Examinations for ECFMG Certification

Time Limit for Completing Examination Requirements

ECFMG requires that international medical graduates satisfy the examination requirements for ECFMG Certification within a seven-year period. This means that once you pass an exam, you will have seven years to meet the other examination requirements for ECFMG Certification. This seven-year period begins on the date of the first exam passed and ends exactly seven years from that date.

Important Note: Accepted Pathways are subject to this seven-year requirement. This means that your Pathways application must be accepted within the seven-year period in order to meet the clinical skills requirement and communication skills requirement for ECFMG Certification.

Once you satisfy all exam requirements for ECFMG Certification within a seven-year period, you have met the time limit for completing examination requirements. However, accepted Pathways are subject to expiration for other purposes, including for becoming ECFMG Certified and for entering the NRMP Match. If you have satisfied all examination requirements within a seven-year period but need to revalidate a Pathway for other purposes, the revalidation can occur outside of the seven-year period. For detailed information on Pathways expiration and revalidation, refer to the ECFMG Certification section of the ECFMG website.

If you do not satisfy all examination requirements within a maximum of seven years, your earliest passing performance will no longer be valid for ECFMG Certification. It is your responsibility to track your progress toward meeting the exam requirements for ECFMG Certification. ECFMG will not notify you of upcoming deadlines to meet the seven-year requirement and will not notify you if one (or more) of your passing performances becomes invalid for ECFMG Certification because you failed to meet the seven-year requirement.

Examples: An international medical graduate passed Step 1 on January 20, 2018 and Step 2 CS on February 20, 2020. He has through January 20, 2025 to take and pass Step 2 CK to satisfy the remaining exam requirements for ECFMG Certification. If he does not take and pass Step 2 CK on or before January 20, 2025, his passing performance on Step 1 would no longer be valid for ECFMG Certification.

An international medical graduate passed Step 1 on November 30, 2017 and Step 2 CK on February 1, 2021. She has through November 30, 2024 to satisfy the clinical skills and communication skills requirements for ECFMG Certification through a Pathway. If she does not have an accepted Pathways application on record by November 30, 2024, her passing performance on Step 1 will no longer be valid for ECFMG Certification.

An international medical graduate passed Step 1 on January 15, 2018, and her 2021 Pathways application was accepted on February 1, 2021. Her Pathway will expire on December 31, 2024 (the expiration date for all 2021 Pathways). If she passes Step 2 CK on November 1, 2024, she will have met ECFMG's time limit for completing the exam requirements. However, her Pathway is still subject to expiration for other purposes, including for becoming ECFMG Certified and for entering the NRMP Match. Since the applicant met ECFMG’s time limit for completing the exam requirements, revalidation of a Pathway for these purposes can occur outside of the seven-year period.

Under this ECFMG requirement, more than one passing performance can become invalid for ECFMG Certification.

Examples: An international medical graduate passed Step 1 on April 1, 2017, and passed Step 2 CK on May 1, 2018. She had through April 1, 2024 (seven years from her Step 1 passing performance) to complete a Pathway, satisfying the remaining exam requirements for ECFMG Certification. She did not have an accepted Pathways application by April 1, 2024, so her passing performance on Step 1 is no longer valid for ECFMG Certification. Her earliest USMLE passing performance that is valid for ECFMG Certification is now the Step 2 CK passing performance on May 1, 2018. She now has through May 1, 2025 (seven years from her Step 2 CK passing performance) to pass Step 1 and complete a Pathway, satisfying the remaining exam requirements for ECFMG Certification. If she does not pass Step 1 and complete a Pathway by May 1, 2025, her passing performance on Step 2 CK will no longer be valid for ECFMG Certification.

An international medical graduate passed Step 1 on January 15, 2018 and her 2021 Pathways application was accepted on February 1, 2021. Her Pathway will expire on December 31, 2024 (the expiration date for all 2021 Pathways). The applicant has until December 31, 2024 to pass Step 2 CK before her Pathway expires. If the applicant does not pass Step 2 CK before this date, she will have until January 15, 2025, to pass Step 2 CK and complete Pathways revalidation. If she does not, her passing performance on Step 1 will no longer be valid for ECFMG Certification.

If you have passed a USMLE Step but this passing performance is no longer valid for ECFMG Certification, you may request an exception to retake the previously passed exam that is no longer valid. The USMLE program limits to four the total number of times an examinee can take the same Step. See Reexamination and Reapplication in The United States Medical Licensing Examination (USMLE) section of this booklet.

Important Notes: Time limits to complete the USMLE for the purpose of U.S. medical licensure are established by state medical licensing authorities and may require completion of all Steps (including Step 3, which is not required for ECFMG Certification) within a certain number of years. Information regarding specific state requirements can be obtained on the Federation of State Medical Boards website .

Applicants who retake a previously passed Step to comply with a time limit should understand the implications of a failing retake performance on their Step 3 eligibility. See Retaking Previously Passed Steps in the USMLE Bulletin of Information.

A passing performance that is no longer valid for ECFMG Certification will still appear on a USMLE transcript.