To apply for USMLE examinations, you must read the USMLE Bulletin of Information and submit an application through your registration entity.

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

A fee may be charged if you change your appointment, depending on how much notice you provide. See the appointment change fee schedule for more information.

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 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.

Go to the website of your registration entity to submit a name change request and/or obtain the form for completing the change, or to request a change to contact information. Supporting document is required for a name change request

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.

NOTE: If you have a scheduling permit, a revised permit will be issued to you with your new name. You must bring your new permit for admittance to the test center or you will not be permitted to test.

The total number of attempts allowed per Step is four (4).

If you have attempted a Step four or more times, including incomplete attempts, and have not passed, you are ineligible to apply for any Step in the USMLE exam sequence. Attempts at the formerly administered Step 2 CS count toward the limit.

The USMLE Composite Committee, the governing body of USMLE, considers all aspects of the examination as they work to ensure that the program fulfills its mission to support medical licensing authorities in the United States. The committee voted to change the number of allowed attempts to protect the integrity of the exam and to more closely match the USMLE attempt limits imposed by the majority of state medical boards.

As part of the review, the committee was also presented with information showing that it is uncommon for individuals with more than four repeated attempts on USMLE Steps to complete the examination sequence successfully, gain access to postgraduate training and ultimately receive a license to practice medicine in the United States.

The policy change is effective for all applications submitted on or after July 1, 2021.

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.

If you have already been granted a physician license by a US medical licensing authority, you may not be eligible to take the USMLE. Please contact the appropriate registration organization with questions about your eligibility.

The Educational Commission for Foreign Medical Graduates (ECFMG) provides such information. Through its Certification program, 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.

The USMLE program recognizes that the recommended seven-year time limit may pose problems for medical licensure for some candidates with a combined degree (i.e., MD/PhD). For this reason, the USMLE program recommends to licensing jurisdictions that they consider allowing exceptions to the seven-year limit for MD/PhD candidates who meet the following requirements:

1. The candidate has obtained both degrees from an institution or program accredited by the LCME and a regional university accrediting body.
2. The PhD should reflect an area of study which ensures the candidate a continuous involvement with medicine and/or issues related, or applicable to, medicine.
3. A candidate seeking an exception to the seven-year rule should be required to present a verifiable and rational explanation for the fact that he or she was unable to meet the seven-year limit. These explanations will vary and each licensing jurisdiction will need to decide on its own which explanation justifies an exception. Students who pursue both degrees should understand that while many states' regulations provide specific exceptions to the seven-year rule for dual-degree candidates, others do not. Students pursuing a dual degree are advised to check the state-specific requirements for licensure listed by the FSMB.

You may take the same examination no more than three times within a 12-month period. Your fourth attempt must be at least 12 months after your first attempt at that exam and at least six months after your most recent attempt at that exam.

If you pass a Step, you are not allowed to retake it, except to comply with certain state board requirements which have been previously approved by USMLE governance. For example, you may retake a passed Step to comply with the time limit imposed by a medical licensing authority for the completion of all Steps or a requirement imposed by another authority recognized by the USMLE program for this purpose. The medical licensing authority must provide information showing that you are an applicant for licensure in that jurisdiction; have fulfilled all requirements for licensure in that jurisdiction; are eligible for licensure except for the out-of-date examination; and have completed the full USMLE sequence, including Step 3. Information regarding retakes allowed to comply with ECFMG requirements is provided at the time of exam application using ECFMG's Interactive Web Applications (IWA).

If you are repeating a previously passed Step because of a time limit imposed by a medical licensing authority, you may apply to retake the examination only after the applicable time limit has expired. An exception to this policy can be granted if, at the time of application and testing:

• you are currently enrolled in an LCME- or COCA-accredited medical school program leading to the MD or DO degree;
• you have previously passed Step 1 and/or Step 2 but have not passed Step 3;
• you are expected to graduate from the medical school program six or more years after the date you first passed Step 1 and/or Step 2; and
• you are otherwise eligible to retake the examination.

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.

If you experience a computer issue during the test, notify test center staff immediately. The testing software is designed to restart the test at the point that it was interrupted.

To report test day issues, such as computer problems or not completing your exam (for any reason), send a written description of the incident to Test Administration Services at testadmin@nbme.org or by fax to (215) 590-9457. Test Administration Services must receive your notice within 10 days of your testing date or it may not be possible to investigate your concerns.

Your correspondence should include your name, your USMLE ID number, the examination name (Step 1, 2 CK, or 3), date of administration, and a detailed description of the difficulty experienced or the reason you decided not to finish the examination.

Please allow at least 15 business days for your report to be investigated and evaluated. You will receive written notification of the investigation results.

If you wish to appeal the results of the investigation, you may submit a written statement to the above office within 10 days of the date of the correspondence containing the results of the investigation. Please include a detailed explanation of the basis for your appeal. A group of senior staff will review the matter. Please be advised that the appeal process can take at least four weeks to complete and may not result in a change to the original decision.

It is important that you read and understand the rules regarding personal possessions. Unauthorized possession of personal items while in the secure areas of the testing centers may lead to a finding of irregular behavior and permanent annotation of your USMLE transcript.

For all Steps, if you bring personal items to the test center, you must store them in a small designated locker outside the secure testing area. Electronic devices must be turned off. All personal items are subject to inspection and are prohibited in the secure areas of the testing center.

If you have a medical need for an item during your USMLE administration, see the list of approved personal items.

Effective May 1, 2023, Prometric will allow candidates to bring water into the test room during their exam. No other beverages are permitted. All water must be in a clear or transparent container with a lid or cap. All labels must be removed, and the container will be inspected for notes or other test aids during the security check. Please review the complete details listed under the “Schedule, Reschedule, Cancel or Confirm Details of Exam” section in Prometric.com’s Frequently Asked Questions.