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Date Updated: September 29, 2017

International Foundations of Medicine (IFOM)

How Does IFOM Compare to the USMLE?

The United States Medical Licensing Examination® (USMLE®) is a three-step examination 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®). Detailed information about the USMLE is available on the USMLE website.

The International Foundations of Medicine® (IFOM®) program is similar in many ways to the USMLE program, but the two are entirely distinct, and the examinations are not substitutes for each other.

Similarities Between IFOM and USMLE

  • The content blueprints for the IFOM Basic Science Exam (BSE) and Clinical Science Exam (CSE) are analogous, though not identical, to those of the USMLE Step 1 and Step 2 Clinical Knowledge (CK) exams, respectively.
  • The majority of test questions on the IFOM BSE and CSE were first used on the Steps 1 or 2 CK exams, respectively, but they have been internationalized by converting laboratory values to international units and carefully revising terminology as needed. The remainder of the content on each IFOM exam is written by the IFOM Committee, a group of physicians who are representative of the international medical community.
  • NBME sets a "standard of competence" for each IFOM exam that is correlated with and approximates the USMLE Step 1 or Step 2 passing standards, for IFOM BSE and CSE, respectively. This enables easy comparison of IFOM performance to potential USMLE performance.
  • The NBME maintains the same high standards for item creation, scoring, test administration, and security for the IFOM exams as for all other NBME exams.

Key Differences between IFOM and USMLE

  • IFOM exam content is intended to represent global health care trends and needs and to target the types of health problems and issues facing patients and physicians outside the United States and Canada. By contrast, the USMLE is designed to test students and physicians intending to practice medicine in the Unites States.
  • The IFOM Committee that writes and reviews items and exam forms represents the global physician community.
  • The IFOM exams are shorter and cost less than the USMLE Step 1 and Step 2 CK exams.
  • IFOM exams can be ordered by schools and agencies for their examinees and can be administered locally or on-site, either over the web or on paper. By contrast, USMLE Steps 1 and 2 CK exams are ordered by and administered only to individual examinees at Prometric Test Centers.
  • IFOM exam feedback enables schools and examinees to compare their performance to that of an international comparison group (in addition to comparing those scores to USMLE Step 1 or 2 CK exam scores).
  • NBME encourages and can facilitate the setting of regional or school-based passing standards for the IFOM exams to accommodate the various needs of different health care communities around the world.
  • In order to serve the very varied test administration needs of schools and students around the world, we offer IFOM administration in two primary modalities: web-based testing at a school or other institution and paper-and-pencil administration at a school or institution. Another modality—individual testing at Prometric Test Centers—is also offered, but only twice a year.

Using IFOM Exams as Preparation for USMLE

For international medical students and graduates intending to take USMLE Step 1 or 2 CK exams, the IFOM BSE and/or CSE could be excellent preparation because of the similarities between the exams. It is recommended that the IFOM exams be taken in English if they are being used as USMLE preparation.



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