Ultimate USMLE IMG Guide — Match 2027
Updated: 4 days ago
MATCH 2027 ❤ Guys, let’s make the USMLE journey a little clearer! Here you’ll find the exams, certification steps, application process and costs to plan your next move, one step at a time.
How to begin USMLE application as an IMG?
The internet is full of blogs and advisories providing tips and resources to secure that coveted US residency. Thousands of IMGs apply for The Match every year into US Medical institutions, and guiding them are a variety of resources, blogs and residents who have already matched in previous years. Here is a step-by-step explanation of the stepping stones and hurdles that you face while applying for a US residency program.
USMLE STEP 1
The STEP 1 exam tests the applicant’s knowledge of the basic sciences.
STEP 1 is a one-day, 8-hour examination. Since May 14, 2026, it is divided into fourteen 30-minute blocks, with up to 20 questions per block. Practice with the current official interface so exam day feels familiar 🙌
A more detailed description is available at the following link:
Q. Which subjects does the exam cover?
A broad generalization of subjects from where questions are asked in this exam are as follows:
Behavioral Sciences
Biochemistry & Nutrition
Genetics
Gross Anatomy & Embryology
Histology & Cell Biology
Immunology
Microbiology
Pathology
Pharmacology
Physiology
Q. What do I need to do to apply?
Start your Application for ECFMG Certification through MyIntealth and follow the current identity and medical-education verification instructions. Since January 12, 2026, IMGs apply for USMLE Step exams through FSMB. MyIntealth and the FSMB USMLE portal have different roles, so make sure you are using the right one!
For identity verification, follow the instructions in your MyIntealth account and complete the documents requested for your application.
Your medical-school status and credentials must meet ECFMG requirements. ECFMG shares eligibility information with FSMB when you apply for an exam. Once your registration is approved and you receive your scheduling permit, arrange your test appointment within your eligibility period through the official scheduling process.
Q. How much will STEP 1 cost me?
Guys, build your budget with the current official fees ❤ Check USMLE and FSMB for exam fees and any charges for your testing region before paying.
Check the applicable rules and fees before rescheduling, extending an eligibility period, or changing a testing region. Leave room in your budget for the specific changes you may need.
Q. How much should I score in STEP 1?
Step 1 is reported as pass/fail. Your goal is to pass confidently and build a strong foundation for Step 2 CK and clinical practice. A strong study plan matters much more than chasing a Step 1 number that is no longer reported 🙌
Q. Is Step 1 reported as pass/fail?
Exactly! Step 1 exams taken on or after January 26, 2022 are reported as pass/fail. Study seriously: the foundation you build now will help you keep moving forward in your USMLE journey 🙌
This is an example of how the new reports looks like:
Pass/fail does not mean you can skip the basics. Understanding the concepts now will help you reason through clinical questions later; use current official practice materials to assess your readiness.
For more details on Pass/Fail:
https://www.usmle.org/usmle-step-1-transition-passfail-only-score-reporting
You can read on my blog a post that I made about my recommendation on how to study for Step 1
Guys, look for resources that fit your budget and your way of learning 😍 Project IMG brings together education, mentorship, and community. Check each current offering for its format, eligibility, availability, and price before you enroll.
USMLE STEP 2 CK
STEP 2 used to include CK (Clinical Knowledge) and CS (Clinical Skills). Step 2 CS was permanently discontinued. Step 2 CK is a computer-based exam taken at an authorized testing center; it is not an online exam you take from home.
Q. What is the STEP 2 CK?
Step 2 CK tests the application of medical knowledge, skills, and understanding of clinical science, and emphasises on public health principles. Step 2 CK also tests your knowledge of the principles of clinical sciences and basic patient-centered skills, all to enhance provision of the best patient care that can be provided under supervision.
Step 2 CK is a one-day, 9-hour examination. Since May 7, 2026, it is divided into sixteen 30-minute blocks, with up to 20 questions per block.
The current Step 2 CK format includes at least 55 minutes of break time and an optional 5-minute tutorial. Check the official exam page and practice interface before your test date.
You can take Step 1 and Step 2 CK in either order if you meet the eligibility requirements. Choose the order that fits your preparation and application plan.
