USMLE 2018 TEST

 
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USMLE Test 2018 Dates, Notification

 

Latest information on USMLE 2018 exam with its notification, exam dates, eligibility, application form also including paper pattern, test centres and USMLE result.

The United States Medical Licensing Examination (USMLE) is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States. This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently. The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual's knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.

USMLE Test 2018 Eligibility:-

Step 1, Step 2 CK, and Step 2 CS

To be eligible, you must be in one of the following categories at the time of application and on the test day:

    * a medical student officially enrolled in, or a graduate of, a US or Canadian medical school program leading to the MD degree that is accredited by the Liaison Committee on Medical Education (LCME),
    * a medical student officially enrolled in, or a graduate of, a US medical school leading to the DO degree that is accredited by the American Osteopathic Association (AOA), or
    * a medical student officially enrolled in, or a graduate of, a medical school outside the United States and Canada who meets the eligiblity criteria of the ECFMG.

If you are dismissed or withdraw from medical school, you are not eligible for USMLE, even if you are appealing the school's decision to dismiss you.

Step 3

To be eligible for Step 3, prior to submitting your application, you must:

    * obtain the MD degree (or its equivalent) or the DO degree,
    * pass Step 1, Step 2 CK, and, if required based upon the rules referenced below, Step 2 CS,
    * obtain certification by the ECFMG or successfully complete a "Fifth Pathway" program (see Special Announcement Regarding Fifth Pathway Certificates and Step 3) if you are a graduate of a medical school outside the United States and Canada, and
    * meet the Step 3 requirements set by the medical licensing authority to which you are applying.

The Three Steps of the USMLE:-

Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for the maintenance of competence through lifelong learning.

Step 2 assesses whether you can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine.

Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care.

USMILE Computer Based Testing (CBT):-

Parts of the USMLE are administered by computer. Prometric provides scheduling and test centers for the computer-based components of the USMLE. Step 1 and Step 2 CK are given around the world at Prometric Test Centers (PTCs). Step 3 is given at PTCs in the United States and its territories only.

USMLE Step 2 Clinical Skills (CS):-

The clinical skills examination is a separately administered component of Step 2 and is referred to as Step 2 Clinical Skills, or Step 2 CS. The computer-based, multiple-choice component of Step 2 is referred to as Step 2 Clinical Knowledge, or Step 2 CK. USMLE Step 2 CS is administered at five regional test centers (CSEC Centers) in the United States.

USMLE Test 2018 Syllabus / Content :-

Step 1:-

Step 1 includes test items in the following content areas:

    * anatomy,
    * behavioral sciences,
    * biochemistry,
    * microbiology,
    * pathology,
    * pharmacology,
    * physiology,
    * interdisciplinary topics, such as nutrition, genetics, and aging.

Step 1 is a broadly based, integrated examination. Test items commonly require you to perform one or more of the following tasks:

    * interpret graphic and tabular material,
    * identify gross and microscopic pathologic and normal specimens,
    * apply basic science knowledge to clinical problems.

Step 1 classifies test items along two dimensions: system and process, as shown below under Step 1 Specifications:

USMLE Step 1 Specifications*
System**

25%-35% General principles
65%-75% Individual organ systems

• hematopoietic/lymphoreticular
• nervous/special senses
• skin/connective tissue
• musculoskeletal
• respiratory
• cardiovascular
• gastrointestinal
• renal/urinary
• reproductive
• endocrine
• immune

Process:-

20%-30% Normal structure and function
40%-50% Abnormal processes
15%-25% Principles of therapeutics
10%-20% Psychosocial, cultural, occupational, and environmental considerations

Percentages are subject to change at any time. See the USMLE website for the most up-to-date information.

The general principles category includes test items concerning those normal and abnormal processes that are not limited to specific organ systems. Categories for individual organ systems include test items concerning those normal and abnormal processes that are system specific.

 
Step 2 Clinical Knowledge (CK)

Step 2 CK includes test items in the following content areas:

    * internal medicine,
    * obstetrics and gynecology,
    * pediatrics,
    * preventive medicine,
    * psychiatry,
    * surgery,
    * other areas relevant to provision of care under supervision.

