Medical schools outside the United States and Canada vary in their educational standards and curricula. The purpose of Educational Commission for Foreign Medical Graduates ECFMG Certification is to assess the readiness of graduates of these schools to enter U.S. residency and fellowship programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). To be certified by ECFMG, you must pass a series of exams; you must also fulfill ECFMG's medical education credential requirements. These requirements include providing ECFMG with copies of your medical education credentials, which ECFMG will verify directly with your medical school. See ECFMG Certification.
If you are an international medical graduate and wish to enter an ACGME-accredited residency or fellowship program in the United States, you must be certified by ECFMG before you can enter the program. You must also be certified by ECFMG if you wish to take Step 3 of the three-step United States Medical Licensing Examination (USMLE). ECFMG Certification is also one of the requirements to obtain an unrestricted license to practice medicine in the United States. See ECFMG Certification.
To be eligible for certification by ECFMG, among other requirements, your medical school must be listed in the International Medical Education Directory (IMED) of the Foundation for Advancement of International Medical Education and Research (FAIMER). If you are a medical school student and you want to apply for examination, your medical school must be listed in IMED and your medical school's "Graduation Years" must be listed as "Current," both at the time you apply for the exam and at the time you take the exam. If you are a medical school graduate, your medical school and graduation year must be listed in IMED to be eligible for examination and for ECFMG Certification. To verify that you meet these requirements, access IMED on this website. See ECFMG Certification.
The certification process begins when you submit your first exam application to ECFMG. At this time, ECFMG will assign you an identification number that you will use throughout the certification process. See USMLE / ECFMG Identification Number.
The time required to complete the certification process is different for each applicant. You may apply for the required exams as soon as you meet the eligibility requirements for examination. All of the exams required for ECFMG Certification are offered continuously throughout the year.
Both medical school students and graduates may begin the certification process. However, since one of the requirements for ECFMG Certification is that your medical education credentials be independently verified by ECFMG with your medical school, you cannot complete the certification process until you graduate. The time required for some aspects of the certification process, such as the time required by your medical school to verify your medical education credentials, is beyond the control of ECFMG. See ECFMG Certification.
To be eligible for ECFMG Certification, you must, among other requirements, pass USMLE Step 1, Step 2 CK, and Step 2 CS. See Examination Requirements. Once you meet the eligibility requirements for examination, you can take these exams in any order. See Eligibility for Examination.
ECFMG will confirm your certification status when it receives a request directly from a medical licensing authority, residency / fellowship program official, or other appropriate organization. For status reports sent to medical licensing authorities, the request can also be sent to ECFMG by you. Approximately two weeks are required for the confirmation to be completed. Please note that there may be a fee for this service. See Confirmation of ECFMG Certification Status. If you apply to residency programs through ERASŪ, ECFMG will send an electronic ECFMG Status Report automatically to all of the programs to which you applied. See Electronic Residency Application Service ERASŪ.
You can apply on-line using ECFMG's Interactive Web Application (IWA). You can also download the paper USMLE application materials from this website. If you do not have access to the Internet, you can request a photocopy of these materials. See How To Obtain This Publication.
Information on preparing for the exams is available in this booklet and in the USMLE Bulletin of Information. Sample test materials for all Steps and Step Components are available on the USMLE Orientation Materials compact disc (CD), which ECFMG sends to applicants when they are registered. The sample test materials on the CD and additional information on examination content and test formats are available on the USMLE website. See Preparation.
Step 1 and Step 2 (CK and CS) are offered continuously throughout the year. Applicants registered for these exams are assigned an eligibility period during which they must take the exam. See When to Apply and Eligibility Periods.
Step 1 and Step 2 CK are offered worldwide at test centers of Prometric, a division of Thomson Learning, Inc. For information on Prometric test centers offering USMLE, visit the Prometric website. Step 2 CS is administered at Clinical Skills Evaluation Centers in Atlanta, Chicago, Houston, Los Angeles, and Philadelphia in the United States. See Testing Locations.
Both students and graduates may take the exams. To take the exams, medical school students must have completed at least two years of medical school. This eligibility requirement means that students must have completed the basic medical science component of the medical school curriculum. Other eligibility requirements apply to both students and graduates. Refer to Eligibility for Examination.
Once registered, you cannot cancel or postpone your registration (except as described below for Step 1 / Step 2 CK). If you do not take the exam, you will not receive a refund or credit of your exam fee(s). For detailed information on ECFMG's payment policy, refer to Payment.
Although you cannot cancel your registration, there are options that provide flexibility. Registered applicants can change their test date and / or test center, subject to availability. See Rescheduling. If you are unable to take Step 1 / Step 2 CK during your assigned eligibility period, you can request an extension of your eligibility period for a fee. See Eligibility Period Extension.
