In regards to what will happen since 5th Pathway is gone...
I have been in practice for awhile so here is my opinion...based on what I know of the TSBME in Texas and their past history...
The TSBME, at this time made up of all US docs, will say...only the Titulo is acceptable. They have done this before. Texas rejected 5th Pathway students but had the law on the books. A lot of states did not accept 5th Pathway at all.
The Texas Board at the time let you sit for the state licensing exam with 5th Pathway BUT Titulo grads had to do 3 years of residency. I think it is the same now, just that 5th Pathway is gone. I took the FLEX in a state that did not require this.
Check with your state but if they tell you an internship is necessary as the minimum for the USMLE Part 3 exam, then you will have to get a Titulo to get into the US to do one.
Summation (IMPORTANT !):...some Mexican schools give the Titulo out at graduation after 4 years. I know two Monterrey grads that told me their schools, one private and one public, in Monterrey do not require Internado or Social Service and that the Titulo was given at graduation. Another student out of Juarez told me his school didn't require anything to get the Titulo either. They didn't have access to 5th Pathway and didn't need it.
**The UAG should have done the same thing decades ago.
Trying to set up a Mexican '5th Year' is not 5th Pathway.