What Is the Hardest Test a Medical Doctor Must Take? (MCAT, USMLE Step 1, Step 2, Step 3)

People going into medical school have to take difficult admissions exams. The most well-known is the Medical College Admissions Test, or the MCAT, and students have to pass it before they can attend medical school.

There’s another series of tests, too, that medical school graduates must take, called the U.S. Medical Licensure Exam, or the USMLE. These two tests are very different because they look at different things. Is one harder than the other, though?

What Is the MCAT?

The MCAT tests whether you’ve sufficiently mastered physical and biological sciences well enough to handle medical school. It’s a multiple-choice, computerized test that the Association of American Medical Colleges administers several times each year and consists of four sections:

  • Biological and Biochemical Foundations of Living Systems
  • Chemical and Physical Foundations of Living Systems
  • Psychological, Social, and Biological Foundations of Behavior
  • Critical Analysis of Reasoning Skills

All prospective medical students must pass this exam to get into medical school.

What Is the USMLE?

The USMLE is the series of exams medical school graduates must take to become licensed practitioners in the United States. This test consists of three steps taken at different times during schooling and post-graduate training:

  • Step 1, which students take at the end of their second year of medical school. It covers basic medical science like anatomy, microbiology, behavioral science, physiology, nutrition, etc.
  • Step 2 (Clinical Knowledge), which focuses on applying knowledge to practice, including in the areas of disease prevention and patient care
  • Step 2 (Clinical Skills) uses actual patients to test a student’s ability to gather information, perform a physical exam, and communicate with patients and colleagues
  • Step 3 is the final exam medical school graduates must take to obtain licenses to practice medicine without supervision.

Which One Is Harder?

It isn’t easy to compare the two tests since they’re administered differently and gauge different things. The MCAT is comprehensive, but tests the academic knowledge you gained in all your pre-med classes. It’s a single-day, standardized test for which you study, similar to every other standardized test you take.

By contrast, the USMLE requires both academic knowledge and practical experience for each step. It’s almost an ongoing process because it not only examines your theoretical knowledge, but it also tests the practical skills you gain as you make your way through your post-graduate work.

Given everything on which the USMLE tests students, Step 3 is probably the most challenging medical training test out there. Experts in various fields, members of state medical boards, and doctors themselves evaluate students in a general medical setting for Step 3, making it the most comprehensive and intimidating test any doctor must take.

Final Thoughts

The MCAT and the USMLE are very different tests that determine very different qualifications, so it’s difficult to say which one is harder. If you’re pursuing a medical degree, you’ll take every section of both tests. You’ll probably find the final test — the USMLE Step 3 — the most difficult though because it tests everything you’ve ever learned.

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Matt Lane

Matt graduated with a BSEd in Kinesiology from University of Georgia and is now pursuing a medical degree. He enjoys sharing his experience with other ambitious young people.