Overview

Introduction 

The United States Medical Licensing Examination® (USMLE®) is a three-step examination for medical licensure in the United States and is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®).

The Composite Committee, appointed by the FSMB and NBME, establishes policies for the USMLE program. Membership includes representatives from the FSMB, NBME, Educational Commission for Foreign Medical Graduates (ECFMG®), and the American public.

Changes in the USMLE program may occur after the release of this Bulletin. If changes occur, information will be posted at the USMLE website. You must obtain the most recent information to ensure an accurate understanding of current USMLE rules. If you are unable to access updated USMLE information via the Internet, you may contact the USMLE Secretariat in writing for updated information.

1. Purpose of the USMLE

2. The Three Steps of the USMLE

3. Examination Committees

4. Ownership and Copyright of Examination Materials

5. CBT – Computer Based Testing

6. Step 2 CS (Clinical Skills)

Source: http://usmleworldwide.com/blog/?p=66

Usmle Step 1 MCQ's # 2

Title: Usmle Step 1 MCQ's # 2

Subject: Behavioral Science

Q NO 2: A 25-year-old woman is brought to the hospital by her husband. The patient complains of severe pain and tenderness in her lower left abdomen. She is diagnosed with appendicitis and scheduled for an emergency appendectomy under general anesthesia. A 2nd year resident performs her surgery. Surgery reveals that the appendix is normal and without inflammation. However, the resident notices a large tumor attached to the patient’s left ovary At this point the resident’s best next course of action would be to do which of the following?

A. Biopsy the tumor and terminate the surgery
B. Excise as much of the tumor as possible without coming into contact with the ovary?
C. Exercising common standards of care, remove the patient’s ovary to eliminate the tumor
D. Seek permission to excise the tumor from the patient’s husband, who is sitting in the waiting room
E. Seek the advice of the supervising surgeon
F. Talk with the patient’s husband, who is in the waiting room, about how his wife would probably want to proceed

Explanation:
The correct answer is A. A competent patient has the right to make all treatment decisions for themselves, including refusal of treatment. If you can access the patient’s wishes by direct conversation, then this must be done. After woman recovers from the anesthesia, she is entitled to full informed consent including descriptions of the: 1) nature of the procedure, 2) the purpose or rationale, 3) the benefits, 4) the risks, and 5) the availability of alternatives. With this information presented, the patient herself can make what ever treatment decision seems best to her.
Excising the tumor (choice B) is treatment without the patient’s consent and permission.
Patient’s wishes, not” common standards of care” (choice C), are what guide treatment decisions. Only if we could not access the patient’s wishes in any way, AND the situation was critical, would we act using judgment as to what would be reasonable care.
Choices D and F are incorrect, because the woman has primary say over her own body. If she were in a coma of some duration, then we might ask the husband under the doctrine of substituted judgment. But here, we can wake her up and ask her directly.
The resident has all of the information required to know the correct actions to take without consulting a superior (choice E). In general, consulting a superior will be the wrong answer on the Step 1 exam.

Source: http://usmleworldwide.blogspot.com/2012/09/usmle-step-1-mcqs-q-no-2.html

Usmle Step 1 MCQ's

Title: Usmle Step 1
Subject: Behavioral Science

Q NO 1: A 29-year-old man presents with a dramatic flourish to his physician’s office, dressed in a “flashy” manner, and describes having brief, superficial relationships. On his way out, he asks the nurse for
a date. Which of the following might also describe the patient?
A. Allows others to make decisions for him
B. Has a restricted range ob emotion
C. Is socially withdrawn
D. Is the “life of the party”
E. Participates in criminal behavior

Explanation:
The correct answer is D. This individual has histrionic personality disorder, characterized by acting in a theatrical manner, which would include being the center of attention at a party. Such individuals are sexually provocative and have difficulty maintaining intimate relationships.
This patient would not have difficulties in self-confidence that would warrant having others make decisions for him (choice A). This describes a patient with dependent personality disorder.
Instead of being limited in expression of feelings (choice B), such as a patient with schizoid personality disorder, this patient expresses feelings openly, often in a yew superficial manner.
This patient would be the opposite of being socially withdrawn (choice C), and would be more likely to be socially gregarious and lively. A patient with avoidant personality disorder would be more likely to be socially with drawn.
While at times they make choices that reflect impulsivity, patients with histrionic personality disorder are not more likely to engage in criminal behavior (choice E). Criminal behavior would more likely be seen in those with antisocial personality disorder.

