To apply for USMLE examinations, you must submit an application through the appropriate entity. See Apply for USMLE.

Step 1 and Step 2 applications must be submitted to the NBME if you are a student or graduate of a medical school in the United States and Canada, or to the ECFMG if you are a student or graduate of a medical school outside the United States and Canada.

Application procedures for Step 3 vary among jurisdictions. Depending on the licensing board, application materials are available from the FSMB or from the medical licensing authority. See also USMLE Bulletin: Applying for the Test and Scheduling Your Test Date.

Information about the cost of the exams is available on the websites of the appropriate registration entities.

A. Appointments at Prometric test centers for Step 1, Step 2 CK, and Step 3 examinations.

Prometric will charge a fee if USMLE examinees change testing appointments (e.g., reschedule, cancel, change test center location) at Prometric Test Centers thirty or fewer days before their scheduled test date.  No fee is charged for changing testing appointments 31 or more days prior to the first day of the scheduled test. 

The date that you change your appointment, using local time at the Regional Registration Center for the Prometric Testing Region, will determine whether you pay a fee and the amount of this fee:

• If you change your appointment 31 or more days before (but not including) the first day of your scheduled test date, there is no fee.
• If you change your appointment fewer than 31 days but more than 5 days before (but not including) the first day of your scheduled test date, there is a $50 fee.
• If you change your appointment 5 or fewer days before (but not including) the first day of your scheduled test date, there is a higher fee. This fee varies by Prometric Testing Region and by exam.

A schedule of fees is provided in the table below. As stated in the USMLE Bulletin of Information, appointments may be changed by following the instructions on your Scheduling Permit for contacting Prometric.  You will need to provide your Prometric Confirmation Number when you change your appointment.  If you reschedule, your rescheduled test date(s) must fall within your assigned eligibility period.

Appointment Change Fees for Computer-based Examinations

Fees (listed in US dollars) effective January 1, 2013 through December 31, 2015

All appointment change fees are paid directly to Prometric

*Step 3 is administered in the US only

B. Step 2 Clinical Skills (CS) examinations

You will be charged a fee if you change your Step 2 CS appointment at a CSEC center 14 or fewer days before your scheduled test date. There is no fee to cancel a scheduled testing appointment; the fee, if applicable, is due at the time of rescheduling. However, the date that you cancel your appointment, using Eastern Time in the United States, will determine whether you pay a rescheduling fee and the amount of this fee. See Applying for the Test and Scheduling Your Test Date in the USMLE Bulletin of Information for specific fee information.

1. Access application materials from the appropriate registration entity. (See also How do I apply for USMLE?)
2. Complete your application materials and submit them to the registration entity.
3. Obtain a Scheduling Permit verifying your eligibility and authorizing you to schedule the examination.
4. Follow the instructions on your Scheduling Permit to schedule your test date at a test center.
5. Bring your Scheduling Permit and identification as described on your Scheduling Permit to the test center on the scheduled date and time and take the examination. See also USMLE Bulletin: Applying for the Test and Scheduling Your Test Date and Testing.

• Step 1 and Step 2 NBME applicants: Update your contact information online on NLES (NBME Licensing Examination Services).
• Step 1 and Step 2 ECFMG applicants: Update your contact information online on OASIS or download the Request to Change Applicant Biographic Information (Form 182) from the Resources section of the ECFMG website and submit the completed form to ECFMG.
• Step 3 applicants: Update your contact information online on the Step 3 Candidate website.

• Step 1 and Step 2 NBME applicants: Enter your name change information online on NLES (NBME Licensing Examination Services) and print the resulting Name Change Authorization Form . Send the form and supporting documentation to NBME.
• Step 1 and Step 2 ECFMG applicants: Print the Request to Change Applicant Biographic Information (Form 182)from the Resources section of the ECFMG website. Send the form and supporting documentation to ECFMG.
• Step 3 applicants: Print the Name Change/Correction Authorization Form from the Forms section of the FSMB website. Send the form and supporting documentation to FSMB.

NOTE: If you have a Scheduling Permit, an updated permit will be issued to you with your new name. You should discard your old permit once you receive the new one. You must bring your new permit for admittance to the test center. Your name on your new permit must exactly match your name on the identification you are required to present at the test center. Name change forms and documentation must be received and processed by your registration entity no later than 7 business days before your scheduled testing appointment, or you will not be able to test.

No test preparation courses are affiliated with or sanctioned by the USMLE program. Information on such courses is not available from the ECFMG, FSMB, NBME, USMLE Secretariat, or medical licensing authorities.

The best preparation for the USMLE is a general, thorough review of the content reflected in the examination descriptions. You should also practice for your exams using the sample test materials. Self-assessment information and materials are also available. In addition, registered examinees who want the opportunity to become familiar with the Prometric test center environment may take a practice exam at the test center, for a fee. Register for a CBT Practice Session »

The USMLE Bulletin can be found at http://www.usmle.org/bulletin. You have the option of viewing the bulletin online or downloading a PDF file.

