How to Extend Eligibility Period for the USMLE Step 1 (step-by-step)

I found this to be a confusing process. There is no secondary information except scattered ValueMD posts.

I will tell you how to do this and what to expect along the way. It can take up to a week to receive your revised permit.

This ECFMG link has some information. Review the table with application processing deadlines.

1. Cancel your exam with Prometric

If it is more than 31 days before your exam, there is no fee to pay, proceed to the next step.

If it is less than or equal to 31 days before your exam, you need to pay a fee to Prometric, call 800-633-3926.

At the time of this writing there is no telephone prompt for reinstating eligibility. Follow the prompt for scheduling and other options. You will end at a prompt asking for your scheduling number. If it is past your eligibility period your number may be denied. If this happens, dial 0#. You may have try this up to four times before the system transfers you.

Someone will come on the phone. Tell them you need to extend your eligibility period for the USMLE Step 1 and it is less than 31 days before your scheduled exam date. They will ask a few security questions and transfer you to someone else. The next person will process your payment.

You will receive a receipt by email. This needs to be forwarded to usmlereg@nbme.org. Include your permit number at the top of the forwarded message.

Four hours later I received a reply. The subject was USMLE Step 1 Scheduling. My ID number was at the top of the message. It confirmed I paid the appointment change fee and Prometric reset my registration. After the ECFMG processes my extention request they will update my Prometric record and email my revised scheduling permit.

2. Send the application

A. NBME

If you are a US or Canadian medical graduate your point of contact is the NBME. Login here. Click on the link to submit a new application. It will take you to the requirements page. At the bottom there is a link to a form which must be mailed.

B. ECFMG

Foreign medical graduates must login to ECFMG online services. The first page has a link for the application to extend eligibility. There is a $65 fee at the end of the online application.

You only need to resubmit form 186 if it has been more than a few years since you applied. The end of the online application will tell you if you need to submit your certification of identification.

My Post-Application Timeline

Update 0 / 4 hours: ECFMG confirms payment was made to Prometric.

Update 1 / 12 hours: “Your Eligibility Period Extension (EPEx) request has been submitted to ECFMG. You will receive email confirmation when your request has been processed.”

Update 2 / 1 day, 6 hours: My eligibility period has been extended to (date). The NBME will issue a new permit and the ECFMG will email it to me in about one week.

Update 3 / 3 days, 12 hours: ECFMG emailed new permit.

Recap
Applied Monday morning and received new permit Thursday night.

I wish you the best for your new eligibility period. Remember, a mistake is only a problem if you don’t learn from it. It is important to take your exam during your extended eligibility period.

Please leave all questions in the comments. Do not email me directly. I will respond here and send a copy to your email. If you have a follow up question, please ask it in the comments.
Thanks!

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Comments

  1. Hello Hussain!

    My eligibility period is ending this 30th. I was hoping to write the exam on 30th or the week after that. Is it possible to have the period extended and still be able to sit for the exam in the old eligibility triad?

    I just thought I’ll get over with the paper work of extension and have the liberty of writing the exam with peace of mind.

    • I do not know the answer to this. Could you please call the ECFMG and let us know what they say? Thanks!!

  2. First off, this page was a big help when I was trying to extend my eligibility period. Unfortunately, due to medical reasons, I need to further postpone my test date. I know that I will have redo the whole ecfmg application and pay the fee again when I take the test in the future.
    My questions is regarding how to deal with prometric in this case. I canceled my appointment online but it was within 30 days. Do I call them up now to pay the fee/e-mail nbme or should I wait until I have registered for the test again. I have not been able to set a date yet because I am unsure what my situation will be. Just trying to figure out if I should call/deal with them now or wait until I register for another testing period.

    Thanks

    • Hey Eric. Sorry for the delay in getting back to you. I am in the surgery rotation right now! Anyway, you already know you only get one extension for your eligibility period. If you do not take the exam during the extended eligibility period and instead reapply for Step 1, you will not need to pay a cancellation fee to Prometric. No matter when you cancel. You pay the examination fee ($580 now?) and book your new appointment.

