Achievable logo
Achievable blue logo on white background

Mastering USMLE Step 1: Tips for international students

Easily navigate the USMLE Step 1 and become a doctor in the U.S. as an international student with our guide covering costs, preparation, and more.
Achievable logo
Amrita Vaswani
04 Nov 2025, 4 min read
Achievable blue logo on white background
Illustration of international student at a laptop studying for USMLE with an illuminated map of the U.S. behind them
Achievable
Achievable blue logo on white background

For many international medical graduates and students seeking to become practicing physicians in the U.S., navigating the United States Medical Licensing Examination (USMLE) Step 1 is a major milestone on this journey. Thousands of candidates from around the world apply to take the test every year, so strategic planning as an international student is absolutely essential. This guide provides a detailed overview of the process, outlining what applicants from outside the U.S. can expect when preparing for and taking the USMLE.

Two students standing together and smiling
Freepik / Freepik / “Smiley friends posing together with books” / FreePik license

What is USMLE Step 1?

The USMLE Step 1 is the first of three required exams in the USMLE sequence for physician licensing in the U.S. This exam evaluates your grasp of core medical sciences, such as anatomy, biochemistry, physiology, microbiology, pathology, and pharmacology, and tests how well you can apply this foundational knowledge to practical clinical scenarios. Understanding the USMLE requirements for international students is vital, as Step 1 specifically assesses whether you can bridge scientific concepts learned through coursework with real-life medical decision-making in a U.S. healthcare setting.

In terms of where candidates typically hail from, India continues to be a major contributor of international medical graduates pursuing entry into the U.S. residency system. For these ambitious candidates, understanding and fulfilling all prerequisites is a key step toward eligibility for advanced clinical training, participation in innovative research, and joining a structured healthcare environment. For many international medical students, the USMLE pathway serves as a gateway to a global and specialized medical career.


How to get started

1. Get Certified

One of the most important USMLE requirements is completing certification through the Educational Commission for Foreign Medical Graduates (ECFMG). For those seeking to become doctors in the U.S., ECFMG registration must be completed before taking the USMLE Step 1. The ECFMG verifies your credentials, educational background, and eligibility, ensuring you are approved to sit for the exam. This verification process can take time, so plan ahead and submit your documents early to avoid delays.

2. Create a Study Plan

Learning how to study for USMLE Step 1 effectively is crucial for international students navigating the path to practicing medicine in America. The content of the USMLE mirrors the subject matter taught in standard medical programs worldwide, but be aware that medical standards specific to the U.S. will also be covered. The vast amount of medical knowledge tested can feel daunting, so organizing a comprehensive study plan is especially important for this test. Allocate sufficient time to review all major subjects and incorporate regular practice exams into your schedule. Practice tests not only sharpen your knowledge but also enhance your pacing and familiarity with question formats crucial for success.

Achievable offers a complete USMLE study resource tailored for Step 1 success, which you can access for free here. Our resources support every step of study for all students, including those from abroad.

3. Schedule the Exam

Once fully prepared, you can schedule the Step 1 exam at a Prometric center or other authorized location abroad. These centers are widely available across major cities, making access convenient wherever you live. Be sure to review the available sites and select the testing location that best fits your needs.

4. Take the Exam

Passing the USMLE Step 1 is a critical threshold all aspiring doctors in the U.S. must cross. This one-day, eight-hour test consists of multiple-choice questions segmented into seven 60-minute blocks. Thorough preparation is essential, as passing is vital for subsequent residency applications and advancing your medical career.


How much does Step 1 cost?

The registration fee for the USMLE Step 1 is $1,020 for international students, compared to $680 for domestic candidates. Please note that the National Board of Medical Examiners (NBME)’s fee assistance program for the USMLE is open to U.S. citizens only. While preparing for the USMLE, keep in mind the costs associated with medical licensure and make sure you have a plan in place to pay for each exam.

Close-up of physician taking notes on a clipboard
rawpixel.com / Freepik / “Physician noting down symptoms of a patient” / FreePik license

To conclude

The USMLE Step 1 can be a daunting challenge, but for thousands of international medical graduates every year, it remains a vital step in realizing their dream of practicing medicine in the U.S. By utilizing the right resources, planning strategically, and building a strong support network, international candidates can efficiently navigate eligibility requirements. As the community of international doctors in the U.S. continues to grow, the demand for accurate information and high-quality USMLE preparation materials also increases. Let Achievable be your partner in passing Step 1 and getting you one step closer to achieving your medical career goals.

Achievable logo
Amrita Vaswani
04 Nov 2025, 4 min read
Achievable white logo on blue background
Achievable USMLE Step 1 - $179
Reach your USMLE Step 1 target score on the first try with Achievable's interactive online exam preparation course. Includes an easy-to-understand online textbook and 1,400+ review quizzes.
Concise online textbook
1.4k+ chapter quizzes
Laptop displaying the Achievable exam prep dashboard and a smartphone displaying a quiz question