Issue 431 – November 19, 2025

USMLE Service Transition Launching January 2026

As previously announced, the United States Medical Licensing Examination^® (USMLE^®) Service Transition will simplify the examinee journey and create a more consistent and efficient process for examinees. To do this, all USMLE Step exam service functions, including exam registration, score report delivery, and customer service, will be combined under the USMLE co-sponsors, the Federation of State Medical Boards (FSMB) and NBME, in two phases in January 2026.

Phase One: USMLE Services for Students and Graduates of International Medical Schools (IMGs) Transition to FSMB

On January 12, 2026, USMLE Step exam services currently provided to IMGs by ECFMG^®, a division of Intealth^®, will transition to FSMB. This change means that all USMLE services for all three Step exams will be managed by FSMB for IMGs.

ECFMG will continue to provide USMLE services to IMGs for Step 1 and Step 2 Clinical Knowledge (CK) through January 7, 2026. Effective January 8, 2026, IMGs will no longer be able to access any USMLE services in ECFMG’s MyIntealth™ portal.

For examinees who plan to apply for Step 1 or Step 2 CK, eligibility period extensions, testing region changes, or score rechecks before the USMLE Service Transition, the USMLE program recommends that all applications and supporting documentation be submitted to ECFMG via the MyIntealth portal no later than December 31, 2025. This date is provided as general guidance for applicants and does not guarantee completion before the USMLE Service Transition. Incomplete USMLE applications and service requests not processed prior to the USMLE Service Transition will need to be resubmitted with FSMB.

IMPORTANT: While this change is being implemented, FSMB’s USMLE portal will be temporarily unavailable and ECFMG’s MyIntealth portal will be briefly unavailable starting on January 8, 2026. During this period, examinees will be unable to access their accounts or create new accounts. Examinees testing during this time should download their scheduling permits by January 7, 2026. Examinees are not allowed to test without a scheduling permit. The USMLE program will announce when the transition is complete and FSMB’s USMLE portal is available again, which is expected to be on January 12, 2026. ECFMG will announce when the MyIntealth portal becomes available again.

Please note that this change does not affect the requirements for ECFMG Certification. After the transition of services takes effect, ECFMG will continue to determine whether IMGs are eligible for ECFMG Certification, and eligibility for certification will continue to be a core requirement for IMGs to take USMLE. ECFMG will share information on certification eligibility with the USMLE co-sponsors for the purposes of registration. Step 1 and Step 2 CK will continue to be required by ECFMG to meet the medical science examination requirement for certification.

For details on the remainder of the USMLE Service Transition, please read the full announcement on the USMLE website.

For the latest information and Frequently Asked Questions, please refer to the USMLE Service Transition Information Hub on the USMLE website.