Q. What does Step 2 CK assess?
The STEP 2 CK exam asks questions related to body systems just like STEP 1, with more focus on investigations and management. Along with it, another part of the exam design is Physician Tasks and Competencies, where test questions are designed to assess any of the physician competencies listed on the www.usmle.org website. The system specifications are also listed on the website itself. Here is a link to the website:-
Q. How to apply?
IMGs now apply for Step 2 CK through the FSMB USMLE portal, as they do for Step 1. Follow the current instructions for eligibility verification, your scheduling permit, and booking an authorized test center.
Q. Fees for applying for STEP 2 CK?
Check the USMLE/FSMB fee schedule for your Step 2 CK examination and testing region before paying.
Check the current rules and charges for rescheduling, eligibility extensions, and testing-region changes before making a change.
Q. What are the average scores of different specialties for STEP 2 CK?
Since the January 2026 service transition, FSMB provides USMLE registration, score-report delivery, and customer service to IMGs. Follow the instructions in your current FSMB account for score reports.
Step 1 has been pass/fail since January 26, 2022. Step 2 CK continues to receive a numerical score. Compare current specialty data and individual program requirements rather than treating an old average as a guaranteed interview cutoff.
Q. Are there any limits on the times the STEPs can be taken?
The standard USMLE limit is four attempts per Step. If you have attempted a Step four or more times, including incomplete attempts, and have not passed, you are ineligible to apply for any Step in the sequence. Check the official eligibility policy for your circumstances before planning another attempt.
OET Medicine
Q. What is the importance of OET Medicine in my USMLE application?
For applicants using the ECFMG Pathways, OET Medicine assesses communication skills. Passing OET alone does not complete ECFMG Certification: you must also meet the requirements of the applicable Pathway and the other certification requirements.
OET Medicine tests communication in healthcare situations. Prepare for the actual listening, reading, writing, and speaking tasks rather than treating it as a general grammar test. Applicants with a valid passing result on the former Step 2 CS follow the applicable ECFMG rules instead of assuming everyone needs a Pathway.
The OET Medicine exam has 4 components:
Listening (45 mins, 42 marks)
Reading (60 mins, 42 marks)
Writing (45 mins) ( has 6 criteria; “Purpose” has a maximum score of 3, the rest have a maximum score of 7)
Speaking (20 mins) ( maximum of 6 marks on each of the four linguistic criteria, and a maximum of 3 marks on each of the 5 Clinical Communication Criteria)
The Listening and Reading tests have the same content for all health professions, while Writing and Speaking tests are specific to professions, as they are based on different situations in different workplaces.
For the 2027 Pathways, ECFMG requires at least 350 in Listening, Reading, and Speaking, and at least 300 in Writing, all in one test administration. If a sub-test falls short, all four must be retaken and the minimums achieved together. Check the official page for accepted test dates and score-release instructions.
Graduating from medical school
Check your medical school in the World Directory of Medical Schools and read its ECFMG Sponsor Note, including the eligible graduation years. A directory listing alone is not enough to establish your eligibility.
Intealth states that its Recognized Accreditation Policy does not affect an individual’s eligibility for ECFMG Certification or USMLE. Do not confuse accreditation reporting with the ECFMG Sponsor Note and the other eligibility requirements you still need to meet.
You can check the post on OET in the blog with all free resources and detailed explanations :)
OET is still required for applicants using the ECFMG Pathways. Follow official announcements, not rumors 🙌
Research
Research can strengthen your application and help you build mentorship, skills, and a clearer specialty interest. Focus on meaningful work and describe your actual contribution honestly. There is no universal publication count or research duration that guarantees an interview or a Match.
Research positions can be paid or unpaid, and eligibility depends on the institution and the role. Ask about supervision, responsibilities, funding, and any work-authorization requirements before committing. Build a realistic budget and send thoughtful applications to teams whose work interests you.
