2011 USMLE ORIENTATION MATERIALS ********************************************************* About the USMLE ********************************************************* The United States Medical Licensing Examination,

or USMLE, is a three-step examin ation for medical licensure in the United States and is sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). Student s and graduates of US or Canadian medical school programs leading to the MD degree th at are accredited by the Liaison Committee on Medical Education (LCME) or leading to th e DO degree that are accredited by the American Osteopathic Association (AOA) registe r for Step 1 and Step 2 with the NBME. Students and graduates of medical schools outside th e United States and Canada register for Step 1 and Step 2 with the Educational Commission for Foreign Medical Graduates (ECFMG). Graduates of medical schools in and outside th e United States and Canada register for Step 3 with the FSMB or a medical licensing autho rity in the United States. ********************************************************* About the USMLE registration entities and sponsoring organizations ********************************************************* The ECFMG is a private, non-profit organization founded in 1956. The ECFMG promo tes quality health care for the public by certifying international medical graduates for entry into US graduate medical education, and by participating in the evaluation and certification of other physicians and health-care professionals. In conjunction with its Foundation for Advancement of International Medical Education and Research (FAIM ER), and other partners, it actively seeks opportunities to promote international medical education through programmatic and research activities. Through its program of certificati on, the ECFMG assesses the readiness of international medical graduates to enter residen cy or fellowship programs in the United States that are accredited by the Accreditatio n Council for Graduate Medical Education (ACGME). The FSMB is a national non-profit association with membership consisting of 70 m edical licensing authorities in 50 American states, the District of Columbia, Guam, Pue rto Rico, the Commonwealth of the Northern Mariana Islands and the US Virgin Islands. It i s the Federation's goal to provide services to its members to help them carry out the responsibilities mandated by state law. The FSMB was founded in 1912, as the res ult of a merger between the National Confederation of State Medical Examining and Licensi

ng Boards (established in 1891) and the American Confederation of Reciprocating Examining and Licensing Boards (established in 1902). Its mission includes continual improveme nt in the quality, safety, and integrity of health care through the development and promot ion of high standards for physician licensure and practice. The NBME is an independent, not-for-profit organization that provides high quali ty examinations for the health professions. Protection of the health of the public through state-of-the-art assessment is the mission of the NBME, along with a major commi tment to research and development in evaluation and measurement. The NBME was founded in 1915 because of the need for a voluntary, nationwide examination that medical licensi ng authorities could accept as the standard by which to judge candidates for medica l licensure. Since that time, it has continued without interruption to provide hig h quality examinations for this purpose and has become a model and a resource of internati onal stature in testing methodologies and evaluation in medicine. For more information about the USMLE registration entities and sponsoring organi zations, visit the ECFMG website at www.ecfmg.org, the FSMB website at www.fsmb.org, the NBME website at www.nbme.org, and the USMLE website at www.usmle.org. ********************************************************* Purpose of these orientation and practice materials ********************************************************* These materials are intended to help orient individuals registered to take Step 1, Step 2 Clinical Knowledge (CK) and Clinical Skills (CS), and Step 3 of the USMLE. If yo u are not registered and would like more information on the examination or how to apply, v isit the USMLE website. All applicants must review and become familiar with the current U SMLE Bulletin of Information, available at the USMLE website (www.usmle.org), before completing applications for USMLE Step 1, Step 2 (CK and CS), or Step 3. ********************************************************* Software description ********************************************************* The software you install has more than 100 practice test items for each Step exa mination. Some practice items may include multimedia files, such as video or audio clips. There are five sample case simulations for Step 3. All Step 3 applicants must review the P rimum CCS tutorial and practice with all the practice cases well in advance of the testing day to have a thorough understanding of how Primum CCS works.

********************************************************* Obtaining orientation materials ********************************************************* All 2011 USMLE orientation materials are available for download from the USMLE w ebsite (http://www.usmle.org). If you receive these materials on CD, however, you do n ot need to download from the website. Instructions are included below to assist in downloading from the web, installin g the files that have been downloaded, installing from the CD, running the practice so ftware, watching the video and reading the documentation in portable document format (PD F). ********************************************************* System requirements ********************************************************* * Windows 2000, XP, or Vista(TM) with administrator privileges where applicable * Intel Pentium or higher processor recommended * 1 GHz or higher * 512 MB RAM or higher * 100 MB available on the hard drive * 8x or higher CD-ROM drive (if using the CD) * Mouse * Microsoft Internet Explorer 6.0 or higher * Windows Media Player * Adobe Reader * Adobe Flash Player, 8.0 or higher * Color display set to 24-Bit or higher or True Color * Resolution set to a minimum of 1024 x 768 Please note: MacIntosh (Mac) and Linux are not supported. ********************************************************* Installing from the CD ********************************************************* Please note: If you have any previous version of the USMLE practice materials in stalled on your computer, you may be asked to remove them during the installation of the 20 11 materials. During installation, if you see a menu asking if you want to modify, repair or r emove components, this means that the installation program has detected a previous ins tallation. Select REMOVE to uninstall any component currently on your machine and then run the installation program again to install the component you want to use. * Insert the CD into your CD drive. If your computer has the CD autorun feature enabled, the CD will start automatically. If the autorun feature is not enabled, open t he Windows Start menu and select Run. Type X:\menu.htm (substitute the letter of your com puter's CD drive for X). Click OK. * The Main Menu that appears on your screen will indicate which portions of the enclosed

