USMLE Exam Fees

What is USMLE?

USMLE is the entrance exam for Medical Postgraduate courses in the USA. You need to pass this 3 step exam, make a good cv, do internships in the US and then eventually give interviews to land a job in the US in a postgraduate programme.

You can only give this exam after MBBS.

The National Board of Medical Examiners (NBME) and Federation of State Medical Boards own USMLE. A committee consisting NBME, ECFMG, and FSMB oversees the exam.

The scoring system, pass/fail regulations, and exam processes are decided by this committee.

The examination board includes US doctors, medical professionals, and educators. They create questions, examine test materials, and make changes. Most notably, the NBME creates education, certification, and license tests.

There are three parts to the USMLE exam:

Step 1 tests candidates’ medical practice skills using basic science. It consists syllabus from subjects that para clinical like Pathology, Microbiology, Pharmacology, Anatomy, Physiology and Biochemistry.
Step 2 CK tests applicants’ medical knowledge and ability to treat patients under supervision. This includes your 3rd year and 4th year subjects like medicine, surgery, paediatrics, etc.
Step 3 – The final exam tests candidates’ chemical and biological knowledge in unsupervised medical situations like emergencies. This exam can be given after you get into a medical postgraduate programme in the US.

To know in detail about the USMLE exam, click here.

Cost of Medical PG in USA

The United States of America is a popular destination for Indian students looking to study abroad. As an Indian student hoping to pursue a medical degree in the United States, you need to appear for the USMLE examination. The full form of USMLE is The United States Medical Licensing Examination. It is conducted in 3 steps, and students need to pass Steps 1 and 2 (in their preferred sequence) before appearing for the USMLE Step 3 exam.

Item	USMLE Fee	Type
Step 1	$1000 + Surcharge of $195 for candidates taking the exam outside the U.S., totaling $1,195.	USMLE Exam Fee + International Test Delivery Surcharge
Step 2 CK	$1000 + $220 surcharge for international venues, leading to a total of $1,220.	USMLE Exam Fee + International Test Delivery Surcharge
Step 3	$1000	Application Fee. However, you can pay this and take this exam after you have secured a position at a medical residency.

Different Costs Associated With The USMLE

As an Indian student going to the US to study and practice medicine, you must pay the schedule of exam fees designed for international students (excluding the USA and Canada). Then you need to schedule your exam through the prometric website. Note that some additional fees may also apply. All prices are in US dollars and are subject to change from time to time. Refer to the USMLE website for the latest schedule of fees.

Item	USMLE Price	Additional Comments
Fee to extend eligibility period (Step 1/Step 2 CK only)	$100 per exam
Testing Region Change (Step 1/Step 2 CK only)	$90 per exam	Fill Form 312 and check testing locations
Rescheduling Fee (for Step 1/Step 2 CK)	$0-604 *(Read more in the rescheduling section below)	Depends on testing region, exam step, and cancelation date
Score Recheck fee (for Step 1/Step 2 CK)	$80 per exam	Fill Form 265 to apply for score recheck
ECFMG Exam Chart	$50 per request form (up to 3 copies)	Fill Form 184
ECFMG CSA History Chart	$50 per request form (up to 3 copies)	Fill Form 297
USMLE – Transcript Paper	$90 per request form (up to 10 transcripts)	Fill Form 172 (request sent by student Fill Form 173 (request sent by institutions)

Rescheduling USMLE fees

If you decide to modify, reschedule or cancel your USMLE appointment or change your test centre location, you have to pay a fee. Here are the USMLE test fees associated with rescheduling.

Date of placing request	Prometric Testing Region	Step 1	Step 2 CK	Step 3
31+ days before test date	All testing regions	No charge	No charge	No charge
5 – 30 days before test date	All testing regions	$50	$50	$50
Less than 5 days before test date	India	$293	$330	N.A. (non-refundable and non-transferable)

ECFMG Registration

The journey to USMLE begins with obtaining an ECFMG (Educational Commission for Foreign Medical Graduates) ID, necessary for scheduling the Step exams. The fee for ECFMG certification is $150. This process, including account creation and verification through Form 186, incurs a fee of $150.

Step 1: The First Milestone

Exam Fee for USMLE STEP 1

The fee for Step 1 is $1000, with an additional surcharge of $195 for candidates taking the exam outside the U.S., totalling $1,195.

Preparation Material Costs

UWorld	3 months	$439
Boards and Beyond (BnB)	2 years	$399
SketchyMedical	6 months	$299
Pathoma Videos	3 months	$85
USMLE NBME Practice Exams	3-4 tests required	each at $60 totalling $240

Step 2 CK: Advancing Clinical Knowledge

Exam Fee for USMLE STEP 2 CK

$1000, plus a $220 surcharge for international venues, leading to a total of $1,220.

Preparation Material Costs

UWorld	3 months	$439
Boards and Beyond (BnB)	2 years	$399
Picmonic	12 months	$135
Kaplan Videos	3 months	$1499
USMLE NBME Practice Exams	3-4 tests required	each at $60 totalling $240

The OET Exam and ECFMG Certification

The introduction of the Occupational English Test (OET) adds a fee of $500. Following this,

ECFMG certification via the OET pathway demands about $900, plus an additional $100 for credential verification via EPIC, summing up to $1,000 for certification.

