Starting December 4, 2024, taking Step 1 or Step 2 CK in India now includes an additional 18% GST on top of your regular USMLE fees—collected and remitted directly to the Indian government. As of March 10, 2025, USMLE launched a new registration portal for Steps 1 and 2 CK, replacing their legacy system. Expect changes in the application interface and navigation.
The United States Medical Licensing Examination (USMLE) is a three-step exam required for medical licensure in USA. It’s jointly administered by FSMB and NBME and is mandatory for MDs planning to practice in USA.
In 2025, the USMLE exam fees include separate charges for Step 1, Step 2 CK, and Step 3. International students — including those from India — must also pay additional fees to the Educational Commission for Foreign Medical Graduates (ECFMG) for application processing, credential verification, and exam eligibility.
On average, the total USMLE cost for Indian students ranges between ₹4–₹4.5 lakhs. All payments are made in USD and can vary slightly due to exchange rate fluctuations and additional services.
The sections below cover each fee in detail, including Step-wise breakdowns, rescheduling policies, and ECFMG charges.
Here’s a summary of the total USMLE cost for Indian students preparing to apply for USA residency in 2025. This includes all exam fees, ECFMG charges, and estimated rescheduling buffer — but excludes airfare, stay, or visa costs for Step 3.
USMLE Fee Step-Wise Breakdown for Indian Students (2025)
The total USMLE exam cost in India 2025 varies depending on how early you register, where you test, and how many steps you plan to take in a single cycle. The higher cost for international students is due to test delivery surcharges, ECFMG fees for USMLE, and other cross-border admin charges.
Each step of the exam—Step 1, Step 2 CK, and Step 3—has a separate registration fee. Step 3 is offered only in USA, which adds travel and accommodation costs for Indian students. Most of these payments are non-refundable and must be made in USD, with INR equivalent depending on exchange rates.
If you're budgeting for the entire step-by-step cost for USMLE process, here’s a clear look at the fee breakdown.
USMLE Exam Fees for Indian Students – Step-by-Step Cost
Exam
Fees + Surcharge in USD
Fees + Surcharge in INR
Step 1 (Intl total $885)
$885 ($680 + $205)
₹75,800 (₹58,200 + ₹17,600)
Step 2 CK (Intl total $910)
$910 ($680 + $230)
₹77,900 (₹58,200 + ₹19,700)
Step 3 (USA/Canada only)
$925
₹79,200
USMLE Fees by Testing Location
The USMLE fees also vary by test location. Here's a comparison of costs in USA vs. outside USA, including delivery surcharges.
Test Location
Step 1 & Step 2 CK
Step 3
US/Canada
$680 (₹55,610)
$925 (₹79,200)
Outside USA
Step 1: $885 ($680 + $205) = ₹75,800
Step 2: $910 ($680 + $230) = ₹77,900
Not available
Indian students testing outside the US will pay approximately ₹27,000 more per step than USA-based applicants. All payments must be made in USD via official portals.
Planning to change your test date? The table below outlines USMLE rescheduling fees by timing window and test location.
Time Before Exam
Fee (USD)
Approx. Fee (INR)
46+ days
$0
₹0
31–45 days
$35
₹2,905
6–30 days
$100
₹8,300
For last-minute changes, the cost increases sharply:
Step 1 (5 days or less):
US/Canada: $140 (₹11,620)
International: $358 (₹29,714)
Step 2 CK (5 days or less):
US/Canada: $157 (₹13,031)
International: $403 (₹33,449)
Step 3 (5 days or less, US only):
Full appointment: $279 (₹23,157)
Partial day reschedule: $140 (₹11,620)
Step 3 rescheduling is allowed only in USA and may involve one or both test days.
To avoid extra charges, reschedule at least 46 days in advance. You must reschedule within your original eligibility window. All changes must be made through the Prometric system using your scheduling permit and confirmation number.
USMLE Exam Fees: Cancellation Policy and Refunds
Once you pay your USMLE exam fees, you cannot cancel your application or get a full refund. This applies to all exam steps—Step 1, Step 2 CK, and Step 3—regardless of location or reason. The policies are strict, especially for international students, so it’s important to plan dates carefully before confirming your test appointment.
