USMLE Exam Day: Rules, ID Requirements and What to Bring

On exam day you need two things to be admitted: your scheduling permit and an acceptable government photo ID whose name matches the permit. Beyond that, the rules are about arriving early, handing over personal items, taking breaks only when the break screen is visible, and protecting exam content. This page summarizes the official rules from the USMLE Bulletin and exam-day pages. Always check the current Bulletin for your test date, because rules and exam formats are updated.

Admission: permit and ID #

Official rules (USMLE):

• Bring a paper or electronic copy of your scheduling permit on each day of your exam.
• Bring a valid, unexpired, government-issued photo ID that includes your signature and a recent photograph. Acceptable examples listed by USMLE include a passport, a driver's license with photograph or a national identity card.
• Your name on the scheduling permit must match the name on your ID. USMLE allows differences only in capitalization, the presence or absence of a middle name, middle initial or suffix, and a middle name versus a middle initial. The ID must use Latin-alphabet letters.
• If you arrive without the permit and an acceptable ID, you will not be admitted and must pay a fee to reschedule.
• Your scheduling permit may list additional ID requirements and limited exceptions. Read it carefully.

For IMGs, the registering organization is generally FSMB since January 2026. Check the current process on usmle.org.

Arrival and check-in #

• Arrive at least 30 minutes before your appointment.
• If you arrive after your appointment time, you may not be admitted. If you arrive more than 30 minutes late, you will not be admitted and must pay a fee to reschedule; the new date must fall within your eligibility period.
• Staff may electronically scan your photo ID and fingerprint, and you sign the test center log at check-in and checkout.
• Staff screen you with a handheld or walk-through device and ask you to empty your pockets. You may be asked to remove eyeglasses for inspection. Screening occurs at check-in and after each break.
• You may bring only your locker key and ID into the testing room, plus approved items.

What you can and cannot bring #

Not allowed in the testing room (store in the locker outside the secure area): cell phones, watches, pagers, tablets, media players, fitness and tracking monitors, any device with transmitting or receiving capability (such as Bluetooth), notes, study materials, pens and pencils, wallets and purses.

• Electronic devices must be turned off. Turning the volume down is not sufficient.
• Jewelry is not allowed except wedding and engagement rings. Ornate hair accessories may need to be removed; religious headwear is subject to visual inspection.
• Writing is allowed only on the laminated note boards provided. Writing on skin, clothing or anything else is a violation.

Allowed, subject to inspection (from the USMLE pre-approved items list): examples include cordless soft-foam earplugs without strings, and water in a clear or transparent container with a lid and all labels removed. Certain medicines or medical devices are also allowed. The full list is on the USMLE website, so check it for your test date.

If you need an item not on the list for a medical reason, request a test accommodation before you apply. The Bulletin describes a process for additional break time (for example, for diabetes or to express milk) that you start when you register.

Breaks #

• You may leave your seat only when the break screen is visible.
• As of the exam pages we reviewed in November 2026, Step 1 and Step 2 CK list a minimum of 55 minutes of break time for test dates under the new format (on or after May 14, 2026 for Step 1; on or after May 7, 2026 for Step 2 CK). Step 3 lists at least 55 minutes on Day 1 and at least 45 minutes on Day 2. Confirm the number for your test date on the Step exam page.
• Time between blocks counts as break time, whether or not you leave your seat. If you finish a block or the tutorial early, the unused time is added to your break time.
• If you exceed your break time, the excess is deducted from your testing time.
• You may use your phone only outside the secure testing area during an authorized break. You cannot access your locker or phone during an unauthorized break.
• Once a block has started, you may not leave the room except in an emergency. The clocks keep running, and the test center reports the incident to the USMLE program.

Because Step 1 and Step 2 CK moved to shorter blocks in 2026, there are more transitions between blocks. Plan your breaks on the day: when you will eat, drink and rest.

Conduct and confidentiality #

By applying, you agree to the Rules of Conduct. These include: you are the person named on the permit; you will not seek or give unauthorized assistance; and you will keep exam content confidential, including not recording or sharing it and not posting content or answers online. Test centers are monitored by staff, in person and through audio and visual recording. Violations can be reported as irregular behavior, which can lead to cancellation of scores, a ban on future testing and a permanent annotation on your transcript.

Practical checklist #

One week before

• Confirm your permit shows the right name, Step, eligibility period and test center.
• Check the Prometric closures page for your center.
• Review the international test center guidance if you are traveling.

The day before

• Put your permit (printed and on your phone) and ID in one place.
• Plan the route and travel time with a buffer.
• Pack what you want for breaks, remembering that anything not on the approved list goes in a locker.

On the day

• Arrive at least 30 minutes early.
• Leave non-approved items in the locker. Turn off all electronics fully.
• Use the optional tutorial time only if useful: finishing it early adds to your break time.
• Take breaks on the break screen and keep an eye on your total break time.

What to do next #

If something goes wrong on the day (a system problem, an illness), tell the test center staff and contact the organization that registered you afterward. For rescheduling rules and fees, see scheduling with Prometric.