Full Member
Nov 19, 2015
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  1. Pre-Medical
This picture shows the steps that an international medical graduate must make to become a licensed physician in the US. What i dont understand is that after "USMLE step 3" there is "Year 1 residency". But the picture also showed "residency training" before USMLE step 3 . Isnt the residency part over before USMLE step 3 ? And again its mentioned after "state licensure" ? what is that ?


Full Member
7+ Year Member
Jun 11, 2013
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  1. Attending Physician
You are eligible to take Step 3 now anytime after graduation from medical school. Previously you had to have six months to a year of residency training to be able eligible.

As a FMG, you will need to be ECFMG certified, meaning Step 1, 2CK, and 2CS along with med school graduation from a WHO listed school. To get a permanent US license, you will need to pass Step 3 as well as complete 2-3 years of residency depending on the state in question.
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Contrary to rumor I am not Jesus
7+ Year Member
Oct 22, 2013
All of Time & Space
many IMGs will take step 3 before applying to residnecy to try to boost their app so the program knows there is no way they can fail it and not get a license

it tests more practical knowledge and less book knowledge, antoher reason they do that strategy

however, the issue is that your first year of training is the best preparation for the test, so if you take it before residency, you have to be sure to study really hard for it and ace it with a good score

if you take it intern year no one cares about the score so long as you pass (although I can't say if fellowship looks at it or not)
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