® Step 2 during 4th year; and USMLE® Step 3 usually during the 1st year of postgraduate training.
- Medical Schools Outside the United States and Canada: Most medical licensing authorities require completion of USMLE® Steps 1, 2, and 3 within seven years, starting when USMLE® Step 1 is passed.
What Information Is Required For Foreign Medical Graduates?
The Educational Commission for Foreign Medical Graduates (ECFMG®) assesses the readiness of graduates of medical schools outside the United States and Canada to enter training programs in the United States.
The ECFMG® Certification Fact Sheet and Booklet, available at the ECFMG website, provide detailed information, including eligibility to take the USMLE.
What Are The Exceptions To the Seven Year USMLE® Completion Policy?
The USMLE® recognizes that candidates with a combined degree (i.e., MD/Ph.D.) may need additional time. As such, the USMLE® recommends that licensing jurisdictions consider allowing exceptions to the 7-year limit for MD/Ph.D. candidates if:
- Both degrees come from an institution accredited by the LCME and a regional university accrediting body.
- The Ph.D. reflects an area of study which ensures continuous involvement with issues related to medicine.
- The candidate requesting a waiver to the 7-year limit should present a verifiable and rational explanation why they were unable to meet the seven-year limit.
- Each licensing jurisdiction's medical board decides on if the explanation justifies an exception.
- Not all states allow exceptions. As such, students pursuing a dual degree should check state-specific requirements for licensure listed by the FSMB.
What Are The Policies On Retaking the USMLE®?
The USMLE® examination may be taken no more than three times within 12 months. The fourth and additional attempts must be at least 12 months after the first attempt and at least six months after the most recent attempt.
If you pass the USMLE, you are not allowed to retake it unless complying with specific state board requirements approved by the USMLE® governance. If repeating a previously passed examination because of a time limit imposed by a medical licensing authority, you will only be allowed to retake the examination if the applicable time limit has expired.
Policy exceptions may be granted if, at the time of application and testing, you are:
- Currently enrolled in an AOA or LCME accredited medical school program leading to the MD or DO degree;
- Previously passed Step 1 and/or 2, but have not passed 3;
- Expected to graduate from the medical school program six or more years after the date you first passed Step 1 and/or 2; and
- Otherwise eligible to retake the examination.
What is ERAS?
The Electronic Residency Application Service (ERAS®) is sponsored by the Association of American Medical Colleges (AAMC). ERAS® allows medical students to select and submit residency applications via the Internet. Students may submit USMLE® transcripts, and medical school transmits letters of recommendation and personal statements.
The ERAS® system of electronic transmittal is available for graduates of accredited medical schools in the United States and Canada through the USMLE.
The ERAS® system of electronic transmittal is available to graduates of medical schools outside the United States and Canada through the ECFMG.
What Can I Bring To The USMLE® Or COMLEX® Testing Center?
Unauthorized personal items in the secure areas of the testing centers may result in a finding of irregular behavior and an annotation in your USMLE® or COMLEX® transcript. Personal items brought to the testing center should be stored in a locker provided outside the secure testing area. Phones and other electronic devices should be turned off. Any personal item brought to the site is subject to inspection.
The personal items below are usually permitted in the secure testing area subject to inspection. These items do not need prior approval. Approved personal items on the following list should be shown to the test center staff when you check-in.
Medicine and Medical Devices
- Cervical collar
- Cough drops (must be unwrapped and not in a container)
- Earplugs (foam with no strings)
- Eye drops
- Eye patches
- Glucose monitor
- Glucose tablets
- Handheld magnifying glass
- Heating pads (non-electric)
- Ice packs
- Lumbar support
- Medical alert bracelet
- Nitroglycerin tablets
- Pills (must be unwrapped and not in a container)
- Stool for elevating a limb
- Surgical face mask
- Boot walking casts
Medical Device Attached to a Person’s Body
- Colostomy bag
- Continuous glucose monitor (CGM)
- Heart rate monitor
- Insulin pump
- Oxygen tank
- Spinal cord stimulator
- TENS units
- Urine bag
- Cochlear implant without wireless enabled
- Hearing aid
- Vocal cord magnifiers
If you have a medical condition that requires the use of an item NOT on the list, contact disabilityservices@NBME.org or 215-590-9700 to request a personal item exception.