Cost of the USMLE journey from start till you match

​Here we provide a detailed breakdown of the cost of your USMLE journey from start till you match. These costs may vary with applicants, as you will see below.

To be accepted into a US residency program, you need to be ECFMG certified, for this you need to take two steps of the United states medical licencing exams. Step 1 (Basic Sciences), Step 2CK- (Clinical Knowledge) and the Step 2 CS- (clinical skills only conducted in U.S.A.). These exams form the basis of a screening test for medical graduates. Whether you graduate from a US medical school (American Medical Graduate or AMG) or from anywhere outside US (International Medical Graduate or IMG), ECFMG certification is required before you can start your residency.

USMLE Step 3 is not a requirement for ECFMG certification and can be taken prior or after a residency match or during your first year of residency (different programs have different criteria), however, for most IMGS it does help your application during the Match cycle if taken earlier.
The breakdown below is an estimated cost of the U.S. residency process and this is just a guide. It may differ based on the duration of United States Clinical Experience (USCE) or other factors.

The cost of exams
We begin with the basic cost of the exams (as of 2018 and in US dollars)
Prior to taking an exam a copy of your medical degree and Transcripts needs to be physically send to Philadelphia to be verified and a basic token from ECFMG is $75. The cost of sending would be approximately $100.
After your token is approved you are eligible to take the USMLE exams. The website is here.
You may choose to have coaching for the exams from different coaching companies and this would be added cost.

You can take Step 2 Ck first and then Step 1 or vice versa. There is no such rule on to which you may take earlier.
The registration fees for Step 1 Is $910 (the exam can be taken in your home country in any approved USMLE Prometric centres), if you happen to cancel or reschedule the exams, an additional charge of 0-$569 may apply, depending on the date of changing.
After completing the Step 1 and after you have received your score it is time to take the step 2 CK exam. Again, this exam can be taken from you home country and would cost an approximately $910 and any rescheduling would cost 0-$569. Price may vary again depending on the date change.

After receiving your Step 2 score. You may schedule a CS exam in the U.S and you will receive a letter from ECFMG that will allow you to travel to the U.S.A to come take the exams ( the permission to grant you a visa is at the discretion of the State department applicants should not assume there is a guarantee of a Visa if you have a CS invitation letter from ECFMG. But majority of the applicants do receive visa).

The USMLE Step 2CS is only conducted in the U.S.A and the cost for registration is $1565. The exams can be taken in different designated locations in U.S.

Hands-on experiences/observership costs

It is also during this time you would engage with different programs for an observership or to try to get any form of USCE in the form of research or electives.
Very few programs offer free observerships. Paid observerships/ electives/ externships and range from $1000$- $3000 per month depending on the program. Remember this is just cost for attending the observership/elective and an expected cost of $50 for lodging and utilities is expected per month. If you are interested in exploring USCE, our team can help. Please check our externships page.

A minimum of 3 months in three different programs is required for having sufficient USCE. Please note it is possible to be sponsored for a free research program and this may help you in cutting down your cost. Living expenses and travel and lodging should be taken into consideration and could vary between $500-$1000 a month.
Once you have completed the USCE, you will need to travel back home for visa applicants, the US visa will limit your stay to a maximum of six months for most applicants (depending on your country), you may request an extension however this can jeopardize future visa approvals. The flight ticket prices may vary with the season you are travelling in.

Application and Interview costs
Now it is time to apply for the Match. You first need an ERAS token. The token costs $75. After this you need to selectively apply to programs of interest. If you plan to apply to approximately 150 programs it would cost about $3000. The ERAS website is here.
 
During this time, it is advisable to live in the U.S and this added cost would not include your interviews. If you do have approximately 5 Interviews in the season, an approximate cost of $3000 should be assumed, depending on where you receive your interview and your base location. For IMG most of the interviews are from the East Coast and it is advisable to stay around that area and you may share accommodation to reduce cost.

Finally, most applicants will need to register with NRMP, which is another $85, without late free. The NRMP match fee is listed here. 
 
So, the total cost of the entire process would be approximately $12,000-$15,000 from start to finish hoping you match the first time. This approximates the cost and may vary with individuals depending on several factors noted above.

Useful Videos for IMGs

What residency programs look for in an IMG applicant