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Capillary loops located in the medulla are also known as _.
The primary function of the descending loop of Henle in the kidney is?
Reabsorption of sodium ions
Reabsoption of water by osmosis
Secretion of hydrogen ions
Secretion of potassium ions
Which of the following is not considered a part of the male urethra?
When glucose if found in urine it is called _____.
Which of the following is not considered a component of kidney stones?
The one of the functions occurring at the distal convoluted tubule in the kidney is?
Passive secretion of hydrogen ions
Passive secretion of potassium ions
Limited re-absorption of water
No re-absorption of sodium
ADH has which of the following effects on the distal convoluted
Decrease water re-absorption
Increase water re-absorption
Decrease the concentration of urine
Increase the urine volume
Which of the following is not associated with the role of the kidneys?
Release of erythropoietin (hormone)
Release of renin (enzyme)
Release of Vitamin E
Activate Vitamin D
Each kidney contains approximately nephrons.
The release of Angiotension II causes which of the following to occur?
Increased filtration rate
Decreased glomerular hydrostatic pressure
Increase synthesis of Vitamin E
Increased release of erythropoietin
Which of the following is an effect of a diuretic?
Decreased Cardiac Output
Increased fluid volume
Increased sodium re-absorption
Increased chloride ion re-absorption
Which of the following is not considered a loop diuretic?
Ethacrynic Acid (EDECRIN)
USMLE USMLE Exam (United States Medical Licensing Examination) Detailed Information
What is USMLE?
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 USMLE assesses a physician's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care. Each of the three Steps of the USMLE complements the others; no Step can stand alone in the assessment of readiness for medical licensure.
Who is USMLE?
Find out more about the USMLE »
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Step 2 CS - limited hotel availability in Philadelphia April 2017
Posted: September 14, 2016
Please be advised that between April 27, 2017 and April 29, 2017, hotel availability in Philadelphia will be limited and rates may be higher than usual. Examinees planning to take the USMLE Step 2 Clinical Skills (CS) exam in Philadelphia should note that while the Philadelphia Clinical Skills Evaluation Collaboration (CSEC) test centers will remain open, it may be difficult and/or more expensive to obtain a hotel room during this time.
Learn more »
UPDATE: USMLE Score Report Retrieval System
Posted: July 14, 2016
The Score Report Retrieval System is now back online.
Please be advised there are intermittent outages with the system that NBME- and FSMB-registered examinees use to retrieve their USMLE score reports. If you have encountered an error when attempting to retrieve your USMLE score report, please try again later. We are working to resolve the issue and will update this message when the system functionality has been fully restored.
Learn more »
USMLE Bulletin of Information
The Bulletin includes information on all aspects of USMLE, such as eligibility requirements, scheduling test dates, testing, and score reporting. You must review and become familiar with the Bulletin before completing your application for USMLE Step 1, Step 2 (CK and CS), or Step 3. Start reading the Bulletin of Information »
Download the PDF version of the 2017 Bulletin »
Download the PDF version of the 2016 Bulletin »
Upcoming Changes to USMLE
A summary of planned changes over the next few years is available. [Updated!]
The Composite Committee of the USMLE initiated a process to undertake a comprehensive review of the USMLE program in 2004. The Composite Committee establishes policy for the USMLE and is composed of representatives of the Federation of State Medical Boards (FSMB), National Board of Medical Examiners (NBME), the Educational Commission for Foreign Medical Graduates (ECFMG), and the American public.
This multi-year project to review and revise the USMLE sequence is called the Comprehensive Review of USMLE (CRU). Additional information about CRU is available.
Do You Need More Information?
Check out the Frequently Asked Questions. If you still can't find answers, contact us.
Questions about USMLE
Show All Answers »
Applying, Scheduling, and Rescheduling
How do I apply for USMLE?
To apply for USMLE examinations, you must read the USMLE Bulletin of Information and submit an application through your registration entity.
