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The USMLE (United States Medical Licensing Examination) is a tripartite test, the doctor must pass two parts to the U.S. to undergo a medical act may. The first step (Step 1) consists of a written, the second (step 2) from a written (clinical knowledge) and practical (clinical skills) examination. International Physicians can take the written exam in testing centers around the world, while the practical examination only in the U.S. itself can be completed. For foreign doctors to examine licensing and co-ordination took place on the ECFMG (Educational Commission for Foreign Medical Graduates).

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