USMLE Exam Fees: Complete Breakdown 2025

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.

If you dream of practicing your medical knowledge in the United States and searching for ways to make it happen, the USMLE Exam is the way. The United States Medical Licensing Examination (USMLE) is a crucial gateway for medical students and graduates aiming to practice medicine in the United States. The exam is taken in three steps: Step 1, Step 2 Clinical Knowledge or CK and Step 3. USMLE Exam Fees is also taken in the same fashion, separate for separate steps.

Understanding the full scope of exam fees is essential for effective planning. From the basic exam registration costs to surcharges for international test delivery, rescheduling charges and certification fees - several factors can influence the total expenditure.

The sections below cover each fee in detail, including Step-wise breakdowns, rescheduling policies and ECFMG charges.

Check out USMLE Exam Dates in 2025, for better preparation and better results.

USMLE Exam Fees Structure: Overview

The USMLE Exam is divided into three steps, each accessing different aspects of medical proficiency of a candidate. Step 1 checks foundation knowledge and medicinal knowledge. Step 2 CK assesses clinical Knowledge and Diagnostic Skills. Final step, Step 3 evaluates the medical knowledge in unsupervised settings.

Each step of the exam: Step 1, Step 2 CK and Step 3 - has a separate registration fee. Step 3 is offered only in the 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 are making a budget for the step-by-step cost of the USMLE process, here is a clean breakdown.

Exam Step	Fees + Surcharge  (in USD/INR)	Additional Notes
Step 1	$(1,020 + 205) = $1,225 (INR 1,05,400)	For international applicants registering via ECFMG
Step 2	$(1,020 + 230) = $1,250 (INR 1,07,550)	Similar to Step 1 fees and conditions
Step 3	$ 925 (INR 79,600)	Payable to FSMB, US testing locations only.

These fees are subject to change annually, so candidates are advised to always confirm with the official USMLE and ECFMG websites before scheduling their exams.

Curious about exam pattern and tips for preparation? Read our guide: USMLE Exam Preparation for getting insights.

USMLE Exam Fees Step-Wise Breakdown

Each step of the USMLE has its own cost structure, policies and associated fees. Below is a detailed breakdown of USMLE exam costs, especially for international students.

Step 1 Cost Details

• Base Exam Fee: $1,020 or approx. INR 87,800 (for international students via ECFMG)
• International Test Delivery Surcharge: $205 or approx. INR 17,650
• Rescheduling Fee: Varies based on notice period; no fee if rescheduled 31+ days in advance via Prometric
• Eligibility Extension Fee: $100 (if the 3-month eligibility period needs to be extended)

Total Estimated Cost (Including Surcharge): $1,325 or approx. INR 1,14,000.

Step 2 CK Cost Details

• Base Exam Fee: $1,020 or approx. INR 87,800 (same as Step 1)
• International Test Delivery Surcharge: $230 or approx. INR 19,800.
• Rescheduling and Extension Fees: Same as Step 1

Total Estimated Cost (Including Surcharge): $1,350 or approx. INR 1,16,160.

Step 3 Cost Details

• Base Exam Fee: $925 or approx. INR 79,600 (paid to FSMB)
• Testing Location: Only available within the United States
• State Licensing Requirements: Vary by state; some may charge additional fees or require separate applications

Total Estimated Cost: Around $925 or approx. INR 79,600 (excluding any state-specific requirements)

Additional USMLE Exam Fees for International Students

Although the majority of the students afford Step 1, Step 2 CK and Step 3, there are some other costs that may increase the overall USMLE expense of international learners. These are extra score reports, re-applications, and handling of documents - all of which may be remitted to ECFMG in USD.

These are some items you should have in your budget should you be planning a full step by step cost of the USMLE process.

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

Things to be remembered while applying for USMLE exam:

• 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.

USMLE Rescheduling Fees and Policies

If in some cases you cannot take your USMLE test on the designated date, you can change or reschedule your test afterwards. The closer to the exam date you request for rescheduling, the more will be the cost.

Rescheduling Prometric exam requires some fees and procedures to follow. 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	₹3,024
6–30 days	$100	₹8,641

For last minute changes, the costs are much higher. The costs for each test and for each region are:

• For Step 1, the fees for US/Canada residents will be $140 or INR 12,046. Candidates belonging to other nationalities (including India) will be charged $358 or approximately INR 30,800.
• For Step 2 CK, the fees for US/Canada residents will be $157 (approx. INR 13,500). Candidates belonging to other nationalities (including India) will be charged $403 or approximately INR 34,800.
• For Step 3, the fees will be the same for all since the exam will only be held in a US location. The fees will be $279 or approximately INR 24,000. If you are rescheduling one or more, but fewer than all days of your appointment, between 1 and 5 days prior to your first scheduled test date, you will be charged a rescheduling fee of $140 or approximately INR 12,046.

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.

The next section describes the payment methods and the refund policy. Before proceeding any further, it’s important to know USMLE Exam Centres in India, to make sure you manage to reach the exam center before time.

USMLE Exam Payment Method & Refund Policy

To cover the USMLE, one should take a few simple steps, however, one should know where to pay and what the requirements are in each step of the exam. 

The CK registrations of Step 1 and Step 2 are done through ECFMG (in the international segments) whereas in Step 3 it is done through Federation of State Medical Boards (FSMB). Only the online payments are accepted by both platforms.

Accepted Payment Methods

 

• Credit or Debit Cards: VISA, MasterCard, American Express, Discover
• Online Payment Portals: Payments must be made directly through the ECFMG or FSMB website during the application process
• No Offline Payments: Bank transfers, demand drafts, and cash are not accepted

Refund Policy

• Non-Refundable Registration Fees: Once paid, USMLE fees are generally non-refundable, even if the applicant cancels their exam.
• Partial Refund (Step 3 only): In very specific cases, FSMB may consider a partial refund if the candidate withdraws before scheduling or due to exceptional circumstances.
• No Refund for No-Shows or Late Rescheduling: Missing the exam or rescheduling too close to the exam date (especially within 5 calendar days) will result in full forfeiture of the fee or an additional rescheduling charge.

To avoid unnecessary financial loss, candidates are advised to plan their eligibility periods, test dates and potential travel well in advance.

Who is Eligible to Give the Exam?

It is possible to pay USMLE exam fees only in case you are officially allowed into the step you are applying for. USMLE eligibility is based on your medical school status, place and step.

USMLE Eligibility Each Step Wise (2025)

It is worth checking the eligibility to each step before paying your step and USMLE fees. This table describes who is allowed to 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.

Conclusion

Understanding USMLE Exam Fees in 2025 is essential for those aspiring to practice their medical knowledge in the United States for better income. The exam is relatively more expensive than others and thus, needs careful planning and preparation.

From the base charges to hidden charges like surcharges, scheduling fees or certification expenses are crucial to know, to avoid last minute rush. To further confirm the authenticity of the information, always refer to the official websites of USMLE and ECFMG. Keep yourself updated and plan your medical journey with clarity and confidence.