On 12 January 2026 the Step exam services that ECFMG had long provided to international medical graduates transferred to FSMB. If you are working from guidance written before that date, this is the part of it that is now wrong.
What moved
Step exam services: registration, score report delivery and customer service. From that date, all three Step exams for graduates of medical schools outside the United States are administered through FSMB.
This was one half of a two-part consolidation. The other half, later the same month, moved Step 3 services for US students and graduates from FSMB to NBME. The net effect is that the split now runs by where you trained rather than by which exam you are taking.
What did not move
ECFMG certification. This is the distinction most worth being clear about, because the two are easy to conflate and the consequences of confusing them are real.
Certification remains a separate process with its own requirements, its own documentation and its own timeline. The transition changed who handles your exam registration. It did not change what you need in order to be certified, or who verifies your medical credentials.
If you are building a timeline, keep those as two tracks. The exam track now runs through FSMB. The certification track runs where it always did.
Transcripts
From June 2026, FSMB processes USMLE transcript requests for the ERAS service, consolidating all USMLE transcript requests with FSMB.
For an applicant this is largely invisible until something is late. Knowing that transcripts and exam registration now sit with the same organisation makes chasing a delay simpler than it used to be.
What to check
Your contact details are current with FSMB. Anything that was only ever correct in an ECFMG record is worth verifying, because notifications about eligibility periods and scheduling now come from a different place.
Name consistency across records. A mismatch between your passport, your medical school records and your exam registration causes delays that are tedious to unwind, and a transition between organisations is exactly the moment such mismatches surface.
Any preparation guide you are relying on. Registration walkthroughs written before 2026 will send you to the wrong place. That does not make the study advice in them wrong, but it does mean the logistics chapter needs replacing with the current official pages.
Why this keeps happening
Three significant administrative changes landed on this exam programme during 2026: the service transition in January, new test delivery software through the spring, and the announcement that testing moves to designated dates in 2029.
None of them changed what is examined. All of them changed something about how you get to the exam. For international applicants, who carry more administrative load than domestic candidates to begin with, that is the category worth re-checking against primary sources each cycle rather than trusting once and moving on.
Frequently asked questions
Does this change ECFMG certification?
No. The transition covered Step exam services such as registration and score reporting. Certification remains its own process with its own requirements.
Which organisation do I contact about a registration problem?
FSMB, for all three Step exams, if you trained outside the United States. That is the practical point of the change.