Guest Post ~ Burning Through the Moolah: The Cost of USMLE for an IMG

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This post was originally written by Arps, aka @Paediatrix on her excellent, but severely malnutritioned blog A(n)nals of an Idle Mind. She wrote these points several months ago, so it is quite likely that the costs have risen further, but this gives an excellent over view of the depths one’s pockets should have if one is considering the USMLE. Arps is on the brink of starting her Pediatric Neurology residency in bigfancy hospital and I wish her all the luck. And of course, I hope she tweets a little less and blogs a little more. And now, I will get out of the way so that you can take in the content of this post. Once again, thanks for letting me repost this on my blog.


I’m going to make a list of the moolah spent by an IMG (Indian in this case) if they want to do a Residency in the US of A.

The journey from USMLE to MD ( Yeah! Borrowing term from Digital Doc :D) is a long, and, of course, expensive one. A lot of juniors at college have asked me this question time and again – “How much will it cost me if I decide to work for a Residency in the USA?”

Having been through almost 3/4th of the process, I’m just listing the basic $s that I have spent on the process till now. By the end of this post you should have a gross idea of how much it’ll cost, and thus you can make a realistic decision of what you want to do next – AIPGEE or USMLE.

(I assume that you have basic idea of what the USMLE and the whole process is like on the whole, and are familiar with the terminology.)

-A lot of costs vary by individual choices. So I’m going to list what I spent as an example where this difference arises.


There are a lot of exams that you need to take to be fully ECFMG certified.

TOEFL: An optional exam that is steadily converting into almost a mandatory one if you want to have a competitive CV for electives- Fee$130 Its $165 now.

USMLE Step 1, 2 (CK & CS): A little over $1400 ($700*2) for USMLE Step 1 and 2CK, and $1200 for CS. EDIT: Exam now costs much more than that. USMLE Step1 $880, Step 2CK $895, CS $1295. Check official website for regular increments!

USMLE World: QBank plus the Self Assessments- They’re worth every penny. For Step 1, a two month UW subscription plus UWSA will cost you $195 ($135 + $30*2). And Step 2, will be $165 ($135+$30)

NBME Self Assessment: To assess your prep, you’ll end up taking online NBME practice tests. Since each test costs $45 to take (and $60 for one “special test’ for each exam), the number of tests you take depends on your preparation. There are some who take none while others end up taking all tests. I spent a total of $375 for NBME SAs for both exams.


Application: Most Universities have an application fee of $100 or so. Although there are some that are free too. Umar Tariq’s website has a comprehensive list of all information for electives. (I spent about $500on applications)

Tuition Fee: This totally varies by University where you end up doing electives. Some like Harvard and Tufts have a fee of $2000-3700, while others like Cleveland Clinic and NIH are free. (I paid about  $1400 as tuition)

Malpractice Insurance: This is another thing that is new for us and since there seems to be just one company that provides MI to students on a monthly basis, they have been increasing the premium with every passing year! I ended up spending about $600 for MI.

Travel and Housing: Of course travel to the US will cost another $1000-1500.

Housing will vary from $300 to $500 per month depending on the location. This cost multiplies depending on how long you stay in the US. (I’ll take my expenditure as $500 since I was in luck wrt housing.)

Misc: Add to it other costs like travel insurance, visa fees, immunization titers before going to the US.

Then there’s the whole other set of expenditure on FOOD (major spending if you don’t know how to cook daily meals!), travel within the country and, of course, SHOPPING in the United States. 😉

Fed Ex:

Giving this a special slot since there is a LOT of paperwork to be sent! There are numerous applications, college documents and Godknowswhat!! Each packet costs about $50, and I’m sure I’ve sent over ten such packets. (= well over $500)

Applying for Residency:

After all this preparation, we come to the main application! It costs a bundle, especially for an IMG!

Registrations: $50 for NRMP and $90 for ERAS token

Application: Come September 1, and a major hole in your pocket is just one click away.

In ERAS, applying to 30 programs in each specialty adds up to $305, and then for each additional program its $25 per program. So, if you are a regular IMG who needs a visa, and is not a big hot shot already in the medical world, you’ll apply to over a hundred programs.

