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USA for Doctors
The United States is one of the top destinations for doctors seeking residency training and a clear path toward medical licensure. Every international medical graduate chasing a U.S. residency spot walks the same three-part road: prove you know the medicine, prove you can apply it, and prove you can communicate it. That's Step 1, Step 2 CK, and OET Medicine. Clear all three, and you're standing at the Match, the process that places you into a U.S. residency program. Nothing about your credentials, English proficiency, or clinical knowledge is taken on trust — everything is verified, tested, and scored before you can apply anywhere.
Pathway Snapshot
International medical graduates begin with ECFMG/MyIntealth verification, then move to USMLE Step 1 and Step 2 CK, followed by OET Medicine and the ECFMG Pathway process. After that, candidates apply through ERAS, register with NRMP for the Match, and complete Step 3 later in the training journey.
Complete Journey: ECFMG/MyIntealth Verification → USMLE Step 1 → USMLE Step 2 CK → OET Medicine → ECFMG Pathway & Certificate → ERAS Application → NRMP Match → Residency → USMLE Step 3 → Board Certification → Independent Practice.
Before you can move into the U.S. exam pathway as an international medical graduate, you must create a MyIntealth account and complete ECFMG credential verification. This is the first practical step in the route — your diploma and transcript must be verified and accepted before you can move forward.
Key steps:
Verification usually takes 2 to 3 months, and FSMB account setup adds about another month on top. Start this well before you plan to sit Step 1 or Step 2 CK.
| Item | Fee | Note |
|---|---|---|
MyIntealth Account Establishment |
$110 | Includes a $50 NotaryCam fee for online ID notarization |
Application for ECFMG Certification |
$580 | Core application |
Verification of Credentials |
$220 | $110 diploma, $110 transcript |
FSMB USMLE Portal Account |
$75 | Required for exam registration |
USMLE Step 1 tests the basic sciences that support medical practice, including anatomy, physiology, pathology, pharmacology, and microbiology. A solid understanding of the basic sciences provides an important foundation for the clinical reasoning assessed in Step 2 CK.
Scoring: Pass/Fail only, no numeric score. Passing score: 196 out of 280.
Format: 8-hour exam with up to 280 questions, split into 14 blocks of 20 questions each (30 minutes per block), with 55 minutes of built-in break time.
Typical prep time: 8 to 12 months.
What we offer
Uworld question bank plus high-yield supplementary question banks, UWSA and NBME self-assessments, flashcards, an AI companion, practice questions in both timed and exam mode, audio questions, a medical library, mentorship, and a community block — study with others, generate exams together, compete with friends, and connect with people going through the same pathway.
Start Step 1 Prep →USMLE Step 2 CK tests real clinical judgment across medicine, surgery, pediatrics, OB/GYN, and psychiatry. It is one of the most important exams in the U.S. pathway — residency programs rely on it heavily when reviewing applicants. Unlike Step 1, it is graded, and it is the number every program screens on first.
Scoring: Score-based exam. Passing score: 218 out of 318. Competitive target: 250 and above.
Format: 9-hour exam with 318 questions, split into 16 blocks of 20 questions each (30 minutes per block), with 55 minutes of built-in break time.
What we offer
Uworld question bank plus high-yield supplementary question banks, UWSA and NBME self-assessments, flashcards, an AI companion, practice questions in both timed and exam mode, audio questions, a medical library, mentorship, and a community block.
Start Step 2 CK Prep →OET Medicine is the English and communication test required for IMGs pursuing the U.S. pathway. It is separate from the Step exams, and it satisfies the communication skills requirement for ECFMG certification.
What we offer
A dedicated OET Medicine course for physicians, with practice for all four components.
Start OET Prep →The ECFMG Pathway is the route IMGs use to satisfy the certification requirements needed for U.S. residency eligibility. Once the required steps are completed, ECFMG can issue the certificate that supports the next stage of the pathway.
You can apply through ERAS before you receive your ECFMG Certificate, but you must meet all ECFMG certification requirements by the NRMP Rank Order List deadline to remain eligible for the Match.
ERAS is the application system used to submit residency applications to U.S. programs. It is the platform where applicants prepare and send their application materials for residency review.
| Item | Fee |
|---|---|
Per program (first 30 in a specialty) |
$11 each |
Per program (after 30) |
$30 each |
USMLE transcript fee |
$80 |
NRMP is the system that places applicants into residency programs. After interviews, candidates rank the programs they interviewed with, and NRMP uses its matching algorithm to assign residency positions.
USMLE Step 3 is the final exam in the U.S. licensing sequence. Step 3 is typically completed during residency — often in the first year — although the timing depends on residency program expectations and state medical licensure requirements. The exam is only administered in the United States. It can also be taken before residency starts to strengthen your application.
Passing score: Combined 200 out of 300 across both days.
Day 1 (Foundations of Independent Practice): 232 questions across 12 blocks of 18–20 questions each, with 45 minutes of break time.
Day 2 (Advanced Clinical Medicine): 180 questions across 9 blocks of 20 questions each, followed by 13–14 patient case simulations, with at least 45 minutes of break time.
Fee: $955, with no international surcharge. Exam is only offered inside the U.S.
What we offer
Uworld question bank plus high-yield supplementary question banks, UWSA and NBME self-assessments, flashcards, an AI companion, practice questions in both timed and exam mode, audio questions, a medical library, mentorship, and a community block.
Start Step 3 Prep →| Pathway Stage | Fee (USD) | Notes |
|---|---|---|
MyIntealth Account |
$110 | Includes NotaryCam fee |
ECFMG Certification Application |
$580 | Core application |
Credentials Verification |
$220 | Diploma + transcript |
FSMB USMLE Portal |
$75 | Required for exam registration |
OET Medicine |
~$455 | AUD $587 |
USMLE Step 1 |
$695 (US/Canada) / $905 (International) | International surcharge $210 |
USMLE Step 2 CK |
$695 (US/Canada) / $930 (International) | International surcharge $235 |
ECFMG Pathway Application |
$925 | Confirm current figure on ecfmg.org |
ERAS Application |
$11–$30 / program | $80 USMLE transcript fee |
NRMP Match Registration |
$85–$135 | $85 standard, $135 late |
USMLE Step 3 |
$955 | U.S.-only administration |
Note on Fees: All fees are set by ECFMG, FSMB, NBME, ERAS, NRMP, and OET. International surcharges apply for testing outside the US and Canada. Candidates testing in certain centers (e.g., India) may also see local tax applied at checkout. Figures shown are for the 2026 cycle. Always confirm exact fees on the official websites before registration.