Networking is still important! You can begin with mentors in your own country, virtual meetings, professional conferences, and colleagues in the USA. A genuine connection and a clear explanation of how you can contribute go a long way 🙂
Here are 7 ways to get a research positions:
𝟏. 𝐅𝐈𝐍𝐃 𝐘𝐎𝐔𝐑 𝐋𝐎𝐂𝐀𝐋 𝐌𝐄𝐍𝐓𝐎𝐑
This is how several of my friends began their research journey in Argentina before finding opportunities in the USA. Building that experience took time. A local mentor can be a wonderful starting point, but there is no single route that works best for everyone ❤
•𝐇𝐨𝐰 𝐃𝐨𝐞𝐬 𝐢𝐭 𝐖𝐨𝐫𝐤? Talk to doctors in your country, in your University or Hospital. 𝑻𝒉𝒆𝒓𝒆 𝒂𝒓𝒆 𝒕𝒐𝒏𝒔 𝒐𝒇 𝒑𝒉𝒚𝒔𝒊𝒄𝒊𝒂𝒏𝒔 𝒂𝒍𝒍 𝒐𝒗𝒆𝒓 𝒕𝒉𝒆 𝒘𝒐𝒓𝒍𝒅 𝒕𝒉𝒂𝒕 𝒅𝒐 𝒓𝒆𝒔𝒆𝒂𝒓𝒄𝒉, it’s not just in the USA, and the ones that work in research in your country probably know a doctor in the USA that is involved in research too, or knows a doctor that knows a doctor in the USA.
• HOW TO DO IT? Approach doctors in your community whose research interests you. Explain your goals, ask whether they can mentor you, and share the skills or ideas you could contribute. Learn the work, be reliable and describe your contribution honestly. Over time, a mentor may introduce you to other teams; neither a position nor a publication is guaranteed.
𝟐. 𝐌𝐄𝐄𝐓 𝐃𝐎𝐂𝐓𝐎𝐑𝐒 𝐈𝐍 𝐓𝐇𝐄 𝐔𝐒𝐀 🇺🇸
•𝐇𝐨𝐰 𝐃𝐨𝐞𝐬 𝐢𝐭 𝐖𝐨𝐫𝐤? If you are going to North America for a 𝗰𝗹𝗲𝗿𝗸𝘀𝗵𝗶𝗽 or 𝗼𝗯𝘀𝗲𝗿𝘃𝗲𝗿𝘀𝗵𝗶𝗽, you will meet a LOT of people. 🙂 •𝐇𝐨𝐰 𝐭𝐨 𝐝𝐨 𝐢𝐭? Talk to the doctors, approach them, tell them the same things that I mentioned before.
It’s your opportunity to meet them in person and show them your interest, don’t miss it!!
Don’t go back to your country empty handed!!𝟑. 𝐔𝐒𝐄 𝐘𝐎𝐔𝐑 𝐂𝐎𝐍𝐓𝐀𝐂𝐓𝐒 •𝐇𝐨𝐰 𝐃𝐨𝐞𝐬 𝐢𝐭 𝐖𝐨𝐫𝐤? If you know people, or have a family member that is a doctor/ professor, talk to them, tell them how important this if for you and ask for their help. Don't be afraid to approach your aunt that still treats you as if you were 10 years old, or that doctor that you met five years ago and haven't talked for a while. •𝐇𝐨𝐰 𝐭𝐨 𝐝𝐨 𝐢𝐭? Simple, just approach them, being very charismatic, showing interest, passion, and enthusiasm!! 😀
𝟒. EMAIL DOCTORS DIRECTLY — Find a doctor or research team working in the field you love and use the contact information published on their official institutional page. Write a short, personal email explaining your interest, relevant skills, and how you could help. A template can organize your ideas, but personalize each message and verify the address before sending!
I got friends from all over the world that got in contact with American doctors doing this, and got a researcher visa sponsored to come and work with them!5. APPLY ONLINE FOR RESEARCH POSITIONS 💻 Check official hospital and university careers pages for roles that fit your training and interests. Read each position's requirements, responsibilities and work-authorization policy. Some opportunities are posted publicly; others depend on a team's current projects. Send thoughtful applications and follow up respectfully.
𝟔. START AS A VOLUNTEER — This is how I got my research position and USCE! You can read the details in my previous posts. Volunteering can help you meet people, show commitment, and learn about opportunities. Apply through the hospital’s official volunteer office. Any later research or clinical role needs its own institutional approval; volunteering does not automatically authorize patient care or guarantee a paid position.
𝟕. 𝐔𝐬𝐞 𝐋𝐢𝐧𝐤𝐞𝐝𝐢𝐧
LinkedIn can help you learn about research teams, discover advertised roles and build professional connections. Verify every opportunity on its official institutional page before sharing documents, making plans or paying a fee.
