Route & Requirements of USMLE | Academically

The Route to the USMLE and the Requirements for the USMLE

Jun 13, 2024 4 min read
Route & Requirements of USMLE


Those doctors thinking about practising medicine in the United States would have definitely heard about the USMLE. International Medical Graduates (IMGs) from all parts of the world flock to the United States to build their medical career. The United States is home to a top-notch healthcare industry and has made several groundbreaking discoveries in the field of medicine. 

Apart from the vast scope and great career potential in the United States, global doctors are also attracted to several factors like educational opportunities, global recognition, research and innovation, and so on. 

Let us learn more about what it takes to become a licensed doctor in the United States. 

What is the USMLE? 

The United States Medical Licensing Examination (USMLE) is a 3-step examination that is the gateway to medical licensure in the United States. This exam is formulated in such a way that the competence of the International Medical Graduates is thoroughly assessed. Apart from theoretical knowledge, the candidate's application of medical concepts in real work scenarios, clinical reasoning, patient interaction, and the ability to make informed decisions, are put to test. 

Clearing the USMLE indicates that you are eligible to provide safe and effective care in the United States.

USMLE Exam Preparation Course

Eligibility Requirements for the USMLE

There are certain requirements that need to be met by the International Medical Graduate to be eligible to appear for the USMLE. As mentioned before, the USMLE is a 3-step examination. 

Let us understand the eligibility requirements for each step.

USMLE Eligibility: Step 1 and 2 

The candidate should meet any one of the following eligibility criteria.

  1. The candidates seeking eligibility must be officially enrolled in or have graduated from a medical school in the United States or Canada, leading to the MD degree. The medical institution should be accredited by the Liaison Committee on Medical Education (LCME), the MD program accrediting body in both countries, and recognised by the US Department of Education.
  2. The candidates pursuing the DO degree in the US, should meet the eligibility requirement of official enrollment or graduation from a medical school accredited by the American Osteopathic Association (AOA) Commission on Osteopathic College Accreditation (COCA), the accrediting entity for osteopathic educational institutions in the USA, recognised by the US Department of Education.
  3. The Candidates enrolled in or graduated from a medical school outside the US and Canada, listed in the World Directory of Medical Schools (WDOMS), should meet the eligibility requirements and criteria established by the Educational Commission for Foreign Medical Graduates (ECFMG). This ensures that the medical education received aligns with international standards for medical practitioners.

USMLE Eligibility: Step 3 

  1. The candidates should have an MD (or an equivalent, MBBS, for instance) degree from an LCME-accredited medical school in the United States or Canada.
  2. The candidates seeking eligibility must possess a DO degree from a medical school in the US, accredited by the American Osteopathic Association (AOA) or an MD (or an equivalent, such as MBBS) degree from medical schools listed in the World Directory of Medical Schools (WDOMS) located outside of the USA and Canada.
  3. The candidates should hold the ECFMG Certification, ensuring their medical education aligns with international standards.

USMLE Exam Registration

To register for the USMLE exam, this pathway should be followed by international medical graduates and students. 

Creation of the ECFMG Account on the Official Website

Go to the website and initiate the process to request a USMLE/ECFMG identification number. Upon initiation, you will be redirected to a new window featuring a form where you can input your details and submit the necessary information. Expect to receive your ECFMG ID and password, which can be changed according to your preferences, approximately two weeks after submission.

USMLE Step 1 Application 

Sign in to your ECFMG account and choose the application tab. Complete the form, providing accurate details, and make the necessary payment for the USMLE exam fee. Additionally, carefully select your eligibility period, keeping in mind that you have a three-month window to schedule your test.

Mailing of Form 183

Once the payment of the USMLE exam fee is done, you'll get a link for Form 183 within the same window. Complete the form, obtaining the required signature and stamp from your medical school's Dean. It is crucial to verify that the Dean's signature aligns with the one on your ECFMG records. Clearly communicate this requirement to your medical school's office staff, as any disparities in signatures may result in the rejection of your form.

This should be posted to the address given below.



3624 Market Street

Philadelphia, PA 19104-2685 


Receiving of the Scheduling Permit

Approximately 2-3 weeks after sending Form 183 by mail, ECFMG will email you your scheduling permit. This document is crucial and must be brought with you on your exam day. Take the time to carefully review the permit, ensuring that all the details mentioned in it are accurate.

Scheduling the Exam Date at a Prometric Centre

Head to the Prometric website, the authorised testing service for all USMLE exams. Choose USMLE, specify your testing location, and select your preferred exam date within your eligibility period. Finalise the booking process by entering the details specified in the scheduling permit.


The decision for IMGs to migrate to the US is arrived at with various factors, encompassing educational, professional, economic, and personal considerations. The US healthcare system's reputation, opportunities for career advancement, and the overall environment make it an attractive destination for many international medical professionals.The skill assessment process before the USMLE exams is a multifaceted journey that goes beyond testing theoretical knowledge. It's a dynamic exploration of a candidate's clinical competence, communication skills, and overall readiness for the responsibilities that come with being a medical professional. Aspiring doctors who embrace and excel in this process lay a solid foundation for success in the USMLE and, ultimately, in their medical careers.

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Dr. Akram Ahmad
Dr. Akram Ahmad
about the author

Dr. Akram Ahmad is a clinical pharmacist and lecturer with over 10 years of teaching and research experience across various subjects of medicine in India, Malaysia and Australia. He is an educationist and a medpreneur with extensive knowledge of the global healthcare diaspora. Through his articles, videos and engaging sessions, he always aims to impart unexplored knowledge about the healthcare world to interested students and professionals.