What Is the Process of USMLE® Registration?

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  • Written By: Natalie M. Smith
  • Edited By: A. Joseph
  • Last Modified Date: 29 October 2019
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The United States Medical Licensing Examination® (USMLE®) is a test given to people who want to practice medicine in the U.S. The process of USMLE® registration generally depends on three factors: which of the three steps one is taking, the location of the medical school and whether accommodations are needed. Test takers contact the appropriate registration entities based on one or more of these factors, complete and return application materials, receive scheduling permits, then schedule their exams with a Prometric test center.

To begin USMLE® registration for the Step 1, Step 2 Clinical Knowledge (CK) or Step 2 Clinical Skills (CS) exam without accommodations, test takers from U.S. and Canadian medical schools must contact the National Board of Medical Examiners (NBME) for application materials. The application process requires test takers to supply personal and medical school information, test fee payments and other data. The USMLE® registration process for Steps 1, 2 CK or 2 CS for test takers from medical schools outside the U.S. and Canada who do not need accommodations is quite similar. These test takers, however, must contact a separate registration entity: the Education Commission for Foreign Medical Graduate Students (ECFMG).


Test takers from all countries who have graduated from medical school, have passed Steps 1, 2 CK and 2 CS and do not need accommodations must contact a specific registration entity as determined by the Federation of State Medical Boards (FSMB). The FSMB website directs Step 3 test takers to the appropriate state authority. This state authority will supply and verify USMLE® registration materials and process test fees.

Requesting accommodations requires an additional course of action, which is also based on which step the test takers are registering for and where their medical schools are located. At the same time that test takers apply to the appropriate registration entities, they must also request test accommodations from the divisions of NMBE, ECFMG and FSMB that handle such requests. For NMBE, it's the Disability Services division, ECFMG has a test accommodations coordinator, and FSMB has a coordinator for special examination services.

After test takers have met all requirements of their particular registration entities, they receive detailed scheduling permits. These documents advise test takers to contact Prometric, the test center that administers the USMLE®. Prometric assists test takers in selecting locations and times to take their USMLE® tests and outlines its own policies regarding test takers. Securing a test date is the final step in the lengthy USMLE® registration process. Additional information concerning USMLE® registration, such as the contact information of the registration entities and their accommodations divisions, is available at the official website of the USMLE®.


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