The eligibility requirements for examination differ depending on whether you are an international medical school student or an international medical school graduate.
To be eligible for Step 1 and Step 2 Clinical Knowledge (CK), you must be officially enrolled in a medical school located outside the United States and Canada that is listed in the World Directory with an ECFMG note stating it meets ECFMG eligibility requirements, both at the time that you apply for examination and on your test day. In addition, the “Graduation Years” in the ECFMG note in your medical school's World Directory listing must be “Current” at the time you apply and on your test day. See Medical School Requirements. An authorized official of your medical school must certify your current enrollment status; instructions will be provided at the time of application for examination.
As soon as you graduate and receive your medical diploma, you must submit a copy of your medical diploma to ECFMG. See Final Medical Diploma and Transcript in Medical Education Credentials.
In addition to being currently enrolled as described above, to be eligible for Step 1 and Step 2 CK, you must have completed at least two years of medical school. This eligibility requirement means that you must have completed the basic medical science component of the medical school curriculum by the beginning of your eligibility period. Although you may apply for and take the examinations after completing the basic medical science component of your medical school curriculum, it is recommended that you complete your core clinical clerkships, including actual patient contact, before taking Step 2 CK.
Important Notes: If your eligibility for an exam changes after you apply but before you take the exam, you are required to inform ECFMG immediately in writing of this change in your status. Such notification must be sent to ECFMG’s Applicant Information Services. Use the contact information for General Inquiries on the Contact ECFMG page of the ECFMG website. Such changes in your eligibility status include, but are not limited to, the following:
- Medical school students who transfer to another medical school after submitting an application for examination must inform ECFMG immediately in writing of this transfer.
- Medical school students who have been dismissed or withdraw(n) from medical school are not eligible for USMLE, even if they are appealing the school's decision to dismiss them or are otherwise contesting their status. Medical school students who have been dismissed or withdraw(n) from medical school must inform ECFMG immediately in writing of their dismissal or withdrawal.
- Medical school students who take a leave of absence should consult with their medical schools about whether they will be considered officially enrolled in medical school during leave. Your medical school may consider a student on leave of absence to be withdrawn from medical school. Medical school students who are not officially enrolled in medical school are not eligible to apply for or take USMLE. Applicants who take a leave of absence after submitting an application for examination to ECFMG must inform ECFMG immediately in writing of this leave.
Failure to inform ECFMG that you may no longer be eligible to take the examination may result in a finding of irregular behavior and permanent annotation of your record. See Policies and Procedures Regarding Irregular Behavior.
If you take a Step for which you are not eligible, results for that exam may not be reported or, if previously reported, may be canceled.
Back to top
[Last update: September 14, 2022]