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USMLE (Step 1, Step 2 CK, Step 3)

The USMLE is the three-step licensing exam for M.D. physicians, accepted by every state medical board. Step 1 is pass/fail; Step 2 CK needs 218 and Step 3 needs 200 to pass. For 2026 and 2027, Steps 1 and 2 CK cost $695 each and Step 3 costs $955.

Steps3
Step 1Pass/failSince Jan 26, 2022
Step 2 CK pass218Step 3: 200
Fees$695Step 3: $955
Test datesFees and fee helpOfficial practiceMedicine license steps

Made by FSMB and NBME. Who: M.D. students (Steps 1 and 2 CK), residents (Step 3) and international medical graduates. Checked on the owner's own pages, 21 Oct 2026.

Who takes it

  • State medical boards grant licenses and use USMLE results to do it. Used since 1992 and accepted by all state medical boards, it is the exam for M.D.s; D.O.s take COMLEX-USA.
    USMLE
    About the USMLEUSMLE (FSMB and NBME)
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    21 Oct 2026
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  • Students of LCME- or COCA-accredited programs apply for Steps 1 and 2 CK through NBME; students and graduates of schools outside the U.S. apply through FSMB and need ECFMG Certification before Step 3.
    USMLE
    Apply for Exams: 2026 & 2027 application fees and fee assistanceUSMLE (FSMB and NBME)
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    21 Oct 2026
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  • Attempt limits: four or more failed attempts at a Step ends eligibility for every Step; at most three tries at the same Step in 12 months, the fourth at least 12 months after the first and 6 months after the last. A passed Step cannot be retaken except to meet a board's time limit.
    USMLE
    Bulletin of Information: EligibilityUSMLE (FSMB and NBME)
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    21 Oct 2026
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Format and sections

All three Steps are taken at Prometric test centers.

USMLE
Step 1USMLE (FSMB and NBME)
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21 Oct 2026
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StepWhat it testsFormat
Step 1Science basic to medicine: principles and mechanisms of health, disease and therapyOne 8-hour day: fourteen 30-minute blocks of up to 20 questions (from May 14, 2026), with at least 55 minutes of breaks
USMLE
Step 1USMLE (FSMB and NBME)
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21 Oct 2026
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Step 2 CKClinical knowledge for patient care under supervisionOne 9-hour day: sixteen 30-minute blocks of up to 20 questions (from May 7, 2026), with at least 55 minutes of breaks
USMLE
Step 2 CK (format before and after 7 May 2026)USMLE (FSMB and NBME)
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21 Oct 2026
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Step 3Unsupervised general practice, mainly in ambulatory settingsTwo days. Day 1 (Foundations of Independent Practice): 232 questions in 12 blocks, about 7 hours. Day 2 (Advanced Clinical Medicine): 180 questions in 9 blocks plus 13–14 computer case simulations, about 9 hours
USMLE
Step 3 Exam Content (two-day format, FIP and ACM)USMLE (FSMB and NBME)
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21 Oct 2026
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Scoring

Results are on a 3-digit scale. Current minimum passing scores:

USMLE
Examination Results & Scoring (current minimum passing scores)USMLE (FSMB and NBME)
Checked
21 Oct 2026
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StepMinimum passing scoreFor exams on or after
Step 1Pass/fail only (passing standard 196 on the 3-digit scale)Jan 26, 2022
Step 2 CK218July 1, 2025
Step 3200Jan 1, 2024
  • Results usually come within four weeks; USMLE says to allow at least eight.
    USMLE
    Examination Results & Scoring (current minimum passing scores)USMLE (FSMB and NBME)
    Checked
    21 Oct 2026
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  • On Step 3 the case simulations count toward your score and can decide pass or fail.
    USMLE
    Bulletin of Information: Scoring & Score ReportingUSMLE (FSMB and NBME)
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    21 Oct 2026
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Fees and fee waivers

Application fees for 2026 and 2027:

USMLE
Apply for Exams: 2026 & 2027 application fees and fee assistanceUSMLE (FSMB and NBME)
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21 Oct 2026
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StepFee
Step 1$695
Step 2 CK$695
Step 3$955
  • Testing outside the U.S. and Canada adds a region fee: $210 for Step 1 and $235 for Step 2 CK (not a USMLE fee).
    USMLE
    Apply for Exams: 2026 & 2027 application fees and fee assistanceUSMLE (FSMB and NBME)
    Checked
    21 Oct 2026
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  • NBME runs a USMLE Fee Assistance program for medical students and residents with demonstrated financial need.
    USMLE
    Apply for Exams: 2026 & 2027 application fees and fee assistanceUSMLE (FSMB and NBME)
    Checked
    21 Oct 2026
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Test dates

  • No national test dates: after your application is approved you choose a date at a Prometric center; the exams are not given on major local holidays.
    USMLE
    Apply for Exams: 2026 & 2027 application fees and fee assistanceUSMLE (FSMB and NBME)
    Checked
    21 Oct 2026
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Official practice

  • Once registered you get the interactive testing experience, with tips on the exam software and sample test questions.
    USMLE
    Step 1USMLE (FSMB and NBME)
    Checked
    21 Oct 2026
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Used by these careers and colleges

Careers on this site whose step-by-step roadmap includes this exam, and the license it leads to.

The license at the end of this route

Careers that need it

Next on this site

Sources

Where these facts come from

Official and primary sources only, each checked on the date shown. Rules on testing, aid, licensing and immigration change, so confirm a detail with its source before you rely on it.