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:

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

Important Note on Validity of Pathways: The Pathways are offered on a seasonal application cycle, and international medical graduates should consider the timing of their applications carefully. If you meet the clinical skills requirement and communication skills requirement for ECFMG Certification through the Pathways, your accepted Pathway is subject to expiration. The expiration date is based on the Pathways season for which the Pathways application was accepted. An accepted, unexpired Pathway is required to become ECFMG Certified. An accepted, unexpired Pathway also is required to participate in the National Resident Matching Program^® (NRMP^®) Main Residency Match^® (The Match^®). For detailed information on the Pathways, including expiration dates for each Pathways season, refer to the ECFMG Certification section of the ECFMG website.

International medical graduates 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).