When Should You Take the USMLE? The Ideal Timeline
Learn when to take the USMLE, including the earliest date and the absolute latest date you should take the exams. Plus, find a timeline to help you plan your exams.
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LEARN WHEN TO TAKE THE USMLE
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Part 1: Introduction to taking the USMLE
Crafting the ideal USMLE timeline is crucial for maximizing your performance and ensuring a smooth transition through each stage of medical training. The USMLE is divided into three steps, each aligning with a specific phase of your medical education.
The USMLE Step 1 is best taken after you’ve completed your pre-clinical coursework, typically at the end of your second year of medical school. This timing allows you to consolidate foundational science knowledge and dedicate a focused study period, which is often three to six months long, to prepare for the exam. Additionally, starting your preparation in the second year allows you to build on recent coursework and take advantage of a dedicated study block before clinical rotations begin.
The USMLE Step 2 (also known as “CK,” which stands for “clinical knowledge”) should ideally be scheduled after you’ve completed the majority of your core clinical rotations, usually during your fourth year of medical school. Scheduling it at this time lets you apply hands-on clinical experience directly to the exam content, making your preparation more effective. Many students dedicate one to three months to focused Step 2 CK study.
The USMLE Step 3 is typically taken after graduation, often during or after your first year of residency, once you’ve gained practical experience in patient management.
While there’s some flexibility in the timeline, careful planning—factoring in study time, clinical obligations, and residency application deadlines—can make a significant difference in your USMLE success. By aligning each exam with your educational milestones and allowing ample preparation time, you’ll be well-positioned to conquer the USMLE and advance confidently toward your medical career. In this guide, we will cover some of the most common questions related to completing and planning for the USMLE exams.
Part 2: Frequently asked questions about when to take the USMLE
When is the earliest I should take the USMLE?
The answer to this question depends on the exam Step you’re focused on.
The earliest time to take Step 1 is immediately after completing your pre-clinical, second-year (M2) curriculum, typically in the spring (February–April), before starting clinical rotations.
The earliest time to take Step 2 is immediately after finishing your third-year core clinical rotations, typically between May and July of your third year.
The earliest time to take Step 3 is immediately after graduating from medical school.
When is the latest I should take the USMLE?
Generally, schools set a deadline for when you need to take Step 1, typically in April after M2. The latest time to take it would be the early summer following M2 and before starting pre-clinical rotations.
The latest time to take Step 2 is typically mid-to-late August of M4. That said, most students take Step 2 somewhere between June and August of M4. Pushing it beyond late August risks having your scores reported to ERAS late. Additionally, if you take it too late and fail, you may not have time to retake it before residency interviews.
The latest you should take Step 3 is typically by the end of your first year of residency to avoid violating program, state licensing, or visa requirements. It’s important to note that some programs will require you to take (and pass) it sooner than this, but the absolute latest you can generally take it is before starting your PGY-2 year (Postgraduate Year 2).
A timeline for taking the USMLE:
Step 1: Spring of M2 (February—April)
Step 2: Between May and July of M4
Step 3: At some point during your first year of residency (ideally well before the end of that first year to be safe)
When should you not take the USMLE?
You should not take the USMLE when you are consistently failing or scoring too close to the minimum passing score on NBME practice exams, as this indicates a high risk of failure. Other critical reasons to postpone include severe personal stress, illness, lack of preparation, or failure to complete a first pass of the material.
When should you not postpone taking the USMLE?
While many focus on how late they can postpone taking the USMLE, some examinees should not postpone it at all. For instance, you should not postpone the USMLE if your recent NBME practice scores are consistently passing (e.g., at least a 215 for Step 1) and stable, even if you feel underprepared or anxious. Additionally, if you have no specific plans to improve your scores between now and the time you anticipate taking it, there’s really no reason to postpone taking it.
You should also consider program deadlines and whether postponing the exam will in any way interfere with them.