Most Step 2 CK test items describe clinical situations and require that you provide one or more of the following:

    * diagnosis,
    * a prognosis,
    * an indication of underlying mechanisms of disease,
    * the next step in medical care, including preventive measures.

Step 2:- CK is a broadly based, integrated examination. It frequently requires interpretation of tables and laboratory data, imaging studies, photographs of gross and microscopic pathologic specimens, and results of other diagnostic studies. Step 2 CK classifies test items along two dimensions: disease category and physician task, as shown below under Step 2 CK Specifications.

Please note that much of the content that addresses normal growth and development and general principles of care is also related to the individual organ systems categories, so that the number of questions that deal solely with normal growth and development and general principles of care is relatively small

USMLE Step 2 CK Specifications:-

Normal Conditions and Disease Categories

    * Normal growth and development and general principles of care
    * Individual organ systems or types of disorders:
          o immunologic disorders
          o diseases of the blood and blood-forming organs
          o mental disorders
          o diseases of the nervous system and special senses
          o cardiovascular disorders
          o diseases of the respiratory system
          o nutritional and digestive disorders
          o gynecologic disorders
          o renal, urinary, and male reproductive systems
          o disorders of pregnancy, childbirth, and the puerperium
          o disorders of the skin and subcutaneous tissue
          o diseases of the musculoskeletal system and connective tissue
          o endocrine and metabolic disorders

Physician Task:-

15%-20%:- Promoting preventive medicine and health maintenance
20%-35%:- Understanding mechanisms of disease
25%-40% :- Establishing a diagnosis
15%-25% :- Applying principles of management

* Percentages are subject to change at any time. See the USMLE website for the most up-to-date information.

Step 2 Clinical Skills (CS):-

Step 2 CS assesses whether you can demonstrate the fundamental clinical skills essential for safe and effective patient care under supervision. There are three subcomponents of Step 2 CS (see Subcomponents of Step 2 CS below): Integrated Clinical Encounter (ICE), Communication and Interpersonal Skills (CIS), and Spoken English Proficiency (SEP).

The Subcomponents of Step 2 CS

Integrated Clinical Encounter (ICE)

    * Data gathering - patient information collected by history taking and physical examination
    * Documentation - completion of a patient note summarizing the findings of the patient encounter, diagnostic impression, and initial patient workup

Communication and Interpersonal Skills (CIS)

    * Questioning skills
    * Information-sharing skills
    * Professional manner and rapport

Spoken English Proficiency (SEP)

    * Clarity of spoken English communication within the context of the doctor-patient encounter

Step 2 CS uses standardized patients, i.e., people trained to portray real patients. You are expected to establish rapport with the patients, elicit pertinent historical information from them, perform focused physical examinations, answer questions, and provide counseling when appropriate. After each interaction with a patient, you will record pertinent history and physical examination findings, list diagnostic impressions, and outline plans for further evaluation, if necessary. The cases cover common and important situations that a physician is likely to encounter in common medical practice in clinics, doctors' offices, emergency departments, and hospital settings in the United States.

The cases that make up each administration of the Step 2 CS examination are based upon an examination blueprint. An examination blueprint defines the requirements for each examination, regardless of where and when it is administered. The sample of cases selected for each examination reflects a balance of cases that is fair and equitable across all examinees. While the set of cases administered on a given day will differ from the set of cases administered on another day, each set of cases is comparable.

The intent is to ensure that examinees encounter a broad spectrum of cases reflecting common and important symptoms and diagnoses. The criteria that are used to define the blueprint and create individual examinations focus primarily on presenting complaints and conditions. Presentation categories include, but are not limited to, cardiovascular, constitutional, gastrointestinal, genitourinary, musculoskeletal, neurological, psychiatric, respiratory, and women's health. Examinees will see cases from some, but not all, of these categories. The selection of cases is also guided by specifications relating to acuity, age, gender, and type of physical findings presented in each case.

