To ensure you have a smooth examination journey, please be aware of the following cautions.
For All USMLE Applicants
USMLE Service Transition
The co-sponsors of the USMLE®, the Federation of State Medical Boards (FSMB) and NBME, are centralizing all USMLE service functions. This change will consolidate all USMLE examinee services, including exam registration, score report delivery, and USMLE customer service, with the USMLE co-sponsors. The goal of this change is to streamline the examinee journey and to create a more consistent and efficient examinee experience.
As part of this work, USMLE services for Step 1 and Step 2 Clinical Knowledge (CK) currently provided to students and graduates of medical schools outside the United States by ECFMG®, a division of Intealth™, will transition to USMLE co-sponsor FSMB. Additionally, USMLE services for Step 3 currently provided to students and graduates of medical schools inside the United States by FSMB will transition to USMLE co-sponsor NBME.
Until the transition occurs, ECFMG will continue to provide USMLE Step 1 and Step 2 CK services to students and graduates of medical schools outside the United States, and FSMB will continue to provide Step 3 services to students and graduates of medical schools inside the United States. For additional information, including details on the timing of this transition, applicants should monitor the USMLE Service Transition Information Hub on the USMLE website.
Important Note: 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.
You must become familiar with the information referenced in this Bulletin if you are an applicant with an eligibility period in 2026. 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.
For Students or Graduates of Medical Schools Outside the US
If you are a student or graduate of a medical school located outside the United States with an eligibility period in 2026, in addition to becoming familiar with this BOI, you must also be familiar with the contents of the 2026 Information Booklet published by ECFMG®, a division of IntealthTM.
If you are a student or graduate of a medical school located outside the United States and your eligibility period extends into 2027 and you test in 2027, you must become familiar with and will be subject to the policies and procedures in the ECFMG 2027 Information Booklet.
The ECFMG Information Booklet is available on the ECFMG website. Students and graduates of medical schools located outside the United States are responsible for monitoring the ECFMG website to ensure they understand current ECFMG policies and procedures.