Discover the Complete Expenditure for Your USMLE Journey in 2025

Welcome! If you're planning to take the USMLE in 2026, it's important to understand how much the entire journey can cost. The USMLE path is an exciting but costly process, and knowing what to expect financially can help you plan better.
This guide gives a complete overview of the expenses International Medical Graduates (IMGs) might face, from studying for the exams all the way to matching into a residency program.

Besides hard work and passion, having a clear plan and being financially ready is key to success. We’ve broken down the costs step by step, covering everything from exam fees and clinical rotations to applications and interviews. By the end, you’ll have a realistic idea of what to budget for each stage of the journey.

Systematic Classification:

  • ECFMG & USMLE Exam Fees
  • USMLE Preparation Resources
  • United States Clinical Experience (USCE)
  • ECFMG Pathway Verification
  • ERAS Application Services
  • NRMP Registration and Match Fees
  • Interview Preparation and Expenses
In USMLE journey, there are two types of costs: Fixed and Variable costs.

Fixed costs include application fees, visa fees, exam fees, ECFMG certification, etc. Unfortunately, you cannot alter these expenses and they typically amount to approximately $15-20k.

Now let's focus on the variable costs, where you have the opportunity to save money through smart planning.

ECFMG & USMLE Exam Fees (2025–2026)​
Cost
Application for ECFMG certification and certificate of verification (Form 186)
$160
​
Step 1
$1,020
​(Includes International Test Delivery Surcharge)
Step 2 CK
$1020 
​(Includes International Test Delivery Surcharge)
Step 3
$895
Occupational English Test (OET)
$400 -$500
Extension of Eligibility Period
​$100 per exam
Testing Region Change
$90 per region change
Score Recheck (Step 1/Step 2 CK)
$80 per exam
USMLE Transcript (Electronic for ERAS)
$80 per ERAS season
USMLE Transcript (Paper Copy)
$70 per request (up to 10)
​Step 1/Step 2CK Rescheduling Fee
​$0 – varies
​(depending on exam, testing region, & date of cancellation)
Total Cost
$4,015
Note: The USMLE Step 1 and Step 2 CK fees include the International Test Delivery Surcharge of $205 each, as per the latest updates effective January 1, 2025.
USMLE Exam Preparation Resources
Cost
Step 1- UWORLD QBANK
$419 / 6 months​
Step 1- FIRST AID
    $55
Step 1- NBMEs 
   $60/ exam x 6 month
Step 2 CK - UWORLD QBANK months
 $419 / 6 months
Step 2 CK - NBMEs  
  $60 / exam x 3
Step 2 CK - CMS form
 $20 / exam
Total Cost - (average)
$1,030
USCE
Cost
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(traveling, 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 Cost - (average for 3 months)
$9,425
ECFMG Pathway Verification
Cost
Application to a Pathway for ECFMG Certification for 2024 Match
$925
USMLE Transcript (Paper Copy)
USMLE Transcript (Electronic)
$70 per request (up to 10)
 $80 (Once per ERAS season)
Total Cost 
$1,175
ERAS Services
Cost
 ERAS Token
$165
ECFMG Certification
$160
Medical School Transcript Translation
$250
CVS Verification of ECFMG Certification
status to State Medical Licensing Authority 
$66
ERAS Program Application
Up to 10 programs/specialty - $99 (total)
11 to 20 programs/specialty - $19 (each)
21 to 30 programs/specialty - $23 (each)
31 or more/ speciality - 27$ each


​If applying to  150 IM (Internal Medicine) Programs
[99$+(10 x 16$) + (10 x 20$) + (120 x 26$)] = 3579$
NRMP
​Registration Fee
(includes the listing of up to 20 programs on the primary rank order list and up to 20 programs on all supplemental rank order lists combined)

Late Fee
Couples
Additional Programs
(For rank order lists with 100 or more ranks, additional charges apply.)

$70




 $50 (after January 31st)
$45 additional per partner
​$30 per program
Total Cost - (average)
$4,415
Interview Preparation
Cost
Virtual Interview
Laptop (if you don't have one)
Accessories like lighting, camera, mic, formal clothes, etc.
$800 - $1300
$100 - $200
Total Cost - (average)
Including laptop: $1200 | Excluding laptop: $150
In-person Interviews (for an avg of 5 interviews)
Travel to the U.S.
Travel in the U.S, food and stay during interviews
$1000 - $1300
​$700 x 5 = 3500
Total Cost - (average)
$4,600

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.
  • 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.
  • 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.
  • 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) 
  • Health insurance($100-$150) 
  • 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.
  • USCE tuition fee - an 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
  • In person interviews the total costs may be around $4600
  • virtual $150​

​
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. ​

​Residency Resources to Help Cut Costs

Turbo CV+  | ERAS Application Package
5 ERAS CV, PS review by Journalist and Physician | Match Strategy Session | Session with Physician
$599
Turbo Match Plan | Fast-Track Solution to Residency
5 ERAS CV, PS review by Journalist and Physician | Match Strategy Sessions | Session with Physician | Match core classes
$1029

Useful Videos for IMGs