Studying for the USMLE in India

If you’re a medical school graduate from India and plan to get a medical license in the U.S., it’s important to familiarize yourself with the process and requirements so you know what to expect. In order to complete a residency program in America, Indian international medical graduates (IMGs) must first gain certification from the U.S. Educational Commission for Foreign Medical Graduates (ECFMG). To be eligible for this certification, IMGs must satisfy a number of requirements, including passing the United States Medical Licensing Examination^® (USMLE^®). We’ll help you on your journey to becoming a doctor in the U.S. by giving you information about how to prep for the USMLE in India, including USMLE exam fees in India, Indian USMLE exam centers where you can take the exam, and more.

How to Become a U.S. Doctor as an IMG From India

Becoming a doctor in the U.S. can be long and challenging, but it’s definitely possible for medical school graduates from India. Here’s what you’ll need to do to earn a medical license in America as an IMG from India:

1. Register for ECFMG certification
2. Take a USMLE Step 1 prep course and prepare for the exam
3. Pass the USMLE Step 1 
4. Take a USMLE Step 2 CK prep course and prepare for the exam
5. Earn a good score on the USMLE Step 2 CK
6. Prepare for and pass the Occupational English Test (OET)
7. Receive your ECFMG certificate 
8. Submit a MyERAS^® application and register for NRMP
9. Match with a U.S. residency program! 
10. Take USMLE Step 3

ECFMG certification is a requirement for IMGs who want to practice medicine in the U.S. Earning ECFMG certification means you have met the standards required to work in the U.S. healthcare system. To be eligible for ECFMG certification, IMGs from India must meet a number of requirements, including:

• Have graduated from a medical school that is listed in the World Directory of Medical Schools
• Pass Step 1 and Step 2 CK of the USMLE
• Complete a clinical skills assessment
• Meet English language proficiency requirements

Once you have been certified by the ECFMG, you are eligible to apply for residency programs in the U.S. and take the USMLE Step 3.

How to Apply for USMLE From India

Another critical step on your journey to becoming a doctor in the U.S. is passing the USMLE. To apply for the USMLE from India, you have to complete a six-step process:

1. Create an account on the ECFMG website.
2. Fill out the USMLE Step application form.
3. Once your payment is submitted, fill out Form 183, which requires a sign and stamp by the Dean of your medical school.
4. Once Form 183 is completed, mail it to the address listed on the form.
5. 2-3 weeks after mailing in your form, you will receive an email from the ECFMG containing your scheduling permit. 
6. Book an exam date on the Prometric website.

USMLE Exam Centers in India

USMLE exams are administered at Prometric centers around the world. Below, we list some of the Prometric exam centers in India where you can take the USMLE Step 1 and Step 2 CK. Here are the regions in India where you can take the USMLE at an official test center:

• Chennai
• Hyderabad
• Ahmedabad
• Bangalore
• Kolkata
• Allahabad
• Mumbai
• New Delhi

Please note that this is not an exhaustive list, and the availability of the testing centers might change. Refer to the Prometric website for the most up-to-date information.

OET Exam Centers in India

The Occupational English Test (OET) is an English language exam designed specifically for healthcare professionals. The exam is used to determine test-takers’ level of English proficiency to ensure they are competent enough to deliver superior healthcare. Earning a satisfactory score on the OET is also a requirement of ECFMG certification. In India, the OET exam is offered multiple times per year in 40 countries. It is held in major cities across India, including:

• Ahmedabad
• Amritsar
• Bengaluru
• Chandigarh
• Chennai
• Coimbatore
• Hyderabad
• Kochi
• Kolkata
• Mumbai
• New Delhi
• Thiruvananthapuram

The following are current fees for ECFMG programs and services, including the USMLE exam fees in India. All fees are in U.S. dollars and are subject to change.

• USMLE Step 1 exam fee in India: $1,000
• USMLE Step 2 CK exam fee in India: $1,000 
• USMLE Step 1 and Step 2 CK rescheduling fee: $0 – varies (depending on exam, testing region, and date of cancellation)
• USMLE paper transcript: $70 per request form 
• USMLE electronic transcript: $80 per ERAS season

2023 USMLE Step 3 exam fees for Indian IMGs are currently $915 but are increasing to $925 in 2024. Please note the USMLE Step 3 can only be taken in the U.S.

How should I take the USMLE after doing PG in India?

You do not have to wait until you have graduated from medical school in India to take the USMLE Step 1. As long as you are officially enrolled in a medical school listed in the World Directory of Medical Schools, you are eligible to take the USMLE. While there is no fixed time that an IMG from India must begin taking the USMLE, we recommend taking Step 1 once you have completed the basic science subjects of your medical school while the content is fresh in your mind. The USMLE Step 1 has recently transitioned to pass/fail scoring, so all you have to worry about is passing the exam. Step 2 CK is typically taken between the third and fourth years of medical school, whenever you’ve had enough time to prepare and feel you can earn a good score. Remember, once you’ve earned a passing score on any of the USMLE exams, you are not allowed to retake them in order to earn a higher numerical score.

[  Keep Reading: USMLE Scoring Guide ]

The sooner you take the USMLE Step 1, the better. Most students who take Step 1 immediately after completing the basic science ( Pre and Paraclinical ) subjects report that it’s easier to recall difficult subject matter. But depending on how your curriculum was taught and your grasp of the material, it may or may not be optimal to take Step 1 during the summer after completing your basic sciences. Consider some of the points below, and decide what’s best for you. 

