A joint Program of the federation of state medical boards of the united states, inc

www.usmle.org

12

2018 Bulletin of Information

ELIGIBILITY FOR THE USMLE

CHANGE IN ELIGIBILITY STATUS 

If your eligibility for a Step or Step Component changes after you submit your application but before your 

scheduled test date(s), you must notify your registration entity promptly. Failure to notify your registration 

entity that you may no longer be eligible to take the examination may result in a finding of irregular behavior. If 

you take a Step or Step Component for which you are not eligible, results for that examination may not be 

reported or, if previously reported, may be canceled. 

GRADUATES FROM UNACCREDITED MEDICAL SCHOOLS IN THE US OR CANADA 

If you graduated from an unaccredited medical school in the US or Canada and are eligible for initial licensure by a 

US medical licensing authority, you may take the USMLE only upon specific request by that medical licensing 

authority.  The medical licensing authority should submit the request to sponsor you to the 

USMLE Secretariat

 in 

advance of your application for each Step.

SEQUENCE OF STEPS 

If you meet the eligibility requirements, you may take Step 1, Step 2 CK, and Step 2 CS in any sequence. You may 

take Step 3 only after passing Step 1, Step 2 CK, and Step 2 CS.

NUMBER OF ATTEMPTS AND TIME LIMITS

The USMLE program limits  to six the total number of times an examinee can take the same Step or Step 

Component. An examinee is ineligible to take a Step or Step Component after six or more prior attempts to pass 

that Step or Step Component, including incomplete attempts. All attempts at a Step or Step Component are 

counted toward the limit, regardless of when the examinations were taken. 

Information regarding state-specific requirements for licensure can be obtained on the 

FSMB website

. Note: 

MD/PhD students should reference the 

USMLE website

 for more specific information regarding exceptions to time 

limits. 

RETAKING FAILED EXAMINATIONS 

You may not take the same Step or Step Component more than three times within a 12-month period. Your fourth 

and subsequent attempts must be at least 12 months after your first attempt at that examination and at least 

six months after your most recent attempt at that examination.  

---

www.usmle.org

13

2018 Bulletin of Information

ELIGIBILITY FOR THE USMLE

RETAKING PREVIOUSLY PASSED STEPS 

If you pass a Step or Step Component, you are not allowed to retake it, except to comply with the time limit of a 

medical licensing authority or another authority recognized by the USMLE program. Visit the 

USMLE website

 for 

more information. If you have not yet passed Step 3 and need to retake a previously passed Step 1 or Step 2 

examination in order to meet a time limit imposed by a US medical licensing authority or another authority 

recognized by the USMLE program, you should understand that if you fail a retake, you will no longer be eligible to 

take Step 3.  In order to meet the examination requirements for Step 3 eligibility, you must have achieved a 

passing performance on the most recent administration  of the examinations intended to meet those 

requirements. 

PREVIOUSLY LICENSED PHYSICIANS 

If you have already been granted a license by a US medical licensing authority based on previous licensure 

examinations, such as the Federation Licensing Examination (FLEX) or the NBME certifying examinations, you 

are not eligible to take the USMLE.

 

---

APPLYING FOR THE TEST AND SCHEDULING YOUR 

TEST DATE 

APPLICATION MATERIALS 

Step 1, Step 2 CK, and Step 2 CS 

Students and graduates of LCME- or AOA-Accredited programs should apply for Step 1, Step 2 CK, and Step 2 

CS by following the instructions on the 

NBME website

. Students and graduates of medical schools outside the US 

and Canada should apply for Step 1, Step 2 CK, and Step 2 CS by following the instructions on the 

ECFMG 

website

. 

IMPORTANT 

If you are dismissed or withdraw(n) from medical school, you are not eligible for USMLE, even if you are 

appealing the school’s decision or are otherwise contesting your status.  

Step 3 

Graduates with an MD or DO degree from an LCME- or AOA-Accredited medical school, and graduates of 

medical schools outside the US and Canada that are listed in the 

World Directory of Medical Schools

 as 

meeting ECFMG eligibility requirements, should apply for Step 3 by following the instructions on the 

FSMB 

website

. 

EXAMINEES WITH DISABILITIES REQUESTING TEST ACCOMMODATIONS 

The USMLE program provides reasonable accommodations for examinees  with disabilities under the 

Americans with Disabilities Act (ADA). If you are an individual with  such  a  disability and require test 

accommodations, visit the 

USMLE website 

before you apply for each Step or Step Component for 

information regarding test accommodations, including procedures and documentation requirements.  

EXAMINEES WHO REQUIRE ADDITIONAL BREAK TIME 

Examinees with physical or health conditions who require additional break time should complete the request 

form

  and  submit  it  with  a  letter  from  a  qualified  health  care  professional  documenting  the  medical  need. 

Examples include lactation (to express breast milk) and diabetes (to monitor/treat blood glucose). Requests 

for additional break time should be made prior to, or at the same time as, registration for a Step examination. 

PERSONAL ITEM EXCEPTIONS (PIE) 

Unauthorized  possession  of  personal  items  while  you  are  in  the  secure  areas  of  the  testing  center  is 

prohibited. Exceptions to this policy may be made in certain limited circumstances. A list of approved personal 

items permitted in the secure testing area (subject to inspection by test center staff) is available at the 

USMLE 

website. 

www.usmle.org

14

2018 Bulletin of Information

---