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The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States and assesses a physician’s ability to apply knowledge, concepts, and principles and to demonstrate patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care. 

Medical licensing authorities in the U.S. require IMGs to be certified by the ECFMG in addition to other requirements, in order to obtain a medical resident license or permanent license to practice medicine. In the United States and its territories, 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. The USMLE is sponsored by the Federation of State Medical Boards of the United States, Inc. (FSMB), and the National Board of Medical Examiners®(NBME®)