  3. Just to clarify….If i do decide to cancel a month before my test date and not pay the fee, do I still need to call prometric or email NBME for anything? Or is just cancelling online sufficient?

    And then all I need to do is the ECFMG part and then they will give me a new scheduling number to register again with prometric, right?

    Thanks

    • If it is more than 31 days from your exam, cancel on prometrics website. Then logon to ECFMG’s IWA and complete the form to extend your eligibility, pay ECFMG’s $65 fee, print off any forms you need to mail, and call it a day.

  4. Hi…got a few questions.

    My exam is set for Dec. 30th (oct-dec period). I may want to postpone my test date if I do not feel ready closer to the date (is it ok that it will be during the next year?). Also,is there a limit as to how close to my scheduled test date that I can cancel with prometric (the fee is ok)?

    If I cancel my test online with prometric, I don’t understand if I have to/what is this e-mail we’re supposed to send to NBME. If you cancel and pay online with prometric, won’t they already know?

    Also, I can’t remember if I submitted a form 186 or 183 (what’s the difference?) to ecfmg when i first registered. I think I read somewhere that if it was a 183 I would need to submit it again for every application (or will it already be on file b/c I only did it a few months ago and this is just a postponement?). I am worried b/c that might take extra time and push me closer to the deadline for getting an extension.

    Thanks

    • Yes, it is okay that it will be next year. The important part is that it is the next 3 month period. As far as I know, you can cancel up to the day before.

      When I did this, Prometric didn’t offer a payment option for cancelled appointments on their website. If such an option is available now, forward the email receipt to the NBME.

      My understanding of IWA is that if you have to submit a form 183 or 186, it will notify you at the end of your application process. 186 is good for 5 years. 183 needs to be done for every application because those schools don’t use the ECFMG’s Medical School Portal. Here is an official link that compares the two: https://iwa2.ecfmg.org/iwafaq.asp#21

  5. Hi, i have not booked any date with prometric yet. My eligibilty period is oct-dec ,but my problem is that my form 186 needs to go to my med school the second time.USMLE hasnt recieved the form yet from the school. The process of extending the eligibility period needs online aplicatiion plus Form 186.i dont know if i haveto wait for my form to reach usmle first then apply

    • Sara, if you want to extend it to after December you can use the online application. You only need to submit form 186 a second time if it has been more than 5 years since you submitted it the first time.

  6. Hi. I have my step 1 scheduled for november 4 but I want to reschedule the date for december. Do i have to call prometric to reschedule or can I reschedule and pay the fee through the prometric website? Thank U very much for your help!

    • If nothing has changed since I wrote this, you have to call Prometric and pay the fee if you want to reschedule less than 31 days before your exam during your eligibility period.

  7. Hey Hussein, Thank you for this article. It actually cleared up a lot of things for me.
    But I’m still so confused. my eligibility ends on october 31st and my exam is on october 31st. I’ve already extended my eligibility period once so i cant do that again. I would just have to reapply for another scheduling permit, correct? But before I do that, I have to call prometric and cancel over the phone? I see that there is an option to cancel on the prometric website. what is the difference between that and over the phone?
    I’m still so confused and so stressed. I almost wanna give up!

    This is what I thought the ECFMG person told me..
    1) Cancel my prometric date
    2) the earliest I can reapply for a scheduling permit is nov 15
    3) After that it would take 3 weeks to process that and then I’d get my new scheduling permit.

    Would this be counted as an incomplete attempt? would it affect me in the future?

    • You can cancel your appointment on the Prometric website. If you are more comfortable canceling over the phone you can do that too. As far as I know, it does not matter which way you do it. It will not be scored as incomplete. The delay may be something you get asked about during an interview one day. Other than that I don’t see it being much if a problem.

      Reapply for the exam using IWA. Before submitting your application, make sure you still qualify with your school to take the exam. They need to approve your application (behind the scenes) before you are issued a new scheduling permit.

