Request for Recheck of USMLE
®
Step 1, Step 2 CK, or Step 2 CS Score
Form 265
Form 265, Rev. MAR 2015
Page 1 of 1
Step 1 Date of Examination / /
Month Day Year
Step 2 CK Date of Examination / /
Month Day Year
Step 2 CS Date of Examination / /
Month Day Year
For Step 1/Step 2 Clinical Knowledge (CK), standard quality assurance procedures ensure that the scores reported for you
accurately reflect the responses recorded by the computer. When a request for score recheck is received, the original
response record is retrieved and rescored using a system that is outside of the normal processing routine. The rechecked
score is then compared with the original score.
For Step 2 Clinical Skills (CS), score rechecks first involve retrieval of the ratings received from the standardized patients
and from the physician note raters. These values are then resummed and reconverted into final scores in order to verify
whether the reported pass/fail outcome was accurate. There is no rerating of encounters or of patient notes; videos of
encounters are not reviewed. Videos are used for general quality control and for training purposes and are only retained for a
limited period of time.
Patient notes are carefully reviewed, in some instances by multiple physicians, before scores are released. As part of the
quality control procedures for initial scoring, examinees who fail Step 2 CS solely on the basis of the Integrated Clinical
Encounter subcomponent and who are performing at a level that is near the minimum passing point have their patient notes
rated by multiple physician note raters. Therefore, patient notes are not reviewed again when a recheck is requested.
For all Steps and Step Components, a change in your score or in your pass/fail outcome based on a recheck is an
extremely remote possibility.
Instructions:
To
obtain a score recheck, complete and sign this request form.
To submit payment, complete all information requested on the
Payment for Service(s) Requested (Form 900), which is
included with this request form. Include a payment of US$80.00 for each exam for which a recheck is requested.
You should check “Score Recheck: USMLE Step 1/Step 2 CK/Step 2 CS” in item 2 of the payment form. Submit the
completed payment form with your request for recheck.
Return the completed Form 265 along with payment (Form 900) by fax, to (215) 386-3185, or mail to ECFMG, 3624 Market Street,
4th Floor, Philadelphia, PA 19104-2685 USA.
Direct questions to ECFMG at (215) 386-5900.
Important Notes:
Your recheck request must be received at ECFMG
®
no later than 90 days after your score report release date.
For more information on score rechecks, please refer to the USMLE Bulletin of Information and the USMLE website at
www.usmle.org.
Score recheck results will be sent to your address of record.
Please allow four to six weeks for your request to be processed.
1
USMLE / ECFMG
Identification Number:
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Enter your
Identification
Number.
First Name(s) Middle Name(s)
Enter Your Name.
Last Name(s) (Surname/Family Name) Generational
Suffix (Jr, Sr,
II, III, IV)
2
Indicate the
exam/date to be
rechecked.
3
Signature Submitted by:
Signature
Date
1
2
3
Enter your
Identification
Number.
Enter your
name.
Indicate the
service(s)
for which
you are
providing
payment.
Select a
method of
payment
and
complete all
information
requested.
Do
NOT
send cash.
For detailed information on ECFMG’s Payment and Refund policies, refer to the ECFMG Information Booklet and to the ECFMG website at www.ecfmg.org.
Form 900, Rev. DEC 2016
Page 1 of 1
This form is available on the ECFMG website at www.ecfmg.org.
Application for ECFMG Certification ($75)
Application for USMLE Step 1/Step 2 CK ($895 per exam*)
Application for USMLE Step 2 CS ($1,550 per exam)
Extension of USMLE Step 1/Step 2 CK Eligibility Period
($70 per exam)
Testing Region Change: USMLE Step 1/Step 2 CK
($65 per region change*)
Score Recheck: USMLE Step 1/Step 2 CK/Step 2 CS
($80 per exam)
ERAS
®
Token ($105) – ERAS Applicants: Do NOT use this
form to pay for transmission of your USMLE transcript via
ERAS. Instead, login to AAMC’s MyERAS website.
USMLE Transcript ($65 per request form – up to 10
transcripts) – ERAS Applicants: Do NOT use this
form to pay for transmission of your USMLE transcript via
ERAS. Instead, login to AAMC’s MyERAS website.
ECFMG Exam Chart ($50 per request form – up to three copies)
ECFMG CSA History Chart ($50 per request form – up to 10 copies)
CVS – State Board ($40)
EVSP (J-1 visa sponsorship) ($325)
Reprint ECFMG Certificate ($50)
Name Change on ECFMG Certificate ($50)
File Copy Fee ($25)
Translation Fee – Medical School Transcript ($250)
*International test delivery surcharges also may apply and must be
included in payment. For the list of fees, see the ECFMG website at
www.ecfmg.org/fees.
Previous Balance/Other (Specify):
$
USMLE
®
/ ECFMG
®
Identification Number:
P
A
Y
M
E
N
T
First Name(s)
Middle Name(s)
Last Name(s) (Surname or Family Name)
Payment for Service(s) Requested
Form 900
BY MAIL/COURIER: ECFMG, 3624 Market Street, 4th Floor, Philadelphia, PA 19104-2685 USA
TELEPHONE: (215) 386-5900 •
FAX: (215) 386-3185 •
INTERNET: www.ecfmg.org
Generational
Suffix (Jr, Sr,
II, III, IV)
®
Charge my credit card.
(A)
(B)
/
Credit Card
Number:
Exp. Date
(Month/Year):
Check One:
Name of Card Holder:
Address of Card Holder:
City:
State:
Country:
Zip/Postal Code:
Signature of Card
Holder:
VISA
MASTERCARD
DISCOVER
AMERICAN EXPRESS
By signing below, I authorize ECFMG to charge my credit card in the amount indicated above.
My check, bank draft, or money order made payable to ECFMG is enclosed.
Payment must be made in U.S. funds through a U.S. bank. Include your USMLE/ECFMG Identification Number on your check.