USMLE Service Transition Information Hub

In this section, you will find:

Frequently Asked Questions about the USMLE Service Transition

The co-sponsors of the United States Medical Licensing Examination® (USMLE®), the Federation of State Medical Boards (FSMB) and NBME, are developing plans to centralize all USMLE service functions. This change will consolidate all USMLE examinee services, including exam registration, score report delivery, and USMLE customer service, with the USMLE co-sponsors. The goal of this change is to streamline the examinee journey and to create a more consistent and efficient examinee experience.

USMLE Service Transition Announcements

Update: 2025 Change in Provision of USMLE Service Functions
February 18, 2025

Change in Provision of USMLE Service Functions
November 1, 2024

Frequently Asked Questions

All Examinees

Does this transition change the eligibility requirements for the USMLE?
No. These changes will not affect the eligibility requirements for taking any of the USMLE Step exams. Learn more about USMLE eligibility for each of the Step exams.
Is there anything that I need to do now?
No. Until these changes take effect, ECFMG will continue to provide USMLE services to IMGs for Step 1 and Step 2 CK, and FSMB will continue to provide Step 3 services to all examinees. NBME will continue to provide USMLE services to USMGs for Step 1 and Step 2 CK.
What is the reason for these changes?
The goal of these changes is to create a more consistent and efficient examinee experience by consolidating all services with the USMLE co-sponsors, FSMB and NBME.
When will these changes take effect?
These changes are expected to take effect no earlier than mid-2025. The USMLE program will release more details on the timing of this transition as they become available. Please monitor the USMLE website for announcements and additional information.
I’ve already taken the USMLE Step exams. Do I need to retake them?
No. These changes will not affect your USMLE exam history.
Will this change where I can take the Step exams?
No. All examinees will continue to schedule and take USMLE exams in authorized Prometric test centers. Step 1 and Step 2 CK will continue to be administered at available test centers worldwide, and Step 3 will continue to be administered only in the U.S. and its territories.
Will there be any service interruptions?
All efforts are being made to minimize or prevent service interruptions.
Will this affect how I request my USMLE transcript?
No. FSMB will still provide all USMLE transcripts. For more information on requesting an official transcript, please consult the USMLE Transcripts page.

International Medical Students and Graduates (IMGs)

Will these changes affect the requirements for ECFMG Certification?
No. There are no changes to the requirements for ECFMG Certification resulting from the centralization of USMLE service functions. Learn more about ECFMG Certification at ecfmg.org.
Will ECFMG still verify my eligibility for the USMLE Step exams?
Yes. 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 the USMLE. ECFMG will share information on Certification eligibility with the USMLE co-sponsors for the purposes of registration.
I’m an IMG entering a U.S. residency or fellowship program. Do I still need ECFMG Certification?
Yes. The centralization of USMLE service functions will not change the requirement for IMGs to be ECFMG certified before entering graduate medical education (GME) in the U.S. IMGs who plan to enter U.S. GME still must achieve and maintain ECFMG Certification.
I’ve already applied for ECFMG Certification. Do I need to start over?
No. These changes will not affect your progress toward ECFMG Certification.
What services will change with this transition?
All Step 1 and Step 2 Clinical Knowledge (CK) services currently provided to IMGs by ECFMG will transition to USMLE co-sponsor FSMB. These services include exam registration, score report delivery, eligibility period extensions, testing region changes, and USMLE customer service.
I’ll be graduating from a Canadian medical school in 2026. What does this change mean for me?
Individuals who graduate from Canadian medical schools on or after July 1, 2025, will be considered IMGs for the purpose of entry into GME programs in the U.S. In order for these graduates to enter Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs, the ACGME will require that they either obtain ECFMG Certification or hold a full and unrestricted license to practice medicine in the U.S. licensing jurisdiction in which the ACGME-accredited program is located. For more information, please refer to the USMLE Bulletin of Information.

U.S. Medical Students and Graduates (USMGs)

What Step 3 services will change with this transition?
All Step 3 services currently provided to USMGs by FSMB will transition to USMLE co-sponsor NBME. These services include exam registration, score report delivery and eligibility period extensions.
Where do I register for Step 1 and Step 2 CK after the transition?
NBME will still provide all services for Step 1 and Step 2 CK to USMGs. These services include exam registration, score report delivery and eligibility period extensions.