Computer USMLE

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Computer-based USMLE

An Introduction forStudents and Graduates of

Foreign Medical Schools

The Educational Commissionfor Foreign Medical Graduates

3624 Market StreetPhiladelphia, PA 19104-2685 USA

(215) 386-5900

www.ecfmg.org

ECFMGSM is an organization committed to promoting

excellence in international medical education.


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Computer-based USMLE

An Introduction for Students and Graduates ofForeign Medical Schools

Table of Contents Page

Introduction 1About This Brochure.... 1Why Computer-based Testing?.. 3When Does CBT Begin? 4CBT Registration: Some New Policies and Procedures. 4

Registration Entity and Test Delivery Entity. 4Eligibility Period 5Testing Region... 6Examination Fee and International Test

Delivery Surcharge 7Scheduling Permit. 8Application and Payment... 11

An Overview of Registration and Scheduling:

What You Need To Do. 12Examinees with Documented Disabilities.. 18Format of Computer-based Step 1 and Step 2. 18Minimum Passing Scores 19How to Prepare.. 20Directory of Services. 22Glossary. 24Copyright1999 by the Educational Commission for Foreign Medical Graduates(ECFMGSM). All rights reserved. Portions reprinted, with permission, from the USMLE

1999 Bulletin of Information on Computer-based Testing (CBT). Copyright1998 bythe Federation of State Medical Boards of the United States, Inc. and the NationalBoard of Medical Examiners (NBME).


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INTRODUCTIONSince the introduction of Steps 1 and 2 of the United StatesMedical Licensing Examination (USMLE) in 1992, theEducational Commission for Foreign Medical Graduates(ECFMGSM) has administered these exams to students andgraduates of foreign medical schools in paper and pencilformat. Test questions were presented to examinees in papertest booklets, and examinees wrote their responses on paperanswer sheets, which were collected and scored.Beginning this year, ECFMG will register eligiblestudents/graduates of foreign medical schools for computer-

based administrations of Step 1 and Step 2. With theintroduction of computer-based testing (CBT), the testquestions will be presented to examinees on a computerscreen. Examinees will choose their answers using thecomputers mouse or keyboard, and their responses will berecorded by the computer, rather than on an answer sheet.ABOUT THIS BROCHUREComputer-based testing has many advantages over the former

paper and pencil format. Some of these advantages arediscussed below. However, along with these benefits comemany changes for applicants. One obvious change is thatexaminees will take the exams using a computer. There arealso significant differences in the registration process forcomputer-based USMLE. For example--students andgraduates of foreign medical schools will continue to apply forthese exams through ECFMG, but they will schedule their owntesting appointments with Sylvan. Sylvan is the entity thatwill actually administer the exams in its test centers.

We at ECFMG realize that many of you have questions aboutCBT. We also know that the idea of taking Step 1 and Step 2by computer is a source of anxiety for many of you, especially


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if you have limited or no experience with computers. ECFMGhas developed this brochure to address these questions andconcerns by: Explaining the new policies and procedures that apply to

computer-based Step 1 or Step 2;

Reviewing what you need to do to register, schedule andtake the exam;

Describing the format of computer-based Step 1 andStep 2; and

Providing interactive practice materials in the form of

the enclosed compact disc (CD).Although this brochure provides an introduction to computer-based Step 1 and Step 2, applicants for these exams mustread the appropriate edition of the combined ECFMGInformation Booklet / USMLE Bulletin of Information fordetailed information on policies and procedures. The currenteditions of these publications are available on the enclosedCD. They are also available in printed format from ECFMG atno cost. The information in this brochure is subject tochange. Notice of any such changes will be posted on the

USMLE web site at http://www.usmle.org or on the ECFMGweb site at http://www.ecfmg.org. In the event that anyinformation in this brochure differs from the correspondinginformation in the ECFMG Information Booklet / USMLEBulletin of Information, the latter publications will containthe most current and accurate information.

For information and application materials for computer-basedStep 3, you should contact the individual licensing authoritiesor the Federation of State Medical Boards, Department of

Examination Services, 400 Fuller Wiser Road, Suite 300,Euless, Texas 76039-3855, USA; Telephone: (817) 571-2949;Internet: http://www.fsmb.org.

