United States Medical Licensing Examination (USMLE)

In order to apply for United States (U.S.) medical residency programs, and eventually become licensed in the U.S. to practice medicine, students must pass the United States Medical Licensing Exams (USMLE). The exams are divided into four distinct parts: Step 1, Step 2 Clinical Knowledge (CK), Step 2 Clinical Skills (CS), and Step 3.

The Step 1 examination is the most difficult of these. Preparation for this exam should begin from the first week you begin your studies at UQ. It is impossible to do well on Step 1 if you wait to begin your preparations until a few months before the exam.

As outlined in the MD Ochsner program rules (see 4.6(2)), students must attempt the United States Medical Licensing Examination Step 1 examination before commencing Phase 2 of the program.  This is known as the “sit to progress” rule.

It is important to note that passing the first three parts of the USMLE is compulsory for students entering the National Resident Matching Program (NRMP), which is how applicants obtain a medical residency in the U.S. The USMLE Step 1 score is the most important factor in receiving a residency position. Experience at UQ and elsewhere has shown that students who sit the USMLE Step 1 prior to their clinical years (Phase 2) perform on average better than students who delay completion of the examination.  Students who delay the examination have higher fail rates and lower mean scores.

USMLE Step 1

USMLE Step 1 assesses a student’s knowledge of clinical sciences relevant to the practice of medicine. The Faculty of Medicine provides a number of resources to assist MD Ochsner students prepare for Step 1.  Although a difficult test it is not an impossible test.  Every year thousands of medical students take and pass the exam.

USMLE Step 2

USMLE Step 2 is broken into two components: Clinical Skills and Clinical Knowledge. These exams are completed when students are in the fourth year of the MD program. Students must pass both of these exams to be eligible for the National Residency Match Program (NRMP).

For more details on the USMLE please visit their website.

Study Support - Step 1

The Faculty of Medicine is dedicated to preparing students for this exam. The following resources will be available for Phase 1 MD Ochsner students in 2018:

Year 1

Semester 1


  • Orientation to USMLE prep


  • Access to Becker subscription
  • Becker Introductory webinar
  • First Aid distributed


  • Becker integrated case


  • Becker integrated case
  • Students should continue to attend peer tutorials, researcher led tutorials, and USMLE seminar series

Semester 2


  • Becker integrated case


  • Becker integrated case
  • Students should continue to attend peer tutorials, researcher led tutorials, and USMLE seminar series


Year 2

Semester 1


  • Becker integrated case


  • Becker integrated case


  • UWorld subscription distributed
  • Becker integrated case
  • Students should continue to attend peer tutorials, researcher led tutorials, and USMLE seminar series

Semester 2


  • 1st Invigilated CBSSA exam


  • Becker integrated case
  • 2nd Invigilated CBSSA exam
  • Register with ECFMG through IWA


  • Generate Form 186 through ECFMG, complete and follow Faculty process
  • Pay the USMLE exam fee and register for the exam period: November - January
  • Becker integrated case


  • Becker integrated case
  • Final CBSSA voucher to be distributed for home use
  • Students should continue to attend peer tutorials, researcher led tutorials, and USMLE seminar series


  • 5-day Becker intensive course

November – December

  • Take multiple CBSSA practice exams (own expense)
  • Attempt USMLE Step 1 prior to Phase 2

Becker Professional Education Package

  • 24-month access to Becker's eCoach Interactive eBooks with multimedia resources (audio, video, 3D animations and other interactive features). Over 200 hours of instruction covering the following disciplines: anatomy; behavioural science; biochemistry; immunology; medical genetics; microbiology; pathology; pharmacology; physiology.
  • 24-month access to Becker's Step 1 Question Bank.
  • 4 hours of Live Online customized review, with Doctor Lionel Raymon. Dr Raymon will utilise his Integrated Cases deliver style to provide customized instruction reflecting the UQ curriculum content covered during each quarter. The classes are administered using Adobe Connect on weekends.