      Keep studying!

  8. hi hussein.very nice article,just have a question.do i still need to submit any 186 form,if i extend my eligibility,since i just submit my form 186 few months ago when i was getting registered for my step 1 for the first time?i mean they have it already my 186..so i dnt have to do it again ryt?

    • Thank you and yes, you are correct. From the EPEx Overview page, “Once accepted by ECFMG, Form 186 remains valid for five years.”

  9. pls hussein, i log on to my own ecfmg account and i cannot find extend your eligiblity period?

  10. Hi. I have the step 1 for september 18 and my window ends on september 30. I want to change my window for the next contiguous period. Do I have to cancel my appointment first with prometric and then submit the estension form to NBME? How do I cancel or reschedule with prometric? Thank you very much for your help.

    • Cancel your appointment using the Prometric website. After doing that call them and pay the fee. If you are an IMG, login to ECFMG’s IWA and submit the online form to extend your eligibility period. If you are a US grad, you extend through the NBME.

  11. Hi Hussain,
    Please clear my confusion, i have eligibility period Jun-August but i have not schedualed an appointment with prometric. Now i want to extend my eligibility period, what do i do now?
    Should i apply directly to ecfmg for the said extension paying only 65 $ or do i have to call prometric anyway?
    Please reply fast.

    • Skip prometric step since you do not have an appointment scheduled.

      Submit your application to extend your eligibility period to ECFMG and pay their $65 fee.

  12. Hi. My USMLE eligibility period in may-june-july. I scheduled my exam for 30th july but dont think i am prepared enough. I am planning to extend my eligibility period to the next slot. I still have >31 days before my scheduled test date. Can i get an extension from ECFMG and then reschedule my test date in the extended eligibility period without paying the 50$ (as i will do it 31 days before the test date) or does rescheduling in the next slot always involve payment?

    • Hussein says:

      1. You will have to pay the extension application fee to ECFMG.
      2. You will not have to pay anything to Prometric if you cancel more than 31 days in advance.

      Best wishes for your exam!

  13. Mohamed Khedr says:

    Thank you for this great post.
    Just to clarify some misunderstood concepts, so I :
    1- cancel my appointment first using the Prometric website
    2- I call Prometric for reinstating my eligibility period and pay the fees and send the e-mail to NBME (even though I am an IMG ? )
    3-I contact ECFMG to extend eligibility and wait for new scheduling permit and use that on prometric to schedule my new appointment ?

    And what happens if I request extension through ECFMG without reinstating my eligibility period with prometric first?

    Thank you very much

    • Hussein says:

      1. Yes.
      2. Yes, call Prometric and forward the email to usmlereg@nbme.org
      3. Yes. Login to IWA and submit the application for extending your eligibility period.
      4. I don’t know what will happen if you skip reinstating with Prometric.

  14. hey hussian i gt the mail 4m nbme just nw……reinstating my eligibity record on prometric site………nw i guess i just hav 2 wait 4 the new scheduling permit..THANKS HUSSIAN FOR UR GUIDANCE….ur post really been helpful….

  15. 1-contacted the prometric n payed the 50$ cancellation fee
    2-have send the receipt to usmlereg@nbme.org(but didnt get ne mail)
    3-went to iwa n gt my eligibility extended(n gt the confirmation mail)

  16. hey i gt the mail 4m ecfmg but no response 4m nbme………should i resend the mail /wait…………..

    • Sorry, I do not know which email you are referring to. NBME does not ever send you an email if you are an IMG. Please write in proper English what steps you have completed.

  17. hey hussian ….u asked to send the permit num to nbme rt??……..is tht the permit num on the previous scheduling permit issued…..n we dnt need to include the usmle id??

    • I received a response doing exactly what I wrote in this article. However, including your USMLE ID number is a good idea. It is an extra identifier that could be used if your permit number was incorrect.