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WHY COMPUTER-BASED TESTING?The transition to CBT is part of an overall plan undertaken bythe USMLE parent organizations to enhance the Step exams.Computer-based testing offers a number of advantages overthe former paper and pencil format, including the following: Shorter Testing Time. The former paper and pencilStep 1 and Step 2 were each two-day exams. Computer-basedStep 1 and Step 2 are each one-day exams. Computer-basedadministrations of Step 1 will last about 8 hours. Computer-based administrations of Step 2 will last about 9 hours. Flexibility. Computer-based testing offers examineesgreater opportunity and flexibility in taking Step 1 andStep 2. ECFMG offered each of the former paper and pencilexams twice per year--on fixed dates. However, forcomputer-based Step 1 and Step 2, applicants choose thethree-month time period during which they would like to takethe exam. They may take the exam on any date that it isoffered during this three-month period, provided that spaceis available at the desired test center.

In addition, eligible applicants for CBT may attempt eachStep up to three times in any twelve-month period.Applicants who wish to retake a computer-based Step onlyneed to wait 60 days between attempts on the same Step.

Wider Access. Computer-based Step 1 and Step 2 areoffered at nearly 500 Sylvan Technology Centers(STC)worldwide. Nearly 200 of these centers are located outsideof the United States and Canada. These numbers represent asignificant increase over the 79 ECFMG test centers thatwere available to students and graduates of foreign medicalschools under the paper and pencil format. Under computer-based testing, students/graduates of both foreign and US

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medical schools will test at the same Sylvan TechnologyCenters. Faster Score Reporting. The fact that the test materialsand examinee responses are stored electronically will allowECFMG to mail scores to examinees within several weeks oftheir test dates, rather than the eight weeks that wererequired before scores could be mailed for paper and penciladministrations. (During the initial implementation of CBT,however, it may take up to three months for scores to becomeavailable for the earliest examinees.)WHEN DOES CBT BEGIN?The last paper and pencil administrations of Step 1 andStep 2 have already taken place, on October 20-21, 1998 andMarch 2-3, 1999, respectively.Computer-based administrations of Step 1 began in May 1999.Computer-based administrations of Step 2 are expected tobegin during the second half of August 1999. ECFMG iscurrently accepting applications for both exams.The next section explains some of the new policies andprocedures that apply to computer-based Step 1 and Step 2.After this section, we will review what you need to do to register, schedule and take these exams.CBT REGISTRATION:SOME NEW POLICIES AND PROCEDURES Registration Entity and Test Delivery EntityRegistered applicants for computer-based Step 1 or Step 2will need to communicate with two organizations, ECFMG andSylvan. As was the case under paper and pencil

administration, ECFMG acts as your registration entity. Uponreceipt of your completed application and payment anddetermination that you are eligible, ECFMG will notify the

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National Board of Medical Examiners(NBME) of your

eligibility. The NBME, one of the USMLE parentorganizations, will mail your scheduling permit within twoweeks of this notification.

Tip: If the beginning of your eligibility period is morethan six months away, your scheduling permit willnot be mailed until approximately six monthsbefore the beginning of your assigned eligibilityperiod.

Although your scheduling permit will be mailed by NBME, youshould contact ECFMG if you have questions or concerns aboutthis document.The scheduling permit is your authorization to contact Sylvan,the test delivery entity, to schedule your testing appointment.Sylvan is the organization that will actually administer theexam to you in one of its Sylvan Technology Centers. When

you contact Sylvan, its representatives will be able to tell youwhat locations and dates are available to take the exam. Theywill also schedule your testing appointment. You will alsocontact Sylvan if you need to reschedule your testing

appointment within your three-month eligibility period.After you take the exam, your scores will be mailed to you byECFMG. You will continue to contact ECFMG for services suchas duplicate score reports and USMLE transcripts, as well as for information on any aspect of the ECFMG certificationprocess. Eligibility PeriodInstead of registering for an exam administered on a specificdate, you will choose a three-month period during which youwould like to take the exam. You must select this three-monthperiod on the application form that you send to ECFMG. Thisthree-month period is referred to as your eligibility period,

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since you will only be eligible to take the exam during the

three-month period assigned to you. You may take the examon any day that it is offered during your assigned eligibilityperiod, provided that there is space at the test center youchoose.

