You will need to create an account on ecfmg, then pay for certification, pay intially the step 1 exam fee you will then be able to have either form 186 (for graduates) 183(medical students), have your medical school create a transcript and a diploma copies sealed with school seal, have those forms sealed and signed by an official of your school, after which you send it to ecfmg wait few weeks for ecfmg send documents to your school and send those documents again to ecfmg wait for ecfmg to update your status that your docs are authenticated this is the time when you are able to have the permit for step1