If you cancel a scheduled exam, only a partial refund may apply. But if you've already used your scheduling permit or miss the eligibility window, the fee is forfeited. Additional payments made to ECFMG or Prometric are non-refundable under all circumstances.
This table shows what to expect if you cancel in time.
If you cancel your USMLE registration, here's what refund amount you can expect depending on your step and status.
Exam Step
Refund Eligibility
Refund (USD)
Step 1 (before scheduling)
Yes
$50–$100 (₹4,150–₹8,300)
Step 2 CK (before scheduling)
Yes
$50–$100 (₹4,150–₹8,300)
Step 3
No refunds
$0
Refund method: Refunds are issued to the original payment method only. No cash or third-party redirection is allowed.
Processing time: Can take up to 4–6 weeks, depending on the payment gateway.
Non-refundable components: Prometric appointment fees, ECFMG service charges, test delivery surcharge, and missed appointments.
If your exam permit changes due to approved accommodations, your earlier booking is canceled automatically. Use the updated permit for a new appointment. The original one becomes invalid and cannot be reused or transferred.
Indian students must also account for forex transaction fees and conversion charges if they cancel and receive a partial refund. These costs further reduce the refunded amount in INR.
ECFMG and ERAS Fees for USMLE – Indian Student Breakdown
For Indian and other international medical graduates (IMGs), the Educational Commission for Foreign Medical Graduates (ECFMG) handles eligibility verification for USMLE registration. These are mandatory fees in addition to the Step 1, Step 2 CK, and Step 3 exam charges.
Core ECFMG Charges for 2025
International students, including those from India, must pay additional ECFMG fees. This table breaks down core certification and ERAS-related charges.
Fee Type
Amount (USD)
Application for Certification
$160 (₹13,280)
Step 1/Step 2 CK (total, incl. surcharge)
$1,020 (₹84,660)
— Breakdown (surcharge part)
$205 (₹17,015)/$230 (₹19,090)
ERAS Token
$165 (₹13,695)
These fees apply per attempt and are payable directly to ECFMG through your online account.
You must apply for ECFMG certification before scheduling USMLE Step 1 or Step 2 CK.
The ECFMG fees for USMLE are not refundable if your certification is denied or incomplete.
Additional Costs Beyond Standard USMLE Exam Fees
While most students budget for Step 1, Step 2 CK, and Step 3, there are other charges that can add to the total USMLE cost for international students. These include additional score reports, reapplications, and document handling — often paid through ECFMG in USD.
If you're planning a full step-by-step cost for the USMLE process, include these items in your budget.
Common Extra Charges for USMLE Candidates (2025)
Item
USD
INR (Approx.)
Additional score report (per school/transcript)
$80
₹6,640
ECFMG exam chart/credential service
$50
₹4,150
Eligibility period extension (Step 1/2 CK)
$100
₹8,300
Testing region change (Step 1/2 CK)
$90
₹7,470
Step 3 score recheck
$80
₹6,640
Step 3 eligibility extension processing
$70
₹5,810
EPIC courier fee (intl.)
$30
₹2,490
Document handling/courier (intl.)
$30
₹2,490
All costs are non-refundable once processed.
Extra score reports are often needed when applying to multiple USA residency programs.
Step 3 eligibility requires a separate application after completing Step 2 CK and obtaining ECFMG certification.
Failed attempts require full repayment of the exam fee at rebooking — no discounts or partial credits apply.
How to Pay USMLE Fees in India – Accepted Methods in 2025
All USMLE exam fees must be paid in USA dollars (USD) through online portals. Payments are accepted through credit cards, e-checks, and electronic fund transfers. International students — including those from India — may face issues with local debit or prepaid cards, so it's important to check compatibility before submitting payment.
USMLE Payment Guidelines for Indian Students
These are the accepted payment methods for USMLE exam fees in India and the status of each method based on compatibility.
Payment Method
Accepted?
Notes
International Credit Cards
Yes
Visa, MasterCard, AMEX preferred
Debit Cards (India-based)
Limited
Often declined due to forex rules
Fund Transfers/Wire
Yes
Slower processing time
UPI/PayPal/Wallets
No
Not accepted
e-Checks (USA Banks only)
Yes
For USA residents only
All USMLE payments must be made through your ECFMG account (for Steps 1 & 2 CK) or FSMB account (for Step 3).
