Purpose of this Addendum

This addendum pertains to the United States Medical Licensing Examination® (USMLE®) program’s 2026 Service Transition centralizing all USMLE service functions with the USMLE co-sponsors, the Federation of State Medical Boards (FSMB) and NBME.

US medical students and graduates registering or applying for USMLE Step exams on or after January 26, 2026, and international medical students and graduates registering or applying for USMLE Step exams on or after January 12, 2026 and beyond should familiarize themselves with this addendum and the terms of the 2026 Bulletin of Information which remain in full force and effect. As USMLE policies and procedures are subject to change, applicants are urged to check the USMLE website for updates.

USMLE Service Transition

Beginning in January 2026, US medical students and graduates will register for all three Step exams through NBME, and all medical students and graduates from medical schools outside the United States will register for all three Step exams through FSMB. 

The USMLE® Service Transition simplifies the examinee journey and creates a more consistent and efficient process for examinees. Following the USMLE Service Transition in January 2026, all service functions, including exam registration, score report delivery, and USMLE customer service, will be combined under the USMLE co-sponsors, FSMB and NBME.

For Students or Graduates of Medical Schools in the US

Students and graduates of LCME- or COCA-accredited programs should apply for Step 1, Step 2 Clinical Knowledge (CK) and Step 3 with NBME and by following the instructions on the MyUSMLE Portal.

For Students or Graduates of Medical Schools Outside the US*

Students and graduates of medical schools outside the US that are listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements should apply for Step 1, Step 2 CK and Step 3 with FSMB and by following the instructions on the FSMB’s USMLE portal. 

*Important note for Students and Graduates of a Medical School Outside the US: This change does not affect the requirements for ECFMG Certification. After the transition of services takes effect, ECFMG will continue to determine whether students and graduates of medical schools outside the United States are eligible for ECFMG Certification, and eligibility for Certification will continue to be a requirement to take the USMLE. ECFMG will share information on Certification eligibility with the USMLE co-sponsors for the purposes of registration. Step 1 and Step 2 CK will continue to be required by ECFMG to meet the medical science examination requirement for Certification. 

Cautions

To ensure you have a smooth examination journey, please be aware of the following cautions.

USMLE Service Transition

 The co-sponsors of the USMLE®, the FSMB, and NBME, have centralized all USMLE service functions. For additional information, visit the USMLE Service Transition Information Hub on the USMLE website.

If you are a US medical student or graduate registering or applying for USMLE Step exams on or after January 26, 2026, or an international medical student or graduate registering or applying for USMLE Step exams on or after January 12, 2026, you must become familiar with the information referenced in this addendum and the 2026 Bulletin of Information. If your eligibility period crosses into the next calendar year (i.e., 2027), please note that you are responsible for reading and abiding by the policies and procedures described in the 2026 and 2027 editions of the USMLE Bulletin of Information (BOI).

If changes in the USMLE program occur after the release of this BOI, they will be effective when posted on the USMLE website. You are responsible for checking the USMLE website for updates and changes to the USMLE policies and procedures.

Who Is Eligible to Take the USMLE?

Step 1 and Step 2 CK

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 medical school program leading to the MD degree that is accredited by the LCME, OR
• A medical student officially enrolled in, or a graduate of, a US medical school leading to the DO degree that is accredited by the Commission on Osteopathic College Accreditation (COCA), OR
• A medical student officially enrolled in, or a graduate of, a medical school that is outside the US, listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements, and that meets other eligibility criteria of the ECFMG.

Step 3

Eligibility requirements for Step 3 are:

• Passing scores on Step 1 and Step 2 CK, AND
• An MD degree or the DO degree from an LCME- or COCA-accredited US medical school, OR the equivalent of the MD degree from a medical school outside the US that is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements and obtain ECFMG Certification and have a valid and unexpired ECFMG Certificate, AND
• Meet all other eligibility criteria as listed in the USMLE Bulletin of Information.

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 an accredited US graduate medical education program that meets state board licensing requirements.

Applying for the Test and Scheduling Your Test Date

To apply for a USMLE Step, you must submit an application through the appropriate registration organization. 
Step 1, Step 2 CK, and Step 3 are administered at Prometric centers. Step 3 is administered only in the US and its territories. Visit the Prometric website to find the test center closest to you and to schedule an appointment. Appointments at some test centers fill up quickly. Examinees are encouraged to schedule at their preferred test center as soon as they have received their scheduling permit.

Application Materials

For Students or Graduates of Medical Schools in the US

Step 1, Step 2 CK and Step 3

On or after January 26, 2026, students and graduates of LCME- or COCA-accredited programs should apply for Step 1, Step 2 CK and Step 3 with NBME and by following the instructions on the MyUSMLE Portal. 

For Students or Graduates of a Medical School Outside the US

Step 1, Step 2 CK and Step 3

On or after January 12, 2026, students and graduates of medical schools outside the US that are listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements should apply for Step 1, Step 2 CK, and Step 3 with FSMB and by following the instructions on the FSMB’s USMLE portal. After the transition, all registration records will be transferred from ECFMG to FSMB and can be accessed via FSMB’s USMLE portal.

Scoring and Score Reporting

Score Availability

Results are typically available two to four weeks after your test date. However, in rare cases, various factors may delay score reporting. When selecting your test date and inquiring about results, you should allow at least eight weeks to receive notification that your score report is available. 

For international students and graduates only: After the service transition, any score report posted to the ECFMG portal within the prior 365 days will be transferred to FSMB’s USMLE portal.

For Students or Graduates of Medical Schools in the US

Score Reports for Step 1, Step 2 CK and Step 3

On or after January 26, 2026, students and graduates of LCME- or COCA-accredited programs will receive an email notification from NBME when their score report is available. Score reports will remain available on the MyUSMLE Portal for approximately 365 days from the date of the email notification.

For Students or Graduates of a Medical School Outside the US

Score Reports for Step 1, Step 2 CK and Step 3

On or after January 12, 2026, students and graduates of medical schools outside the US that are listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements will receive an email notification from FSMB when their score is available. Score reports will remain available on the FSMB’s USMLE portal for approximately 365 days from the date of the email notification.

Reporting to Third Parties 

NBME reports the results of the USMLE to LCME- and COCA-accredited medical school programs for their students and graduates. If you do not want your Step 1 or Step 2 CK results reported to your medical school, you must send a request from your email account of record to webmail@nbme.org at least 10 business days before your scheduled test date. A separate request must be submitted for each examination administration. If you do not want your Step 3 results reported to your medical school, you must specify your reporting preference on your application. 

For international students and graduates applying through FSMB, you must specify your reporting preference on your application. 

Contact Us

Application and Registration Inquiries

After the service transition, contact the appropriate organization (see below) for information on how to apply for the USMLE, obtain application materials, and receive information on the status of your application and scheduling permit.