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United States Medical Licencing Examination (USMLE) and residency match in United States: Cost estimate for foreign medical graduates (FMG’s)
  1. Kamal Kant Sahu1,
  2. Santosh Rajaram Kale2,
  3. Shamendra Anand Sahu3
  1. 1 Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, 01608, Massachusetts, USA
  2. 2 Department of Internal Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow,11554, New York, USA
  3. 3 Department of Burns and Plastic Surgery, All India Institute of Medical Sciences (AIIMS), Great Eastern Rd, Raipur, 492099, Chhattisgarh, India
  1. Correspondence to Dr Shamendra Anand Sahu, All India Institute of Medical Sciences, Raipur, CG 492099, India; shamendrasahu{at}

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Good medical practice is the ideal aim of every responsible doctor. Access to excellent training and a dynamic environment attracts many doctors from developing nations to developed countries like USA, Canada etc. However, financial burden can pose a big challenge to the applicants. This letter aims to discuss from a foreign medical graduate’s (FMG’s) perspective about the expected expense starting from day one of starting preparation for The United States Medical Licensing Examination (USMLE) steps until the starting day of residency journey.

Cost estimate for USMLE steps fee/ECFMG certification

To apply for residency, an applicant needs to be ECFMG (Educational Commission for Foreign Medical Graduates) certified. ECFMG headquarters, Philadelphia issues an ECFMG certificate once a candidate passes all the three mandatory steps (Step 1, Step 2 CK [clinical knowledge] and Step CS [clinical skills]). Step 1 and CK are online examinations conducted in various centres worldwide. On the other hand, Step 2 CS and Step 3 centres are located exclusively in USA.

As per the official ECFMG website, the total cumulative cost of all steps is $3705 if taken in a single attempt without rescheduling (Step 1, Step 2 CK …

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  • Contributors KKS: wrote the paper, submitted the study. SK: accumulated the literature data and tabulation. SAS: planned the study, edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The views expressed in this letter are those of the authors and do not necessarily reflect the positions of the parent organisations. Authors neither have association nor received grants from any private or government organisation. In this letter, authors have mentioned their personal opinion based on their recent experiences and do not intend to hurt or challenge the functioning of any government or private organising body related to USMLE. Liability claims caused by the use of any information provided will, therefore, be rejected.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.