Total Cost of the IMG Journey (2021)

If you have ever wondered exactly how much it costs to get a US residency, from beginning to end, then this article is for you.

Enough things have changed in the application process this year (2021) that I thought it would be a good idea to revisit the total cost of the IMG Journey. I have included every expense I could think of, but if you think I missed something, feel free to tweet me @chrisquelchh and I'll update the article!

USMLE Step 1:

Before you take any step exams you need to get ECFMG certified, and then you can book an exam using the id number you receive. The step 1 exam itself carries a charge, but there is an additional 'surcharge' for taking it outside of the US or Canada.

  • ECFMG certification - 135$
  • Step 1 exam + surcharge - 975$ + 180$

You will also need to purchase resources to study for step 1. I posted a video last week about resources for step 1 so check that out for a comprehensive list, but I will summarise here. Keep in mind that these are the bare minimum resources, I have not included Boards and Beyond etc. or more practise tests.

  • Resources (Anki, Uworld 3 months, Pathoma, First aid (optional), sketchy, 3 NBMEs) - 954$

Total = 2,244$


  • Step 2 exam + surcharge - 975$ + 200$
  • Resources (Anki, Uworld 3 months, Master the Boards, 3 NBMEs).

Total = 1,754$


The OET is a new test for the 2020 and 2021 match years, focusing on english language for healthcare professionals. There is another ECFMG certification, in addition to the price of the test itself.

  • OET test - 500$
  • Certification - 900$ + 100$

Total = 1500$


Electives are probably the most important part of your application, but unfortunately they can be the most expensive. You should aim to go on 3 electives to be competitive for a US residency.

  • Return flights - 1000$ (roughly)
  • J1/H1B visa - 169$
  • Application fee - 300-500$
  • Elective fee - 0-5000$, usually around 1500$ * 3 = 4500$
  • Food/accommodation - 1000$/month * 3 = 3000$

Total = between 8,500$ - 10,000$

The Match:

So to participate in the match you will need two things, the ERAS token, and the NRMP token.

  • ERAS token - 150$
  • NRMP token - 80$

Application fees:

  • For the first 10 programmes there is a flat fee of 99$
  • For the next 10 it's 16$ each
  • For the next 10 it's 19$ each
  • For the rest it's 26$ each
  • So if you're an IMG and you're looking at maximising your opportunity, you'll probably want to apply to like 150 programs. This comes out to around about $3,560. Yeah, pricey!

Total = 3,790$


Due to COVID a lot of programs aren't doing in-person interviews, which saves us a lot of money. If you manage to get interviews around the same time, and you get five interviews, which is the average for an IMG. By the time you pay for a round trip flights, as well as hotel car rental, you could expect to pay 3500$, but now because the interviews are all online, that process is completely free!

Total = 3500$ (best case scenario for in-person interviews)


So the toatl price for your IMG journey, including the steps, learning resources, as well as electives, and applying to residency comes out too.... insert drum roll here

$ 18,058

Keep in mind that this is a rough estimate, the number I have given is definitely an underestimate, to be safe I would budget a few thousand dollars more than this.

If you want to learn more about what resources you will need for step 1, check out my video where I go over the 4 resource method that I used to ace my USMLE!

If you got this far, thanks for reading such a long post. I hope it was helpful to at least someone out there! If you guys have any specific questions the fastest way to reach me is via twitter DMs 🐀 Subscribe for future newsletters on my IMG journey. Cheers!

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