Cost of the USMLE journey from start till you match (2021)

Expenses in Usmle journey (Updated 2021)

Here we will discuss the total cost of USMLE journey for International Medical Graduates or IMGs from the time you start preparation of the USMLE exams till the time you Match in residency.

Along with passion and determination, a well laid plan and preparedness for the expenses at various stages is also vital in the USMLE journey. 

To ease  the discussion and understanding I will first break this down in a systematic way based on how much is the cost for each component of the journey like exams, USCE, applications etc. and towards the end I will classify it in the most practical way so that IMG’s can accordingly plan and prepare for their expenses. 

  1. Systematic classification
  2. Classifying the expenses per year from start of the journey 


Systematic classification
Costs for: 
  1. Initiation to ecfmg certification
  2. Applications
  3. Interview season
 
  1. Costs for initiation to ECFMG certification:
  1. USMLE Exams
  2. Resources
  3. USCE
  4. ECFMG Pathway verification
​​

USMLE Exams

 

Exam

Cost

Application for ecfmg certification and certificate of verification (Form 186)

$150

 Step 1

 $975 + $180 (Surcharge fee for writing outside the US)

 

Step 2 CK

$975 + $200 (Surcharge fee for writing outside the US)

Extension of eligibility period fee for Step 1 & step 2 CK

$90 /exam

Step 1/Step 2 CK Testing Region Change

 $85 / change

Rescheduling Step 1/ Step 2 CK

$0 to $604 (depending upon the exam, testing, region and date of cancellation)

Occupational english test(OET)

454 U.S dollars(587 AUD)

                                    TOTAL(average)

$3067

 

 

    nbsp; Exam Resources

Step 1

 

- UWORLD QBANK

-  FIRST AID  

-   NBMEs  

 

 

 

    $419 / 6 months

    $55

    $60 /exam x 6

Step 2 CK

 

- UWORLD QBANK months

-    NBMEs  

- CMS forms

 

 

 

    $419 / 6 months

    $60 / exam x 3

    $20 / exam

                                    TOTAL(average)

$1600

USCE

 

Application fee (non – refundable )  

$100 - $300(Avg. 200 x 3)

Elective fee (paid on acceptance)  

$1000 - $6000(Avg. 1500 x 3)

Others

Health insurance

 

Professional liability insurance

Accommodation

Cost of living(travelling, food etc.)

$100 to $150 (for 6 months)

$300 to $350 /month(Avg. 300 x 3)

$600 to $800/month(Avg. 700 x 3)

$300-500/month(Avg 400 x 3)

 

 

                TOTAL(average for 3 months)

$9425

 

 

ECFMG Pathway verification

 

 

Pathway application

$900

Fee to verify a credential through EPIC

$100

 

 

 

 

2. Costs for Applications 

 

ERAS Token

150$

USMLE Transcript

$85

ECFMG Certification

$75

ERAS Program Application

Up to 10 programs / speciality - $99 (total)

11 to 20 programs / speciality - $16 (each)

21 to 30 programs / speciality - $20 (each)

31 or more/ speciality - 26$ each

 

if applying to  150 IM Programs

[99$+(10 x 16$) + (10 x 20$) + (120 x 26$)] = 3579$

NRMP registration

$150

                            TOTAL(average)

$4039

 

 

 

 

 

3. Costs during Interview season

1. Virtual

 

Laptop (if you don't have one)

$800 - $1300

Accessories like lighting, camera, mic, formal clothes etc.

$100 - $200

                                   TOTAL(average)

Including laptop: $1200

Excluding laptop: $150

 

- Best part of such a setting is it avoids all costs associated with travelling and accommodation for interviews.

- You may have to spend on basic logistics, like  Laptop(if you don't have one), accessories like lighting, camera, mic etc. may add cost from 100-150 dollars.

 

2. In-person interviews(for an avg of 5 interviews)

 

Travel to U.S

$1000 - $1300

Travel in the U.S, food and stay during interviews

$700 x 5 = 3500

                 TOTAL(average for 5 interviews)

$4600

 

 

 

 

Breakdown per year from start of the journey 

It is quite helpful if you know in advance how much money you should be prepared with, at various stages of the USMLE journey. Overall the expenses are relatively less in the beginning but towards the mid when IMG’s go for rotations in the U.S, during application and interview season is where the expenses are highest. Here are the details of the same.

At the start to 6 months
At the inception of the journey expenses are relatively minimal and are usually for purchasing resources for  usmle step 1 exam and applying for the certificate of verification/form 186 process. The amount that you need to be ready with is around $624.
  • Application for certification (Form 186) -  $150
  • UWORLD QBANK - $419 / 6 months
  •  FIRST AID  - $55
6 months to 1 year 
The costs are majorly for applying to purchasing nbme’s and step 1 exam, costing $1500 
  • Nbme’s - $360(60 x 6)
  • Step 1 - $975 + $180
1 year to 1.5 years
Expenses here are for step 2 ck preparation, exam and applying to clerkships which will cost around $3500.
  • UWORLD QBANK - $419 / 6 months
  • Nbme’s and cms forms - $360
  • Step 2 - $975 + $200
  • Application fee for rotations($100-$300/university rotation), Immunizations, Malpractice($300-$350/month) and health insurance($100-$150) and other documentation for rotations - upto $1,500 
1.5 to 2 years
Here is where we will have a lot of expenses as an IMG for rotations, cost of living during rotation and applying to programs and cost around $17,300  
  • USCE tuition fee - average of $1500 per rotation x 3 = $4500
  • Flight charges for travel to U.S = $1000-1200/round trip
  • Accommodation during rotation - $600 to $800/month x 3 = $1800 - $2400
  • Cost of living during rotation(food and other expenses) - $300 - $400/month x 3 = $900 - $1200
  • ECFMG certification(pathway + credential verification) and Application(ERAS token, transcripts, cost to apply to programs etc.) = $5039

2 - 2.5 years
The costs here are during interviews if any. If interviews are virtual the cost burden is significantly reduced to just $150 as discussed above. With in person interviews the total costs may be around $4600



Conclusion
The average cost from the inception of match in the usmle journey for an IMG is around $21,000 - $25,000(INR 15,50,000 - 18,50,000). The total cost may vary depending on factors like number of cycles applied, having family in the U.S, paid vs non paid rotations, number of programs applied etc., You will eventually realise that this is the best investment you made in your life. It takes some time to get the fruits but the money and efforts are absolutely worth it if you have weighed the pros and cons of the U.S vs Home country medical career for you and decided to pursue the U.S residency journey. ​

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