Ultimately, if you’re consistently doing well on practice exams, it’s probably best to bite the bullet and go ahead and take the USMLE.
What factors should you consider when deciding when to take the USMLE?
Your decision about when to take the USMLE depends largely on achieving consistent, passing practice scores, having foundational knowledge, and managing personal factors such as burnout and scheduling flexibility. You’ll also want to align your plans with completion of curriculum milestones (e.g, pre-clinical studies for taking Step 1 or clinical rotations for taking Step 2/CK).
Other factors to consider include:
Your academic and personal schedules,
Mental and physical readiness (your ability to have the stamina for a long exam),
Specific program requirements (does the program you’re applying to require specific USMLE scores?),
Availability of test dates (Prometric sites can fill up fast, so be sure you’re able to take it when you’d like), and
Mastery of subjects.
How would accommodations impact my decision on when to take the USMLE?
Your need for accommodations will significantly impact your decision of when to take the USMLE, primarily due to the lengthy application and approval timeline. The USMLE website recommends allowing approximately 60 business days (about three months) to receive an initial decision on a new accommodation request.
Another important consideration is document gathering. Gathering the necessary documents
(evaluations, personal statements, prior accommodation records, etc.) can take an additional three to six months—and that’s before you even submit your application.
You’ll also want to give time for a potential need to appeal any decisions you disagree with along the way. The appeal process can take an additional 60 business days, adding a few months to your application timeline.
Keep in mind that when you request accommodations, your scheduling permit is automatically put on hold. This means you cannot schedule your exam date with Prometric until a decision has been made and an accommodated permit is issued.
Finally, you’ll want to consider testing logistics. For example, extended time may require testing over two days, and additional break time may make Step 2 CK a two-day exam or Step 3 a three-day exam. These are important to bear in mind when deciding when you’ll sit for the exams.
How many times can I take the USMLE?
You generally have four attempts per USMLE Step, per a policy updated in July 2021, with strict waiting periods between attempts (at least six months after the last attempt and twelve months after the first), and a total limit of three attempts in a twelve-month period. While it’s rare, some states (like Florida or New York) may allow an appeal for a fifth attempt if you've exhausted the limit.
Can you retake a USMLE Step that you’ve already passed?
Generally speaking, if you’ve passed a Step, you are not permitted to retake that Step. The exception to this rule is when a retake may be needed to comply with certain state board requirements. For example, you can retake a passed Step to comply with a specific time limit that may be imposed by a medical licensing authority in order for you to complete all Steps. Alternatively, if there’s a requirement imposed by another authority that the USMLE program recognizes for a similar purpose, you may be permitted to retake a passed Step.
How long are USMLE scores valid?
USMLE scores generally remain valid for seven years from the date of passing the first Step, and you’ll have seven years to complete all required Steps for licensure. Most states require examinees to take (and pass) all three Steps within the seven-year period.
In some cases, this time period can be extended for MD/PhD candidates or by specific state medical boards. But, you should keep in mind that if a score expires, you may be required to retake that portion of the exam.
How does my graduation year affect the expiration of my USMLE scores?
When you graduate does not really affect your USMLE scores expiring. Instead, you’re bound to the seven-year timeline mentioned above. You have seven years from the date of passing the first Step to complete all required and remaining Steps.
Final thoughts
Though there can be some flexibility in the timeline for taking the USMLE, it’s important to carefully plan every facet of your timeline as doing so can make a huge difference in how successful you are. Careful preparation can ultimately make or break your outcome, so it’s critical that you organize your time in a manner that allows you to take advantage of what you’ve learned recently as you sit for the next portion of the USMLE. For comprehensive and personalized help in your preparation, we’d be honored to assist you!
About the Author
Dr. Shirag Shemmassianis the Founder of Shemmassian Academic Consulting and one of the world's foremost experts on medical residency admissions. For over 20 years, he and his team have helped thousands of students match to top residency programs using his exclusive approach.
