In the United States, the individual medical licensing authorities (“state medical boards”) of the various jurisdictions grant a license to practice medicine. Each medical licensing authority sets its own rules and regulations and requires passing an examination that demonstrates qualification for licensure. Results of the USMLE are reported to these authorities for use in granting the initial license to practice medicine. The USMLE provides them with a common evaluation system for applicants for initial medical licensure.
This is intended as a brief description of the organizations that are directly involved with or contribute to the USMLE program. The USMLE®, or the United States Medical Licensing Examination® program, is owned by two entities: the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners® (NBME®).
The FSMB is a non-profit organization that represents the 70 state medical and osteopathic boards of the United States and its territories. The individual medical boards are responsible for licensing physicians, investigating patient complaints, and disciplining physicians who violate the law. The FSMB acts on behalf of its state board members in providing a national assessment program, providing tools that facilitate the documentation and distribution of credentials, sponsoring a national database for tracking disciplinary actions, and acting as a national voice for the individual boards on issues of importance to licensing and practice.
The NBME is a non-profit organization that serves the public through assessments of health professionals. The approximately 80-member board includes representation from national experts who contribute to the design of its examinations, at-large members who bring a variety of perspectives including the public, and representatives from a number of organizations including the Association of American Medical Colleges (AAMC), the American Board of Medical Specialties (ABMS), the American Medical Association (AMA), the Resident and Fellows Section of the AMA, the American Medical Student Association (AMSA), the Council of Medical Specialty Societies (CMSS), the Educational Commission for Foreign Medical Graduates (ECFMG), FSMB, the Student National Medical Association (SNMA), the uniformed services, and the Department of Veterans Affairs.
The NBME develops a number of assessments used in medical education, licensure, and certification, domestically and internationally, and is involved in research and development intended to advance medical education and the science of assessment.
USMLE is governed by a number of committees that include members from the ECFMG, FSMB, NBME, and the public. This committee is responsible for the overall direction of the program, identifying and approving procedures for scoring and determining the pass/fail standard, and all significant policies and procedures.
Members of USMLE test committees include scientists, educators, and clinicians from every region of the United States. Virtually all LCME-accredited medical schools in the United States have been represented on USMLE test committees. USMLE test committee members represent a “national faculty of medicine” drawn from medical schools, state medical boards, and clinical practice settings across the United States.
USMLE was created in response to the need for one path to medical license for allopathic physicians in the United States. It was desirable to create one examination system accepted in every state, to ensure that all licensed MD’s had passed the same assessment standards – no matter in which school or which country they had trained. Today all state medical boards utilize a national examination – USMLE for allopathic physicians, COMLEX-USA for osteopathic physicians.