Intealth ECFMG

Educational Commission for Foreign Medical Graduates

ECFMG 2023 Information Booklet

Examinations for ECFMG Certification


Examination Requirements

To be eligible for ECFMG Certification, you must satisfy the medical science examination requirement, the clinical skills requirement, and the communication skills requirement. ECFMG has established time limits for completing these examination requirements for ECFMG Certification. See Time Limit for Completing Examination Requirements in Examinations for ECFMG Certification.

Medical Science Examination Requirement

To satisfy the medical science examination requirement for ECFMG Certification, you must pass Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination (USMLE). Refer to the USMLE Bulletin of Information for more information.

Clinical Skills Requirement and Communication Skills Requirement

To satisfy the clinical skills requirement and the communication skills requirement for ECFMG Certification, you must:

  • Complete an ECFMG Pathway, which includes attaining a satisfactory score on the Occupational English Test (OET) Medicine, OR
  • Have a passing performance on the former Step 2 Clinical Skills (CS) component of USMLE that is valid for ECFMG Certification.

For detailed information on the Pathways, refer to the ECFMG Certification section of the ECFMG website. The Pathways allow qualified IMGs to meet the clinical skills and communication skills requirements for ECFMG Certification and to compete for positions in U.S. graduate medical education. The Pathways are offered on a seasonal application cycle, and IMGs should consider the timing of their applications carefully. For example, if you need to meet the clinical skills and communication skills requirements for ECFMG Certification and you plan to participate in the 2023 NRMP Match in March 2023, you should apply to one of the 2023 Pathways. If you plan to participate in a future Match, you should monitor the ECFMG website for information on future requirements.

IMGs also should be aware that ECFMG Certificates issued based on a Pathway are subject to expiration. See Standard ECFMG Certificate in ECFMG Certification for more information.

Important Note: Prior to its discontinuation by the USMLE program in 2020, Step 2 CS was the exam that satisfied the clinical skills and communication skills requirements for ECFMG Certification. A passing performance on the former Step 2 CS component of USMLE that is valid for ECFMG Certification still satisfies the clinical skills and communication skills requirements. This means that, if you have a passing performance on Step 2 CS that is valid for ECFMG Certification, you do not have to (and are not eligible to) pursue a Pathway.

Certain Former Exams Not Accepted

All international medical graduates pursuing ECFMG Certification must meet the current examination requirements. Passing performance on the following former examinations cannot be used to meet the examination requirements for ECFMG Certification:

  • ECFMG Examination;
  • Federation Licensing Examination (FLEX);
  • Visa Qualifying Examination (VQE);
  • Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS);
  • NBME Part I and Part II; and
  • ECFMG Clinical Skills Assessment (CSA).

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[Last update: September 14, 2022]

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