What is the cost of the USMLE exams?
Information about the cost of the exams is available on the websites of the appropriate registration entities.
Is there a fee for changing my appointment?
A fee may be charged if you change your appointment, depending on how much notice you provide. See the appointment change fee schedule for more information.
Preparing for USMLE
How do I prepare for the test? Is there a review book for USMLE?
No test preparation courses are affiliated with or sanctioned by the USMLE program. Information on such courses is not available from the ECFMG, FSMB, NBME, USMLE Secretariat, or medical licensing authorities.
The best preparation for the USMLE is a general, thorough review of the content reflected in the examination descriptions. You should also practice for your exams using the sample test materials. Self-assessment information and materials are also available. In addition, registered examinees who want the opportunity to become familiar with the Prometric test center environment may take a practice exam at the test center, for a fee. Register for a CBT Practice Session »
Where can I obtain a copy of the USMLE Bulletin of Information?
The USMLE Bulletin can be found at http://www.usmle.org/bulletin. You have the option of viewing the Bulletin online or downloading a PDF file.
How do I update my contact information (email, mailing address, phone number) or register a name change?
Go to the website of your registration entity to submit a name change request and/or obtain the form for completing the change, or to request a change to contact information. Supporting document is required for a name change request
Name change forms and documentation must be received and processed by your registration entity no later than 7 business days before your scheduled testing appointment.
NOTE: If you have a scheduling permit, a revised permit will be issued to you with your new name. You must bring your new permit for admittance to the test center or you will not be permitted to test.
What should I do if I have a disability that requires test accommodations?
If you have a documented disability covered under the Americans with Disabilities Act (ADA) and require test accommodations, you must obtain information regarding procedures and documentation requirements from the Test Accommodations section of this website.
You must submit your application for the Step and your request for test accommodations with required documentation at the same time.
Is there a limit on the number of times Steps can be taken?
You are ineligible to take a Step or Step Component if you have made six or more prior attempts to pass that Step or Step Component, including incomplete attempts.
Do the Steps have to be taken at particular points during my medical education and career?
You must pass Step 1 and Step 2 before you are eligible to take Step 3. In LCME-accredited medical schools, although Step 1 and Step 2 can be taken in any order, most students will take Step 1 at the end of their second year and Step 2 in their fourth year; Step 3 is usually taken during the first or second year of postgraduate training. Students and graduates of medical schools outside the United States and Canada should contact the ECFMG for information on ECFMG Certification and Step 1 and Step 2 eligibility. Most medical licensing authorities require completion of USMLE Steps 1, 2, and 3 within a seven-year period, which begins when you pass your first Step. Check the FSMB website for further information on such requirements.
If a physician currently holds a license in one state and has not taken USMLE, is it necessary to pass USMLE to seek licensure in another state?
Generally no, although this should be specifically checked with individual medical licensing authorities or the FSMB.
I am a graduate of a medical school outside the United States and Canada. How can I get information on what is required to enter graduate medical education and/or practice medicine in the United States?
The Educational Commission for Foreign Medical Graduates (ECFMG) provides such information. Through its Certification program, ECFMG assesses the readiness of graduates of medical schools outside the United States and Canada to enter residency or fellowship programs in the United States. The ECFMG® Certification Fact Sheet provides an overview of ECFMG Certification and preliminary information on entry into US programs of graduate medical education. For detailed information on these topics, including eligibility to take the USMLE, refer to the ECFMG Information Booklet. Both publications are available on the ECFMG website.
I am a MD/PhD candidate and the state board where I am applying for licensure requires applicants to complete all three Steps within seven years. Is there an exception to this policy?
The USMLE program recognizes that the recommended seven-year time limit may pose problems for medical licensure for some candidates with a combined degree (i.e., MD/PhD). For this reason, the USMLE program recommends to licensing jurisdictions that they consider allowing exceptions to the seven-year limit for MD/PhD candidates who meet the following requirements:
The candidate has obtained both degrees from an institution or program accredited by the LCME and a regional university accrediting body.
