USMLE Cost: Every Fee for All Three Steps
Sitting all three Steps once, inside the United States, comes to $2,345 in exam fees. Everything else on top of that is optional, avoidable, or specific to international graduates.
Below is every fee we can find published, with where each one comes from. All of them are subject to change, so treat this as a map rather than a quote!
If you are budgeting a whole path through medical licensure, these are the numbers you can pin down today 🙂
- The USMLE cost at a glance
- How much USMLE Step 1 costs
- Step 2 CK and Step 3
- What international graduates spend on top
- The USMLE cost of moving your date
- The costs nobody budgets for
- When each fee falls due
- What preparation adds to the USMLE cost
- Where the USMLE cost can come down
- USMLE cost, common questions
- Related reading
The USMLE cost at a glance
Registration fees are set for 2026 and 2027, and they are non-refundable.
That is the floor for anyone testing inside the US, and every other line on this page adds to it!
Current figures are at usmle.org, which is the only source to trust on this!
A failed attempt means the full fee again. No Step has a reduced rate for a repeat attempt.
How much USMLE Step 1 costs
Step 1 is $695 for the 2026 and 2027 registration years, plus a $210 international test delivery surcharge if you sit it outside the United States or Canada.
The surcharge is charged by the test delivery provider rather than by the USMLE program, and it is applied per exam rather than per registration.
Testing in India carries a further 18% goods and services tax, collected and remitted to India, applied since 4 December 2024.
So the honest range on a single Step 1 sitting runs from $695 in the US to roughly $1,068 in India once the surcharge and tax are added!
Step 2 CK and Step 3
The USMLE cost for Step 2 CK matches Step 1 at $695, with a slightly higher international surcharge of $235.
Step 3 is $955, the most expensive of the three, and it is administered only in the United States, so no regional surcharge applies.
Step 3 registration runs through the Federation of State Medical Boards, and the fee attaches to a three-month eligibility period. Miss the period and the fee does not transfer, so book with room to spare!
What international graduates spend on top
The USMLE cost for graduates of medical schools outside the US and Canada carries a second set of fees, because ECFMG certification is a prerequisite for Step 3 and for entering US residency.
Not everybody needs the Pathways application, and the ones who do are meeting the clinical and communication skills requirements through that route.
An all-in figure for an international graduate, with the surcharges and the certification fees, lands well north of $4,000 before a single question bank is bought. Better to know that at the start than halfway through!
Current ECFMG fees are at ecfmg.org and change annually!
The USMLE cost of moving your date
Rescheduling with Prometric is free if you do it early and expensive if you do it late.
The window is counted from the day you make the change, in local time at the regional registration center, and it excludes the test date itself. Count carefully, because a single day either side of a boundary changes what you are charged!
Your new date has to fall inside your existing eligibility period. Moving beyond it means requesting an extension, which carries its own fee from whoever registered you.
If your practice scores are telling you to sit later, changing the date six weeks out costs nothing and changing it three days out costs $158. That is the whole argument for deciding early rather than hoping 🙂
The fee table is published at usmle.org.
The costs nobody budgets for
Registration fees are the visible part of the USMLE cost. For most students the invisible part is bigger 🙂
- Question banks. A year of the main Step 1 bank runs into the hundreds, and most people buy more than one subscription window.
- NBME self-assessments. Bought individually, and you want several across a preparation run.
- Review resources. Books, video subscriptions and flashcard decks.
- Travel and accommodation. If the nearest Prometric center is a long way off, this is a line of its own, and it doubles on a retake.
- A retake. The full fee again, plus the weeks of preparation. Our pass rate page shows how much lower the odds are second time round.
A delayed residency application. Failing a Step and rebooking can move you out of a cycle, and the cost of a lost year dwarfs every fee on this page.
That is the case for spending more up front on preparation than on a second attempt!
When each fee falls due
The USMLE cost arrives in instalments across several years rather than in one bill, which makes it easy to underestimate.
Nothing here is refundable, and none of it transfers between eligibility periods, so the order you commit money in matters!
NBME self-assessment prices are published at nbme.org and they sell bundles at a saving during promotional windows 🙂
What preparation adds to the USMLE cost
Registration buys you a seat. Everything that gets you ready for it is separate, and adds up to more than the seat did 🙂
- Question bank subscriptions. Sold by window, so a longer preparation run costs more. One bank finished beats two half-used.
- NBME self-assessments. From $62 each, and the only practice written by the people who write the exam. Two or three across a run.
- Review resources. A content reference, and usually a video or flashcard subscription alongside it.
- Tutoring, if you need it. Priced by the hour, and our tutor comparison covers the three situations where it is the wrong call.
None of that is compulsory, and a well-run preparation buys fewer things than a badly-run one!
Where the USMLE cost can come down
Four things are available, and not one of them involves buying less preparation 🙂
- The NBME fee assistance program. Applications open annually, and it covers part of the registration cost for students who qualify.
- Book early and reschedule early. The difference between a 46-day and a 5-day change is $158 on Step 1.
- Pick one question bank and finish it. Half of two banks costs twice as much and teaches less than all of one!
- Sit it once. The most reliable saving anywhere on this page!
USMLE cost, common questions
How much does the whole USMLE cost, all in?
$2,345 in registration fees for all three Steps inside the United States, at the 2026 and 2027 rates. International surcharges and ECFMG certification add substantially to that.
Is the USMLE fee refundable?
No. Registration fees are non-refundable and non-transferable between eligibility periods or between applications.
How much does a retake cost?
The full fee again. $695 for Step 1 or Step 2 CK, $955 for Step 3, with no reduction for a repeat attempt.
Is there help with the USMLE cost?
The NBME runs a fee assistance program for USMLE registration, with applications opening each year. Your school's financial aid office is the other place to ask 🙂
Why is Step 3 more expensive?
It runs over two days with computer-based case simulations alongside the multiple-choice blocks. Our USMLE overview sets out how the three Steps differ!
Does it cost more to test abroad?
Yes. $210 on Step 1 and $235 on Step 2 CK, charged by the test delivery provider, plus 18% goods and services tax in India.
Related reading
- What is the USMLE, the three Steps, formats and attempt limits
- USMLE pass rates, all three Steps by examinee group
- The complete USMLE Step 1 guide, what it tests and what passing takes
- USMLE Step 1 study schedule, 3 weeks to 6 months
- 8 best USMLE Step 1 tutors, and when to skip tutoring
- The USMLE exam guide, all three Steps