Planning for USMLE Step 1? The cost is more than just the exam fee — it includes registration, scheduling, and potential retakes. Here’s the full breakdown so you can budget accurately.
USMLE Step 1 Registration Fee
The primary cost is the exam registration fee paid to ECFMG (Educational Commission for Foreign Medical Graduates). As of the latest revision (early 2026), the Step 1 registration fee is $1,000 (approximately ₹83,000 at current exchange rates). This covers:
- Application processing
- Eligibility period (up to 3 months)
- One scheduled exam attempt
Note: Fees are set in USD. Actual INR cost varies with exchange rates and bank charges. Always verify the exact amount on the official ECFMG portal.
Additional Costs to Factor In
Beyond the base fee, budget for:
- International transaction fee: 2–3% charged by Indian banks on USD payments
- Travel & accommodation: If testing in India (e.g., Delhi, Mumbai), plan for ₹3,000–₹10,000 depending on location
- Study materials: UWorld, First Aid, and NBME practice tests — expect ₹15,000–₹40,000
Take a free USMLE Step 1 demo mock to find out where you stand: Try the demo →
Retake Fee for USMLE Step 1
If you need to retake Step 1, you must re-register and pay the full registration fee again. There is no discounted retake rate. The same $1,000 fee applies for each new attempt.
Important: You can take Step 1 a maximum of 6 times. After 4 failed attempts, you must apply for a special permission letter from ECFMG.
Re-evaluation / Score Review Cost
USMLE does not offer a formal re-evaluation service. If you suspect a technical error, you can request a score review — but this is rarely granted. The fee for a score review is $80, and it only checks for administrative errors, not re-grading. Most requests are denied.
Accepted Payment Methods
ECFMG accepts these payment methods for the registration fee:
- Credit card: Visa, MasterCard, American Express, Discover — instant processing
- Debit card: Must have a Visa or MasterCard logo
- Wire transfer: Available but slower (5–7 business days); extra bank fees apply
- Online check (US bank only): Not available for Indian candidates
Pro tip: Use a credit card with no foreign transaction fee to save 2–3%.
Refund Policy for USMLE Step 1
Refunds are limited. Here’s what you can expect:
- Full refund: If you cancel before your eligibility period starts (minus a $50 processing fee)
- Partial refund: If you cancel after the eligibility period begins but before scheduling — $200 fee applies
- No refund: After you schedule your exam or on test day (no-show)
Refunds are processed back to the original payment method within 30 days. Note: No refunds for retake fees once paid.
See USMLE Step 1 mock-test packs and pricing: View plans →
Tips for Indian Candidates
- Currency fluctuation: INR/USD rates change daily. Use a forex card to lock in a rate.
- GST: No GST on exam fees paid to ECFMG (foreign service).
- Proof of payment: Save all receipts and bank statements for visa interviews.