If you’re an international medical graduate (IMG) planning to take the USMLE Step 1 in 2026, one of the first questions on your mind is probably: “How much will USMLE Step 1 cost?” That’s honestly a very valid concern. The USMLE journey is not just academically demanding; it’s also a major financial investment. The exam fee you see on the official website is only part of the story. Once you add international surcharges, application fees, preparation resources, and unexpected extras, the total amount can surprise many students.
This blog breaks down every cost related to USMLE Step 1 in 2026.
What Is the USMLE Step 1 Exam?
USMLE Step 1 is the first licensing exam required to practice medicine in the United States. It tests your understanding of basic medical sciences and how well you can apply them to clinical scenarios. As of now, Step 1 is Pass/Fail, but that doesn’t make it less important. A strong Step 1 foundation is crucial for Step 2 CK and your future residency applications.
Are you planning to take the USMLE Step 1 in 2026? Then, it is better to enroll in Academically’s USMLE Preparation Course. You will get live and recorded lectures, study materials, question banks, AI-based mock tests, personalised guidance and so much more.
USMLE Step 1 Exam Fee in 2026
Let’s start with the most important number.
Base Exam Fee
- US Medical Students (USMGs): $695
- International Medical Graduates (IMGs): $1,020
IMGs pay more because registration and credential verification are handled through ECFMG/FSMB, which includes additional administrative processes.
International Test Delivery Surcharge (Very Important for IMGs)
If you’re taking the exam outside the U.S. or Canada, an additional surcharge applies:
- International Test Delivery Surcharge: $205
Total Step 1 Exam Cost for IMGs (USD)
$1,020 + $205 = approximately $1,225
This is the minimum amount most IMGs will pay just to sit for Step 1.
USMLE Step 1 Fees in INR
| Expense | USD | Approx. INR |
| Step 1 Exam Fee (IMG) | $1,020 | ₹85,700 – ₹86,700 |
| International Surcharge | $205 | ₹17,200 – ₹17,500 |
| Total Step 1 Exam Cost | $1,225 | ₹1,02,900 – ₹1,04,200 |
So realistically, an IMG should expect to spend around ₹1.03–1.05 lakh just for the Step 1 exam itself.
ECFMG Certification and Application Costs
Before booking your Step 1 exam, you must be registered with ECFMG.
ECFMG Application Fee
- One-time ECFMG application fee: ~$160
- Approx. INR: ₹13,400 – ₹13,600
This fee covers:
- Verification of your medical school credentials
- Confirmation of your eligibility for the USMLE exams
Good news: you pay this only once during your entire USMLE journey.
Additional USMLE-Related Fees You Should Know About
These fees don’t apply to everyone, but many students end up paying at least one of them.
| Fee Type | USD | Approx. INR |
| Eligibility period extension | ~$100 | ₹8,400 – ₹8,500 |
| Test center / region change | ~$90 | ₹7,500 – ₹7,700 |
| Rescheduling fee (late) | $100–$400 | ₹8,400 – ₹34,000 |
| Score recheck | ~$80 | ₹6,700 – ₹6,800 |
| USMLE transcript (for ERAS later) | ~$80 | ₹6,700 – ₹6,800 |
Pro tip: Most of these charges are avoidable with early planning.
Hidden but Real Costs Most Students Forget
This is where the budget really starts to grow.
Study Resources
Almost every student uses paid resources:
- Question banks (UWorld, AMBOSS): $400–$600
- NBME practice exams: $60–$120 per test
- Review books (First Aid, Pathoma, Sketchy): $100–$300
- Online coaching / preparation courses (optional):
- $300–$1,500+
- ₹25,000 – ₹1.25 lakh (varies by platform, duration, and mentorship level)
Estimated total preparation cost: $800 – $3,000 (₹65,000 – ₹2.5 lakh)
Travel and Logistics
Even in your home country, you may spend on:
- Travel to the Prometric center
- Hotel stay
- Food and transport
Estimated cost: $300–$1,000+ (₹25,000 – ₹80,000+)
Total Estimated Cost for USMLE Step 1 (IMGs – 2026)
| Expense Category | USD | Approx. INR |
| Step 1 exam + surcharge | ~$1,225 | ₹1.03–1.04 lakh |
| ECFMG application | ~$160 | ₹13–14k |
| Study materials | $500–$1,500 | ₹40k – ₹1.25 lakh |
| Travel & logistics | $300–$1,000 | ₹25k – ₹80k |
| Extra/buffer costs | $200–$500 | ₹15k – ₹40k |
Realistic Total (Step 1 phase only):
$2,500 – $5,500 USD (₹2.0 – ₹4.5 lakh)
(Does not include Step 2 CK, electives, or residency applications.)
How to Reduce Your USMLE Step 1 Expenses
- Book your exam early to avoid rescheduling fees
- Stick to high-yield resources (more ≠ better)
- Share resources legally with friends
- Plan eligibility periods carefully
- Keep a 5–10% buffer for currency fluctuations
Final Thoughts
The USMLE Step 1 exam in 2026 is a major milestone and a significant financial commitment, especially for IMGs. While the exam fee itself is high, the real cost includes preparation, logistics, and administrative expenses.
When you understand the numbers clearly, you can plan smarter, avoid unnecessary spending, and focus on what truly matters: passing Step 1 with confidence.
If you need any help or have questions about USMLE Step 1, reach out to the experts at Academically.