In one of the biggest administrative shake-ups in USMLE history, the USMLE program has announced a complete restructuring of who will manage exam registration, score reporting, and customer support starting January 2026. This shift affects every international medical graduate (IMG) and every U.S. medical student and graduate, making it essential to understand what’s changing and what you need to do before the deadlines.

Here’s a clear breakdown of the transition, timelines, portal blackouts, and action items so you can stay ahead.

Phase 1: January 12, 2026 – Major Changes for IMGs

Beginning January 12, all USMLE services currently handled by ECFMG will be transferred to FSMB.
This includes:

• Step 1, Step 2, and Step 3 exam registration
• Score report delivery
• Customer service
• All exam-related services

What this means:
ECFMG’s MyIntealth portal will no longer support USMLE functions after January 12. IMGs will shift completely to the FSMB USMLE portal for registrations, communications, and exam records.

Phase 2: January 26, 2026 – Changes for U.S. Graduates

All Step 3 services for U.S. medical school students and graduates will transition from FSMB to NBME.
NBME will now manage all USMLE services (Step 1, Step 2, Step 3) for U.S. graduates via the MyUSMLE portal.

Mandatory Portal Blackouts (Critical)

To implement the transition, certain portals will go offline temporarily.

For IMGs (January 8-12, 2026):

During this blackout:

• No account access
• No new account creation
• No exam registrations
• No service requests

ECFMG’s MyIntealth portal will also experience brief downtime.

For U.S. Graduates (January 23-26, 2026):

• No access to Step 3 services
• No application submissions
• No extensions or rechecks

Plan ahead to avoid delays.

Critical Action Items and Deadlines By December 31, 2025 (IMGs)

Submit all applications and required documentation to ECFMG via MyIntealth. This includes:

• New exam registrations
• Eligibility period extensions
• Region changes
• Score rechecks

Applications not processed by ECFMG before the transition must be re-submitted to FSMB.

By January 7, 2026 (IMGs testing during blackout)

Download your scheduling permit beforehand. You cannot test without it and you won’t be able to access portals during the blackout.

By January 15, 2026 (U.S. Graduates)

Submit all Step 3 applications to FSMB before the transition. Incomplete applications must be resubmitted to NBME afterward.

By January 22, 2026 (U.S. grads testing during blackout)

Download Step 3 scheduling permits before the blackout.

What’s NOT Changing (Important!)

ECFMG Certification remains exactly the same.

• Certification requirements are unaffected
• ECFMG still determines IMG eligibility
• Step 1 and Step 2 scores continue to count toward ECFMG Certification

This restructuring impacts administrative management only, not certification criteria or exam content.

Why This Matters for You

This transition affects how quickly you can register, access reports, apply for exams, and submit documents. Portal blackouts and new administrative pathways can cause avoidable delays, especially during peak USMLE prep or Match season.

Early action is the key to avoiding missed deadlines.

Final Takeaway

The 2026 USMLE administrative overhaul marks a historic shift in how IMGs and U.S. graduates interact with the exam ecosystem. Understanding the new structure and preparing before the blackouts can save weeks of delay, financial loss, and unnecessary stress.

Stay updated, stay prepared, and use this transition to streamline your exam strategy, not hinder it.