Tip: If there is no space available at your first choice oftest center on the date that you want, you can askabout space at other centers (if available) on thatdate. You can take the exam at any STC offeringUSMLE, provided that the center is located in the

testing region that you selected.If you apply for both Step 1 and Step 2 on the sameapplication form, you can choose the same eligibility periodfor both exams, or you can choose a different eligibilityperiod for each Step.

You should know that you may not change your eligibilityperiod once it has been assigned. If you do not take the examduring your assigned eligibility period, you will lose yourpayment for the exam, and you will need to submit a new

application and full payment of all applicable fees to take theexam.

Testing RegionSimilarly, instead of selecting a specific test center, you willchoose a geographical region in which you would like to take the exam. This geographical region is called your testingregion. You must enter this testing region on the applicationform that you submit to ECFMG.

Tip: Be sure to write out the name of the testing region

that you choose (for example "Africa") on theapplication form. Do not list specific cities orSylvan center codes on the application.

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You may take the exam at any Sylvan Technology Center in

the testing region that offers USMLE, provided that space isavailable on the date that you request. You may not change

your testing region once it has been assigned.

A list of testing regions and Sylvan Technology Centers isincluded with the ECFMG Information Booklet. However,since the list of STCs offering USMLE is subject to change,

you should visit the Sylvan web site athttp://www.sylvanprometric.com for current information onthe STCs available in particular testing regions before you

select a testing region. Once you have received yourscheduling permit, you can contact Sylvan directly for currentinformation--simply follow the instructions for contactingSylvan on your scheduling permit. A list of testing regions andSTCs is also available on the ECFMG web site athttp://www.ecfmg.org.

Examination Fee and International Test Delivery Surcharge

Applicants for the former paper and pencil exams werecharged one fee for each of these exams. For the computer-based Steps, the total fee consists of the examination fee

plus the appropriate international test delivery surcharge, ifapplicable.

All applicants must pay the examination fee. The amount ofthe examination fee is listed in the USMLE applicationmaterials. If you choose a testing region other than theUnited States/Canada, you must also pay the internationaltest delivery surcharge for the international testing regionthat you select. These surcharges currently range fromUS$100 to US$270 depending on the testing region you

select. The surcharges represent the additional cost ofoffering Step 1 and Step 2 by computer in locations outside ofthe United States and Canada. If you choose to take the

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exam within the United States or Canada, you do not need to

pay a surcharge.

You must send full payment of both fees with your applicationto ECFMG. If you do not send full payment with yourapplication, your application will be returned to youunprocessed.

Tip: If you apply for both Step 1 and Step 2 on the sameapplication form, you must send full payment ofthese fees for both exams or your application willbe returned to you unprocessed.

Scheduling PermitAfter you are registered by ECFMG for computer-basedStep 1 or Step 2, ECFMG will notify the NBME of youreligibility. The NBME will mail your scheduling permit withintwo weeks of this notification. The scheduling permit is yourkey to the next step in the process: scheduling your owntesting appointment with Sylvan. The scheduling permit is avery important document, and you should be careful not tolose it. You cannot schedule your testing appointment or take

the exam without it. Although your scheduling permit will bemailed by NBME, you should contact ECFMG if you havequestions or concerns about this document. If you lose yourscheduling permit, you should contact ECFMG immediately.

Tip: If the beginning of your eligibility period is morethan six months away, your scheduling permit willnot be mailed until approximately six months beforethe beginning of your assigned eligibility period.

The scheduling permit contains the following information:

Your name and mailing address; The exam for which you registered--either Step 1 or

Step 2 (If you register for both Step 1 and Step 2 on the

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same application form, you will receive two separate

scheduling permits, one for Step 1 and one for Step 2.); Your eligibility period--the three-month period during

which you are eligible to take the exam; and Your testing region--the geographical region in which you

will take the exam.

It also contains two important numbers:

Your Scheduling Number-- you must provide this numberwhen you contact Sylvan to schedule your testingappointment; and

Your Candidate Identification Number (CIN)--you mustenter your CIN into the computer at the Sylvan center onthe date of your test in order to unlock your exam. Youmust keep this number confidential. For your ownprotection, do not share your CIN with anyone.

