ECFMG, through its program of certification, assesses whether international medical graduates are ready to enter residency or fellowship programs in the United States that are accredited by the Accreditation Council for Graduate Medical Education (ACGME) . ACGME requires international medical graduates who enter ACGME-accredited programs to be certified by ECFMG.
ECFMG Certification assures directors of ACGME-accredited residency and fellowship programs, and the people of the United States, that international medical graduates have met minimum standards of eligibility to enter such programs. ECFMG Certification does not, however, guarantee that these graduates will be accepted into programs; the number of applicants each year exceeds the number of available positions.
ECFMG Certification is also one of the eligibility requirements for international medical graduates to take Step 3 of the three-step USMLE . Medical licensing authorities in the United States require that international medical graduates be certified by ECFMG, among other requirements, to obtain an unrestricted license to practice medicine.
ECFMG defines an international medical graduate as a physician who received his/her basic medical degree from a medical school located outside the United States and Canada*. Citizens of the United States who have completed their medical education in schools outside the United States and Canada are considered international medical graduates; non-U.S. citizens who have graduated from medical schools in the United States and Canada are not considered international medical graduates.
Important Note: Students and graduates of medical schools located in Canada should refer to the Important Notices section of this booklet for information on potential changes in 2025.
* The United States and Canada refer to the geographic locations where citizens are issued passports by the governments of either the United States or Canada.
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[Last update: August 21, 2023]