The USMLE Step 1 fee for a graduate of a Pakistani medical school is US$695 plus a US$210 region fee for testing outside the US and Canada, US$905 in all. Step 2 CK is also US$695, with a US$235 region fee. At Rs 277.01 a dollar, Step 1 taken in Pakistan costs about Rs 250,694, or Rs 251,948 with a filer's card advance tax.
Students and graduates of medical schools outside the US apply through the Federation of State Medical Boards (FSMB). Tick the Steps you are taking and any ECFMG charges you still owe, and the calculator totals them in rupees.
USMLE and ECFMG fees for Pakistani graduates
| Item | US dollars | Rupees at 277.01 |
|---|---|---|
| Step 1 application | US$695 | Rs 192,522 |
| Step 1 region fee, outside US and Canada | US$210 | Rs 58,172 |
| Step 2 CK application | US$695 | Rs 192,522 |
| Step 2 CK region fee, outside US and Canada | US$235 | Rs 65,097 |
| Appointment change, 31 to 45 days before | US$35 | Rs 9,695 |
| Appointment change, 6 to 30 days before | US$100 | Rs 27,701 |
| Appointment change, 5 days or fewer, Step 1 | US$158 | Rs 43,768 |
| Appointment change, 5 days or fewer, Step 2 CK | US$178 | Rs 49,308 |
| Eligibility period extension | US$70 | Rs 19,391 |
| Score recheck | US$80 | Rs 22,161 |
| MyIntealth account (ECFMG) | US$110 | Rs 30,471 |
| Application for ECFMG Certification | US$580 | Rs 160,666 |
| Verification of diploma and transcript | US$220 | Rs 60,942 |
Rupees at Rs 277.01 per US dollar, the State Bank rate for 8 October 2026, before card charges and tax.
Application fees are for 2026 and 2027. The region fee is charged on top of the USMLE fee for any Step 1 or Step 2 CK exam taken outside the US and Canada.
Changing your Prometric appointment
Prometric charges a fee for any change (reschedule, cancel or change of centre) made 45 days or fewer before your test date. The fee depends on the date you make the change.
| When you change | Step 1 | Step 2 CK |
|---|---|---|
| 46 days or more before | Free | Free |
| 31 to 45 days before | US$35 | US$35 |
| 6 to 30 days before | US$100 | US$100 |
| 5 days or fewer before | US$158 | US$178 |
Your new date must fall inside your eligibility period. If you need more time, a one-time three-month extension costs US$70.
ECFMG charges
International medical graduates also deal with ECFMG on the way to certification. Its most common charges:
- MyIntealth account, US$110. This includes US$50 for online notarisation of your identification form.
- Application for ECFMG Certification, US$580.
- Verification of credentials, US$220: US$110 for your final medical diploma and US$110 for your final transcript.
Tick the ones you have not yet paid. If ECFMG has to translate a document that is not in English, it charges US$52 a page.
Worked examples
Step 1 in Pakistan, filer. US$695 + US$210 = US$905, and US$905 × Rs 277.01 = Rs 250,694. Tax at 0.5% = Rs 1,253. Total about Rs 251,948.
Step 1 and Step 2 CK, non-filer. US$1,835 in all, about Rs 513,396 with 1% tax.
First application with ECFMG charges. Step 1 plus the MyIntealth account, certification application and credential verification come to US$1,815, about Rs 505,287 for a filer.
Step 1 moved 20 days before the test. The US$100 Prometric fee takes the total to US$1,005, about Rs 279,787 for a filer.
Fees you cannot get back
The Step application fee is non-refundable and cannot be moved to another exam. The eligibility extension (US$70) and a score recheck (US$80, within 90 days of your score report) are also non-refundable. A recheck is very unlikely to change a score.
FSMB accepts American Express, MasterCard and Visa. A Pakistani card payment abroad carries section 236Y advance tax of 0.5% for filers and 1% for non-filers. Before you apply, make sure your degree is in order with the HEC attestation fee and, where needed, the MOFA attestation fee.
Questions people ask
What is the USMLE Step 1 fee in Pakistan?
US$695 application fee plus a US$210 region fee for testing outside the US and Canada, US$905 in all. At Rs 277.01 a dollar that is about Rs 250,694, plus 0.5% card advance tax for filers.
What is the USMLE Step 2 CK fee for Pakistani students?
US$695 plus a US$235 region fee outside the US and Canada, US$930 in all, or about Rs 258,907 for a filer at Rs 277.01 a dollar.
Where do Pakistani graduates apply for USMLE?
Students and graduates of medical schools outside the US apply for Step 1 and Step 2 CK through the Federation of State Medical Boards (FSMB). Graduates need ECFMG Certification before they can take Step 3.
How much does it cost to reschedule a USMLE exam?
Nothing 46 days or more before the test. Then US$35 at 31 to 45 days, US$100 at 6 to 30 days, and US$158 (Step 1) or US$178 (Step 2 CK) at 5 days or fewer.
Can I get a refund of the USMLE fee?
No. The Step application fee is non-refundable and non-transferable. If you cannot test in your eligibility period, a one-time three-month extension costs US$70.
How much does USMLE Step 1 cost in rupees from Pakistan?
Testing in Pakistan, Step 1 has two parts: the US$695 application fee and the US$210 region fee charged outside the US and Canada. At Rs 277.01 that is Rs 250,694, or about Rs 251,948 after a filer's 0.5% advance tax. Booking Step 2 CK as well, with its US$235 region fee, brings the total to about Rs 510,855.
Last reviewed 9 October 2026. Results are estimates; official notices always take precedence.