Keep your LinkedIn introduction short and personal: explain which project interests you and what you could contribute. Check the person's current institutional role, and follow the team's official application process when one is listed.
If finding an opportunity is taking longer than you hoped, please do not read that as a reflection of your worth ❤ Keep a realistic shortlist, ask your community for guidance and take it one thoughtful application at a time.
I just want the best for all of you, I want you to succeed!!
𝗦𝗵𝗼𝘄 𝗲𝘃𝗲𝗿𝘆𝗼𝗻𝗲 𝗵𝗼𝘄 𝗴𝗿𝗲𝗮𝘁 𝗜𝗠𝗚 𝗮𝗿𝗲!!Volunteer work:
Volunteer work can show service, teamwork, and commitment. Describe the organization, dates, responsibilities, and your actual contribution honestly, and keep documentation when available. Clinical activities must stay within the role and permissions approved by the organization.
If you would like to contribute to Project IMG, check our current website or official channels for volunteer opportunities and how to apply.
If you join a team, communicate clearly, meet agreed deadlines, and ask for help early when you need it 🙂
USCE (United States Clinical Experience)
USCE requirements vary by residency program; it is not a separate universal requirement for registering for USMLE. Research what your target programs accept and look for experience relevant to your specialty. A useful LoR describes work the writer actually observed. Confirm the experience, supervision, eligibility, cost, and letter policy before you commit.
Electives/Clerkships
Electives and clerkships are usually designed for enrolled medical students. Some institutions use VSLO; others have their own visiting-student process. Check your home-school eligibility, host-school rules, availability, and the current total fees directly.
Subinternships
Subinternships can offer supervised clinical responsibilities to eligible students. Duties, supervision, and permitted patient contact depend on the host institution. They do not give a visiting student independent authority to practice.
Externships
Externship is used differently by different providers. Before applying, ask whether graduates are eligible, what patient contact is permitted, who supervises you, and what institutional approvals and insurance are required. Do not assume the label guarantees hands-on care or a strong LoR.
Observerships
Observerships generally involve shadowing and learning rather than providing hands-on patient care. They can help you understand the healthcare setting and build connections. Confirm the institution’s permitted activities and whether your target residency programs accept this experience.
Telerotations
Virtual rotations can offer learning and mentorship, but each residency program decides whether and how it values them. They should not be described as equivalent to in-person clinical experience. Confirm the format, cost, supervision, and letter policy before enrolling.
Project IMG rotation opportunities: check the current details before booking 🙌
Explore Project IMG’s clinical rotations and ask about available specialties, dates, supervision, fees and booking conditions. Choose an experience that fits YOUR goals and training.
Research Electives
Research electives can help you develop relevant skills and mentorship. Confirm whether the role is paid, what work is expected, and how your contribution will be credited. A research LoR should describe your actual work; it is different from a letter assessing clinical performance.
Build your own budget — one step at a time
ECFMG/MyIntealth certification, credential verification, and the applicable Pathway.
USMLE registration and region fees; any rescheduling or eligibility-extension charges.
OET Medicine and the study resources you actually need.
Clinical or research experience: tuition, application fees, insurance, travel, and housing when applicable. There is no universal requirement to buy three rotations.
Application-platform charges, the IMG token, transcripts, and separate NRMP registration when applicable.
Visa-related costs, flights, living expenses, and a contingency fund based on your circumstances.
For the 2027 ERAS season, application fees are $11 per program for the first 30 in each specialty, then $30 for each additional program in that specialty. For example, 100 programs in one specialty cost $2,430 in application fees alone. Tokens, transcripts, Match registration, and other expenses are separate.
Interviews: confirm virtual versus in-person arrangements and budget for travel only when needed.
Virtual interviews can reduce travel costs. Check each program’s format and keep a separate budget for any required travel.
Visa expenses: verify current official and sponsor fees for your visa category rather than relying on an old estimate.
There is no single total that fits every IMG. Your budget depends on your testing region, study resources, program list, travel, experience choices and personal situation. Build YOUR budget before committing to expenses ❤
Look for free and affordable resources — you do not need to buy everything to begin 🙌
Initial apprehension
Many factors prevent students from taking the USMLE route. It can be due to easier lives in their home countries, fear of leaving family alone, shortage of information, fewer resources and financial constraints. Sometimes senior doctors who have settled into the US as IMGs offer hard-hitting advice that is not palatable to many. Medical graduates outside the US might be scared off because opportunities seem low after graduation. Also many become tired of the lengthy process and fail to persevere due to other opportunities and life goals taking precedence.
