How International Medical Graduates Can Financially Plan For The USMLE Step 1 Exam?

The email popped up on Maria’s phone at 2 AM, but she was still awake. When she saw the words “Offer of Admission,” the next few minutes were a total blur of happy screams and waking up her parents. 

This was it. After years of hard work in a healthcare system with limited resources, she had her golden ticket to study medicine in the United States.

For a couple of days, she was floating in the air. She pictured the white coat ceremony, the high-tech labs, and learning from the best in the world, and a successful preparation for the USMLE Step 1 exam. 

Then, she actually started reading the orientation packet. Buried in all the forms about visas and tuition was something that made her stop: the cost. 

USMLE Step 1 Exam: The Cost Is  A Bigger Concern Than You Think

Back home, just getting into medical school was the biggest hurdle. But she quickly learned that in the U.S., this test is something else entirely. It’s a massive, make-or-break exam on years of American medical knowledge. 

Suddenly, her excitement about coming from a developing country to pursue her dream was mixed with a cold, hard wave of panic. Her hands started to shake. It hit her all at once: “How on earth am I going to pay for this?”

Because Step 1 isn’t just a test of your knowledge; it’s a test of your wallet. The fees, the review courses, the practice exams, the study materials—it all adds up, and fast. 

For someone like Maria, the financial mountain felt just as steep as the academic one. She realized that figuring out how to pay for it was the first real challenge she had to face. 

This is a relatable phase from the life of most IMGs, and although you may have planned it out, there are a few things that may have been skipped. So here is a list of things you can do to fund your US med program: 

1. The “Application Fee” Is Just The Tip Of The Iceberg. Map The Whole Iceberg

Everyone knows the exam itself costs money. But the real budget-killers are the hidden costs that creep up on you. Most people just save for the application fee and then get blindsided. Before you even start seriously studying, sit down and map out every single potential cost. This isn’t just about the exam fee. Think about:

Study Resources: Are you using UWorld? Sketchy? First Aid? A combination? Get the real prices, don’t guess.

Practice Exams: The NBME practice tests and the USMLE Ready practice test aren’t free. You’ll need to take several. Factor in the cost of each one.

International Transaction Fees: This is a big one nobody talks about. Paying for these American services from your home country often comes with foreign transaction fees from your bank. These small percentages add up to a surprising amount over time.

The “What-If” Fund: What if you get sick and need to extend your subscription? What if you have to travel to a different city for the exam? Having a small buffer for surprises is non-negotiable.

2. Think Local Currency For Your Study Materials

It’s tempting to buy every resource brand new from the official website. But for IMGs, that can be a huge financial drain. Get creative and think like a local student in your own country.

Used Books are Gold: Physical copies of books like First Aid are often passed down. Check with seniors who have already taken the exam, or look on local student forums and social media groups. A used copy from last year is often 90% as good for a fraction of the price.

Group Subscriptions: Can you share the cost of a UWorld subscription with one or two trusted friends? You can create different “tutor” accounts to track your own progress separately while splitting the bill. This alone can save you hundreds of dollars.

IMG Communities: There are massive online communities of IMGs on platforms like Reddit and Facebook. People are constantly selling their used materials or sharing tips on affordable resources. Tap into that collective knowledge.

3. Your Study Time Is A Financial Asset. Protect It

This might sound strange, but your ability to focus is directly tied to your finances. Many IMGs feel pressured to keep working long hours in a clinic or hospital while studying to make ends meet. This can be a false economy.

If you’re exhausted from work, your study hours become less effective. You might end up needing to extend your study period by months, which means paying for extended subscriptions, more practice tests, and delaying your eventual income as a doctor.

Think of it this way: spending $500 now to take 2 months off work to study full-time might be a better financial decision than stretching your prep over 6 months while working. 

Start A USMLE Sinking Fund Before You’re Ready To Study

A “sinking fund” is just a fancy name for a savings account for a specific future expense. Most people decide to take Step 1 and then scramble to find the money. The smart move is to start saving for it the moment you even think about a USMLE journey.

Budget For The After. The Bill Doesn’t Disappear After You Hit Submit

You walk out of the testing center, mentally exhausted. The last thing you want to think about is money. But the financial planning doesn’t stop when the exam does. 

You need to have a small financial plan for what comes next. There’s a waiting period for your score. 

This can be a few weeks of limbo where it’s hard to be productive. Having a little cash set aside for a modest celebration or a stress-relieving activity is important for your mental health.

The Next Step

Let’s say you pass. Congratulations! Now what? Step 2 CK is right around the corner, and the financial cycle starts all over again. 

If you don’t have to start from scratch because you’ve already begun saving for the next exam, you maintain your momentum. Planning for the “after” ensures that no matter the result, you are financially and mentally prepared to keep moving forward on your journey.