Key facts
- ECFMG and Intealth charge separately for certification, credential verification, the Pathways application, the ERAS token and several smaller services.
- Fees are revised on a published schedule, and ECFMG has announced increases that apply from a stated date and for an upcoming application season, so always read the current schedule.
- USMLE exam fees are a separate budget line, and since January 2026 IMGs register for Steps through FSMB.
- The OET is paid to OET, not to ECFMG.
ECFMG and Intealth charge for each service separately, so your total depends on which services your path uses. The fee amounts change on a published schedule, and ECFMG has announced increases that took effect from a stated date and others tied to the opening of the next application season. This page therefore explains each category and when it is charged, and sends you to ECFMG's fee page for the number.
The fee categories #
| Category | What it pays for | When you pay |
|---|---|---|
| Certification application | Opening and processing your application for ECFMG certification | When you apply |
| Credential verification | Verifying your final diploma and final transcript with your school (see EPIC) | When you submit credentials for verification |
| Pathways application | Reviewing your application to meet the clinical and communication skills requirement | When you apply during the Pathways window |
| ERAS token | The token that lets you register in MyERAS (see the token guide) | When you request it |
| Residency application support | ECFMG's role in sending certification status and documents to programs through ERAS | Usually tied to the application season |
| Certification Verification Service report | A report confirming your certification status, used by licensing boards and others | When you order it |
| EPIC portfolio and reports | Establishing a credential portfolio and sending verified credentials to another organization | When you create the portfolio or order a report |
| Replacement or change services | Re-issuing or changing documents | Case by case |
Some entries above are described from search summaries of ECFMG's pages. Names and bundling vary, so use the fee page as the reference.
Costs that are not ECFMG fees #
- USMLE Step fees. Since January 2026, FSMB provides USMLE registration for IMGs. See the USMLE transition notice and the NBME fee page. International test-center charges and rescheduling or extension fees are separate lines.
- OET fee. Paid to OET, not to ECFMG. See the OET guide.
- School charges. Some schools charge for issuing transcripts or letters needed for verification.
- Translations and courier costs. Documents not in English need translation that meets ECFMG's requirements, and some schools use paid courier services.
- Payment costs. International card fees and exchange rates.
How fees differ by situation #
| Situation | What changes |
|---|---|
| Different graduation years or schools | The number of credentials ECFMG must verify can differ, and some need translation |
| Using a Pathway versus holding a valid former Step 2 CS | Only Pathway applicants pay the Pathways fee and take the OET |
| Applying earlier versus later | Fee schedules change by date and season, so waiting can cost more |
| Retakes | Exam retakes mean another USMLE fee. An OET retake means another OET fee |
Hidden or commonly missed costs #
- Paying for a service in one season and needing it again in the next because rules or windows changed.
- Ordering extra verification reports "just in case" and paying for each one.
- Paying a third-party "assistance" company for tasks you can do yourself on the official site. Pay only through official ECFMG channels.
- Forgetting that being ready for the ERAS season involves ECFMG-side and AAMC-side fees. See ERAS and match costs.
How to budget #
- Open the official fee page and list only the services your path actually needs.
- Record the fee and the date you checked it. Re-check before each payment.
- Add a contingency for repeated services and delays, since a late step can mean paying again in a new season.
- Put exam, OET, ECFMG, ERAS and NRMP fees on separate lines so you can see where money goes. The whole-journey view is in total cost of matching.
Refunds and disputes #
We did not verify ECFMG's refund terms, so we state none. In general, fees paid to testing and credentialing organizations are often tied to the service delivered, so read the policy before paying and keep receipts. For disputes, contact the organization's support channel through your account.
What is different for IMGs #
Everything here applies to IMGs. US and Canadian graduates do not pay ECFMG certification fees. Sequence matters for cost: see the timeline to avoid paying for a step before you can use it.
Frequently asked questions
How much does ECFMG certification cost?
Several separate fees add up, and the current amounts are on ECFMG's fee page. We do not quote numbers because ECFMG revises them, including increases announced for specific dates.
Are ECFMG fees refundable?
Do not assume so. ECFMG's refund terms are in its fee and policy pages, which we could not open directly. Read them before paying, and ask ECFMG support if unclear.
Are exam fees paid to ECFMG?
Not any more for IMGs. From January 2026 FSMB provides USMLE registration and related services to IMGs, so Step fees follow the USMLE and FSMB pages.
Do I pay fees again each year?
Some services are charged per use (a verification, a token, a report), and fee schedules change by year or season, so a service bought in a later season may cost differently.
Sources
- ECFMG / Intealth: fees
- ECFMG News: fee increases beginning April 1, 2026
- USMLE: service transition launching January 2026
- NBME: USMLE fees
Found something out of date? Tell us and we will check it against the source.