The USMLE (United States Medical Licensing Examination) is the three-step exam sequence required for medical licensure of MD graduates in the United States. It’s cosponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME).
Here’s how each step works, how it’s scored and what it costs in 2026. Then refresh high-yield concepts with the USMLE practice quiz.
Key takeaways
- Step 1 is pass/fail (since January 2022).
- Step 2 CK is scored 1–300; 218 passes.
- Step 3 is a two-day exam; 200 passes.
- 2026 fees: $695 each for Step 1 and Step 2 CK, and $955 for Step 3.
USA USMLE Exam: Quick Facts
- Sponsors
- FSMB and NBME
- Step 1
- About 8 hours; pass/fail
- Step 2 CK
- About 9 hours; 218 to pass
- Step 3
- 2 days; 200 to pass
- Fees (2026)
- Step 1/2 CK $695 · Step 3 $955
- Test centers
- Prometric (Step 3 in the U.S. only)
USMLE Steps Explained
| Step | Focus | Length | Scoring |
|---|---|---|---|
| Step 1 | Basic sciences applied to medicine | 1 day (~8 hours) | Pass/fail |
| Step 2 CK | Clinical knowledge, diagnosis and management | 1 day (~9 hours) | 3-digit score; 218 passes |
| Step 3 | Independent practice, including case simulations | 2 days | 3-digit score; 200 passes |
Osteopathic (DO) students take COMLEX-USA, and many also take the USMLE.
More on USMLE Steps Explained →USMLE Fees and Registration (2026)
U.S. and Canadian students register for Step 1 and Step 2 CK through the NBME; international medical graduates register through ECFMG, which charges additional fees. Step 3 is registered through the FSMB. In 2026, the fees are about $695 for Step 1, $695 for Step 2 CK and $955 for Step 3.
More on USMLE Fees and Registration (2026) →How to Prepare for the USMLE
- Build a long-term study plan: dedicated study periods of 6–10 weeks are common for Step 1 and Step 2 CK.
- Use a large question bank and review every explanation.
- Take NBME self-assessments to gauge readiness.
- Master high-yield biostatistics and ethics. These are “free points.”
- Warm up with our USMLE practice quiz.
Physician assistant candidates should see the PANCE exam guide.
More on How to Prepare for the USMLE →Free practice test
Ready to test yourself?
Choose your test length, practice with instant feedback or take it exam-style, and get your score with an explanation for every answer.
Go to the USA USMLE Exam practice test →USA USMLE Exam FAQs
Is USMLE Step 1 pass/fail?
Yes. Since January 26, 2022, Step 1 results are reported as pass/fail.
Full answer →How much does the USMLE cost in 2026?
About $695 each for Step 1 and Step 2 CK and $955 for Step 3. International graduates pay additional ECFMG fees.
Full answer →How long is USMLE Step 3?
Two days: about 7 hours on day 1 and 9 hours on day 2, including case simulations.
Full answer →Where is the USMLE taken?
At Prometric test centers. Step 1 and Step 2 CK are offered worldwide; Step 3 is offered only in the U.S.
Full answer →Official sources
Disclaimer: This guide is for general information and is not medical advice. Coverage, prices and requirements change and vary by provider and location. Confirm details with your provider, insurer or the agency listed in the sources. Read our editorial policy.