For the purpose of ECFMG Certification, there is no limit on the number of times you can take a Step or Step Component you have not passed. If you fail a Step or Step Component, you may retake it, but you must reapply and pay the appropriate fee(s). Certain restrictions apply when retaking the same Step. Once you pass a Step or Step Component, you may not repeat it, and you will have seven years to pass the other Step(s) and Step Component(s) required for ECFMG Certification. See Time Limit for Completing Examination Requirements and Reexamination and Reapplication.
Effective June 14, 2004, applicants for ECFMG Certification are no longer required to pass the Test of English as a Foreign Language (TOEFL). Currently, applicants satisfy this requirement by passing Step 2 CS, which has a distinct, separately scored subcomponent that assesses spoken English proficiency. Passing Step 2 CS also satisfies the clinical skills requirement for ECFMG Certification.
If you passed an English test, such as the TOEFL exam or the former ECFMG English test, and you also passed the former ECFMG CSA, you can use these passing performances to satisfy the clinical skills requirement for ECFMG Certification. See Clinical Skills Requirement.
If you passed an English test but did not pass the former ECFMG CSA, you must still pass Step 2 CS to fulfill the clinical skills requirement for ECFMG Certification. The date of your passing performance on the English test will not appear on your ECFMG Certificate when it is issued.
If you are certified by ECFMG and the English test pass date and "valid through" date appear on your ECFMG Certificate, you may be eligible for a permanent validation sticker for the English test to be affixed to your Standard ECFMG Certificate. See Validity of the Certificate for Entry into Graduate Medical Education.
Before June 14, 2004, passing performances on the English test were valid for two years from the date passed for the purpose of entering graduate medical education. Applicants whose English test dates had expired were required to pass another English test to revalidate this English test date before entering graduate medical education.
Effective June 14, 2004, passing performances on the English test, regardless of the date passed, do not expire for the purpose of entering graduate medical education. If you passed an English test for ECFMG Certification and were certified before June 14, 2004, you may request a permanent validation sticker for your English test date. See Validity of the Certificate for Entry into Graduate Medical Education.
USMLE Step 2 CS has replaced the ECFMG CSA as the exam that satisfies the clinical skills requirement for ECFMG Certification. Applicants who have not passed the ECFMG CSA must take USMLE Step 2 CS. See Examination Requirements.
If you have passed the ECFMG CSA, you will not be required to pass Step 2 CS for ECFMG Certification. See Examination Requirements. Additionally, applicants who have passed the CSA will not be required to pass Step 2 CS to meet the eligibility requirements for Step 3. See USMLE Step 2 Clinical Skills (CS) Examination and Eligibility in the USMLE Bulletin of Information.
Effective June 14, 2004, passing performances on the CSA that took place on or after June 14, 2001 do not expire for the purpose of entering graduate medical education. If you are certified by ECFMG and the CSA pass date on your certificate is June 14, 2001 or later, you may request a permanent validation sticker for your CSA date. See Validity of the Certificate for Entry into Graduate Medical Education.
If you passed the CSA before June 14, 2001, your passing performance on the CSA remains subject to expiration for the purpose of entry into graduate medical education. See Validity of the Certificate for Entry into Graduate Medical Education.
The final medical school transcript is an official document that is the record of the graduate's medical education, issued by the medical school or university, upon or after graduation.
The format of the final medical school transcript may vary among institutions. The final medical school transcript contains the name of the medical school or university and the name of the graduate. Other items that may be contained in the final medical school transcript include, but are not limited to, the dates of attendance, courses taken, credits for each course, grade in each course, summary of transfer credit accepted and the name of the institution from which the credit was accepted, title of the degree awarded, date degree was awarded, program of study (i.e., medicine), and date the transcript was issued.
ECFMG will notify you when it sends the request for verification of your medical education credentials to your medical school. After ECFMG receives the verification of your diploma and / or your final medical school transcript from your medical school, ECFMG will send you another notification. You can check the status of your medical education credentials using OASIS. See Verification of Credentials.
If you intend to complete a Fifth Pathway program, you are required to notify ECFMG of this intent. See The Fifth Pathway Program.
Most specialties participate in ERASŪ. For the list of participating specialties, visit the ERASŪ website of the Association of American Medical Colleges (AAMC). Programs participating in ERASŪ will, in principle, no longer accept paper applications. However, there may be exceptions by individual program directors. You should contact the programs directly for their policies.
If you apply for an exam or request a service on-line, you can pay the required fees on-line with a credit card (Visa, MasterCard, or Discover) or with an electronic payment from your U.S. checking account. If you submit a paper exam application or request for service and you have a USMLE / ECFMG Identification Number, you can pay in advance using OASIS. All applicants submitting paper applications / requests can pay by credit card, check, or wire transfer by completing the payment section of the application / request form. Payment for all services is due at the time of application. If you do not include full payment, your application / request for service will be rejected. See Payment.
[Last update: 31 August 2005]