If a payment fails, retry after confirming card is enabled for international transactions.
Refunds (if eligible) are sent back to the original payment method. You can't switch accounts later.
Payments may take 3–5 business days to reflect, depending on your bank and card network.
Use a bank-authorized international credit card to avoid delays. Test dates cannot be scheduled until payment is processed in full.
Who Is Eligible to Pay USMLE Exam Fees and Register?
You can pay USMLE exam fees only if you're officially eligible for the step you're applying to. Eligibility depends on your medical school status, location, and step level.
USMLE Eligibility by Step (2025)
Before paying your USMLE fees, confirm your eligibility for each step. This table outlines who can apply, and under what conditions.
USMLE Step
Who Can Apply
Conditions
Step 1
Medical students or graduates
School must be listed in WDOMS; IMGs need ECFMG registration
Step 2 CK
Same as Step 1
Core clinical rotations recommended
Step 3
Medical graduates only
Must be ECFMG-certified (IMGs); Step 1 & Step 2 CK passed
Documents Required for USMLE Exam
Valid passport
Degree certificate or enrollment proof
Medical transcripts
ECFMG ID and application form (for international students)
ECFMG certification is mandatory for all non-USA medical graduates before applying for Step 3. Fees are non-refundable if eligibility is denied after payment. Always verify eligibility before scheduling the exam.
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FAQs
What is the USMLE Step 1 exam fee for Indian students in 2025?
tep 1 costs $885 (₹75,800) for Indian students, including the international testing surcharge. The exact fee in INR depends on the exchange rate at the time of payment.
How much does USMLE Step 2 CK cost for international students?
The USMLE Step 2 CK exam fee 2025 is also $910 (₹77,900) for international test takers, including Indian students.
What is the total cost of the USMLE exam process in 2025?
The total USMLE cost for international students ranges from $4,000 to $6,000 USD (₹3.3–5 lakhs).
What is the ECFMG certification fee for USMLE applicants?
The ECFMG fees for USMLE certification is $160 USD (₹13,300), required for verifying international medical credentials before registering for Step 1 and Step 2 CK.
Are there additional USMLE fees for international test locations?
Yes, there is an international test delivery surcharge of $195 USD (₹16,200) for each step when taken outside the US. This charge is added to the base exam fee.
Can I pay USMLE fees in Indian rupees?
USMLE exam fees must be paid in USD. INR amounts are for reference only.
What are the USMLE rescheduling and cancellation fees?
USMLE rescheduling fees and policies vary by step and timing. If you reschedule less than 31 days before your exam, fees can range from $50 to $100 USD (₹4,100–₹8,300) depending on proximity to your test date.
Is there a fee for extending the USMLE eligibility period?
Yes, extending your eligibility window costs around $70 USD (₹5,800). This option is only available once per registration cycle, and not for Step 3.
Are USMLE exam fees refundable if I cancel?
Partial refunds may be possible if you cancel before your eligibility period ends. However, most USMLE exam fees are non-refundable, especially after your scheduling permit is issued.
What is the USMLE Step 3 registration fee in 2025?
The USMLE Step 3 exam fee in 2025 is $915 USD (₹75,900), which is only applicable once you’ve completed Step 1 and Step 2 CK and received ECFMG certification.
Does the USMLE have a fee waiver option for low-income students?
No, currently there is no formal fee waiver for international students applying for the USMLE. USA citizens may apply for assistance through NBME or individual medical schools.
What payment methods are accepted for USMLE fees in India?
You must pay USMLE fees in USD via international cards or wire transfer. Indian debit/prepaid cards are often declined.
What is the cost of sending USMLE score reports to residency programs?
Sending additional USMLE score reports costs $80 USD (₹6,600) per report through the ERAS system. Some programs also accept free digital delivery during application season.
Are there any hidden charges in the USMLE registration process?
Aside from the main exam fee, hidden charges may include document translation, credential evaluations, mailing fees, and optional services like score rechecks or extra reports.
What is the breakdown of USMLE fees across all three steps?
Here’s a breakdown of USMLE registration charges (approximate USD and INR):
