The exams, in depth

What each exam actually tests, what you study, how applicants prepare, and what it costs. Every figure is approximate and linked to the official fee page, because fees change every year.

Resource names describe what applicants most commonly report using. RoadmapMD sells none of them and earns nothing from them.

USMLE Step 1

Official page Current fees

The format: One day, about 8 hours: seven 60 minute blocks of up to 40 questions each, all multiple choice. Pass or fail since 2022.
What you study: The basic sciences as medicine uses them: anatomy, physiology, biochemistry, pharmacology, pathology, microbiology, immunology, behavioral science and biostatistics, always wrapped in clinical vignettes.
How people prepare: Most IMGs prepare 6 to 12 months studying 4 to 8 hours a day. The near universal core: a question bank worked twice, a review book, spaced repetition flashcards, and self assessments to decide your date. Book the exam when your practice scores are consistently passing, never before.
What applicants report using: Applicants most commonly report using UWorld, First Aid for the USMLE Step 1, Anki, and NBME self assessments, with Amboss and Pathoma as frequent companions.
What it costs: Approximately $1,000 to $1,300 through ECFMG, plus a regional surcharge if you test outside the US. Check the current fee before budgeting.

USMLE Step 2 CK

Official page Current fees

The format: One day, about 9 hours: eight 60 minute blocks. Scored on the three digit scale, and today the single number programs weigh most.
What you study: Clinical knowledge across internal medicine, surgery, pediatrics, OB GYN, psychiatry, family and emergency medicine: diagnosis, next best step, management and prevention.
How people prepare: Typically 4 to 8 months after Step 1. The question bank is again the spine; many add a clinical review course and timed full length practice. Since this score decides interviews, prepare to peak here.
What applicants report using: UWorld dominates reported prep, with Amboss, Anki decks and NBME clinical forms close behind.
What it costs: Approximately $1,000 to $1,300 through ECFMG, plus the regional surcharge outside the US.

OET Medicine

Official page Current fees

The format: About 3 hours across four sections: listening, reading, writing (a referral letter) and a role play speaking test, all set in healthcare scenarios.
What you study: English as you will actually use it with patients and colleagues. ECFMG requires a minimum grade in each section for its communication pathway.
How people prepare: If your daily English is solid, weeks of format practice suffice; if not, months of general English come first. The writing section is where prepared candidates most often slip: practice the letter format specifically.
What applicants report using: The official OET preparation portal, sample tests, and healthcare English courses. Speaking practice with a partner beats solo study here.
What it costs: Approximately $400 to $500 per attempt. Check the current fee on the official site.

USMLE Step 3

Official page Current fees

The format: Two days: day one is multiple choice foundations of independent practice; day two adds advanced clinical medicine plus interactive computer based case simulations.
What you study: Unsupervised ambulatory medicine: managing the patient over time, not just naming the diagnosis.
How people prepare: US graduates usually take it during intern year with weeks of prep. IMGs aiming for an H-1B take it before the Match, which demands a real study block: the case simulations have their own software worth practicing.
What applicants report using: UWorld Step 3 with its CCS case practice is the reported staple.
What it costs: Approximately $900 to $1,000, paid to FSMB. Requires Steps 1 and 2 CK passed.