You do the math.

(I ended up spending over $2500, plus another $70 for a USMLE transcript release)

Then there’s more:

Although till now this is the stage I’ve reached in the process, there’s a lot more to come.

Travelling again to the US, expenditure of travel within the US for interviews, USMLE Step 3, living there for about six months… and it goes on.


Going by this list, USMLEtoMD –till now– has cost about a total of *drumroll* $11,350 *faints*

For those who are planning to start on this journey, this was just a preview for you to have an idea of what the costs are going to be like. Just a thought to keep it realistic.

(And now I won’t have to explain the details individually to anyone who inquires- I can just direct them here! :D)

Note: I’ve tried to keep all figures correct and comprehensive according to my memory. If there is something that you’d like to add or remove, let me know. Hope this post was useful!

Image credit: Google Images

Skeptic Oslerphile, Scientist at the Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases. Interests include: Emerging Infections, Public Health, Antimicrobial Resistance, One Health and Zoonoses, Diarrheal Diseases, Medical Education, Medical History, Open Access, Healthcare Social Media and Health2.0. Opinions are my own!


  1. I’m just curious as a base of comparison and relativity, how much did your medical education cost in India?

    $11,500 sounds like a lot (and it is), but when I look at it in terms of big picture its not so much at all. My 4 years of tuition alone, never mind housing and books etc etc was over $175,000.

    • Mine used to cost 9,000 INR/2 semesters+ books. But I got scholarships for 4 of the 9 semesters, so the 9 semesters cost me 22.5K + say another 22K for books. Thats all. A total of about 50K, tops, with the exam fees put in.

      Thats about $1100. 😉

      • I don’t know the going rate in India, but the average salary for a doctor in the United States is around $200,000+. Which is a pretty sweet reason. Plus, unlike in some countries, a doctor is essentially the most respected profession in this country. Little girls still make their daddies proud when they grow up and marry a doctor. My wife is far more intelligent than I am, she’s a brilliant nueroscientist, soon to be a PhD. But it’s hilarious (and totally unfair) how her family and friends swoon over me since I’ve been in medical school. I’m not exaggerating and it actually drives my wife nuts! Now that I am just a few short weeks away, its like I can do no wrong, a ticker tape parade every time I come into town. Yes, I am exaggerating a bit, but not by much.

        • The social and cultural aspects are similar. There is, in general, a lot of respect for doctors, but the pay is nowhere as good as that. As I have already said, at an entry level, we may rake in something around 6000$ per annum. Now do I win some of that lost sympathy back from you? 😛

  2. Hey PC, Thanks for re-blogging the post. I’ll leave it to you to answer the questions asked above 😉 (the lazy blogger strikes again!)

  3. Im in my final year MBBS in a private college in India and i pay $16,0000 p.a. for tuitions alone. for 4 1/2years. And doing residency in India through private is another 180+ grand. This is the average cost since most students study in private.

  4. How do I get financial support for medical electives in the USA for an Indian medical student preparing for the USMLE?

    What do you mean? The entire process of USMLE is a costly affair. I had seen online somewhere, a girl from India had broken down the costs of giving the USMLE in its entirety, and it was all from her perspective, meaning she had gone through this proce…

  5. How should I prepare for the USMLE as a student in India?

    If you only want to practice in the U.S. for a few years and then come back to India it will be a waste of your time. It will take you a few years just to study for and pass the licensing exam–USMLE. There is already a lot written about this topic, bu…

  6. How can an Indian medical student in his second year MBBS prepare for USMLE Exams?

    If you want to find the cost of taking the USMLE I remember seeing online someone had posted a blog post with a full breakdown of all her costs. It ended up being about 12 lakhs if I am recalling properly. But note that this includes the cost of taking…

  7. Can I get a residency in the U.S. if I graduated from medical school in India in 2008?

    It’s good that you are in the U.S. now. You will save money and time that way. Don’t worry about failing, a lot of Indians fail th first time. In fact, it’s good hat you failed. Now that you have given the exam, you understand what is required for A…

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