How Do I Register for the USMLE Step 1?: Test Fee Costs, Submission Processes, and Schedules

Registering for the USMLE Step 1 is one of the first major steps toward becoming a licensed physician in the United States. The process can feel overwhelming at first, but with a clear understanding of the registration steps, fees, and scheduling options, it becomes much more manageable.

This guide walks through the entire process, from application to scheduling, and offers a few tips for making the most of your preparation period.

Step 1 Registration Overview

The USMLE Step 1 is designed to test a medical student’s understanding of foundational sciences and their application to clinical practice. Because of its importance, proper registration and scheduling are essential to ensure that the exam fits smoothly into your academic timeline.

Before registering, students must determine which application path applies to them:

• U.S. or Canadian medical students register through the NBME (National Board of Medical Examiners).
• International medical students or graduates register through the ECFMG (Educational Commission for Foreign Medical Graduates).

Understanding which pathway applies is critical, as each organization has its own forms, fees, and verification steps.

Step 2: Submitting the Application

For U.S. and Canadian Students (NBME Pathway)

1. Create an NBME account on the official USMLE website.
2. Complete Form 183 or other required documentation to verify enrollment in a medical school accredited by the LCME or CACMS.
3. Submit the application fee through the NBME portal.
4. Wait for eligibility approval, which typically takes one to three weeks.

Once approved, students receive an email with their scheduling permit, which includes an eligibility period for selecting a test date.

For International Students (ECFMG Pathway)

1. Create an account on ECFMG’s Interactive Web Applications (IWA) portal.
2. Submit Form 183 signed by the medical school to verify student status.
3. Pay the exam and international test delivery surcharge if applicable.
4. Once eligibility is confirmed, receive a scheduling permit via email.

Both pathways lead to the same next step: choosing a test date through Prometric.

Step 3: Scheduling the Exam

After receiving the scheduling permit, students can book their test date through Prometric, the official USMLE testing partner. The permit lists a three-month eligibility window, and students can select any available date within that period.

Testing slots fill quickly, especially during peak seasons such as May to July, so early scheduling is strongly recommended. Rescheduling is possible, but fees may apply depending on how far in advance changes are made.

Step 4: Understanding the Fees

As of 2025, the USMLE Step 1 registration fee for U.S. and Canadian students is $670. International applicants pay an additional international test delivery surcharge, which varies by country.

Other potential fees include:

• Rescheduling fees if the test date is changed close to the scheduled time.
• Eligibility extension fees if the testing period needs to be moved to a later window.

Because the fees are significant, it is best to confirm all scheduling details before submitting payment.

Step 5: Preparing for the Exam

After registration, the focus shifts to preparation. Most students spend six to twelve weeks studying full-time before their scheduled date. During this period, effective use of study tools and question banks is crucial for success.

Bootcamp’s USMLE Step 1 prep platform offers everything students need in one place: a comprehensive question bank, high-yield review videos, and progress tracking tools designed to mirror the real exam format. These tools are especially valuable for reinforcing test-taking skills while managing time effectively.

Students who use spaced repetition and active recall techniques see long-term retention gains. Those looking to integrate flashcards into their study can explore the Med School Bootcamp Anki Deck or learn how to use AnKing with Med School Bootcamp to strengthen memory and efficiency.

Start Studying for Step 1

Registering for the USMLE Step 1 is one of the first big steps toward becoming a physician. Once that’s done, you can focus on studying effectively and performing your best on test day. 

Get started with Bootcamp’s USMLE Step 1 resources to study smarter, stay organized, and feel confident on exam day.

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