The PhD should reflect an area of study which ensures the candidate a continuous involvement with medicine and/or issues related, or applicable to, medicine.
A candidate seeking an exception to the seven-year rule should be required to present a verifiable and rational explanation for the fact that he or she was unable to meet the seven-year limit. These explanations will vary and each licensing jurisdiction will need to decide on its own which explanation justifies an exception. Students who pursue both degrees should understand that while many states' regulations provide specific exceptions to the seven-year rule for dual-degree candidates, others do not. Students pursuing a dual degree are advised to check the state-specific requirements for licensure listed by the FSMB.
What are the rules regarding retakes?
You may take the same examination no more than three times within a 12-month period. Your fourth and subsequent attempts must be at least 12 months after your first attempt at that exam and at least six months after your most recent attempt at that exam.
Can I retake a Step that I previously passed?
If you pass a Step or Step Component, you are not allowed to retake it, except to comply with certain state board requirements which have been previously approved by USMLE governance. For example, you may retake a passed Step to comply with the time limit of a medical licensing authority for the completion of all Steps or a requirement imposed by another authority recognized by the USMLE program for this purpose. The medical licensing authority must provide information showing that you are an applicant for licensure in that jurisdiction; have fulfilled all requirements for licensure in that jurisdiction; are eligible for licensure except for the out-of-date examination; and have completed the full USMLE sequence, including Step 3. Information regarding retakes allowed to comply with ECFMG requirements is provided at the time of exam application using ECFMG's Interactive Web Applications (IWA).
If you are repeating a previously passed Step or Step Component because of a time limit, you may apply to retake the examination only after the applicable time limit has expired. An exception to this policy can be granted if, at the time of application and testing:
you are currently enrolled in an LCME- or AOA accredited medical school program leading to the MD or DO degree;
you have previously passed Step 1 and/or Step 2 but have not passed Step 3;
you are expected to graduate from the medical school program six or more years after the date you first passed Step 1 and/or Step 2; and
you are otherwise eligible to retake the examination.
What is ERAS?
ERAS®, the Electronic Residency Application Service, is sponsored by the Association of American Medical Colleges (AAMC) and was developed to transmit residency applications via the Internet, including electronic transmittal of USMLE transcripts to residency programs which participate in ERAS.
Information on electronic transmittal of USMLE transcripts through ERAS is available for students and graduates of accredited medical schools in the United States and Canada from the medical schools.
ERAS is available to students and graduates of medical schools outside the United States and Canada through ECFMG.
How do I report a problem related to my testing administration?
If you experience a computer issue during the test, notify test center staff immediately. The testing software is designed to restart the test at the point that it was interrupted.
To report test day issues, such as computer problems or not completing your exam (for any reason), send a written description of the incident to Test AdministrationS ervices at firstname.lastname@example.org or by fax to (215) 590-9457. Test Administration Services must receive your notice within 10 days of your testing date or it may not be possible to investigate your concerns.
Your correspondence should include your name, your USMLE ID number, the examination name (Step 1, 2 CK, 2 CS, or 3), date of administration, and a detailed description of the difficulty experienced or the reason you decided not to finish the examination.
Please allow at least 15 business days for your report to be investigated and evaluated. You will receive written notification of the investigation results.
If you wish to appeal the results of the investigation, you may submit a written statement to the above office within 10 days of the date of the correspondence containing the results of the investigation. Please include a detailed explanation of the basis for your appeal. A group of senior staff will review the matter. Please be advised that the appeal process can take at least four weeks to complete and may not result in a change to the original decision.
What are the rules regarding what I can and cannot bring into the secure areas of the testing center?
It is important that you read and understand the rules regarding personal possessions. Unauthorized possession of personal items while in the secure areas of the testing centers may lead to a finding of irregular behavior and permanent annotation of your USMLE transcript.