Your scheduling permit tells you how to contact Sylvan toschedule a testing appointment or get current information onthe STCs offering USMLE in your testing region. The contactinformation included on your scheduling permit will vary,depending on whether you register for the UnitedStates/Canada testing region or an international testingregion. The information included for both cases issummarized below.

Contact Information Included on Scheduling Permit

United States / Canada Testing Region

If you are registered to take the exam in the United Statesor Canada, you must call Sylvan to schedule your testingappointment. Your scheduling permit will include the

telephone number

for Sylvans Regional Registration Center for theUS/Canadian testing region.

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International Testing Regions

If you are registered to take the exam in an internationaltesting region, you can contact Sylvan by phone, fax or mail.Your scheduling permit will include the

telephone number, fax number, and mailing address

for Sylvans Regional Registration Center for the testingregion that you selected.

Telephone scheduling is the most direct method. However, ifyou cannot schedule by phone, part of your permit is a formthat you can use to schedule an appointment by fax or mail.

When you schedule your testing appointment, you will receivespecific information from Sylvan. This information willconsist of your confirmed test date and time, the address andtelephone number of the STC and your Sylvan ConfirmationNumber. The scheduling permit includes space for you towrite down this information. Be sure to record all of this

information on your scheduling permit. Do not write anythingelse on the permit. If you need to reschedule your testingappointment with Sylvan, you will need the SylvanConfirmation Number that you recorded on your schedulingpermit when you made your original appointment.

Finally, the scheduling permit includes basic information onhow to schedule your testing appointment, what you need tobring with you to the test center and what you should expectwhen you arrive at the STC on your test date.

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Application and PaymentComputer-based Step 1 and Step 2 are offered on a regularbasis throughout the year. As a result, there is no deadline tosubmit your application and payment for these exams.However, you should consider the following factors whenplanning the timing of your application:First, ECFMG cannot assign you to the eligibility period that

you selected on your application if that eligibility period hasalready begun. In the event that processing of yourapplication is not complete before the beginning of the

eligibility period you selected, you will be assigned to the nexteligibility period. Therefore, you should send your applicationand payment well in advance of the beginning of the eligibilityperiod you select.

Example: An applicant mails her Step 1 application inearly July for the August-September-October eligibilityperiod. ECFMG receives her application in late July, andprocessing of her application is completed on August 5th.Since the eligibility period selected by the applicantbegan on August 1st and the processing of the

application was completed on August 5th, the applicantcannot be assigned to the August-September-Octobereligibility period. In this case the applicant would beassigned to the September-October-November eligibilityperiod and would not be eligible to take the exam inAugust.

Second, if any month in the applicant's desired eligibilityperiod falls within the next calendar year, the applicant mustuse the next year's application materials.

Example: An applicant decides in May 1999 that hewants to apply to take Step 2 during the November-December-January eligibility period. Since the lastmonth of the eligibility period desired by the applicant

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(January) falls within the year 2000, the applicant must

apply using the year 2000 application materials.

Application materials for the next calendar year are expectedto be available in early July of the current year. The year2000 application materials are expected to be available inearly July 1999.Third, the USMLE application materials may specify a dateafter which you cannot use the current year's applicationmaterials and after which you must use the next year'sapplication materials. You should check for this date before

you complete the application form.AN OVERVIEW OF REGISTRATION AND SCHEDULING:WHAT YOU NEED TO DO Get the ECFMG Information Booklet.The Information Booklet contains the application form forcomputer-based Step 1 and Step 2. You can request a freecopy of the Information Booklet 24 hours a day/7days a weekby calling (215) 375-1913. If you are calling from withinNorth America, you can call toll-free at (800) 500-8249. You

can also fax your request to (215) 387-9963 or write toECFMG at the address on the back cover of this brochure. Decide When and Where You Want to Take the Exam.You must choose a three-month eligibility period during the

year when you want to take the exam. You must also choosethe geographical testing region where you want to take theexam. You must enter both the eligibility period and testingregion on your application form.

Tip: Although you need to choose a testing region, you donot need to choose a particular Sylvan TechnologyCenter until you contact Sylvan to schedule yourtesting appointment.