• Most IMGs will find that traditional first-year topics are difficult to recall and that behavioral science and U.S. epidemiology are not covered in their school’s curriculum.
• Many students educated outside the U.S. are not exposed to the types of integrated clinical vignettes that appear on Step 1 and are not accustomed to 8-hour computerized exams. Such factors may cause students to delay studying until they’re able to devote their undivided attention on the exam.
• Full preparation for the USMLE requires not only a firm understanding of the subject matter but also the ability to integrate information across disciplines, apply knowledge to difficult clinical vignette questions, and maintain stamina and concentration during an 8-hour examination period. This takes diligent practice to master well!
• Some U.S. IMGs return during semester breaks to complete a live review course. Although, most non-US IMGs are not able to do this until after graduation when they can attend a Kaplan Medical review course in the U.S. on a student visa, due in part to time constraints during medical school or internship/house surgency.

Your goal should be to have all scores available by September when ERAS^® (Electronic Residency Application Service) becomes activated. Competitive applicants know that their application should be submitted as soon as possible once ERAS begins to accept applications—typically by mid-September. Dates may vary year to year, so check the ECFMG website for the most up-to-date information.

After coming out of your internship year (house surgency), it’s a great feeling to finally be working on a clinical level. Because your clinical knowledge is fresh, it’s tempting to take the Step 2 CK exam first. Although it may be counter-intuitive, we still recommend taking Step 1 first. Here’s why: Step 2 CK has continued to evolve to include more and more material previously relegated only to Step 1.

If you begin reviewing Step 2 CK first, you’ll inevitably find that your basic science foundation is weaker than you realized, which can slow down your preparation as you backtrack to review Step 1 information. This could eventually cause you to miss important Step 2 CK questions on the exam. Our advising experience has shown us that examinees tend to score higher on Step 2 CK after having taken the Step 1 exam first.

Students who prepare for the USMLE with Kaplan will learn the crucial ways in which successful candidates are expected to communicate and interrelate with patients in the US system of healthcare.

How to Prepare for the USMLE in India

The best way to build a comprehensive and personalized study plan and package for the USMLE Step 1 and USMLE Step 2 CK is to enroll in a USMLE prep course with an expert instructor. Kaplan gives you the option to prepare for the USMLE at your own speed or to prepare for the USMLE live with an experienced teacher. International medical students and graduates may find it easier to utilize Kaplan’s On Demand Course given scheduling and language limitations, among other factors. If you are unsure how to prepare for the USMLE from India and want to explore some options, start your prep journey with our free practice resources.

How long does it take to prepare for each USMLE exam?

Based on our experience working with IMGs, preparing for the USMLE Step 1 takes 6 to 12 months, and Step 2 CK (clinical knowledge) takes between 4 and 7 months. Of course, each test-taker is unique, with different strengths and weaknesses; ultimately, the time will vary according to your study style, available time, score goals, fluency in English, and current foundation of knowledge in the subjects.

We find students often underestimate the time needed to prepare for the USMLE, based upon the experience of a family member or friend who took the exam years ago and prepared more quickly. However, not only has the exam become more challenging over the years, but also the average scores required to be competitive for certain medical specialties have increased. So take your time, and do it right—rushing to take your medical licensing exam or using old resources can have a detrimental impact on your candidacy.

Remember: Once you pass the exam, you can’t repeat the exam to attempt a higher score. Programs will also see how many times you attempted the exam, usually eliminating candidates with multiple attempts. For this reason, it is essential not only to pass the exam but to do well on the first attempt.

A common misconception by many Indian medical students is that taking the exam in a particular month will get them a better score. No statistical evidence shows that IMG test results are affected by U.S. students’ test-taking trends. Still, if you’re taking the exam in the U.S., some testing sites may have less availability from June through August when U.S. students are taking Step 1. If you must test during these months, schedule your test date well in advance to secure your spot. Furthermore, suppose you intend to apply for an elective rotation in the U.S. (only available to international students who have not yet graduated). In that case, you may need Step 1 as a prerequisite. Keep this in mind when weighing the advantages and disadvantages of taking Step 1 while enrolled in medical school.

What to Know About the NRMP Match Process for IMGs

The Match process for IMGs can be complicated, so understanding the steps is crucial to your success. To participate in the Match or Supplemental Offer and Acceptance Program (SOAP) as an IMG, you must first be ECFMG certified. The Match eligibility requirements for IMGs must be met before the rank order list deadline. Be sure to research programs you are interested in and review program applications and visa requirements. Individual residency programs ultimately decide if they will consider IMGs and which visa types they will support. 

Once you have decided on a program you are interested in, apply through ERAS. IMGs must request an ERAS token from ECFMG which allows them access to the ERAS website. Applicants must register each year to participate in the main registry match. The match has numerous deadlines so be sure to stay on top of deadlines so you don’t incur late fees. 

After submitting your application, you will interview with programs (if invited), then rank your programs in order of preference. The final step is to wait for match day to see if you Match with a program. If you do, the Match result is binding. Remember: If you don’t Match, you can still participate in SOAP.

When to Take the USMLE Step 3 as an IMG From India

We recommend taking USMLE Step 3 as an IMG prior to starting residency. It is very difficult to prepare for Step 3 while you’re in your first year of residency. Many IMGs say the best time to take Step 3 is between September (applications) and July (start of residency). The eligibility requirements for Indian IMGs to take the USMLE Step 3 are passing scores on the USMLE Step 1 and Step 2, and the equivalent of an MD degree from a school that is listed on the World Directory of Medical Schools, and meeting all other eligibility criteria as listed on the USMLE Bulletin of Information. Finish your medical licensing by taking a Kaplan USMLE Step 3 Prep Course On Demand or Live Online. 

[ Read Next: All About the USMLE Step 3 ]