Comparison of Selected Policies Relating to the ECFMG CSA & USMLE Step 2 CS: Important Information for IMGs

(First paragraph in each segment is the ECFMG CSA and second is USMLE Step 2 CS)

Exam Availability

• The CSA is offered regularly, throughout the year.
  The ECFMG CSA will be administered until spring of 2004. There may be a brief period immediately prior to the implementation of Step 2 CS when the ECFMG CSA will not be administered. The CSA will not be administered after implementation of Step 2 CS.
  
  Step 2 CS will be offered regularly, throughout the year.
  The target date for beginning administration of Step 2 CS is June 1, 2004.

Accepted for ECFMG Certification?

• Yes. Although the ECFMG CSA will not be administered after implementation of Step 2 CS, passing performance on the CSA will continue to be accepted for ECFMG Certification. Applicants who have satisfied the clinical skills requirement for ECFMG Certification by passing the ECFMG CSA will not be required to take Step 2 CS for ECFMG Certification.
  
  Yes. Applicants who have not satisfied the clinical skills requirement for ECFMG Certification by passing the ECFMG CSA can satisfy this requirement by passing Step 2 CS (provided that they meet the Step 2 CS examination and education eligibility requirements).

Eligibility:

• Examination Prerequisites

• Must have:
  Passed USMLE Step 1 (or its equivalent), and
  Satisfied the English language proficiency requirement for ECFMG Certification.
  
  Must have:
  Passed USMLE Step 1 (Passing performance on former basic medical science exams will not satisfy the eligibility requirements for Step 2 CS.)

Eligibility:

Education

• Students:
  At the time of application and on the exam date:
  Must be officially enrolled in a medical school located outside the United States and Canada that is listed in the International Medical Education Directory (IMED).
  The "Graduation Years" in the school's IMED listing must be listed as "Current."
  By the exam date:
  Must be within 12 months of completing the full didactic curriculum.
  
  Graduates:
  Must be a graduate of a medical school located outside the United States and Canada that is listed in IMED.
  Graduation year must be included in the medical school's IMED listing.
  Applicant must have had at least 4 credit years (academic years for which credit hours have been given toward completion of the medical curriculum) in attendance.
  
  SAME for Step 2 CS

Test Centers

• Atlanta, Georgia
  Philadelphia, Pennsylvania
  
  Atlanta, Georgia
  Chicago, Illinois
  Houston, Texas
  Los Angeles, California
  Philadelphia, Pennsylvania

Application

• IMGs register for the CSA with ECFMG. Applicants can visit the ECFMG website to apply on-line or to obtain paper application materials.
  
  IMGs will continue to apply to ECFMG for Step 2 CS. On-line and paper application materials will continue to be available via the ECFMG website. See Applying for Step 2 CS.

Fee

• $1,200
  
  SAME

Scheduling

• Applicants must schedule a CSA date within 4 months of their registration date, and must take their CSA within 12 months of this date. Applicants are assigned to either the Philadelphia or Atlanta test center during the scheduling process.
  
  Applicants must take Step 2 CS within 12 months of their registration date. Applicants can select a testing location, subject to availability, at the time of scheduling.

Scoring

• PASS/FAIL designation
  
  SAME
  A delay in the release of initial scores for Step 2 CS is anticipated. This delay will affect Step 2 CS examinees registered by both ECFMG and NBME. Monitor the ECFMG and USMLE websites for additional information.

Exam Components

• 1. Integrated Clinical Encounter, made up of
  Data Gathering
  Patient Note
  2. Doctor-Patient Communication, made up of
  Interpersonal Skills
  Spoken English Proficiency
  
  To pass the CSA, examinees must pass both components.
  
  
  1. Integrated Clinical Encounter, made up of
  Data Gathering
  Patient Note
  2. Communication/Interpersonal Skills
  3. Spoken English Proficiency
  
  To pass Step 2 CS, examinees must pass all 3 components

Reexamination

• There is no limit on the number of attempts to pass the CSA for ECFMG Certification.
  However, the following restrictions apply:
  After 1 failed attempt, the applicant must wait at least 3 months before retaking the CSA.
  After 2 failed attempts, the applicant must wait at least 6 months before retaking the CSA.
  After 3 or more failed attempts, the applicant must wait at least 1 year before retaking the CSA.
  
  There is no limit on the number of attempts to pass Step 2 CS for ECFMG Certification.
  However, applicants may not retake Step 2 CS within 60 days of their last attempt on Step 2 CS. Additionally, they may not take Step 2 CS more than 3 times in any 12-month period.

Time Limit to Pass for ECFMG Certification

• ECFMG requires that IMGs pass those USMLE examinations required for ECFMG Certification (currently, Step 1 and Step 2 CK) within a 7-year period. This policy does not apply to CSA, since it is not a USMLE exam.
  
  ECFMG will continue to require that IMGs pass those USMLE examinations required for ECFMG Certification within a 7-year period. Since Step 2 CS will be a USMLE exam, applicants for ECFMG Certification must pass Step 1, Step 2 CK, and Step 2 CS within a 7-year period; this requirement will apply to applicants whose earliest USMLE passing performance that is valid for ECFMG Certification is on or after the date that Step 2 CS is implemented.

Validity for Entry into Graduate Medical Education

• Currently, passing performance on the CSA is valid for 3 years for the purpose of entering a program of graduate medical education (GME). This means that individuals whose most recent CSA pass is older than 3 years who have not entered GME must revalidate their passing performance by passing another CSA before starting a program.
  According to ECFMG policy, Step 2 CS, once passed, will not expire for the purpose of entering GME. Additionally, with the implementation of Step 2 CS, passing performance on CSA administrations taking place in the 3-year period before the implementation of Step 2 CS will not be subject to expiration. As a result, examinees who pass the ECFMG CSA during the 3-year period before the implementation of Step 2 CS will not be required to revalidate expired CSA dates before entering GME. These individuals may enter GME regardless of the length of time that has passed between their passing performance on the CSA and their program start date.
  
  
  According to ECFMG policy, Step 2 CS, once passed, will not expire for the purpose of entering GME

Required for NRMP Participation?

• The National Resident Matching Program (NRMP) requires that IMGs who wish to participate in the Match pass all examinations required for ECFMG Certification. Since passing the CSA is currently required for ECFMG Certification, IMGs must pass the CSA to participate in the Match.
  
  Once implemented, Step 2 CS will be required for ECFMG Certification. As a result, IMGs who wish to participate in the Match will be required to pass Step 2 CS. To participate in the 2005 Match, IMGs who are required to satisfy the clinical skills requirement for ECFMG Certification and who have not satisfied this requirement by passing the ECFMG CSA must pass Step 2 CS.

Meeting Eligibility Requirements for Step 3

• Although the ECFMG CSA will not be administered after implementation of Step 2 CS, passing performance on the CSA will satisfy the clinical skills requirement for taking Step 3.
  
  Passing Step 2 CS will be required in order to apply for Step 3 of the USMLE. IMGs should closely monitor this web page and the USMLE website at www.usmle.org for the effective date of this requirement.