Source: http://usmleworldwide.blogspot.com/2012/08/usmle-step-1-mcqs.html

USMLE Step 2 Clinical Knowledge (CK) Minimum Passing Score

USMLE examinations are mandatory for all first and then a clinical internship, engage thereafter as a doctor. Preparation for USMLE Step 2 Clinical Knowledge can be a stressful business. It comprises of multiple choice questions on clinical applications of medical knowledge divided on eight 44 question sets. It requires many hours of dedication. USMLE scores are unfortunately the only real way to a residency program can evaluate the qualifications of a candidate. For this reason, many students feel extreme pressure to get the highest score possible. This pressure is even greater on foreign graduates. For many, they begin to lag the United States without any clinical experience, a language barrier and many years of lay-off of a traditional classroom. But despite these obstacles, it is worth the challenge.
  
    Most foreign graduates are married, have children and have a job, the usual scenario. The most important thing a student has to do is set a time line and transmit this timeline to your significant other very clearly and honestly. Without (or in some cases parents) your spouse's full support you will not achieve your goal. They need to know how long it will take, where do you stand now and what is your plan. If you share this information with them openly and completely your trip will free ride, and especially you have zero stress from your life, which is invaluable, while preparing for the USMLE Step 2 in particular.

    The score of USMLE Step 2 Clinical Knowledge is reported in 2 digits and 3 digits scores. The minimum score required to pass this exam is 75 in the two digits score and 189 in 3 digits score; however, from 1st July 2012 the passing score is increased to 196. Good luck and work hard. Hard work always pays.

Source: http://usmleworldwide.blogspot.com/2012/07/usmle-step-2-clinical-knowledge-ck.html

Attempt Limit for USMLE Examinations

All doctors wishing to practice medicine in the United States must take the USMLE (United States Medical Licensing Exam), beyond who have graduated in that country or outside it. Medical graduates from outside the U.S. must take the USMLE before entering a residence or a research program. After approving the USMLE and received the certificate from the Commission for Foreign Medical Graduates Educational (Educational Commission for Foreign Medical Graduates - ECFMG) there is no distinction between foreign and American physicians when applying for residencies and other programs. In the perspective of attempt limits regarding the USMLE examinations, the http://blogs.askdoc-usmle.com provide the useful updates regarding that as per this blog, “Examinees who have made six or more attempts to pass a Step or Step component, including incomplete attempts, should be aware that all applications to register for additional attempts will not be processed unless they are submitted on or before December 31, 2012. This limit was first announced in August of [last year]. The effective date for the six-attempt limit depends upon whether an examinee has taken any Step or Step Component (including incomplete attempts) before January 1, 2012. Examinees who had NOT taken any Step or Step Component before January 1, 2012
if you did not take any Step or Step Component before January 1, 2012, the six-attempt limit went into effect for all exam applications that you submitted on or after January 1, 2012. Examinees who have taken any Step or Step Component before January 1, 2012.
If you have taken any Step or Step Component (including incomplete attempts) before January 1, 2012, the six-attempt limit is in effect for all exam applications that you submit on or after January 1, 2013.  After that date, all attempts at a Step or Step Component will be counted toward the limit, regardless of when the exams were taken.” To have further detailed, a particular individual can go ‘Bulletin of Information’ section of this blog. There are several source provides a rich online environment where medical students can prepare their vital clinical examinations. These web sites offers preparatory exams direct medical professional assessments such as the USMLE Step 2 Clinical Skills. In the perspective of preparation USMLE Step 2 Clinical Skills there are several source on the web is a very comprehensive program with availability on convenience of taking courses online. There are several source offers a unique interactive experience that provides the opportunity to enhance learning and readiness of the medical examination candidates.

In the perspective of Review of Step 2 Clinical Skills. Evaluates if the applicant can demonstrate mastery of basic skills examination for essential patient care safely and effectively. There are three sub-components theme of the review of clinical skills step 2:

Another cutthroat advantage of these sources is that it uses only Board certified health professionals to develop and implement the contents. Web based USMLE courses are available in different lengths. Usually registration is simple and payments are accepted only paypal to protect the subscriber information.

Source: http://usmleworldwide.blogspot.com/2012/07/attempt-limit-for-usmle-examinations.html