For all Steps, if you bring personal items to the test center, you must store them in a small designated locker outside the secure testing area or in the designated storage area for Step 2 CS; electronic devices must be turned off. All personal items are subject to inspection and are prohibited in the secure areas of the testing center.
For Step 2 CS, the entire testing session from orientation until the evaluation is completed, including all breaks, is considered a closed and secure testing session, and the entire test center, including the orientation room and the restrooms, is a secure testing area. Therefore, the rules regarding unauthorized possession during Step 2 CS apply to the orientation room and to all breaks.
Join Us Wednesday to Find Out Why Your ">USMLE Scores Are So Important
Find out in Kaplan’s Live event why ">USMLE scores are so important, and get your ">USMLE questions answered live.
If you’re an international medical graduate on your way to practicing medicine in the U.S., you’ve probably encountered some questions about the multiple steps of the Board exams, or collectively the United States Medical Licensing Examination (">USMLE).
This Wednesday, Kaplan’s Senior National Medical Advisor Mark Ratliff will host a live event about why ">USMLE scores are so important for becoming a doctor in the U.S.
Learn more about USMLE scores
In addition to addressing participants’ questions in real time, Mark will be touching on some of the following topics:
The best ways to achieve high scores
How long it will take to get a high score
Importance of scores when securing a residency interview
How you’ll know when you’re ready to take the test
How can you participate?
Simply follow the link below to our live event at 7:30 p.m. EST on Wednesday, November 16th, to see Mark’s responses to participants’ questions, and to ask him questions of your own.
About the host
Mark Ratliff is a graduate of Ohio State University and has spent the past eight years instructing and advising international students and doctors. As a Kaplan test-taking expert, Mark uses personalized study techniques and his extensive teaching expertise to motivate his students and help them achieve their Residency goals. He believes that all students have their own plan for success and that he can help them find it. He also provides guidance regarding the Residency application process and the key ingredients to a successful Match.
Join Mark and your fellow ">USMLE test takers this Wednesday, November 16, at 7:30 to 8:00 p.m. EST on for the live event to learn more about why your ">USMLE scores are so important.
ScholarRx Launches Powerful New Search Tool for ">USMLE-Rx Product Suite
FOR IMMEDIATE RELEASE: 111016
ScholarRx Launches Powerful New Search Tool for ">USMLE-Rx Product Suite
Elizabethtown, KY: ScholarRx is pleased to announce the launch of Rx Search, a robust new tool that allows users to search at a concept level within the ">USMLE-Rx product suite. Rx Search, based on advanced natural language processing techniques, is a simple, yet fast, search bar on the ">USMLE-Rx Dashboard that allows users to search within ">USMLE-Rx applications by content type, category, and concept. Results can be queued into Qmax tests and Flash Facts study decks.
For institutional subscribers, Rx Search allows faculty to quickly find content at a granular, topic level within First Aid for the ">USMLE Step 1, Qmax question banks, and Flash Facts. For programs using Rx Dashboard, statistics on individual students’ performance on these topics will appear on the Rx Dashboard, allowing administrators to understand how their students are performing in specific areas of study.
The Rx Search tool can also be used to map an institution’s entire curriculum at the concept level and integrate the results with ScholarRx and other content sources. The result is a comprehensive and seamless body of medical knowledge designed to improve teaching and learning outcomes.
About ScholarRx: ScholarRx (ScholarRxm) is a digital learning company that delivers medical test-preparation and curriculum support services to improve medical education outcomes in programs across the globe. Its ">USMLE-Rx product suite, integrated with bestselling book First Aid for the ">USMLE Step 1, has prepared more than 150,000 students to excel on the ">USMLE. us at ScholarRxm or contact us at infoScholarRxm to learn more.
