[note: this entry will be updated and re-posted with further steps as i go through the process. please feel free to share your tips and comments if you are an International Medical Graduate that has already completed the USMLE Step 1 and lived to tell about it.]

hello and welcome to the process of finishing the Basic Science program and preparing to write the United States Medical Licensing Exam, as written by a 5th semester Canadian student going to school in the Caribbean.

1) get a USMLE ECFMG # (~5 days)
go to the ECFMG On-line Services and click “first-time user”. the information you need at this point consists of just your legal name, birthdate, birth country, gender, medical school, and email address. it takes about 5 business days for them to send your number and temporary password via email.

2) pick your window & pay (~15 minutes)
use your assigned number and temporary password to sign-in. this part of the application requires more info such as your expected graduation date and name of degree, citizenship (when you were born, when you attended medical school and current), social security (or other nationally identifying) number, as well as confirmation of previously entered info. you get to select which three-month window (ie: May 1st – July 31st, 2009) in which you anticipate taking the exam.

you are also expected to pay (via credit card or electronic cheque) $710 at the end of the process. there are surcharges if you want to take the exam in a country outside of the US or Canada.

3) certification of ID (form 186) (~4 weeks)
print out the page provided after you complete step 2 above. attach a passport photo from within the last 6 months and take the document to your school official to sign. i mailed mine into Dr. Collins at the Gardner head office and she forwarded it on to the ECFMG after signing/stamping. this process took about 4 weeks from the day i mailed it to Dr. Collins to the day ECFMG notified me (via email) of acceptance of the document.

4) school verification
after passing the NBME Comprehensive Subject Exam, MUA will send verification to the ECFMG that you are eligible to take the Step 1 exam. you should receive an email confirming your registration for the 3-month eligibility period you selected and details about scheduling with a Prometric test centre.

5) scheduling permit
less than a week later, you should receive an email with a link to the print/re-print scheduling permit. this is important. you must bring it to the testing centre with you when you want to take the exam. you also need to use the number provided on it to book your test with Prometric. it’s best to book as soon as you get your permit in order to ensure you get the day you want.

6) rock it!
confirm your test appointment a week in advance. print out your scheduling permit, Prometric exam confirmation, directions to the centre and anything else you might need. ensure the name on the paperwork exactly matches your photo identification. continue cramming. get a good night’s sleep.

get it over with!

see you on the other side.

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photo: SkyTrain escalator in Vancouver, BC

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