Requirements

To be certified by ECFMG, international medical graduates (IMGs) have been required to pass Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical Skills (CS) of the United States Medical Licensing Examination^® (USMLE^®). In response to the suspension of Step 2 CS by the USMLE program, we have identified pathways that will allow qualified IMGs who have not passed Step 2 CS to meet the requirements for ECFMG Certification. These pathways allow ECFMG Certification to continue to perform its critical function of providing assurance to the public and U.S. graduate medical education (GME) programs that IMGs are ready to enter supervised training.

Please note: Applicants who have a passing performance on USMLE Step 2 CS that is valid for ECFMG Certification and/or are certified by ECFMG are ineligible for the pathways. These individuals do not need to pursue the pathways described below to meet the requirements for ECFMG Certification or to participate in the 2021 Match, and they do not need to read the following information.

These pathways are directed toward IMGs who intend to enter the 2021 Match. All other eligibility requirements for ECFMG Certification will remain in effect. An on-line application process for the following pathways currently is in development and is expected to be available by the end of August 2020. Instructions for applying to the pathways will be available very soon. We are providing information as soon as it is available to enable individuals to plan and prepare as they seek to enter U.S. GME programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) for the 2021-2022 academic year.

Pathways

Applicants who wish to enter an ACGME-accredited GME program for the 2021-2022 academic year and are unable to take Step 2 CS due to the suspension may meet the clinical skills requirement for ECFMG Certification through one of five pathways. Please refer to the additional information on the pathways and eligibility requirements, below.

English Language Proficiency Assessment

Applicants who pursue one of the following pathways will be required to attain a satisfactory score on an English language proficiency assessment. All applicants, regardless of citizenship, will be required to satisfy this requirement. ECFMG will accept the Occupational English Test (OET) Medicine to satisfy the English language proficiency requirement. See the English Language Proficiency Assessment page for more information.

Obtaining Permanent ECFMG Certification

ECFMG Certificates based on one of the clinical skills pathways listed below will expire if the applicant does not enter an ACGME-accredited GME program for the 2021-2022 academic year. Once the applicant successfully completes the first year of ACGME-accredited training, the certificate is no longer subject to expiration.

Eligibility for All Pathways

Applicants who are eligible to pursue ECFMG Certification based on one of the pathways include those who:

• Do not have a passing performance on Step 2 CS that is valid for ECFMG Certification.
• Are not barred by ECFMG from pursuing certification.
• Are not barred by USMLE from taking a Step or Step Component from August 1, 2020 to January 31, 2021.
• Have not failed a USMLE Step or Step Component (Step 1, Step 2 CK, or Step 2 CS) two or more times.
• Have taken or been registered for any USMLE Step or Step Component since January 1, 2018.

Please note: Applicants who have a passing performance on USMLE Step 2 CS that is valid for ECFMG Certification and/or are certified by ECFMG are ineligible for the pathways. These individuals do not need to pursue the pathways described below to meet the requirements for ECFMG Certification or to participate in the 2021 Match, and they do not need to read the following information.

Pathways and Eligibility Requirements

Applicants must meet all requirements listed in Eligibility for All Pathways, above. Applicants also must meet all requirements listed below for the pathway that is the basis for obtaining their ECFMG Certificate.

Information on the limited circumstances in which ECFMG will consider exceptions to certain pathway eligibility requirements is available in the FAQs section. Please also review the FAQs section carefully for information on eligibility requirements and circumstances for which there will be no exceptions.

Applicants who already have been issued a license to practice medicine without supervision in another country must apply using Pathway 1.

Additional details and specific instructions to meet the requirements for each pathway will be announced very soon.

Pathway 1: Already Licensed to Practice Medicine in Another Country

• Applicant has held a license/registration to practice medicine without supervision in any country at any time on or after January 1, 2015. A provisional license will meet the requirements for this pathway if it permits unsupervised practice. Individuals who hold only a license that requires supervised practice, such as a training license, are not eligible for this pathway. The license/registration does not need to be currently valid.
• The license/registration has not been subject to disciplinary action.

Pathway 2: Already Passed a Standardized Clinical Skills Exam for Medical Licensure

• Applicant has successfully completed a secure, standardized clinical skills exam in English as a requirement for medical licensure or registration in another country, which is deemed acceptable by ECFMG. This includes such exams as:
  • – General Medical Council: Professional and Linguistic Assessment Board (PLAB) Part 2
  • – Australian Medical Council: Clinical Examination Part 2 or Workplace Based Assessment
  • – Medical Council of Canada: Qualifying Examination Part 2 or National Assessment Collaboration Examination
  • – Medical Council of New Zealand: NZREX Clinical
  • – Medical Council of Ireland: Pre-Registration Examination System (PRES), Level 3
• Date of examination must be on or after July 1, 2018.

In addition to the acceptable exams listed above, ECFMG will consider:

• Objective Structured Clinical Examinations (OSCEs) administered as part of the medical licensure or registration process, in any language
• Medical school-administered OSCEs that meet the requirements for clinical skills assessment mandated by the appropriate medical regulator for licensure, only if the medical school:
  • (1) is located in a region/country that is not served by a WFME-recognized accrediting agency; and
  • (2) is accredited by an agency that is recognized by the appropriate government agency in that region/country and that is responsible for licensure.

Pathway 3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME)

• Applicant’s medical school must meet one of the following requirements (in addition to meeting all other ECFMG requirements):
  • currently accredited by an agency recognized by WFME. See the list of eligible schools; or
  • was accredited by an agency recognized by WFME at the time the applicant matriculated.
• Date of graduation must be on or after January 1, 2018.
• An authorized school official must attest to applicant’s clinical skills.

Pathway 4: Medical School Participates in U.S. Federal Student Loan Program

• Applicant’s medical school must meet one of the following requirements (in addition to meeting all other ECFMG requirements):
  • currently participates in the U.S. Federal Student Loan Program. See the list of eligible schools; or
  • was approved for participation in the U.S. Federal Student Loan Program at the time the applicant matriculated; or
  • has a petition for reconsideration in process with the U.S. Federal Student Loan Program.
• Date of graduation must be on or after January 1, 2018.
• An authorized school official must attest to applicant’s clinical skills.

Pathway 5: Medical School Issues Degree Jointly with a U.S. Medical School Accredited by Liaison Committee on Medical Education (LCME)

• Applicant is a student or graduate of a medical school that grants an MD degree issued jointly with a U.S. medical school accredited by LCME (and meets other ECFMG requirements). Currently, these include:
  • – Weill-Cornell Medicine – Qatar
  • – Duke University – National University of Singapore Medical School
• Date of graduation must be on or after January 1, 2018.
• An authorized school official must attest to applicant’s clinical skills.

The preceding information is current as of July 30, 2020, and is subject to change. Please visit the ECFMG website frequently for updates regarding these requirements.