Exceptions to USMLE® Reexamination Policy

USMLE policy on reexamination generally does not allow applicants to retake a Step if they have already passed that Step. There are, however, certain exceptions to this policy that have been previously approved by USMLE governance:

Exception #1

Applicants who have already passed a Step may retake a passed Step to comply with the time limit of a medical licensing authority for the completion of all Steps. This exception applies only to applicants for medical licensure in a jurisdiction who have fulfilled all requirements for licensure in that jurisdiction; are eligible for licensure in that jurisdiction except for the out-of-date exam; and have completed the full USMLE sequence, including Step 3. If you are repeating a Step because of a time limit, you may apply to retake the Step only after the applicable time limit has expired.

If you wish to request exception from the USMLE policy on reexamination on this basis, you should send your written request to ECFMG marked to the attention of the Registrar. You may only request the exception at the time that you apply for the exam that was previously passed. Exceptions to the reexamination policy are not approved prior to your submitting the exam application. You must make a written request to ECFMG for each exam application you submit. Your request must be supported by the following:

  • The USMLE Retake Sponsorship Form. The USMLE Retake Sponsorship Form must be completed in its entirety by the medical licensing authority to which you are applying for licensure, including original signature and original seal, and sent by the medical licensing authority directly to ECFMG on your behalf. ECFMG must be able to determine that the USMLE Retake Sponsorship Form came directly from the medical licensing authority.

    The USMLE Retake Sponsorship Form confirms to ECFMG that you are an applicant for licensure in the medical licensing authority's jurisdiction; that you have completed the full USMLE sequence, including Step 3; that you are otherwise eligible for licensure in that jurisdiction except for the medical licensing authority's time limit for completion of all Steps; and that retaking the previously passed Step will not exceed the medical licensing authority's limit on the number of attempts to pass the Step.

    You do not need to provide the USMLE Retake Sponsorship Form to the medical licensing authority. The medical licensing authority has this form.


Exception #2

You may retake a passed Step to comply with the time limit imposed by ECFMG for the completion of all Steps required for ECFMG Certification. For the purpose of ECFMG Certification, ECFMG requires that applicants pass the USMLE Steps required for ECFMG Certification within a seven-year period.


Instructions for submitting support documentation for the exceptions outlined above.

  • Make a written request and send to: Intealth, ECFMG Certification Program, 3624 Market Street, 1st Floor, Philadelphia, PA 19104, USA.

  • You must make a written request to ECFMG for each exam application you submit.

  • For Exception #1, your written request must be supported by specific documentation as outlined above.

  • Exceptions to the reexamination policy are not approved prior to your submitting the exam application.