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Complete the Application Form.Be sure to follow the application instructions carefully andcomplete all items. If you are asked to provide additionaldocumentation, such as copies of your medical school diploma,be sure to include it with your application. If your applicationis not complete, it will be returned to you unprocessed.Tip: If the eligibility period that you want is not listed

on the application form, you do not have theappropriate edition of the Information Booklet andapplication materials. You must use the application

materials for the calendar year in which yourdesired eligibility period ends.

Include Full Payment.You must pay all fees at the time that you send yourapplication. If you do not include full payment, yourapplication will be returned to you unprocessed.Tip: Your payment will be applied to any amount that

you owe to ECFMG before it is applied to your examregistration. If the funds remaining are not

sufficient to cover all fees for the registration(s)you request, your application will be returned toyou unprocessed.

Receive Your Scheduling Permit.Once ECFMG processes your application and determines that

you are eligible, ECFMG will notify NBME of your eligibility.NBME will mail your scheduling permit within two weeks ofthis notification. If the beginning of your assigned eligibilityperiod is more than six months away, your scheduling permitwill not be mailed to you until about six months before thebeginning of your eligibility period. Although your schedulingpermit will be mailed by NBME, you should contact ECFMG if

you have questions or concerns about this document.

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Choose Some Specific Dates and Sylvan TechnologyCenters for Taking the Exam.Before you contact Sylvan to schedule your appointment, youshould choose several dates when you could take the exam.All of the dates that you choose must fall within the eligibilityperiod indicated on your scheduling permit.Tip: When choosing your potential testing dates,

remember that: Sylvan Technology Centers are closed on

major local holidays;

USMLE exams are not given during the firsttwo weeks of January; and The busiest testing times in the US/Canada

testing region are May through July andNovember through December.

You should also choose one or more STCs where you couldtake the exam. The STCs that you choose must fall withinthe testing region indicated on your scheduling permit.A list of the STCs available in each testing region is includedwith the ECFMG Information Booklet. However, the list ofSTCs available for computer-based Step 1 and Step 2 issubject to change. To obtain the most current information onavailable STCs, you can visit the Sylvan web site athttp://www.sylvanprometric.com or the ECFMG web site athttp://www.ecfmg.org. You can also contact Sylvan for thisinformation before scheduling your testing appointment.Simply follow the instructions for contacting Sylvan on yourscheduling permit. Schedule Your Testing Appointment with Sylvan.When you are ready to schedule your testing appointment, youshould contact Sylvan. You can schedule your testingappointment with Sylvan up to six months in advance of your

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assigned eligibility period. You must contact Sylvan before

12:00 noon (local time at the Regional Registration Center foryour testing region) at least five business days (two businessdays for the US/Canada testing region) before the exam datethat you want. Space at STCs is available on a first-come,first-served basis. After you receive your scheduling permitand decide when and where you want to take the exam, youshould contact Sylvan as soon as possible to increase yourchances of getting the date and location you want.

Scheduling by telephone is the most direct method. The

telephone number for Sylvans Regional Registration Centerfor your testing region is listed on your scheduling permit. Ifyou are registered for an international testing region and donot have access to a telephone, you can contact Sylvan by faxor in writing. Sylvans fax number and mailing address arelisted on your scheduling permit. Simply make a clearphotocopy of the Form to Schedule an Appointment by Fax orMail that appears on your scheduling permit and send it toSylvan.

Tip:When scheduling by fax or mail, be sure to copy the

form that appears on your scheduling permit. Do notsend your original scheduling permit to Sylvan. Whencopying the form, be sure not to copy yourconfidential Candidate Identification Number thatappears below the form.

When you contact Sylvan to schedule, you will need to give theScheduling Number listed on your scheduling permit. Sylvanwill let you know what dates are available at the location(s)

you have chosen.

When you make your appointment, Sylvan will confirm with youthe date and time of your exam. Sylvan will give you theaddress and telephone number of the Sylvan Technology

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Center you selected. You will also receive a Confirmation

Number. Be sure to write all of this information in the spacesprovided on your scheduling permit. Do not write anythingelse on your scheduling permit.

