ECFMG®IRequest for an Official USM LE T ranscript
Form 172
A USMLE transcript includes a complete results history of all USMLE Steps or Step Components you have taken and
f or which results are available, as of the date the transcript is processed. For more inf ormation, see Scores &
Transcripts on the USMLE website.
To obtain your USMLE transcript, or to have it sent to a third party, please complete and sign this request f orm. (If you
have applied for or taken USMLE Step 3, or if you want your USMLE transcript sent to a state medical board, do not
use this f orm. See “Important Notes” below.)
You may request a maximum of 10 transcripts on each request form.
You must make a payment of US$70.00 for each form you submit.
You must make the payment on-line via OASIS on the ECFMG website, in advance of submitting your form.
After confirming that the payment has been added to your ECFMG financial account, submit a scanned image
of the completed Form 172 via e-mail to [email protected]. If you cannot submit the f orm via e-mail, you
may mail the completed form to ECFMG at Intealth, ECFMG Certif ication Program, 3624 Market Street, 1st Floor,
Philadelphia, PA 19104, USA.
Please allow 10 business days f or your request to be processed.
Direct questions to ECFMG at (215) 386-5900 or inf o@ecf mg.org.
Important Notes:
ECFMG does not provide USMLE transcripts to state medical boards or other licensing authorities. If you want your
USMLE transcript sent to a state medical board, you must contact the FSMB at (817) 868-4000 or www.f smb.org. To
provide your ECFMG certification status to these entities, contact ECFMG’s Certification Verif ication Service or visit
www.ecf mg.org/cvs.
Individuals who have applied for or taken USMLE Step 3 must contact the FSMB at (817) 868-4000 or www.fsmb.org
to request a transcript.
ERAS Applicants: Do not use this form to request transmission of your USMLE transcript via ERAS. Instead, log into
www.myeras.aamc.org.
1 USMLE / ECFMG
Identification Number: �-���-���-�
2
First Name(s) Middle Name(s)
Last Name(s) (Surname/Family Name) Generational
Suffix (Jr, Sr,
II, III, IV)
3 I hereby authorize ECFMG to release an official copy of my USMLE Transcript to the individual(s) listed on page 2 of this form.
Signature (Using the Latin Alphabet) Date
The fee for requesting one through 10 official USMLE For office use only
transcripts is $70.00. Payment must be made on-line via
OASIS, in advance of submitting the form.
This form is available on the ECFMG website at www.ecfmg.org.
Form 172, Rev. AUG 2023, Page 1 of 2
USMLE / ECFMG Identification Number: �-���-���-�
4
Enter the Name Name
name and
address for
each Organization Organization
individual or
institution
that is to Street Address/Post Office Box Street Address/Post Office Box
receive a
copy of your
official City State/Province City State/Province
USMLE
transcript.
ZIP/Postal Code Country ZIP/Postal Code Country
Do not
enter state
medical
boards or Name Name
other
licensing
Organization Organization
authorities.
Instead, see
“Important
Street Address/Post Office Box Street Address/Post Office Box
Notes” on
page 1.
City State/Province City State/Province
ERAS
Applicants:
Do not use ZIP/Postal Code Country ZIP/Postal Code Country
this form to
request
transmission
of your Name Name
USMLE
transcript via
ERAS. Organization Organization
Instead,
log into
www.myeras Street Address/Post Office Box Street Address/Post Office Box
.aamc.org.
City State/Province City State/Province
ZIP/Postal Code Country ZIP/Postal Code Country
Name Name
Organization Organization
Street Address/Post Office Box Street Address/Post Office Box
City State/Province City State/Province
ZIP/Postal Code Country ZIP/Postal Code Country
Name Name
Organization Organization
Street Address/Post Office Box Street Address/Post Office Box
City State/Province City State/Province
ZIP/Postal Code Country ZIP/Postal Code Country
Form 172, Rev. AUG 2023, Page 2 of 2
