This can be a confusing process. Everyone is saying one thing or another. I wrote this back in 2011 but updated it in October 2014 after comments about updates to the process. If you find this article is not up-to-date, please share the details in a comment.
Let’s get started! First check you are not past the ECFMG processing deadlines. This link is also the official information page about extending your eligibility. Below you will find a summary of student experience. Including my own.
1. Cancel your exam with Prometric
At this point, the original guide used to say: if it is less than or equal to 31 days before your exam, call Prometric and pay the appointment change fee so you can extend your eligibility period. However, in the comments one of our colleages reported Prometric is now saying there is no fee to pay before extending the eligibility period.
After you cancel your exam, continue to the next step.
2. Send the application
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.
Foreign medical graduates must login to ECFMG online services. The page after you login has a list titled Begin a New Application. Under there you will find the application appropriately named, “Request to Extend a USMLE Eligibility Period (EPEx) for Step 1″. Have your credit card handy because at the end you have to pay $65.
After all of this is done, you will be prompted to resubmit form 186 (certification of identification) if it has expired. If you sent the ECFMG your picture within the last 5 years you won’t be prompted to do it again.
Response Timeline (and how long it took for me to receive the response)
Email 1 (12 hours later): “Your Eligibility Period Extension (EPEx) request has been submitted to ECFMG. You will receive email confirmation when your request has been processed.”
Email 2 (1 day, 6 hours later): My eligibility period has been extended to (date). NBME will issue a new permit and the ECFMG will email it in about one week.
Note: Before you receive email 2, your school must approve your extension via the ECFMG Medical School Web Portal. If you don’t receive anything after a week, call your school! You may have to requalify for the exam.
Email 3 (3 days, 12 hours later): ECFMG emailed new permit.
3. Now that you have your new permit…
If you cancelled your last appointment more than 31 days before your exam, there is no fee to pay, go study!
If it was less than or equal to 31 days before your exam, you need to pay a fee to reinstate your eligibility record at Prometric before you can reschedule. Keep your new permit handy because you will need the scheduling number. Get ready to be on the phone for 20-30 minutes and dial 1-800-633-3926. The 2 minute recording will recommend using the website, but the only way to reinstate is over the phone. Press 2 to “schedule an appointment”. You will be placed in the queue. When the agent comes on say, “I need to reinstate my eligibility for Step 1.”
4. Go back to working on the dream!
Go study now instead of saying you will start fresh tomorrow. Every time you learn something new, there is a benefit. Even if it is only one new concept. They add up over a lifetime. :)
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.