Requirements for ECFMG Certification for 2024 Match
Overview
To be eligible for ECFMG Certification, international medical graduates (IMGs) must satisfy a number of requirements, including the medical science examination requirement, the clinical skills requirement, and the communication skills requirement. Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination® (USMLE®) are the exams currently administered that satisfy the medical science examination requirement.
To meet the clinical and communication skills requirements for ECFMG Certification, eligible IMGs can use the Pathways. The Pathways allow qualified IMGs to continue to pursue ECFMG Certification and to compete for positions in U.S. graduate medical education (GME), while providing assurance to the public and U.S. GME programs that IMGs are ready to enter supervised training.
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Who Should Use the Pathways?
The Pathways for ECFMG Certification for the 2024 Match (2024 Pathways) are intended for IMGs who need to meet the clinical skills requirement and the communication skills requirement for ECFMG Certification and who plan to participate in the 2024 National Resident Matching Program® (NRMP®) Main Residency Match® (The Match®) in March 2024.
If you are an IMG who needs to meet the clinical and communication skills requirements for ECFMG Certification, and you intend to participate in the 2024 Match, you must apply to one of the 2024 Pathways. There will be no exceptions to this requirement, or to the eligibility requirements for the Pathways. See Applying to the Pathways below for an overview on how to apply.
Important Note: In addition to satisfying the clinical and communication skills requirements for ECFMG Certification through a Pathway, you also must:
- Have passed Step 1 and Step 2 CK to participate in the 2024 Match, and
- Satisfy all other requirements for ECFMG Certification to be certified by ECFMG.
Important Note: If you already have satisfied the clinical and communication skills requirements for ECFMG Certification, you do not need to (and are not eligible to) pursue a Pathway to meet the requirements for ECFMG Certification or for participation in the 2024 Match. Individuals who already have satisfied the clinical and communication skills requirements for ECFMG Certification include:
- IMGs who have a passing performance on USMLE Step 2 Clinical Skills (CS) that is valid for ECFMG Certification (even if they previously failed Step 2 CS),
- IMGs who are certified by ECFMG, and
- IMGs with an approved application to the 2021, 2022, or 2023 Pathways.
If you applied to a Pathway for the 2021, 2022, or 2023 Match or familiarized yourself with the 2021, 2022, or 2023 Pathways requirements, you should review the 2024 Pathways information carefully to ensure an understanding of 2024 Pathways eligibility and requirements. You also should review the Important Information for 2021, 2022, and 2023 Pathways Applicants.
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Assessment of Communication Skills, Including English Language Proficiency
As part of the Pathways, applicants are required to attain a satisfactory score on the Occupational English Test (OET) Medicine to satisfy the communication skills requirement for ECFMG Certification. All Pathways applicants, regardless of native language, language of instruction at medical school, or citizenship, must satisfy this requirement in addition to meeting the requirements of a specific Pathway. There will be no exceptions.
See the
Assessment of Communications Skills, Including English Language
Proficiency page for more information.
Important Note: Obtaining a satisfactory score on OET Medicine is only one of the requirements for completing a Pathway. Applicants also must submit an on-line application for the appropriate Pathway. See Applying to the Pathways below.
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General Eligibility for All Pathways
Applicants who are eligible to pursue ECFMG Certification based on one of the Pathways include those who:
- Have not already met the clinical and communication skills requirements for ECFMG Certification. (If you have a passing performance on Step 2 CS that is valid for ECFMG Certification,* or if you have a previously approved Pathways application, you have already met the clinical and communication skills requirements for ECFMG Certification and are not currently eligible to pursue a Pathway.)
- Are not barred by ECFMG from pursuing ECFMG Certification.
- Have submitted an Application for ECFMG Certification.
- Have previously been registered for a USMLE Step or Step Component. This means that, if you have never been registered to take a USMLE Step or Step Component, you must apply for and be registered for a USMLE exam before you can submit a Pathways application.
*ECFMG has established time limits and other rules for completing the examination requirements for ECFMG Certification. For detailed information, see
Examination Requirements and Time Limit for Completing Examination Requirements
in the
Examinations for ECFMG Certification
section of the ECFMG Information Booklet.
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The Pathways
In addition to meeting the requirements in General Eligibility for All Pathways, Pathways applicants also must meet all requirements for the Pathway to which they apply.
Important Note: Applicants who failed Step 2 CS one or more times must apply to Pathway 6 in order to meet the clinical and communication skills requirements for ECFMG Certification, regardless of whether they meet the eligibility requirements for other Pathways.
As a reminder, applicants who have a passing performance on Step 2 CS that is valid for ECFMG Certification do not need to (and are not eligible to) apply to a Pathway, even if they previously failed Step 2 CS.
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Pathway 1: Already Licensed to Practice Medicine in Another
Country
Pathway 1 is for applicants who currently hold or have recently held a license/registration to practice medicine without supervision. Applicants who meet the eligibility requirements for Pathway 1 must apply to Pathway 1 in order to meet the clinical and communication skills requirements for ECFMG Certification, unless they failed Step 2 CS; see Important Note.
