Form Filling Guide

This comprehensive guide is designed for International Medical Graduates (IMGs) applying for the United States Medical Licensing Examination (USMLE). Updated for 2025, it incorporates the latest ECFMG requirements, including institutional eligibility through WFME recognition and the transition to digital form submissions. The guide provides a step-by-step walkthrough of the entire application process, from obtaining your ECFMG ID to scheduling your Step 1 and Step 2 CK.

• Valid Passport:
  • Must be unexpired at the time of any ECFMG or USMLE-related process.
  • Use your passport name exactly across all documentation.
• Medical School Recognition:
  • Your school must be listed in the World Directory of Medical Schools (WDOMS) with an ECFMG Sponsor Note.
  • For exam applications in 2024 and beyond, your school must be accredited by an agency recognized by the World Federation for Medical Education (WFME).
  • Example: For Indian applicants, the National Medical Commission (NMC) must be listed under WFME-recognized bodies.
  • Important Note: If your Form 186 is accepted before your country's WFME accreditation deadline, you may still proceed with the USMLE even if recognition is not achieved later. However, it's safer to wait for your country's official status if it is still pending.

• Go to the ECFMG Website.
• Navigate to: Online Services → For Physicians → Interactive Web Applications (IWA).
• Choose "If you have never been issued a USMLE/ECFMG ID..."
• Fill the form with correct passport-aligned information.
• Submit the form and wait 2–3 business days to receive your ECFMG ID and a temporary password via email.

• Login to the IWA Portal with your ECFMG ID.
• Click "Application for ECFMG Certification".
• Complete all sections including:
  • Biographic and academic data
  • Medical school details
• Pay the one-time non-refundable $160 fee.
• Download the generated Form 186.
• Complete Form 186 via NotaryCam for ECFMG:
  • Upload your completed Form 186 and a color scan of your passport's identity page.
  • Use a device with webcam and microphone for the video session.
  • During the video session, a notary confirms your identity, you e-sign the document, and a live photo will be taken.
  • Form 186 is electronically submitted to ECFMG.
• ECFMG typically confirms approval within 2–5 business days.

• Login again to the IWA Portal.
• Select "Begin New Application".
• Choose either Step 1 or Step 2 CK.
• Enter:
  • Personal details and expected graduation year
  • Preferred 3-month eligibility period
  • Testing region (e.g., India has an additional fee of approximately $200)
• If You Are a Graduate:
  • Submit a copy of your final diploma digitally through IWA.
  • Provide certified English translation if applicable, from official or recognized services.
  • Do not send physical copies unless specifically instructed.
• Pay the fees:
  • Step 1: Approximately $1,000
  • Step 2 CK: Approximately $1,050
• Receive a confirmation email after submission.

• Your school must verify your student/graduate status.
• If your school uses EMSWP (Online System):
  • ECFMG contacts your school directly via the ECFMG Medical School Web Portal (EMSWP).
  • A school official verifies your status electronically.
• If your school does not use EMSWP:
  • Download Form 183 from IWA.
  • Fill your section and submit it to your school.
  • Your school must complete their part, sign, stamp, and mail the original physical copy to:
    ECFMG, 3624 Market Street, Philadelphia, PA 19104-2685, USA
  • Processing time is approximately 2–3 weeks after delivery.
• This is how we sent our Form 183:

• Tips from our Form 183 Submission:
  • Make sure your college uses the exact same stamp that was previously submitted to ECFMG. If the stamp used on Form 183 doesn't match the one on their record, your application may be delayed or even rejected.
  • Ask your seniors who have already applied or check with your college officials to confirm the correct stamp.
  • Form 183 must be received by ECFMG within 1 month of submitting your online application. Late arrival can result in cancellation or the need to repeat the process.
  • When sending Form 183, the sender name on the package/envelope should be your college's name, not your personal name. Using your own name has led to rejection in several cases.

• After application approval and school status confirmation, you will receive an email notification.
• Retrieve your Scheduling Permit from the IWA Portal.
• This permit is required to schedule and take your exam.

• Visit the Prometric USMLE Scheduling website.
• Click "Schedule".
• Enter:
  • Your Scheduling Permit ID
  • First four letters of your last name
• Choose a test center and date within your 3-month eligibility window.
• Receive booking confirmation via email.
• On exam day, bring:
  • Printed permit and confirmation email
  • Original valid passport (matching your ECFMG information)

ECFMG allows a one-time extension of your 3-month exam eligibility window for the same exam and testing region.

• Submit the request via the IWA Portal.
• Request must be made before the current eligibility period expires.
• Only one extension is allowed per exam registration.
• ECFMG Extension Fee: $100
• To avoid the appointment change fee, you must change your appointment 31 or more days before (but not including) the first day of your scheduled test date.
• If you cancel your appointment within 30 days or do not test as scheduled, you must call Prometric (number found in your scheduling permit) and pay a reinstatement fee before scheduling a new appointment.
• The reinstatement fee is separate from the Prometric rescheduling fee, which ranges from $0–$358 depending on how far in advance you reschedule your appointment.
• To avoid additional charges, apply for the extension before scheduling your exam.
• To know more about Prometric policies, visit the Prometric FAQ Page.

Ensure Prometric test centers are available in your region during the extended period.

Below is an updated summary of key fees for international exam-takers:

• ECFMG Certification (Form 186): $160
• Step 1 Exam: $1,020 + $205 International Surcharge
• Step 2 CK Exam: $1,020 + $230 International Surcharge
• Testing Region Change: $90 per exam (Form 312)
• Score Recheck (Step 1/2 CK): $80 per exam (Form 265)
• Prometric Rescheduling Fees: $0 – $358 depending on notice and region
  • 46 or more days before test: $0
  • 31–45 days: $35
  • 6–30 days: $100
  • 5 or fewer days (U.S. & Canada): $140
  • 5 or fewer days (Outside U.S. & Canada): $358
  • Step 3 (U.S. & Canada, partial reschedule): $279

*International surcharges apply to all non-US/Canada test takers. Always verify current rates via the official ECFMG Fees Page.

• Form 186 Validity: 5 years from the date of acceptance.
• WFME Clause: Early submission (before your country's WFME deadline) can protect you from later disqualifications.
• ECFMG Certification Components:
  • Verified Form 186
  • Passed Step 1
  • Passed Step 2 CK
  • Passed OET Medicine with required score

• ECFMG Official Site
• World Directory of Medical Schools
• WFME Recognized Accrediting Agencies
• IWA Application Portal
• Prometric USMLE Scheduling