How to register for the USMLE – Step 1 exam

I. Registering for the exam. Paperwork.


I. 1. When to register for the your Step 1 Exam?


  • a. Best time is AFTER you have spent some time, around 2 months, building up concepts off KAPLAN Videos. This will allow you to realistically gauge your study rate, and estimate appropriate time for you to reach your goal.


  • b. DO NOT FORCE YOURSELF to a specific exam time, in order to “motivate” yourself. It rarely works, and you might force yourself in the end to enter the exam not well-prepared. This is a nightmarish scenario. So stick to scheduling the exam AFTER you’re sure of the pace of your own study time, and after creating a realistic time table.

I. 2. Important notes for both Students and Graduates.


  • a. First, you create your ECFMG account here ( ). Since your name is the most difficult part of your profile to be changed, MAKE SURE to write it as is in the passport. Better yet, if you don’t have a passport, write your name as easily as possible so as to avoid confusion later on. Thus use 4 names, with “First Name” the first three ones, and “Last Name” as the last one.
  • b. Next day, your profile will be created and you will need to verify it and pay fee of ($75). You can start applying for the exam. First, you’ll fill a 23-step application, then you’ll pay the exam fee ($890) and Prometric fee ($180). No Prometric fee if test is taken in the USA.
  • c. Now, paperwork you’ll be doing from this point till the Match involves two major categories. THE first one is the #1. Certification of Identification form (186 or 183), which serves to insure that you’re actually currently enrolled, or was enrolled, in a Med. School listed in IMED.
  • d.  #2. Verification of Medical Education Credentials, or in other words, now that they know you were a student, they want to make sure that you actually RECEIVED YOUR DEGREE off that Med. School, and wasn’t suspended or dismissed from it for example. This is done OBVIOUSLY after passing your 6th year exams, and having your Diploma ready. (It can work with the Temporary one, but you’d still need to send the original before the match). For this verification process, they usually need two photocopies of the Diploma on Letter-sized paper, two Original Official translations of the Diploma on Letter-sized paper, Two full-face 5*5 Passport-like Photographs, One Form 187 (Tells ECFMG that you’re submitting important documents), One Form 344 (a checklist), and Two Forms 345 (a request to your Med School to send ECFMG the verification of the Diploma). All the three forms are filled entirely by you. Also to speed things up, send Two Original Official English Transcripts as well. Further details here, (
  • e. Obviously, If you register for the exam while being a student, you only need documents for track #1 (Certification of Identification), and the others will wait till after you graduate. BUT, if you register while being a graduate, they will ask you for the ENTIRE set of documents, for both #1. Certification of Identification, and #2. Verification of Medical Education Credentials.

I. 3. Now, If you are a STUDENT.


  • a. At the end of your application, and depending on your school participation in ECFMG Medical School Web Portal (EMSWP), which is the “Med School” account at ECFMG, you’ll either be issued Form 186 (If the school has EMSWP account), or Form 183 (Med School doesn’t have EMSWP account).


  • b. Either forms will be signed by an official representative like Registrar, Vice Dean, or Dean. When filling any of these forms, stress to the Secretary of the Registrar/Vice dean that both the typed name and the Registrar’s official signature should be via the same pen. Also remember that you should write your name, sign and date your signature AFTER the form has been signed and dated by the dean, so that you write the SAME DATE in your signature. This is because proper filling of Form 186 requires you to “APPEAR before an authorized official”, meaning that you both sign together.


  • c. Afterward, the form will be put in an envelope, with the envelope itself signed and stamped, and sent DIRECTLY from the school outgoing mail.


  • d. When either forms are received by ECFMG, they either confirm its authenticity online through your school EMSWP account (for 186), or via mail form (for 183). If either process was delayed, you can’t be issued a scheduling permit for the exam.


  • e. Form 186 will be only sent ONCE, and it remains valid for 5 years. Each time you apply for an exam, your credentials will be reaffirmed via EMSWP. Form 183 will be resent with EACH exam application.


  • f. Once you graduate, complete #2 documents.


I. 4. And if you are a graduate,


  • a. All medical school graduates MUST print a Certification of Identification Form (Form 186) after completing the on-line part of the application, if they do not have a valid Form 186 on file with ECFMG, regardless of School’s EMSWP participation. No use for Form 183 here, even if your school does NOT have EMSWP. However, the certification of Form 186 can be via THREE different routes depending on how easy it is to return to your Med School to get your School official to sign Form 186. Thus,


  • b. Route #A. to certify Form 186 is certification through School Official, which is similar to student’s 186 certification, however, it applies to schools EITHER WITH OR WITHOUT EMSWP access. Again, leave the Form at Registrar/Vice Dean/Dean secretary, and after he signs and dates it, you sign and date. The verification back from ECFMG can be online (If school has EMSWP), or by mail (If no EMSWP). Note that in theory, you need to “APPEAR before an authorized official” for your From 186 to be approved. That is, you both sign it together.


  • c. Route #B. for the 186 is certification through US-approved Notaries (Consular Official off the embassy for $50, Notary Public for L.E ~50, First Class Magistrate in US, or Commissioner of Oaths in US), WITHOUT the need to go to the Med School and “APPEAR before an authorized official” to certify it. After the Notary certifies it, you can send it to the ECFMG. HOWEVER, to be eligible for this route, it’s either that your school must have an EMSWP account, OR ECFMG has already verified your credentials before.


  • d. What if you’re away from home, thus can’t “APPEAR before an authorized official”, you haven’t still verified your credentials, and your school doesn’t have the EMSWP account? If you certify via Notary and send to ECFMG, there’s no way for ECFMG to reconfirm your credentials. Thus, after getting them notarized (via Route #B), SEND THE CREDENTIALS by mail to your school to get certified by your Official, WITHOUT ECFMG enforcing the need to “APPEAR before an authorized official” in person. Hence, it’s a mix of Route #B, then Route #A.
  • e. Don’t forget to verify your credentials via Track #2 documents.

I.  5. In Summary,


  • a. If you are a student and your school DOES NOT participate in EMSWP then your only option is Form 183 certified through School Official.


  • b. If you are a student and your school participates in EMSWP then you have only one option, Form 186 certified through School Official.


  • c. If you are a graduate and your school participates in EMSWP then you can choose one of two types, either Route #A (If at home) or Route #B (If away).


  • d. If you are a graduate and your school DOES NOT participate in EMSWP then you can choose either Route #A (If at home) or Route#B THEN #A (If away).


  • e. If you are a graduate and your school already verified your credentials before then you can choose either Route #A (If at home) or Route #B (If away).


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