(FSMB) and the National Board of Medical Examiners (NBME) Physicians with an M.D. Degree or any Undergraduate Human medicine degree (i.e MBBS) are required to pass this examination before being permitted to practice medicine in the United States.
Students and graduates of medical schools outside the United States or Canada listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements register for Step 1 and Step 2 with the Educational Commission for Foreign Medical Graduates (ECFMG). Each of the three steps of the USMLE examination complements the other; no step stands alone in the assessment of readiness for medical licensure.

Step 1- Assesses whether medical school students or graduates understand and can apply important concepts of the basic sciences to the practice of medicine. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning. Step 1 is constructed according to an integrated content outline that organizes basic science material along two dimensions: system and process.

Step 1- United States Medical Licensing Examination is a one-day examination. It is divided into seven 60-minute blocks (7 hours total) and administered in one 8-hour testing session The number of questions per block on a given examination form will vary, but will not exceed 40. The total number of items on the overall examination form will not exceed 280. The Step 1 score is frequently used in medical residency applications as a measure of a candidate’s likelihood to succeed in that particular residency (and on that specialty’s board exams), and it has been cited by residency program directors as their most important criterion in selecting graduating medical students for their residency program. If the student passes the exam, he or she may not repeat it to achieve a higher score, and any failed attempt is permanently recorded. This “one-time deal” situation is the reason the Step 1 is unanimously viewed as the most arduous and paramount examination a medical student will ever sit during his or her entire career.

Step 2- USMLE Step 2 is designed to assess whether medical school students or graduates can apply medical knowledge, skills and understanding of clinical science essential for provision of patient care under supervision. Step 2 is further divided into two separate exams:
1. Step 2 CK
2. Step 2 CS
Pattern of United States Medical Licensing Examination Step 2 CK assesses whether medical school students or graduates can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills that provide the foundation for the safe and competent practice of medicine.

Step 2 CK- Step 2 CK is a one-day examination. It is divided into eight 60-minute blocks, administered in one 9-hour testing session. Test item formats may vary within each block. It is constructed according to an integrated content outline that organizes clinical science material along two dimensions: physician task and disease category. USMLE Step 2 CS assesses the ability of medical school students or graduates to apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision, and includes emphasis on health promotion and disease prevention. Step 2 ensures that due attention is devoted to the principles of clinical sciences and basic patient- centered skills that provide the foundation for the safe and effective practice of medicine. The examination is offered in following cities across the USA:

Step 3- United States Medical Licensing Examination Step 3 is the final exam in the USMLE sequence and assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings.
Step 3 is a two-day examination. The first day of testing includes 233 multiple-choice items divided into 6 blocks of 38-40 items; 60 minutes are allotted for completion of each block of test items. Items with an associated pharmaceutical advertisement or scientific abstract are included in each of these multiple-choice blocks. There are approximately 7 hours in the test session on the first day.
There are approximately 9 hours in the test session on the second day. This day of testing includes 180 multiple-choice items, divided into 6 blocks of 30 items; 45 minutes are allotted for completion of each block of test items. This is followed by 13 case simulations, each of which is allotted a maximum of 10 or 20 minutes of real time.

The structure of Healthcare system in Germany is very Unique. It is very much oriented to provide highest quality of care to the patients in the all the possible ways. There are different types of hospitals which are located and planned so conveniently in all the regions that patients receive the needed quality treatment within no time. High level of care in the treatment is achieved by use of the latest medical diagnostics and therapy options.
There is NO tuition fee in Germany for Post-grad programs and instead the students earn handsome stipend throughout the studies.
Residency in Germany is not a conventional PG program. It is a hands-on on the job training program under Experienced and certified physicians in Government as well as private hospitals.
At present, there are plenty of opportunities for you to enter into a post-grad program in Germany since there is a shortage of Doctors and relative less competition than other developed countries.
Undoubtedly German qualifications and specialization degrees (known as ‘Facharzt’ in Germany) have excellent reputation worldwide.

Post graduation / Residency Programs in Germany, after completing a bachelor’s degree in Medicine (i.e. MBBS), are different poles from the U.S. or the U.K.
We assure you to not only provide practical guidance, but also a firm backbone for your dream of becoming a Facharzt (Specialist) in Germany. Questions?
How to begin with the language courses? Where to give the exams? Up to which level should one learn the German language? When to go to Germany? Which Visa to apply for? Which language institute is better in Germany? In which state there is more chance to get into Residency Program? Which state has which Entrance Exam? And so on. We have all the explanations, even better perhaps!

Here are a few answers, which may ease the pressure a bit

Learning German Language

Q: Is there a way to get into the Residency Program in Germany if I don’t learn the German language?
A: NO. The Residency program in Germany is completely in GERMAN LANGUAGE. If you do not have fluency in German, you cannot get admission into Residency Program in Germany. Period.

Q: There is no need to get Panic. Learning new language takes time. And believe us, it is worth spending! How?
A: Common! We’ve all grown up learning so many languages, One more to add to the kitty! For the learning purpose, The German language is divided into various levels according to their difficulty. It is in reference to ‘Common European Framework of Reference for Languages’.

Q: The levels are : A1 A2 B1 B2 C1 C2.
A: The difficulty of the language increases with each level. After completing each level, there is an Exam, which get you a Certificate. The certificate of B2 level is the ‘minimum’ requirement to apply for the entry into the residency program in Germany. Certificate of C1 level of your German language helps you to grab a spot into Residency.

Q: What is actually a B2 level of German Language?
A: The student who reaches up to B2 level and has a B2 certificate of German Language, He can understand the main contents of complex and abstract topics, also understands specialized discussions on his own primary area of specialization. He can communicate so spontaneously and fluently that a normal conversation with native speakers is easily possible without a great deal of effort on either side. He can express himself on a wide range of topics in a clear and detailed manner. Also he can explain his position on current issues and indicate the benefits and drawbacks of various options.

Q: Who takes this exams and who issues the language certificates?
A: So, ‘Goethe Institut’ & ‘Telc’, these two are the officially recognized institutes worldwide when it comes to German Language. Unless you have language certificate from either of the institutes, you cannot apply for the residency program in Germany.

Q: Where can you learn the language?
A: There are official centers of Goethe Institute in India in various cities. You can learn the language there. Also, in the smaller cities where Goethe institute is not there, there are numbers of private institutes. There you can learn the language and then you can register yourself as a external student and give the exam. This is how it works with most of the students in India as per our experience. It is cheaper and convenient both.

Q: What after you have learnt the language?
A: After learning the language comes very crucial part. You need to decide when you want to come to Germany? On which visa, Job seekers or Language course visa or Internship Visa?
Most of students take advice from people who doesn’t have sufficient knowledge or experience with this and end-up spending lot of money and waste their precious time. There are some special language courses for Doctors which are actually needed to be done before you start working in Hospital.

Hospitalization and Residency

There are different requirements to start residency in each state of Germany. Basically your entry into residency in Germany is divided in two parts :

Now, Each state has different requirements for obtaining these licenses.
Basic requirements which are common to every state of Germany:

For obtaining Temporary medical license in Germany, you have to apply first with the local Health Ministry, which will forward your request to respective Medical council and they will give you the appointment for Medical-language exam. On passing this exam you will be issued a temporary medical license. The validity of this temporary license depends on which state are you applying in. Usually it is between 6 months and 2 years. Within this time-period you must apply for Permanent license (Approbation) and clear the Knowledge Test for Approbation in order to get permanent license.