Eligibility for the USMLE Examinations
- Who is Eligible
- Change in Eligibility Status
- Graduates of Unaccredited Medical Schools
- Sequence of Steps
- Attempts/Time Limits
Who is Eligible to Take the USMLE?
Step 1, Step 2 CK, and Step 2 CS
To be eligible, you must be in one of the following categories at the time you apply AND on the day of your examination:
- a medical student officially enrolled in, or a graduate of, a US or Canadian medical school program leading to the MD degree that is accredited by the Liaison Committee on Medical Education (LCME),
- a medical student officially enrolled in, or a graduate of, a US medical school leading to the DO degree that is accredited by the American Osteopathic Association (AOA), or
- a medical student officially enrolled in, or a graduate of, a medical school that is outside the US and Canada, listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements, and that meets other eligibility criteria of the ECFMG.
IMPORTANT: Individuals who passed Step 2 prior to the implementation of Step 2 CS are not permitted to take Step 2 CK, except under the specific exceptions to the retake policy approved by the Composite Committee (see page 12), but are permitted to take Step 2 CS, provided they meet all other eligibility requirements.
Individuals who were not required to pass Step 2 CS for Step 3 eligibility but elect to take Step 2 CS and subsequently fail the examination are not eligible for Step 3 until they have passed Step 2 CS(most recent administation) and the individual meets all other Step 3 requirements.
IMPORTANT: If you are dismissed or withdraw(n) from medical school, you are not eligible for the USMLE, even if you are appealing the school’s decision to dismiss you or are otherwise contesting your status. If you are on a leave of absence, please check with your registration entity before submitting your application, or if you have already registered, do so before testing.
To be eligible for Step 3, before submitting your application, you must:
- obtain the MD degree (or its equivalent) or the DO degree from an LCME- or AOA- accredited US or Canadian medical school, or from a medical school outside the US and Canada that is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements,
- pass Step 1, Step 2 CK, and Step 2 CS,
- obtain certification by the ECFMG or successfully complete a “Fifth Pathway” program if you are a graduate of a medical school outside the US and Canada
IMPORTANT: Individuals who hold valid Fifth Pathway certificates issued through December 31, 2009, and are otherwise eligible, may use their Fifth Pathway certificates to meet Step 3 eligibility requirements for applications submitted through December 31, 2016. Effective January 1, 2017, the USMLE Program will no longer accept Fifth Pathway certificates for the purpose of meeting Step 3 eligibility requirements.
Individuals holding Fifth Pathway certificates that are not accepted by the USMLE Program for purposes of meeting Step 3 eligibility must obtain ECFMG certification in order to meet Step 3 eligibility requirements.
Note: The USMLE program recommends that, for Step 3 eligibility, applicants should have completed, or be near completion of, at least one postgraduate training year in a US-accredited graduate medical education program that meets state board licensing requirements.
Change in Eligibility Status
If your eligibility for a Step or Step Component changes after you submit your application but before your scheduled test date(s), you must notify your registration entity promptly. Failure to notify your registration entity that you may no longer be eligible to take the examination may result in a finding of irregular behavior. If you take a Step or Step Component for which you are not eligible, results for that examination may not be reported or, if previously reported, may be canceled.
Graduates from Unaccredited Medical Schools in the US or Canada
If you graduated from an unaccredited medical school in the US or Canada and are eligible for initial licensure by a US medical licensing authority but are not in one of the eligibility categories, you may take the USMLE only upon specific request by that medical licensing authority. The medical licensing authority should submit the request to sponsor you to the USMLE Secretariat in advance of your application for each Step. You must pass Steps 1, 2 CK, and 2 CS before you can take Step 3.
Sequence of Steps
If you meet the eligibility requirements, you may take Step 1, Step 2 CK, and Step 2 CS in any sequence. You may only take Step 3 only after passing Step 1, Step 2 CK, and Step 2 CS.
Number of Attempts and Time Limits
The USMLE program limits to six the total number of times an examinee can take the same Step or Step Component. An examinee is ineligible to take a Step or Step Component if the examinee has made six or more prior attempts to pass that Step or Step Component, including incomplete attempts. All attempts at a Step or Step Component are counted toward the limit, regardless of when the examinations were taken.
Information regarding state-specific requirements for licensure can be obtained on the FSMB website. Note: MD/PhD students should reference the USMLE website for more specific information regarding exceptions to time limits.
Retaking Failed Examinations
You may not take the same Step or Step Component more than three times within a 12-month period. Your fourth and subsequent attempts must be at least 12 months after your first attempt at that examination and at least six months after your most recent attempt at that examination.
Retaking Previously Passed Steps
If you pass a Step or Step Component, you are not allowed to retake it, except to comply with the time limit of a medical licensing authority or another authority recognized by the USMLE program. Visit the USMLE website for more information. If you have not yet passed Step 3 and need to retake a previously passed Step 1 or Step 2 examination in order to meet a time limit imposed by a US medical licensing authority or another authority recognized by the USMLE program, you should understand that if you fail a retake, you will no longer be eligible to take Step 3. In order to meet the examination requirements for Step 3 eligibility, you must have achieved a passing performance on the most recent administration of the examinations intended to meet those requirements.
Previously Licensed Physicians
If you have already been granted a license by a US medical licensing authority based on previous licensure examinations, such as the Federation Licensing Examination (FLEX) or the NBME certifying examinations, you are not eligible to take the USMLE.