If you already have a scheduled testing appointment and youneed to reschedule within your eligibility period, you mustcontact Sylvan, not ECFMG. You will need to provide yourConfirmation Number. For this reason, you should be sure torecord your Confirmation Number on your scheduling permitwhen you schedule for the first time. If you contact Sylvan

before 12:00 noon (local time at the Regional RegistrationCenter for your testing region) at least five business daysbefore your original appointment, you can cancel or reschedulethe appointment free of charge. However, you must still takethe exam within your eligibility period and testing region, or

you will lose your payment for the exam. If you give notice ofless than five business days, you will need to pay Sylvan arescheduling fee when you arrange your new appointment.

Take the Exam.On the date of your testing appointment, you should arrive atthe Sylvan Technology Center thirty minutes before yourscheduled start time. If you need directions to the testcenter, you should call the test center using the telephonenumber that Sylvan provided when you scheduled yourappointment.You also need to bring both your original scheduling permitand one of the following forms of unexpired, government-issued identification that contains both your signature andphotograph: passport, driver's license, national identity cardor other form of unexpired, government-issued identification

that contains both your signature and photograph. If yourgovernment-issued form of identification contains yourphotograph but not your signature, you can use another form

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of unexpired identification that contains your signature, such

as a student/employee identification card or a credit card, tosupplement your photo-bearing, government-issuedidentification.

Tip: The name on your scheduling permit must match thename on your form(s) of identification exactly. Ifthe name listed on your scheduling permit is notcorrect, contact ECFMG immediately.

If you arrive more than thirty minutes late or do not haveboth the scheduling permit and proper identification, you will

not be allowed to take the exam. If you are not allowed totake the exam for these reasons, your payment will not berefunded. You will need to reschedule your testingappointment and pay Sylvan a rescheduling fee.

Before beginning the exam, you will be asked to:

Present your scheduling permit and identification; Sign in; Have your photograph taken; and Store all of your personal belongings in a locker.

The proctor at the test center will tear off the part of yourscheduling permit that contains your Candidate IdentificationNumber (CIN) and give it to you. The proctor will keep therest of your scheduling permit.

Tip: Be careful not to lose the portion of your schedulingpermit that contains your CIN. You will need toenter your CIN into the computer at the beginningof the exam and after each break.

A proctor will lead you to a computer in the testing area. Tobegin your exam, you must enter your CIN into the computer.The exam will begin with a brief tutorial. The tutorial willhelp you become familiar with how the computer and test

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software work. The answers that you choose during the

tutorial do not contribute to your score on the exam.

Your testing appointment is over when you complete the examor when you run out of testing time, whichever happens first.After completing the exam, you will sign out, and a proctorwill give you a Test Completion Notice. The Test CompletionNotice is your confirmation that you took the exam. Thisnotice does not include your score.

EXAMINEES WITH DOCUMENTED DISABILITIES

Appropriate accommodations will be made for USMLEexaminees with documented disabilities. If you have adocumented disability covered under the Americans withDisabilities Act (ADA), you must get the ECFMG Request forTest Accommodations for Examinees with Disabilities andfollow its instructions before you send your application forthe exam to ECFMG. You can download this publication fromthe ECFMG web site at http://www.ecfmg.org. You can alsorequest a copy by calling (215) 386-5900, by faxing to (215)386-6327 or by writing to the address on the back cover of

this brochure. ECFMG will forward your request for testaccommodations to NBME. NBME will inform you of theoutcome of your request once it has been processed.

FORMAT OF COMPUTER-BASED STEP 1 AND STEP 2In some ways the computer-based exams are similar to theformer paper and pencil exams. They consist of the sametypes of multiple-choice questions that appeared on the paperand pencil exams. However, the questions will be organizeddifferently. Computer-based Step 1 and Step 2 are composedof groups of 25 to 50 questions. Each group of questions iscalled a "block." Step 1 consists of seven blocks of questions.Step 2 consists of eight blocks of questions.

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You will have between 30 and 60 minutes to complete each

block of questions. Once you start working on a block, you cannot stop the exam clock. The computer will keep track of howmuch time you have left in each block and for the entireexam. The questions in a block will appear on the computerscreen one at a time. You will read the material available andselect an answer to the question. You can select an answer bypointing to the answer and "clicking" with the computer'smouse or by typing the letter (A, B, C, etc.) corresponding tothe answer on the computer's keyboard. When you arefinished with a question, you choose to move on to the next

question. Once you complete a block or time runs out, you cannot go back to the questions in the block.