First Aid

  • Comprehensive Step 1 study guide

NBME practice exams (Year 2 only)

  • Two Step 1 practice examinations (CBSSA) will be provided for students to complete under exam conditions
  • One Step 1 practice examination (CBSSA) will be provided for students to complete at home

USMLEWorld QBank

  • 6-month access to USMLEWorld QBank

Blackboard resources

Study Support - Step 2

The Step 2 exams are completed during Year 4. The following resources will be provided to Ochsner students in Phase 2:

  • USMLEWorld QBank
    • 6-month access to USMLEWorld QBank for USMLE Step 2 CK + Self-Assessment Form 1
    • Vouchers are provided to students at the beginning of Year 3 and upon successfully passing USMLE Step 1. Students do not need to submit anything to OCS Student Affairs to receive the vouchers. Our office receives the scores directly from ECFMG. The vouchers can be activated at a later date, without any deadline for activation.
  • Online resources for USMLE Step 1, Step 2 CK, and Step 2 CS are available through the Ochsner Medical Library. Students receive access to the Ochsner Medical Library online resources upon beginning Year 3.
  • Simulated Step 2 CS practice exam offered by the Ochsner Clinical School
  • Step 2 Study Guide

Sit to Progress


As outlined above, students are required to attempt USMLE Step 1 prior to commencing Phase 2.  As such, the Faculty recommends that students apply for the November—January testing window and attempt Step 1 by December 31 the year prior to Phase 2.  Notwithstanding, the Faculty recognises that students may attempt Step 1 at the beginning of January in Year 3. To accommodate this, the Faculty requires students to provide evidence that they have attempted Step 1 by March 1 Year 3 of the M.D. program.

When you undertake the USMLE Step 1 exam, you will be provided with an embossed receipt from the Prometric Center. You are required to provide a copy of this to the Faculty.

Please ensure you upload your Prometric Center receipt via Placements. This will show up as a To Do task on your home page. Click on the task or navigate to My Details and upload your Prometric Center receipt under the Step 1 Documentation section.


Students do not have to achieve a particular grade on the USMLE Step 1; students are only required to have attempted the test. Please note that a passing grade must be achieved for residency applications following graduation and if a student wishes to undertake an away clinical placement outside of the PLC.

Consequences - failure to sit

Failure to comply with this program rule will impact on the student’s continued enrolment in the program. Students should contact the Faculty of Medicine (med.enquiries@uq.edu.au) if they have any concerns.

Students who do not attempt the USMLE Step 1 before 01 March of their third year of the program will see the following impacted:

  • Suspended enrolment in the program
  • Ineligible to preference for Phase 2 Year 4 clinical placements
  • Ineligible to participate in research opportunities at the Ochsner Clinical School
  • Ineligible to become an OMSA officer
  • Ineligible to apply for an away clinical placement outside of personalised learning course (in addition, students must pass USMLE Step 1 before becoming eligible)
  • Delayed graduation date
  • Delayed eligibility to apply for the NRMP by one year
  • Adverse comment included in the MSPE (Dean’s letter)
  • Lose competiveness for NRMP positions in the U.S.
  • Comment included in ECFMG certification after graduation
  • Eligibility for financial aid
  • Visa status

How to raise concerns

Students who feel unprepared for the USMLE Step 1 should reach out to their Society Head, and the Phase 1 Lead, Dr Tammy Smith (tammy.smith@uq.edu.au) for feedback and advice. Students are encouraged to seek support early.  Details of the Society Heads can be found here.

Students should contact the Faculty of Medicine (med.enquiries@uq.edu.au) if they are experiencing difficulties with meeting the sit to progress rule.

Timeline to apply

When you apply to sit Step 1, you must select a three-month eligibility period for when you intend to take the exam. The first available Step 1 eligibility period for current Year 2 students is the November 2018 to January 2019 period. The December 2018 to February 2019 eligibility period would also allow you to sit the test by the required deadline. Students must have completed all of Phase 1 requirements by the start date of the examination eligibility period (i.e. November). If a student selects an eligibility period that begins before they have completed Year 2 coursework, the Faculty will not approve the application and there may be significant delays in the application.

Eligibility periods will not be confirmed until the second half of the year. Students will also not be able to apply for an examination period until they are confirmed. Students are encouraged to regularly check the ECFMG website after mid-August and begin the application process when the period becomes available. Information about relevant forms can be found here. Contact the Ochsner Partnership Advisor if you have any questions. 

The Faculty of Medicine suggests that students apply for the November to January eligibility period. If the exam is completed prior to December 31, students can be settled in New Orleans for the mandatory week-long orientation. It is important to note that Step 1 is not offered during the first two weeks of January. 

Phase 1 Student Contact

For all enquiries regarding Phase 1 (Years 1 and 2), please contact the Ochsner Partnership Advisor in Brisbane: 

Phone: +61 7 3346 4866
Email: med.ochsner@uq.edu.au  

Phase 2 Student Contact

For all enquiries regarding Phase 2 (Years 3 and 4), please contact the Ochsner Clinical School Office of Student Affairs in New Orleans:

Phone: +1 504 842 0197
Email: StudentAffairs@ochsner.org