Crush the ">USMLE Announces Scholarship Program
La Jolla, CA, November 9, 2016 (com) - Crush the ">USMLE is dedicated to helping medical professionals obtain licensure as quickly and as effortlessly as possible. Getting this certification is difficult, especially given the rigors of the medical profession. That's why Crush the ">USMLE is offering its scholarship program, as it will give medical professionals a break on some of the costs and hassle associated with obtaining licensure.
By providing this annual ">USMLE scholarship, Crush the ">USMLE offers an easier path to certification. In order to be considered for this ">USMLE scholarship, applicants should be actively pursuing the first step of medical certification. At the very least, medical students should be looking to secure a license to practice medicine.
"Medical school and hospital shifts were enough to occupy all of my time and attention. Passing the various steps of the ">USMLE were just unwanted cherries on the top of the medical sundae. That's why the Crush the ">USMLE scholarship was a lifesaver—it helped me pass without having to spend too much time doing so!"
Dr. James A., Former Scholarship Winner
This is an annual scholarship for medical professionals who need to obtain licensure. Applicants must enter prior to May 2017, when the winner will be chosen and announced by our staff.
luded with Grand Prize
$605 reimbursement of ">USMLE Step 1 fees
GraduateX ">USMLE Review Course ($289 value)
You can learn more here:
Crush the ">USMLE
What is ">USMLE?
What is ">USMLE - The United States Medical Licensing Examination or ">USMLE is a screening test for medical graduates who want to practice medicine in the US. The examination offers medical licensure in US and is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) - two important regulatory bodies in USA. Apart from that, ">USMLE is governed by a committee that includes members from the FSMB, NBME, the public and, most importantly, the Educational Commission for Foreign Medical Graduates (ECFMG) which assesses international medical students who want to enter into a residency programme in USA. Before you get answers to all your queries regarding what is ">USMLE, you should know that ">USMLE is a three-step programme. The three steps in ">USMLE are Step1, Step 2- Clinical knowledge and Clinical Science and Step 3. Steps 1 and 2 are usually taken when the student is in medical school and step 3 is taken after graduation.
Here, we have explained what is ">USMLE in detail and all the three steps of ">USMLE along with their test patterns and eligibility criteria:
What is ">USMLE Step 1?
">USMLE Step 1: The ">USMLE Step 1 test is taken by students who are enrolled in or have passed medical school with a degree from a college recognised by the World Directory of Medical schools. Step 1 assesses a candidate’s knowledge of the concepts of science in terms of medical practice. Step 1 covers around 18 disciplines and inter-disciplines of medicine some of which are given below:
Biostatistics and epidemiology
">USMLE Step 1 is a one-day exam and mainly consists of multiple-choice questions. The 8-hour long question paper is divided into seven 60-minute blocks. The total number of questions in STEP 1 does not exceed 310. While the number of questions per block will vary, they will not exceed 40.
">USMLE Step 1 pattern:
Computer based test covering 310 MCQ questions.
What is ">USMLE Step 2?
">USMLE Step 2(CK and CS): The Step 2 of ">USMLE is further divided into Clinical Knowledge and Clinical Science. It is same as Step 1 in terms of eligibility in that it can be taken by students who are enrolled in or have passed medical school with a degree from a college recognised by the World directory of Medical schools. In Step 2 papers the emphasis is more on health promotion and disease prevention.
The major difference between CK and CS is that while CK is an MCQ based paper, CS puts test takers through a simulated patient care process where they have to take care of standardised patients i.e., people trained to portray real patients.
">USMLE Step 2 CK is a 9-hour test with 60-minute blocks. Like Step 1, the number of questions in a block does not exceed 40 items with the total number of questions is restricted to 350.
In ">USMLE Step 2 CS has three subcomponents: Integrated Clinical Encounter (ICE), Communication and Interpersonal Skills (CIS) and Spoken English Proficiency (SEP). Candidates will have to treat patients in a professional manner, diagonise them and answer their queries.
">USMLE Step 2 pattern:
Step 2 CK
Computer based test covering 350 MCQ questions.