You can take breaks, including a lunch break, between blocksof questions. You will have at least 45 minutes of break timefor the entire testing day. If you finish one or more blocksearly, you can take this extra time as break time.

Tip: You should be careful not to use all of your breaktime too early in the testing day. The brief tutorialat the beginning of the exam is included on theenclosed compact disc. If you are already familiarwith the tutorial and choose to skip it on the examdate, you can use this extra time for breaks.

Your testing day is over when you have completed all blocks ofquestions or when you run out of time, whichever happensfirst. The entire testing day for Step 1 will last eight hours.The testing day for Step 2 will last nine hours.MINIMUM PASSING SCORESThe minimum scores required to pass computer-based Step 1and Step 2 are expected to remain the same as they were forthe paper and pencil exams. Just as under paper and pencilformat, though, these minimum passing scores are reviewed

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periodically and may be adjusted without notice prior to score reporting.HOW TO PREPAREECFMG provides registered applicants with free practicematerials for computer-based Step 1 and Step 2. Thesematerials are available in two formats--as a printed booklet and in the form of a compact disc (CD). ECFMG sends boththe printed booklet and the CD to applicants when they are registered for Step 1 and/or Step 2.Both the booklet and CD will help you become familiar with

the types of questions you will encounter on the exams. Thecompact disc will help you to become familiar with theoperation of a personal computer and with the exam softwarethat you will encounter on the date of your exam.

If you do not have extensive experience with computers, youmay be concerned about taking a computer-based exam. TheNBME has conducted field trials to determine the effect ofprior computer experience on examinee performance oncomputer-based exams. These field trials show that

experience with computers generally does not affect howexaminees score on computer-based, multiple-choice exams.Practice with the exam software is also not consideredessential.

Although not considered essential, it is recommended that youpractice with the exam software before taking the exam.One way to do this is to take the practice tests on theenclosed CD. The CD contains a brief tutorial and practicetests for both Step 1 and Step 2.

If you do not have the CD, there are other ways to get theseinteractive practice materials. If you have access to theInternet, you can download them from the USMLE web site athttp://www.usmle.org.

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If you have already received your scheduling permit for acomputer-based Step, you can schedule a practice session forthis Step at a Sylvan Technology Center. You must pay a feeto Sylvan for this service. You should know that the practicematerials used for the practice sessions at Sylvan TechnologyCenters are the same materials included on the enclosed CD.No new material will be presented during the Sylvan practicesessions.

If you would like to take a practice session at a SylvanTechnology Center, you must register for the practice session

to obtain a practice session scheduling permit. You canregister for a practice session on the USMLE web site athttp://www.usmle.org. Information on the fee for thepractice sessions is also available at this site. If you do nothave access to the Internet, you can call ECFMG at (215) 386-5900 to register and get information on the fee for thisservice.

Tip: When you register for a practice session, you will beasked for the Scheduling Number and Candidate

Identification Number from your Step 1 or Step 2scheduling permit. You must have your Step 1 orStep 2 scheduling permit before you can register fora practice session.

We hope that you find this brochure helpful in preparing totake computer-based USMLE Step 1 and Step 2. If you havequestions about which entity to contact as you proceedthrough registration and scheduling, please refer to thefollowing directory. If you have questions about CBT that arenot answered here, you can call ECFMG's ApplicantInformation Services at (215) 386-5900.

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Directory of Services

FOR CONTACT

Questions on your eligibility orthe status of your application orpayment

Incorrect name and/or addresson your scheduling permit

Lost or missing scheduling permit

Information on testaccommodations or to obtain theRequest for Test

Accommodations for Examinees

with Disabilities

Duplicate score report or USMLEtranscript

Questions about ECFMGCertification

ECFMG3624 Market StreetPhiladelphia PA 19104

USA

(215) 386-5900

www.ecfmg.org

The ECFMG Information Bookletand application materials forStep 1 and Step 2

Call ECFMG 24 hours a

day / 7 days a week at(215) 375-1913 or(800) 500-8249, if callingfrom within NorthAmerica. Fax yourrequest to (215) 387-9963. Mail your requestto

ECFMG3624 Market Street

Philadelphia PA 19104USA

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Directory of Services(continued)

FOR CONTACT

Scheduling or rescheduling yourtesting appointment

Current information on the STCsoffering USMLE

Scheduling a practice session ata Sylvan Technology Center

Sylvan

Follow the instructionsfor contacting Sylvan on

your scheduling permit.

