USMLE Exam Fees: For Step 1, 2 & 3

Did you know that over 20,000 international medical graduates take the USMLE annually? The United States is a top choice for aspiring Indian medical students, and the United States Medical Licensing Examination (USMLE) is crucial for getting a medical license in the country.

As an Indian student aiming for a medical degree in the US, navigating the USMLE costs can seem complex. Here, we will discuss the USMLE fees for all the steps, the registration process, and other essential information.

What is USMLE?

The USMLE is owned by two key medical authorities: the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB). The exam is governed by a committee that includes members from the NBME, ECFMG, and FSMB. This committee makes all the decisions about the exam, including the scoring system, pass/fail rules, and other procedures.

The USMLE program has three examination stages – 

• Step 1 - It assesses whether candidates can apply basic scientific knowledge to medical practice.
• Step 2 CK - The test analyzes whether candidates can apply medical knowledge and skills to treat patients under supervision. It includes multiple disciplines like internal medicine, pediatrics, psychiatry, surgery, and gynecology.  
• Step 3 – This is the exam's final stage, which examines if the candidate can apply chemical knowledge and biomedical understanding in tackling unsupervised medical practice, like emergencies. 

Therefore, extensive preparation is required to pass the USMLE to move ahead with one’s medical career. Read further to know about the USMLE costs to help you plan better.

Why Take USMLE Exam?

The primary reason to take the USMLE test is to examine an aspiring physician's medical practice capabilities. Candidates can also assess themselves if they are eligible to provide safe and effective medical services.

Allopathic medicine students must take this exam to successfully obtain their MD degree. On the other hand, osteopathic medicine students can opt for USMLE or the Comprehensive Osteopathic Medical Licensing Examination for their D.O degree.  

So, the USMLE test reduces the need for multiple complicated exams to assess a medical student.  

How to Register for USMLE Exam?

You can register for the USMLE through one of three channels: NBME, ECFMG, or FSMB.

The application process for the Step 1 and Step 2 exams is similar, where only NBME and ECFMG are involved. LCME or COCA-accredited medical program students in Canada or the USA must apply through the NBME channel for the Step 1 and 2 exams.

However, medical graduate students from outside the USA or Canada have to apply through ECFMG for Step 1 and 2 exams. Then, for the Step 3 exam, students must register through the FSMB channel.

Further, all aspiring candidates must be registered students of recognized medical institutes to initiate the registration process.

Different Costs Associated with USMLE

When preparing for the USMLE, knowing the various fees associated with the exam is essential. These USMLE costs can add up, so having a clear understanding helps you better plan your finances.

ECFMG Certification Fee

Starting off, as an international student, one of the first fees you will encounter is for the ECFMG certification, which is about $160. This certification is crucial as it ensures that foreign medical graduates meet US standards. It is a necessary step for practicing in the United States.

Structure of USMLE Step 1, Step 2 & Step 3 Fees

The USMLE exam fees vary depending on the step you’re taking and your location. Here’s a closer look at what you’ll need to budget for:

Item	USMLE Fee	Type
Step 1 Exam Fee + International Test Delivery Surcharge (if testing outside the USA/Canada)	$1,000	Examination Fee
Step 2 CK Exam Fee + International Test Delivery Surcharge (if testing outside the USA/Canada)	$1,000	Examination Fee
Step 3	$925	Examination Fee
ECFMG Exam Chart (up to three copies)	$50 per request form	ECFMG Exam Chart Fee
ECFMG CSA History Chart (up to three copies)	$50 per request form	ECFMG CSA History Chart Fee
USMLE Transcript - Paper (up to 10 transcripts)	$70 per request form	USMLE Transcript Fee
USMLE Transcript - Electronic Transmission for ERAS	$80 per ERAS season	Electronic Transcript Fee

Source: ECFMG(Educational Commission for Foreign Medical Graduates)

These are the basic USMLE fees for all steps to register and sit for each exam. For international students, the costs are a bit higher due to additional administrative and testing location fees.