Electives, Visa, and Travel Expenses

Electives are pivotal for gaining U.S. clinical experience and obtaining Letters of Recommendation (LORs). Average costs include:

Visa Fee	$165 for a six-month travel visa
Flight Costs	Roughly $1200 for a round-trip
Elective Fees	Approximately $1,500 per elective, with three electives recommended for a competitive application, totaling $4,500.
Living Expenses	Estimated at $3,000 for three months.
Health insurance	$300 for three months
Malpractice insurance	$900
Living Expenses	Estimated at $4,000 for three months.

Application to the Match

ERAS Token	Costs $165
NRMP Registration	Priced at $85
USMLE Transcript Fee	$80
Application Fees	These vary by the number of programs applied to but estimate around $3,000 for 120+ programs.

Interviews and Visa Processing

Interview Travel Costs (if conducted in-person)	$28,00 for five interviews.
Interview Travel Costs (if conducted in person)	Around $500.

Total USMLE Journey Expenses

With Virtual Interviews: estimated at $20,000.

With In-Person Interviews: The total may reach approximately $25,000, excluding miscellaneous travel expenses.

Refund rules

You may place a refund request provided you have funds in your ECFMG financial account. You need to send a written request to finance@ecfmg.org to claim a refund. Suppose you have money in your account due to payment for an examination application that was rejected (because you were deemed ineligible or you sent an incomplete application).

In such a case, you will be required to pay a $100 refund processing fee. Approved refunds are generally issued to the source method/account of payment. E.g., if you paid your USMLE fees using your visa credit card, the ECFMG will refund the sums back to the same card.

Things to remember

Consider your exam application timing, eligibility period and test date carefully. You are not allowed to cancel or postpone your registration once you place the request for the same. You will not be eligible for a refund if you do not appear for the test on the scheduled date or fail to reschedule your appointment. In such an event, you will have to reapply for the exam, which includes paying all the applicable USMLE fees once again.

As mentioned above, you can reschedule your test date and centre, subject to availability. If you have registered for Step 1 and Step 2 CK, you may also request to extend your eligibility period and testing regions.

If you are unable to obtain the appropriate visa to enter the USA (typically to appear for Step 3 of the exam), you may place a request for a full refund of the USMLE exam fee. The ECFMG considers other exceptional requests on a case-wise basis, typically after your eligibility period expires.

Forfeiture of fees

If you have any funds in your ECFMG financial account, you can utilise them for up to two years towards the payments of applications submitted or any services requested by you. If you do not use these funds in this time frame, you will have to forfeit them to ECFMG, which means you will lose those funds.

The two-year period for utilising funds is calculated from the date of your last transactional activity in your ECFMG account. You can check your account status, dates of payments made, etc., using the MyECFMG mobile app or via the OASIS website.

USMLE fees – Mode of Payment

You can pay your USMLE exam fees, including submitting ECFMG certification applications and requesting various services through various online and offline modes of payment. Online remittance is the quickest and the safest mode of payment that you can rely on The accepte modes of USMLE fee payments include:

Payments via Credit Card

You can utilize your Visa, MasterCard, American Express, or Discover credit cards featuring a security code (PIN&CVV) to make USMLE fee payments.

Electronic Cheques

You can also pay your USMLE exam fees using electronic cheques. However, if you choose this mode of payment, you should have a checking account in a US bank. You also need to have either a US driver’s license or a US Social Security Number. Ensure your account has sufficient funds. Cheques returned due to insufficient funds are subjected to a $10 processing fee, along with an extra TeleCheck returned fee, which can range from $10 to $40 depending on the US state of which the cheque is drawn. Click on the link to know more about TeleCheck Returned Check Fees.

You may make advance payments using the payment methods mentioned above by visiting the OASIS page on the ECFMG website or via the MyECFMG mobile app. Another way to make an advance payment is to utilise the Payment for Service(s) Requested Form, i.e. Form 900. You can find this form under the Resources section of the official EFMCG website. Note that payments made using Form 900 can only be made via:

Credit Card

Accepted cards include Visa, MasterCard, American Express and Discover.

Cheque, money order, or bank drafts

These should be made in the name of the ‘Education Commission for Foreign Medical Graduates’. Such payments should be made in US dollars, with funds paid through a US bank account. You need to write your full name and your assigned USMLE/ECFMG identification number on the flip side of the cheque or along with your money order or bank draft.

Note that you cannot submit Form 900 via e-mail. You need to submit it by mail, courier, or fax strictly. You can either fax the form at (215) 386-3185 or mail it to the below address:

ECFMG,
3624 Market Street,
4th Floor,
Philadelphia, PA 19104-2685
USA

If you opt to make an advance payment of your USMLE fees, it is your responsibility to verify that the payment is received and credited to your ECFMG financial account before you start the application process or make any request. You can, once again, verify your ECFMG account status using the MyECFMG mobile app or via OASIS.

Note: If you choose to make transactions using multiple credit cards for your various payments (application fee, USMLE exam stepwise fee, etc.), you need first to credit your ECFMG financial account using OASIS or the MyECFMG mobile application. Alternatively, you may submit multiple copies of Form 900.

Note that cash payments are not accepted.