Downloading practice materialsfrom the Internet

Visit the USMLE web siteat http://www.usmle.org.

Information or a schedulingpermit for a Sylvan practicesession

Visit the USMLE web siteat http://www.usmle.orgOR call (215) 386-5900.

Information and applicationmaterials for Step 3

Federation of StateMedical Boards

Dept. of Examination

Services400 Fuller Wiser RoadSuite 300Euless TX 76039-3855USA(817) 571-2949http://www.fsmb.org

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Glossary

CandidateIdentification Number

The number listed on your scheduling permit that you willenter into the computer on the date of your test. See pages9, 17.

CBT Computer-based testing. See page 1.

CD Compact disc. See pages 20-21.

CIN See Candidate Identification Number above.

Confirmation Number The number Sylvan will give you when you schedule yourtesting appointment. See pages 10, 15-16.

ECFMG Educational Commission for Foreign Medical Graduates,your registration entity.

Eligibility Period The three-month period, indicated on your schedulingpermit, during which you are eligible to take the exam.See pages 5, 11-12.

Examination Fee The fee that all applicants pay to take the exam. Seepage 7.

International TestDelivery Surcharge

The additional cost of taking the exam in an internationaltesting region. See page 7.

National Board ofMedical Examiners

A USMLE parent organization and the entity that willmail your scheduling permit. See pages 5, 13, 18.

NBME See National Board of Medical Examiners above.

Registration Entity The entity that determines your eligibility and processes

your application and payment. See page 4.Scheduling Number The number listed on your scheduling permit that you

must provide to Sylvan when scheduling your testingappointment. See page 9.

Scheduling Permit The document sent to eligible applicants authorizingthem to schedule their testing appointments. See page 8.

STC Sylvan Technology Center. 14.

SylvanThe entity that will administer the exam to you in one ofits test centers, your test delivery entity. See pages 4-5.

Test Delivery Entity The entity that will administer the exam to you in one ofits test centers. See page 5.

Testing Region The geographical region in which you choose to takethe exam. See page 6.

See page 4.

See pages 7, 12,

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ECFMG AIMS AND MISSIONSThe Educational Commission for Foreign Medical Graduates(ECFMG) has the responsibility of evaluating qualifications ofgraduates of foreign medical schools who seek entry intopostgraduate medical education positions in the UnitedStates, and has an organizational commitment to promoteexcellence in international medical education.In recognition and fulfillment of public responsibilities for thequality of health care, its delivery, and health professionseducation, the sponsoring organizations established ECFMG toconcern itself with international medical education and

graduates of foreign medical schools.To meet its responsibilities, ECFMG identifies the following asits aims and missions: Provide information to graduates of foreign medicalschools regarding entry into graduate medical education andhealth care systems in the United States; Evaluate the qualifications of graduates of foreign medicalschools for entry into graduate medical education and healthcare systems in the United States;

Identify the cultural and professional needs of graduatesof foreign medical schools and assist in the establishment ofeducational policies and programs to meet these needs; Provide international access to testing and evaluationprograms; Gather, maintain, analyze, and disseminate data andconduct research studies on such data concerning graduatesof foreign medical schools; Assist foreign medical schools and other institutions andinternational agencies concerned with health professionseducation through consultation and cooperation relative toprogram development, standard setting and evaluation.


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ECFMG SPONSORING ORGANIZATIONS

The Educational Commission for Foreign Medical Graduates(ECFMG) is a separate, non-profit organization sponsored by:

The American Board of Medical SpecialtiesThe American Medical AssociationThe Association of American Medical CollegesThe Association for Hospital Medical Education

Federation of State Medical Boards of the United

States, Inc.The National Medical Association

Educational Commission for Foreign Medical Graduates3624 Market Street

Philadelphia PA 19104-2685 USA(215) 386-5900

www.ecfmg.org

Documents

Computer USMLE