practice materials must be installed. * Select the hyperlink corresponding to the practice software you want to instal l. * At the file download prompt, choose 'open'. * If you receive a security warning "authenticode signature not found," click 'Y es' to continue the installation. * On-screen prompts will guide you through the installation. * When installation is complete you should see a folder(s) on your desktop with icon(s) for the practice materials you selected. If the desktop folder(s) containing p ractice materials do not appear, click on your desktop area and press F5 to refresh yo ur screen or right-click and select Refresh from the pop-up menu. ********************************************************* Instructions to download materials from the USMLE website ********************************************************* Please note: If you receive orientation materials on a CD, YOU DO NOT NEED to d ownload files from the USMLE website - these are the same files provided on the CD. * All downloadable files are zipped. * Click the link for the portion that you want to download. * Make a note of the name of the file. * Depending on the configuration of your computer, you may see a dialog box aski ng whether you want to "Open" or "Save" the file. Choose "Save". * Save this file to your desktop (or make a note of the path where you save the file). ********************************************************* Installing downloaded files ********************************************************* Files downloaded from the web are zipped. If you do not have a utility to unzip a file, you can obtain an evaluation copy from http://www.winzip.com/downwzeval.htm. Please note: If you have any previous version of the USMLE practice materials in stalled on your computer, you may be asked to remove them during the installation of the 20 11 materials. * During installation, if you see a menu asking if you want to modify, repair or remove components, this means that the installation program has detected a previous installation. * Select REMOVE to uninstall any component currently on your machine and then ru n the installation program again to install the component you want to use. * Double click on the file on your desktop (or navigate to the location where yo u saved the downloaded file and double click). * Unzip the file to your desktop (or make a note of the location where the file is saved). * Make a note of the file name - it will end in ".exe". * Double click on the unzipped file on your desktop (the one that ends with ".ex e").

* If you receive a security warning "authenticode signature not found," click 'Y es' to continue the installation. * Dialog boxes will appear on your screen to guide you through the rest of the i nstallation. * When installation is complete you should see a folder(s) on your desktop with icon(s) for the practice materials you selected. If the desktop folder(s) containing p ractice materials do not appear, click on your desktop area and press F5 to refresh yo ur screen or right-click and select Refresh from the pop-up menu. Please note: the video does not need to be installed, just unzipped. Please se e "Watching the Step 2 Clinical Skills (CS) Video" below. ********************************************************* Running the Step 1, Step 2 CK, and Step 3 tutorials, practice multiple-choice questions ("Test Items"), and Primum computer-based case simulations (CCS) ********************************************************* * Download and/or install the portion of the practice software that you want to use. * To view items you must set your screen resolution to 1024 x 768 or higher. Ple ase use your manual or system's Help if you need assistance changing these settings. * Once your resolution is set, open the USMLE folder on your desktop and double click on the practice software that you want to use. The multiple choice items are foun d in the NBME Test Delivery Software. Primum CCS cases may be run from the NBME Test De livery Software or from the icon for Step 3 CCS. ********************************************************* Watching the Step 2 Clinical Skills (CS) Video ********************************************************* The video is provided in windows media file format, which works best with Window s Media Player, although other players may be used. Windows Media Player can be obtained from the Microsoft website (http://www.microsoft.com). If you are using the CD: * Insert the CD and click the appropriate link. The video will play directly fro m the CD. If you have downloaded from the web: * Double click on the downloaded file to unzip it. * Double click on the unzipped file to play the video. ********************************************************* Reading the Step 2 CS Content Description and General Information Booklet ********************************************************* You must use Adobe Acrobat Reader to view and print the booklet. Acrobat Reader can be

installed on your computer free from the Adobe website (http://www.adobe.com). If you are using the CD: * Insert the CD and click the appropriate link. Adobe Reader will open and disp lay the file for you. If you are using the files on the website, you do not need to download the bookl et in order to read it: * Go to http://www.usmle.org/orientation/menu.html. * Click the link for the booklet. ********************************************************* Technical support ********************************************************* If you have problems that you cannot resolve, visit the USMLE website for freque ntly asked questions, send your inquiry to USMLEtech@nbme.org, or call (215) 590-9700 from 8:30 AM to 4:00 PM Eastern Time in the United States, Monday to Friday. ********************************************************* Copyright information ********************************************************* The United States Medical Licensing Examination is a joint program of the Federa tion of State Medical Boards of the United States, Inc. and the National Board of Medica l Examiners. The orientation package includes proprietary information and material s that are licensed by the National Board of Medical Examiners or owned and copyrighted by the Federation of State Medical Boards and the National Board of Medical Examiners. As to the m aterials that are owned and copyrighted by the NBME and FSMB: Copyright 1998-2010 the Federation o f State Medical Boards of the United States, Inc. and the National Board of Medical Exam iners, except for the following: Copyright 2006-2010 National Board of Medical Examiners as to the computer program test driver. Primum Computer-based Case Simulation Software Version 8.2, Copyright 1988-2010 the National Board of Medical Examiners. Runtime library por tions of the software included with permission from Versant Corporation, Copyright 1996. All rights reserved. Portions of Step 2 CS orientation materials reproduced with permission from the Educational Commission for Foreign Medical Graduates (ECFMG) Clinical Skills Assessment (CSA) Candidate Orientation Manual, Copyright 2002 by the ECFMG. Microsoft PowerPoint Viewer, incl uded in this software, is a product of Microsoft Corporation. Permission to use this software and the other materials installed with it is limited to exam preparation or practice by indivi duals who are registered to take the examinations, and further reproduction, distribution, transmission, or other uses

are prohibited without permission from the copyright holders.