The cost of the match is the part of this journey that gets mentioned last and lands hardest. It arrives in your final years, when your borrowing is closest to its ceiling.
This article adds up the fees that the official organizations publish. We are keeping the list honest: anything we could not confirm is marked, and anything that depends on your choices, such as travel and interviews, is described but not priced. Dates and amounts were last checked on 14 October 2026 and all organizations say fees can change.
The Canadian Side
All amounts are in Canadian dollars. The Medical Council of Canada charges a one-time $150 to set up a physiciansapply.ca account and $232 per medical credential for source verification. The MCCQE application is $1,500. The NAC Examination application is $3,320. [1]
CaRMS then charges, for the 2027 R-1 match, a participation fee of $301.60 that includes four programs, $66.26 for each additional program, and a one-time $136.62 verification fee for applicants who did not graduate from a Canadian medical school. [2]
Adding the confirmed items for one credential and four programs gives $150 plus $232 plus $1,500 plus $3,320 plus $301.60 plus $136.62, which is $5,640.22 before taxes. That is a floor, and it does not include a second exam sitting, extra programs, rescheduling fees, a provincial licensing application, travel, or any of the document service fees CaRMS lists.
The CaRMS fee page also lists letters of reference, medical school performance records, an administrative fee and an ERAS handling fee. We are not sure which of those apply to an IMG applying from abroad. CaRMS says all fees are non-refundable and are subject to applicable provincial taxes. [2]
Provincial requirements add more. The MCC fee page lists a $240 application for medical registration among fees that may apply to IMGs, though we do not know when in the process you would pay it. [1]
The American Side
These amounts are in US dollars. ECFMG charges $580 for the certification application, $945 to apply to a pathway, $220 for credential verification, and $185 for the ERAS token. [3] The NRMP charges an $85 registration fee covering up to 20 program codes, with $30 for each program code ranked beyond 20. [4]
Adding the confirmed items gives $580 plus $945 plus $220 plus $185 plus $85, which is $2,015. That is also a floor.
What it leaves out is substantial. The USMLE Step 1 and Step 2 CK fees are not on the ECFMG page, and the $695 figure on the NBME page applies to US school students, so we could not confirm what an IMG pays. The numbers matter, because the number of programs IMGs apply to is the biggest variable in the American budget.
The Costs That Are Not Fees
Interviews. CaRMS says IMG interviews are coordinated separately, with no national interview period. Many US interviews are now held remotely, but not all, and in-person interviews carry flights and accommodation. We did not find an authoritative source for how many interviews students attend, so we are not estimating.
Electives. Some applicants do clinical electives in Canada or the US to strengthen their application. Electives carry application fees, flights and short-term housing, and we have not priced them here.
Visa and immigration. A J-1 or H-1B comes with fees, and an H-1B is described as having higher legal and administrative costs. [5] Programs often cover some of these but policies vary.
Exchange rates. Fees are in two currencies, and you are probably earning in neither. Every payment in Canadian or US dollars is exposed to the euro rate.
Why Applying to Both Multiplies Cost
The fees above do not share much. A student who applies to both countries needs the MCCQE and NAC, and the USMLE steps and ECFMG certification, and pays both match services. In 2027 the CaRMS result arrives first and the NRMP then withdraws those who matched in Canada. [6] The money for the American side is already spent by then.
That is the honest cost of keeping two options open, and some people decide it is worth it. We just want it in the plan from the start.
How to Use the Numbers
We would build a table with a row for each fee above and a column for each year, and add rows for interviews, travel, electives and visas. We would put the confirmed fees in one colour and the estimates in another. We would add the whole thing to the plan we built for the degree, using our Ireland cost article as the template.
It does not shrink the number. It stops it being a surprise.
The Bottom Line
The confirmed fees for a Canadian-only application come to about $5,640 CAD before taxes, for one credential, one exam sitting and four programs. The confirmed ECFMG and NRMP fees for the US route come to about $2,015 USD, before USMLE exams, ERAS programs, interviews and visas.
Those are floors, not budgets. Check every fee against the MCC, CaRMS, ECFMG, AAMC and NRMP pages before paying, because they change. Our Resources page lists them.
References
- Medical Council of Canada. (2026, September 2). Fees. https://mcc.ca/examinations/fees
- CaRMS. (2026). 2027 R-1 match fees. https://www.carms.ca/en/match-process/your-application/fees/
- Intealth ECFMG. (2026). Fees. https://ecfmg.org/fees/index.html
- NRMP. (2026). Match fees. https://www.nrmp.org/match-fees/
- Council of Residency Directors in Emergency Medicine. (n.d.). CORD residency director toolkit: Advising international medical graduates on U.S. visa pathways for residency training. https://www.cordem.org/wp-content/uploads/CORD-Residency-Director-Toolkit-Advising-International-Medical-Graduates-on-U.S.-Visa-Pathways-for-Residency-Training-3.pdf
- NRMP. (2026). Early matches. https://www.nrmp.org/residency-applicants/get-ready-for-the-match/early-matches/