When Can I Sit the USMLE? Step Eligibility & Timing 2026
Last updated on 03-October-2026, by Dr. Muhammad Dr. Muhammad

 

When Can I Sit the USMLE? Quick Summary

You can take Step 1 and Step 2 CK while still in medical school, in either order, as long as your school is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements. Step 3 comes later: you need to have passed Step 1 and Step 2 CK, hold your medical degree, and, as an IMG, have ECFMG Certification.

When can I sit for the USMLE Steps?

The United States Medical Licensing Examination (USMLE) is a three-step, computer-based exam that US state medical boards use to make licensing decisions. Each Step has its own eligibility rules, and the right time to take it depends on where you are in your training. Medical students and graduates from Pakistan, India, and other countries can take Step 1 and Step 2 CK in their own country, while Step 3 is offered only in the United States. For what each exam covers, see our guide to what the USMLE exam is and what the three USMLE Steps are like.

Eligibility for Step 1 and Step 2 CK

Eligible medical school: You are officially enrolled in, or have graduated from, a medical school listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements (shown as an ECFMG Sponsor Note on the school's listing).
Students can apply: You don't need to have graduated; enrolled medical students can take both exams.
Any order: If you are eligible, Step 1 and Step 2 CK can be taken in any sequence.
Attempts remaining: You have fewer than four previous attempts at any USMLE Step, and you have not already passed the Step you are applying for.
Does my school's accreditation affect my eligibility?
No. Under ECFMG's Recognized Accreditation Policy, put in place in November 2024, the World Directory now notes which schools are accredited by an agency recognized through the WFME or NCFMEA. ECFMG has confirmed this does not affect your eligibility for ECFMG Certification. Recognized accreditation can, however, help you meet ECFMG's clinical skills requirement through Pathway 3, which is for graduates of WFME-accredited schools.

Eligibility for Step 3

Passed Step 1 and Step 2 CK: Step 3 is only available once you have passed both.
Medical degree: You hold an MD or equivalent degree from a medical school listed in the World Directory.
ECFMG Certification: As an IMG, you have a valid ECFMG Certificate, which requires Step 1, Step 2 CK, an ECFMG Pathway, and the OET Medicine test.
Postgraduate training (recommended): The USMLE recommends completing at least one year of accredited US postgraduate training before taking Step 3.

When is the best time to take each Step?

There is no fixed year of study for Step 1 or Step 2 CK; the right time is when your preparation is strongest. Most candidates follow this pattern:

Step 1
Usually after the basic science (pre-clinical) years, while anatomy, physiology, pathology, and pharmacology are still fresh. See our Step 1 exam guide.
Step 2 CK
Usually after core clinical rotations in medicine, surgery, pediatrics, obstetrics & gynecology, and psychiatry, often in the final year or soon after graduating. See our Step 2 CK exam guide.
Step 3
Usually during or after the first year of US residency, once you hold ECFMG Certification. It is taken only in the United States.

For a year-by-year plan, see our USMLE exam timeline.

How to register for Step 1 and Step 2 CK

  1. Check that your medical school has an ECFMG Sponsor Note in the World Directory of Medical Schools.
  2. Apply through the FSMB via the USMLE website. Since January 12, 2026, the FSMB handles USMLE registration, scheduling permits, and score reports for IMGs, while ECFMG continues to handle certification.
  3. Choose your eligibility period and testing region, then book a date at a Prometric test center, available worldwide for Step 1 and Step 2 CK.
  4. Sit the exam. Results are usually released within four weeks, though you should allow up to eight.
Start practising early
Our Step 1 Qbank (3000+ questions) and Step 2 CK Qbank (2000+ questions) let you practise in the exam format from your first year of preparation.

Frequently asked questions

> Can I take USMLE Step 1 while still in medical school?

Yes. Officially enrolled medical students are eligible for Step 1 and Step 2 CK, as long as their school is listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements.

> Do I have to pass Step 1 before taking Step 2 CK?

No. If you are eligible, you can take Step 1 and Step 2 CK in any order. You must pass both before you can take Step 3.

> Can I take the USMLE in Pakistan or India?

Step 1 and Step 2 CK are offered at Prometric test centers worldwide, so candidates can usually test in or near their home country. Step 3 is offered only in the United States and its territories.

> Does WFME accreditation of my medical school affect my USMLE eligibility?

No. ECFMG's Recognized Accreditation Policy, in place since November 2024, only reports which schools have recognized accreditation; ECFMG has confirmed it does not affect eligibility for ECFMG Certification.

> How many times can I attempt each Step?

A maximum of four times per Step, and a Step you have passed cannot be retaken. See our guide to USMLE retake limits.

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