Step 2 CS
12 patient cases with 15 minutes for each patient and 10 minutes to record each patient note.
Held across six test centers in the US
What is ">USMLE Step 3?
">USMLE Step 3: The ">USMLE step 3 is the final examination in the ">USMLE testing process. Unlike Step 1 and Step 2, the ">USMLE step 3 can be taken only by graduates of medical colleges i.e by candidates who have completed the programme. However, like the other two steps, Step 3 is also applicable to international students from institutes recognised by the World Directory of Medical schools. ">USMLE Step 3 checks whether the candidate is ready for unsupervised medical practice. Clearing ">USMLE Step3 leads to the final licence for students to practice medicine in USA.
Step 3 is a two day exam divided between Foundations of Independent Practice (FIP) and Advanced Clinical Medicine (ACM).
The first day of testing includes 260 multiple-choice items divided into 6 blocks of 38-44 items. The second day, which is 9 hour long, includes 200 questions divided into 6 blocks of 33 questions.
">USMLE Step 3 pattern:
260 MCQs divided into six 60-minute blocks, each block contains approximately 44 questions
200 MCQs divided into six 45-minute blocks, each block contains approximately 33 questions
The eligibility criteria for all the three steps of ">USMLE are different. The table below lists the major eligibility requirements of ">USMLE for Step 1, Step 2 and Step:
Should be enrolled in or graduate of a medical school outside of the US and Canada, which is listed in the World Directory of Medical Schools.
Meets ECFMG certification eligibility criteria.
Must meet eligibility requirements at time of application.
Step 2 - CK and CS
Should be enrolled in or graduate of a medical school outside of the US and Canada, which is listed in the World Directory of Medical Schools.
Meets ECFMG certification eligibility criteria.
Must meet eligibility requirements at time of application.
Clear Step 1, Step 2 CK, and Step 2 CS
Possess a degree equivalent to US and Canadian MD degree from a medical school listed in the World Directory of Medical Schools.
Candidates who hold valid Fifth Pathway certificates issued through December 31, 2009 are eligible to meet Step 3 eligibility requirements for applications
Candidates who do hold Fifth Pathway certificates that are not accepted by the USMLE Program have to obtain ECFMG certification
To know whether your medical school is listed in the World Directory of Medical Schools, go to the World Directory’s website and click on search. There are dropdowns for country, Medical school name, city and whether they are operational or not. You can select just your country to get the entire list of institutes from your country or directly type in your medical college’s name to know whether it is in the list or not.
Candidates can get their ">USMLE scores three to four weeks after the test. However, ">USMLE Step 2 CS exam's results follow a different exam schedule. The ">USMLE result for Step 2 CS is declared as either Pass or Fail. The examination body has determined the minimum ">USMLE result required to clear the exam.
Aspirants are given the opportunity to choose an eligibility period within which they have to take the ">USMLE exam. While ">USMLE is available year round, your eligibility period cannot fall in the first week of January and on major holidays.
US Department of Education does not have to recognize medical programmes offered by universities outside the US
The headline ‘Degrees issued by Texila American University are not recognised by the US Department of Education’ sprawled above an article published on .guvanaguardianm is completely misleading. It is a known fact that the US Department of Education does not have to recognize medical programmes offered by universities located outside the United States.
Texila American University never claimed that it is recognized by the US Department of Education. The graduates of Texila American University who intend to apply for Residency in the USA are required to write and clear the ">USMLE Step 1, 2 & 3 Exams, which are administered by Educational Commission for Foreign Medical Graduates (ECFMG) in the United States. The same applies to the graduates of any other international university across the globe that are located in countries outside the United States. The medical graduates who study in the universities located in the United States are also required to take the ">USMLE Step 1 & 2 Exams.
The requirements for applying for the ">USMLE exams can be found on the official website of ECFMG at
The Graduates of Texila American University are fully eligible to apply for the ">USMLE exams as per the Medical Education Credential Requirements mentioned by ECFMG.