The United States Medical Licensing Examination (USMLE)
Applying for Examination
Before applying to ECFMG for examination, international medical students/graduates must:
- submit an Application for ECFMG Certification. See Application for ECFMG Certification.
- read the applicable editions of the ECFMG Information Booklet and the USMLE Bulletin of Information.
To apply for USMLE Step 1, Step 2 CK, and/or Step 2 CS, use ECFMG's Interactive Web Applications (IWA). A complete application consists of the on-line part, which you complete using IWA; the Certification of Identification Form (Form 186) or Certification Statement (Form 183), which you obtain through IWA; and any other required documents. You should read the detailed overview and instructions that accompany the application for examination in IWA before you begin working on the application; these resources will help you plan the timing of your application and outline any necessary items (such as photographs and official signatures) that require advance planning.
Important Note: You should also consider deadlines imposed by the National Resident Matching Program (NRMP) and graduate medical education (GME) programs. It is solely the responsibility of the applicant to complete the required exams in time to meet deadlines imposed by the NRMP and/or GME programs. Since the number of applicants seeking to complete these exams may exceed the spaces available in time to meet those deadlines, there is no guarantee that sufficient spaces will be available for all applicants to meet deadlines imposed by the NRMP and/or GME programs. ECFMG assumes no liability of any kind if an applicant does not complete the exams in time to have results available to meet NRMP and/or GME program deadlines. See Examination Results for information on scoring turnaround times.
For all exams, there is an examination fee. For Step 1 or Step 2 CK, there is an additional international test delivery surcharge, if you choose a testing region other than the United States/Canada. You must pay all applicable fees at the time you apply for examination. For the current exam fees and international test delivery surcharges, see the Fees page on the ECFMG website.
When you apply for Step 1 or Step 2 CK, you must select a three-month eligibility period, such as
If you are unable to take Step 1/Step 2 CK during the three-month eligibility period assigned to you, you may request a one-time, contiguous eligibility period extension (EPEx) using ECFMG’s IWA. Refer to the EPEx Overview in IWA for more information and instructions.
If you do not take Step 1/Step 2 CK during your original or extended eligibility period or if you are unable to extend your eligibility period, you must reapply by submitting a new application and fee(s), if you wish to take the exam.
When you apply for Step 2 CS, you are assigned a 12-month eligibility period that begins on the date that the processing of your application is completed. Your eligibility period will be listed on your scheduling permit.
Once your Step 2 CS eligibility period has been assigned, it cannot be changed or extended. You can schedule a testing appointment for any available date in your eligibility period, and reschedule a testing appointment within your eligibility period. See Scheduling the Examination for more information. If you do not take Step 2 CS during your assigned eligibility period, you must reapply by submitting a new application and examination fee, if you wish to take the exam.
Step 1 and Step 2 CK are delivered at Prometric test centers worldwide. Prometric's test centers are grouped into defined testing regions. When you apply for Step 1 or Step 2 CK, you must choose the testing region where you want to take the exam. A list of Prometric testing regions is available on the ECFMG website.
You can take the exam at any test center in your testing region that offers USMLE, provided there is space available on the date you choose. The test centers available for USMLE Step 1 and Step 2 CK are subject to change. To obtain current information on specific test centers, visit the Prometric website or follow instructions on the scheduling permit for contacting Prometric.
If you are unable to keep your Step 1 or Step 2 CK testing appointment at the test center you select, you can reschedule for a different test center within your testing region, subject to availability. To avoid a rescheduling fee, you must reschedule more than 30 calendar days before your scheduled testing appointment. Refer to your scheduling permit for details.
If you are unable to take Step 1 or Step 2 CK in the testing region you selected, you may request a change to your testing region. For more information, see the Request to Change USMLE® Step 1/Step 2 CK Testing Region (Form 312), available in the Resources section of the ECFMG website and from ECFMG, upon request.
Step 2 CS is administered at six test centers in five cities in the United States. Once you are registered for the exam, you will select a test center, subject to availability, when you schedule your testing appointment. If you are unable to keep your testing appointment at the test center you select, you can reschedule for a different center, subject to availability. To avoid a rescheduling fee, you must cancel or reschedule more than 14 calendar days before your scheduled testing appointment. Access Step 2 CS Calendar and Scheduling on the ECFMG website for more information.
Examinees with Disabilities Requesting Test Accommodations
The USMLE program provides reasonable accommodations for examinees with disabilities under the Americans with Disabilities Act (ADA). If you are an individual with such a disability and require test accommodations, visit the USMLE website before you apply for each Step or Step Component for information regarding test accommodations, including procedures and documentation requirements.
Examinees Who Require Additional Break Time
Examinees with physical or health conditions, such as lactation (to express breast milk) and diabetes (to monitor/treat blood glucose), may apply for additional break time. See the USMLE Bulletin of Information for more information.
Personal Item Exceptions (PIE)
Unauthorized possession of personal items while you are in the secure areas of the testing center is prohibited. Exceptions to this policy may be made in certain limited circumstances. See the USMLE Bulletin of Information for more information.
Important Note: Please note that ECFMG will not provide services of any kind if doing so would be considered violative of any applicable federal, state, or local laws or regulations. Additionally, ECFMG may delay provision of services while investigating whether the services or surrounding circumstances violate such laws, regulations, or ECFMG's policies and procedures.