  18. Hi I want to know if my eligibility period is in oct-December and my exam date is like 27th can I extend my eligibility period to next year consecutive 3 months like in dec-feb

    • Oct-Dec 2012 would be extended to Jan-Mar 2013. However, the deadline has passed to extend Oct-Dec eligibility.

  19. Thank you sooo very much! You saved me from a heart attack. I also accidentally submitted my ecfmg before contacting the prometric but your post cleared things up for me.
    Thank you so much again.

  20. I replied directly to cesar after reading his email. I forgot to add the answer here. If you have already extended once then you will need to reapply for the exam. Perhaps under very very special circumstances they would consider a second extension but you would have to call them to inquire about that. For most people, who do not feel confident enough to write the exam, there is no leeway in regards to this rule.

    By the way, I got my score 2 weeks ago, I passed!!

  21. hi, i’ve already asked for an extension (i supposed to have my test on the eligibly period of june-agost) and already got it untill november. But i need to ask for a new extension. Is it possible to ask for a new one?
    I would appreciated a fast answer, thank you very much!

  22. i called the prometric and paid my 50 dollars for which they gave me a receipt.
    i was told to dn send a mail to usmlereg@nbme.org tellin them i had paid.i gt the followin mail an hour later

    USMLE ID XXXXXXXX

    Step 1 06/01/2012 – 11/30/2012

    Dear Dr. XXXXX:

    Thank you for contacting NBME to confirm that you paid the appointment change fee.

    Prometric reinstated your eligibility record, and I updated your eligibility period in their system. You may now go online or call Prometric to schedule a new appointment in your extended eligibility period using the Scheduling Number from your Scheduling Permit. Do not attempt to “reschedule” using your previous Prometric Confirmation Number, as that number is no longer valid.

    i guess i jut hav o wait for ecfmg to send me my permit!thank u hussain for the guidance

  23. i gt da foloowin response from ecfmg…
    Dear Doctor:

    We have received your Interactive Web Application (IWA) Request to Extend a USMLE Eligibility Period. Your eligibility period for the Step 1 has been extended to November 30, 2012. Your testing region remains the same as stated in your original registration notice.

    In the near future, the National Board of Medical Examiners (NBME) will issue a new permit showing your extended eligibility period. Only electronic scheduling permits will be generated; applicants will access their electronic scheduling permits using ECFMG’s Interactive Web Application (IWA). You will not receive a paper permit by postal mail. Please note that in about one week you will receive another email from ECFMG to notify you that your new scheduling permit is available. Although this new permit will be issued by NBME, you should contact ECFMG if you have any questions or concerns about this permit.

    You must bring this new permit and acceptable identification with you to the test center on the date of the exam.

    This new permit is very important, and you should be careful not to lose it. You cannot take the exam without this new permit. If you lose this new permit, you may print another one by using IWA. If the name on the permit is not correct, you must contact ECFMG immediately.

    Please refer to the ECFMG Information Booklet and USMLE Bulletin of Information for detailed information on scheduling your testing appointment and taking the exam. Both of these publications are available on the Publications page of the ECFMG web site at http://www.ecfmg.org.

  24. i havent goten any response until now…i guess ill have to wait until monday o call da prometric n ill keep updatin my status!

  25. I think they will email you and hold your application until the prometric portion is complete. Please note, I do not know what the outcome has been in the past for this situation.

  26. Hi mr hussein,

    i have a small problem.i applied for exension of eligibilty period first and paid 65dollars and then cancelled my appointment.i cant call the prometric now because its a weekend.what do i do now?will ecfmg reject my application for extension or wait unil i have contacted prometric and made the payment with them?

  27. HI, thanks for the guidance but i want to know that can i extend my elgibility period more than more than 90days/3months. eg my triad is 1st Apr to 30 June , can i extend it to 1st sep to 30 november ?

  28. Hi, thank you so much for this! This is so far the best guide to a very confusing process (that I myself went through today). Thank you!

  29. Nice article. Simple and well written.

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