Posted: November 19, 2025
As previously announced, the United States Medical Licensing Examination® (USMLE®) Service Transition will simplify the examinee journey and create a more consistent and efficient process for examinees. To do this, all USMLE Step exam service functions, including exam registration, score report delivery and customer service, will be combined under the USMLE co-sponsors, the Federation of State Medical Boards (FSMB) and NBME, in two phases in January 2026.
Phase One: USMLE Services for Students and Graduates of International Medical Schools (IMGs) Transition to FSMB
On January 12, 2026, USMLE Step exam services currently provided to IMGs by ECFMG®, a division of Intealth®, will transition to FSMB. This change means that all USMLE services for all three Step exams will be managed by FSMB for IMGs.
ECFMG will continue to provide USMLE services to IMGs for Step 1 and Step 2 Clinical Knowledge (CK) through January 7, 2026. Effective January 8, 2026, IMGs will no longer be able to access any USMLE services in ECFMG’s MyIntealth portal.
For examinees who plan to apply for Step 1 or Step 2 CK, eligibility period extensions, testing region changes, or score rechecks before the USMLE Service Transition, the USMLE program recommends that all applications and supporting documentation be submitted to ECFMG via the MyIntealth portal no later than December 31, 2025. This date is provided as general guidance for applicants and does not guarantee completion before the USMLE Service Transition. Incomplete USMLE applications and service requests not processed prior to the USMLE Service Transition will need to be resubmitted with FSMB.
IMPORTANT: While this change is being implemented, FSMB’s USMLE portal will be temporarily unavailable and ECFMG’s MyIntealth portal will be briefly unavailable starting on January 8, 2026. During this period, examinees will be unable to access their accounts or create new accounts. Examinees testing during this time should download their scheduling permits by January 7, 2026. Examinees are not allowed to test without a scheduling permit. The USMLE program will announce when the transition is complete and FSMB’s USMLE portal is available again, which is expected to be on January 12, 2026. ECFMG will announce when the MyIntealth portal becomes available again.
Please note that this change does not affect the requirements for ECFMG Certification. After the transition of services takes effect, ECFMG will continue to determine whether IMGs are eligible for ECFMG Certification, and eligibility for Certification will continue to be a core requirement for IMGs to take USMLE. ECFMG will share information on Certification eligibility with the USMLE co-sponsors for the purposes of registration. Step 1 and Step 2 Clinical Knowledge (CK) will continue to be required by ECFMG to meet the medical science examination requirement for Certification.
Phase Two: Step 3 Services for Students and Graduates of U.S. Medical Schools Transition to NBME
On January 26, 2026, Step 3 services currently provided to students and graduates of U.S. medical schools by FSMB will transition to NBME. This second phase of the USMLE Service Transition will centralize all examinee services for students and graduates of U.S. medical schools with NBME.
FSMB will continue to provide Step 3 services to all examinees until January 22, 2026. Effective January 23, 2026, students and graduates of U.S. medical schools will no longer be able to access Step 3 services in FSMB’s USMLE portal.
For examinees who plan to apply for Step 3, eligibility period extensions, or score rechecks before the USMLE Service Transition, the USMLE program recommends that all applications and supporting documentation be submitted to FSMB no later than January 15, 2026. This date is provided as general guidance for applicants and does not guarantee completion before the USMLE Service Transition. Incomplete USMLE applications and service requests not processed prior to the USMLE Service Transition will need to be resubmitted with NBME.
IMPORTANT: While this change is being implemented, FSMB’s USMLE portal will be temporarily unavailable starting on January 23, 2026. During this period, examinees will be unable to access all Step 3 services. Examinees testing during this time should download their scheduling permits by January 22, 2026. Examinees are not allowed to test without a scheduling permit. The USMLE program will announce when the transition is complete and Step 3 services are available again, which is expected to be on January 26, 2026.
For the latest information and Frequently Asked Questions, please refer to the USMLE Service Transition Information Hub.
Key Dates: USMLE Services for IMGs Transition to FSMB
December 31, 2025: The USMLE program recommends that all exam registration activities, including the provision of supporting documentation, be submitted to ECFMG by this date. This date is provided as general guidance for applicants and does not guarantee completion before the USMLE Service Transition. Applications and requests that are incomplete or not processed by the transition will need to be resubmitted with FSMB following the USMLE Service Transition.
January 7, 2026: All examinees testing during the outage period (January 8-12) should download their scheduling permits by this date.
January 8, 2026: While the USMLE Service Transition is being implemented, FSMB’s USMLE portal will be temporarily unavailable during this outage period and is expected to be offline for several days. ECFMG’s MyIntealth portal will be briefly unavailable. IMGs should monitor the ECFMG website for notice that the MyIntealth portal is available again.
January 12, 2026: FSMB’s USMLE portal will be available on this date, and FSMB will begin managing all USMLE services for IMGs.
Key Dates: Step 3 Services for Students and Graduates of U.S. Medical Schools Transition to NBME
January 15, 2026: The USMLE program recommends that all exam registration activities be submitted with FSMB by this date. This date is provided as general guidance for applicants and does not guarantee completion before the USMLE Service Transition. Applications and requests that are incomplete or not processed by the transition will need to be resubmitted with NBME following the USMLE Services Transition.
January 22, 2026: All examinees testing during the outage period should download their scheduling permits by this date.
January 23, 2026: FSMB’s USMLE portal will be temporarily unavailable during this outage period. During this period, examinees will be unable to access all Step 3 services.
January 26, 2026: All Step 3 services will be available, and NBME will begin managing all USMLE registration services for students and graduates of U.S. medical schools through the MyUSMLE℠ Portal.