If you have a documented disability covered under the Americans with Disabilities Act (ADA) and require test accommodations, you must obtain information regarding procedures and documentation requirements in advance of applying for each Step. This information is available from your registration entity (ECFMG or NBME) if you are applying for Step 1 and Step 2, from the FSMB if you are applying for Step 3, and from the Test Accommodations section of this website.

You must submit your application for the Step and your request for test accommodations with required documentation at the same time.

You must pass Step 1 and Step 2 before you are eligible to take Step 3. In LCME-accredited medical schools, although Step 1 and Step 2 can be taken in any order, most students will take Step 1 at the end of their second year and Step 2 in their fourth year; Step 3 is usually taken during the first or second year of postgraduate training. Students and graduates of medical schools outside the United States and Canada should contact the ECFMG for information on ECFMG Certification and Step 1 and Step 2 eligibility. Most medical licensing authorities require completion of USMLE Steps 1, 2, and 3 within a seven-year period, which begins when you pass your first Step. Check the FSMB website for further information on such requirements.

An examinee is ineligible to take a Step or Step Component if the examinee has made six or more prior attempts to pass that Step or Step Component, including incomplete attempts.

The effective date for the six-attempt limit depends upon whether an examinee has taken any Step or Step Component (including incomplete attempts) before January 1, 2012.

• Examinees who have NOT taken any Step or Step Component before January 1, 2012 
  If you have not taken any Step or Step Component before January 1, 2012, the six-attempt limit is in effect for all exam applications that you submit on or after January 1, 2012.

  Example 1: On January 15, 2012, Examinee A submits his application for his first attempt at any Step or Step Component. The six-attempt limit will be effective at that time for all Steps and Step Components and Examinee A will be allowed to take each Step or Step Component no more than six times, including incomplete attempts.

• Examinees who have taken any Step or Step Component before January 1, 2012 
  If you have taken any Step or Step Component (including incomplete attempts) before January 1, 2012, the six-attempt limit is in effect for all exam applications that you submit on or after January 1, 2013. After that date, all attempts at a Step or Step Component will be counted toward the limit, regardless of when the exams were taken.

  Example 2: Examinee B's application for a seventh attempt at a particular Step or Step Component is received on December 15, 2012. For this examinee, the six-attempt limit will not prevent the seventh attempt, since the application was submitted before January 1, 2013. However, if Examinee B fails the exam, he will not be eligible to submit an application after January 1, 2013 to retake that Step or Step Component.

  Example 3: Examinee C attempts to submit an application for a seventh attempt at a particular Step or Step Component on or after January 1, 2013. The application will not be processed, since all exam applications submitted on or after January 1, 2013 will be subject to the six-attempt limit.

See USMLE Bulletin: Eligibility: Retakes

Generally no, although this should be specifically checked with individual medical licensing authorities or the FSMB.

The Educational Commission for Foreign Medical Graduates (ECFMG) provides such information. Through its program of certification, ECFMG assesses the readiness of graduates of medical schools outside the United States and Canada to enter residency or fellowship programs in the United States. The ECFMG® Certification Fact Sheet provides an overview of ECFMG Certification and preliminary information on entry into US programs of graduate medical education. For detailed information on these topics, including eligibility to take the USMLE, refer to the ECFMG Information Booklet. Both publications are available on the ECFMG website.

ERAS®, the Electronic Residency Application Service, is sponsored by the Association of American Medical Colleges (AAMC) and was developed to transmit residency applications via the Internet, including electronic transmittal of USMLE transcripts to residency programs which participate in ERAS.

Information on electronic transmittal of USMLE transcripts through ERAS is available for students and graduates of accredited medical schools in the United States and Canada from the medical schools.

ERAS is available to students and graduates of medical schools outside the United States and Canada through ECFMG.

No. If you pass a Step, you are not allowed to retake it, except to comply with the time limit of a medical licensing authority for the completion of all Steps or a requirement imposed by another authority recognized by the USMLE program. See USMLE Bulletin: Eligibility - Retakes.

To obtain your USMLE transcript or have it sent to a third party, you must contact one of the three USMLE registration entities. Which entity you contact depends on which Steps you have taken and where you want your transcript sent.

• To have a transcript sent to a medical licensing authority at any time, submit your request through the FSMB.
• If you have not registered for or taken Step 3 and you want a transcript sent to a third party other than a medical licensing authority, submit your request through the same entity that registered you for Step 1 and/or Step 2, the ECFMG or the NBME.
• Once you register for or take Step 3, all requests for USMLE transcripts must be submitted through the FSMB.