All three steps of the USMLE exam must be passed before a physician with an
M.D. degree is eligible to apply for a 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: 92% for U.S.
M.D. medical school graduates, 81% for U.S.
D.O. osteopathic medical school graduates, and 73% for international medical school graduates
[3]. Overall pass rates for first time USMLE Step 3 test takers are: 95% for U.S.
M.D. medical school graduates, 95% 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 total cost to take all three portions of the process is $2900.
[4]
While not recommended by the creators of the USMLE, the Step 1 score is frequently used in
medical residency applications as a measure of a candidate's likelihood to succeed in that particular residency (and on that specialty's board exams). More competitive residency programs such as
Radiology,
Ophthalmology,
Plastic Surgery,
Orthopedic Surgery and
Dermatology usually only accept applicants with high Step 1 scores. The Step 1 exam is arguably the hardest and most important examination a medical student will take during his/her career.