Optional and Need-Based USMLE Costs Associated with USMLE Step 1 and Step 2 CK

There are additional costs associated with USMLE Step 1 fees for international students and Step 2 CK. Here are a few to keep in mind:

Item	USMLE Fee	Type
Extension of Eligibility Period (Step 1/Step 2 CK only)	$100 per exam	Eligibility Period Extension
Step 1/Step 2 CK Testing Region Change	$90 per region change	Testing Region Change Fee
Score Recheck (Step 1/Step 2 CK)	$80 per exam	Score Recheck Fee

Source: ECFMG

These fees can add up quickly, so it’s essential to plan accordingly. Extensions, international testing, and region changes are common additional costs many students face.

Rescheduling USMLE Fees

Rescheduling your exam might be necessary, but it comes with its own set of fees, depending on how close you are to your exam date:

Date of Placing Request	Prometric Testing Region	Step 1 Fee	Step 2 CK Fee	Step 3 Fee
46 or more days before (but not including) the first day of the scheduled test date	All testing regions	No Fee	No Fee	No Fee
31-45 days before (but not including) the first day of the scheduled test date	All testing regions	$35	$35	$35
6-30 days before (but not including) the first day of the scheduled test date	All testing regions	$100	$100	$100
5 or fewer days before (but not including) the first day of the scheduled test date	US and Canada	$137	$155	$275*
5 or fewer days before (but not including) the first day of the scheduled test date	Outside the US and Canada	$352	$396	N/A

Source: USMLE

* Note: The higher fee for rescheduling Step 3 within 5 days is due to the extended duration and complexity of the test.

Additional Costs Associated with USMLE Fees – ERAS Support System, EVSP, CVS and Translation Costs

There are several additional costs associated with the USMLE, which are important to consider.

ERAS Support Services

Item	USMLE Cost
ERAS Token	$165
Electronic Transmission of USMLE Transcript for ERAS	$80 per ERAS season

Source: ECFMG

EVSP

Item	USMLE Cost
Application for J-1 Visa Sponsorship	$370**

Source: ECFMG

Note: An additional $220 SEVIS fee, payable to the Department of Homeland Security, is required of initial applicants for J-1 sponsorship.

CVS

Item	USMLE Cost
Verification to State Medical Licensing Authority	$66

Source: ECFMG

Translation

Item	USMLE Cost
Medical School Transcript	$250

Source: ECFMG

These costs are particularly relevant for international students. The ERAS Support System helps with residency applications, EVSP supports exchange visitor sponsorships, and CVS verifies certification. Translation costs depend on the number and type of documents needing translation.

Refund Rules

Looking to know the refund rules for USMLE exam fees? If you have money in your ECFMG financial account, you can request a refund by emailing finance@ecfmg.org. 

If your payment was for an exam application that was rejected, your refund will be subject to a $100 processing fee. Approved refunds will typically be issued using the same method as the original payment.

Forfeiture of Fees

Funds in your ECFMG financial account are available for two years to pay for USMLE costs or services. Any funds not used within this period will be forfeited to ECFMG. 

You need to monitor your account status using OASIS and request a refund if you won’t be using the funds within the two-year period.

USMLE Fees – Mode of Payment

Paying the USMLE exam fees is straightforward with a few available options. You can use a credit card or an electronic cheque to cover your registration and other associated fees.

Payments via Credit Card

Paying via credit card is the most common and convenient method. The USMLE accepts major cards like Visa, MasterCard, American Express, and Discover. This method ensures your registration is confirmed instantly, making the process smooth and efficient. To use this option, you must have a credit card with a security code.

Electronic Cheques

Another option is to use electronic cheques. With a valid checking account in a national bank, and either a Social Security Number or driver’s license, you can provide your bank account details and authorize the payment to be directly debited from your account. 

Checks returned for insufficient funds will be subject to a $10 processing fee and Telecheck Returned Check Fees. This is a secure and straightforward option if you prefer not to use a credit card.