How to keep up the self-motivation?
The most difficult thing in any student’s journey is the ability to keep up their own motivation while chasing a goal. End goals are hyped up in the mind of a student which lead to anxiety, self-doubt, and the ubiquitous imposter syndrome.
It is normal to feel anxious or lose motivation sometimes. Break your plan into small steps, protect time for rest and ask for support when you need it. You do not have to carry this journey alone ❤
Have a clear picture of your goal, and break it into smaller steps.
Take one day at a time. If you can handle today, you can begin again tomorrow.
Protect your budget and build a study plan you can sustain.
Take breaks, rest, and talk to someone you trust when things feel overwhelming. Seek professional support when you need it.
Spend time with family or friends and make room for something you enjoy.
Keep a checklist of your next requirements and confirm them in official sources.
Ask mentors and colleagues for perspective. You do not have to figure out every step alone ❤
Choose your own comfort zone
Guys, choose a study routine you can sustain. Find the time and place where you learn best, and try a study partner or small group if that helps YOU. Keep the ideas that work for you; you do not need to copy someone else’s entire routine.
Follow through with your passions.
If working as a doctor in the U.S. is your goal, take the next step with patience and a realistic plan ❤ There may be setbacks, financial limits and changes along the way. Stay open to guidance and to the path that fits your life. Your worth is bigger than one application outcome.
We created #ProjectIMG to help international doctors move forward together 😍
Check the current Project IMG website for education, community, service, and clinical-rotation opportunities. Availability, eligibility, and pricing depend on the specific resource or program.
•It was created to help international doctors, medical students, residents, fellows, and all the medical community😍
•All the content is our own, and created from IMGs and AMGs to their peers :)
•You will meet study partners, discuss problems that we are facing in our USMLE journey, get guidance from people that have gone through what we are going
Share opportunities like research, volunteer, USCE,
Announcing the next IMG Events, monthly newsletters 😊
Explore the current Project IMG website at https://projectimg.com/ and our official channels to find the community and opportunities that fit your stage of the journey.
Sebastian Arruarana, MD ❤
Your Match 2027 budget — clear numbers, realistic planning
Current official fees checked October 2, 2026. Amounts below are in USD unless noted. Fees can change, and the items that apply depend on your own route. Build your budget before committing ❤
1 · MyIntealth and ECFMG Account establishment: $110. Application for ECFMG Certification: $580. Credential verification: $220 for diploma and transcript together. Pathway application: $945 when applicable.
2 · USMLE Step 1: $695. Step 2 CK: $695. Step 3: $955 for the stated 2026–2027 periods. Testing outside the US and Canada adds an international region fee: $210 for Step 1 and $235 for Step 2 CK.
3 · OET and preparation Check the current OET booking price for your location and delivery mode. Set aside only what you need for preparation and a possible retake. Free official practice materials are a good place to start.
4 · ERAS applications IMG ERAS token: $185. For the 2027 season, the first 30 programs in each specialty cost $11 each; additional programs in that specialty cost $30 each. A list of 100 programs in one specialty costs $2,430 in application fees. Transcript and other charges are separate.
5 · NRMP registration Standard Main Residency Match registration: $85. Late registration after January 29, 2027 adds $50. Extra rank-list and couples fees may apply; check the official schedule for your list.
6 · Your own circumstances Include clinical-experience fees when applicable, insurance, housing, travel, visa-related costs, and an emergency buffer. There is no single total for every IMG, and buying more rotations does not guarantee a Match.
This is a very helpful guide for IMGs preparing for the USMLE, especially in understanding the process and key requirements. Along with medical exam prep, improving English skills is equally important. Practicing with free pte practice resources and regular pte listening practice can help build strong communication skills needed for success abroad.
Really you have done good work for IMG. Thank you so much .
Hi Doctor, thank you for such an amazing post. I was wondering if being on Argetina´s IAR (Internado Anual Rotatorio) counts as still being a medical student for doing the clerkships.
Amazing work, everything well explained! Really appreciate your time and efforts 👍🏻
Great work done.