 
Step 3:-

Step 3 is organized along two principal dimensions: clinical encounter frame and physician task (see Step 3 Specifications below). Step 3 content reflects a data-based model of generalist medical practice in the United States.

Encounter frames capture the essential features of circumstances surrounding physicians' clinical activity with patients. They range from encounters with patients seen for the first time for nonemergency problems, to encounters with regular patients seen in the context of continued care, to patient encounters in (life-threatening) emergency situations. Encounters occur in clinics, offices, skilled nursing care facilities, hospitals, emergency departments, and on the telephone. Each test item in an encounter frame also represents one of the six physician tasks. For example, initial care encounters emphasize taking a history and performing a physical examination. In contrast, continued care encounters emphasize decisions regarding prognosis and management.

USMLE Step 3 Specifications:-

Clinical Encounter Frame

20%-30%    Initial care
50%-60%    Continued care
15%-25%    Emergency care

Physician Task:-

8%-12%    Obtaining history and performing physical examination
8%-12%    Using laboratory and diagnostic studies
8%-12%    Formulating most likely diagnosis
8%-12%     Evaluating severity of patient's problems
8%-12%     Applying scientific concepts and mechanisms of disease
45%-55%   Managing the patient

• health maintenance
• clinical intervention
• clinical therapeutics
• legal and ethical issues

* Percentages are subject to change at any time. See the USMLE website for the most up-to-date information.

High-frequency, high-impact diseases also have an effect on how the content of Step 3 is organized. Clinician experts assign clinical problems related to these diseases to individual clinical encounter frames to represent their occurrence in generalist practice
Primum® Computer-Based Case Simulations (CCS)

Step 3:- examinees test using two formats: multiplechoice questions and Primum computer-based case simulations (CCS), a testing format that allows you to provide care for a simulated patient. You decide which diagnostic information to obtain and how to treat and monitor the patient's progress. The computer records each step you take in caring for the patient and scores your overall performance. This format permits assessment of clinical decision-making skills in a more realistic and integrated manner than other available formats.

In Primum CCS, you may request information from the history and physical examination; order laboratory studies, procedures, and consultants; and start medications and other therapies. Any of the thousands of possible entries that you type on the "order sheet" are processed and verified by the "clerk." When you have confirmed that there is nothing further you wish to do, you decide when to reevaluate the patient by advancing simulated time. As time passes, the patient's condition changes based on the underlying problem and your interventions; results of tests are reported, and results of interventions must be monitored. You suspend the movement of simulated time as you consider next steps. While you cannot go back in time, you can change your orders to reflect your updated management plan.

The patient's chart contains, in addition to the order sheet, the reports resulting from your orders. By selecting the appropriate chart tabs, you can review vital signs, progress notes, patient updates, and test results. You may care for and move the patient among the office, home, emergency department, intensive care unit, and hospital ward.

The cases used in the CCS portion of the Step 3 examination are based upon a CCS examination blueprint. The blueprint defines the requirements for CCS examination forms. The CCS blueprint is used to construct CCS examination forms focusing primarily on presenting symptoms and presenting locations. Presenting symptoms relate to the Step 3 Problem/Disease List and are associated with the central nervous system, eye/ear/nose/mouth/throat, respiratory system, circulatory system, digestive system, behavioral/emotional disorders, musculoskeletal system, skin/subcutaneous tissue, endocrine/nutrition/ metabolic disorders, kidneys/urinary tract, reproductive system, pregnancy/childbirth, neonate/childhood illnesses, blood and blood-forming organs, infectious/parasitic diseases, injuries/wound/toxic effects/burns, and health maintenance issues. Presenting locations include the outpatient office, emergency department, inpatient unit, intensive care unit, and the patient's home.

You will see cases related to some, but not all, of these problem/disease and location categories. The intent is to ensure that all examinees encounter a broad range of cases reflecting common and important symptoms and diagnoses. The selection of cases is also guided by specifications relating to age and gender. Each CCS examination form is structured to reflect a balance of cases that is fair and equitable for all examinees.

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