See the Pathway 1 page for more information, including eligible licensure dates.
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Pathway 2: Already Passed an Objective Structured Clinical Examination (OSCE) for Medical Licensure Administered by an Acceptable Medical School
This Pathway is for applicants who do not meet the eligibility requirements for Pathway 1, but who attend or have graduated from a medical school that administers an OSCE specifically required for medical licensure by the medical regulatory authority (MRA) in that country. The medical school must meet certain ECFMG requirements and the applicant must have successfully completed the OSCE.
See the Pathway 2 page for more information, including eligible graduation dates and medical school requirements.
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Pathway 3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME)
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Pathway 4: Medical School Accredited by Agency that Has Received a Determination of Comparability by National Committee on Foreign Medical Education and Accreditation (NCFMEA)
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Pathway 5: Medical School Issues Degree Jointly with a U.S. Medical School Accredited by Liaison Committee on Medical Education (LCME)
Pathways 3, 4, and 5 are for applicants who do not meet the eligibility requirements for Pathway 1 and are students or recent graduates of a medical school that meets eligibility requirements established by ECFMG for Pathway 3, 4, or 5.
See the page for Pathways 3, 4, and 5 for more information, including eligible graduation dates.
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Pathway 6: Evaluation of Clinical Patient Encounters by Licensed Physicians
Pathway 6 is for applicants who do not meet the eligibility requirements for Pathway 1, 2, 3, 4, or 5. To meet the requirements for Pathway 6, the applicant’s clinical skills must be evaluated by licensed physicians using ECFMG’s Mini-Clinical Evaluation Exercise (Mini-CEX) for Pathway 6.
See the Pathway 6 page for more information.
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Applying to the Pathways
To meet the clinical and communication skills requirements for ECFMG Certification through one of the Pathways, please follow these steps:
- Consider the timing of your Pathways application. ECFMG Certificates issued to applicants who satisfy the clinical and communication skills requirements for ECFMG Certification through a Pathway are subject to expiration. See Information on Expiration of the ECFMG Certificate below for more information. In addition, if you do not complete your 2024 Pathways application and meet all requirements for your application by the time the current application season ends after the 2024 Match, your application will be rejected and you will be required to reapply to the Pathways in a future application season, and pay the applicable application fees at that time, in order to meet the clinical and communication skills requirements for ECFMG Certification.
- Determine your eligibility to apply to a Pathway by reviewing all information on this website carefully.
- If you believe you are eligible to apply to a Pathway, complete and submit your Application for Pathways for ECFMG Certification for 2024 Match. Your application must be submitted by January 31, 2024.
- Meet the communication skills requirement by attaining a satisfactory score on each of the four sub-tests (Listening, Reading, Writing, and Speaking) of the OET Medicine test. You should take OET Medicine on or before the last available test date in December 2023. If you test after this date, your OET scores may not be available in time to complete your Pathways application before the 2024 Match.
- Release your OET Medicine scores to ECFMG. See Assessment of Communication Skills, Including English Language Proficiency for instructions. ECFMG must receive your scores directly from OET by January 31, 2024. ECFMG will continue to receive and process results after this date, but results received after January 31, 2024 may not be processed in time for you to participate in the 2024 Match.
- Ensure that all required documentation in support of your Pathways application is received by ECFMG. See the detailed instructions for the Pathway to which you are applying for complete information on required documentation and deadlines. It is your responsibility to ensure that ECFMG receives all required documentation.
- Monitor the status of your application by logging into the Application for Pathways for ECFMG Certification for 2024 Match. You will be notified by e-mail when processing of your application is complete. Please note: If you have not met all requirements for your Pathways application when the current application season ends, your application will be rejected and you will be required to reapply and pay any and all required application fee(s) in a future application season in order to meet the clinical and communication skills requirements for ECFMG Certification.
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Information on Expiration of the ECFMG Certificate
ECFMG Certificates issued to applicants who satisfy the clinical and communication skills requirements for ECFMG Certification through a Pathway will be valid through December 31, 2024. Once the applicant successfully completes the first year of training in a U.S. GME training program accredited by the Accreditation Council for Graduate Medical Education (ACGME), the ECFMG Certificate will no longer be subject to expiration.
Please monitor this website for instructions on how to document completion of the first year of ACGME-accredited training and make your ECFMG Certificate valid indefinitely.
If you do not enter an ACGME-accredited training program by December 31, 2024, your ECFMG Certificate will expire. Should you wish to enter a GME program in the future, you will be required to meet the clinical and communication skills requirements for ECFMG Certification in place at that time in order to revalidate your ECFMG Certificate.
If you were certified by ECFMG based on a 2021 or 2022 Pathway and your ECFMG Certificate lists an expiration date in 2021 or 2022, this expiration date has been extended through December 31, 2024. Please see the Important Information for 2021, 2022, and 2023 Pathways Applicants page for more information.
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Impact of Pathways on the Time Limit for Completing Examination Requirements
ECFMG requires that IMGs 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 pass the other exam(s) required for ECFMG Certification. This seven-year period begins on the date of the first exam passed and ends exactly seven years from that date.
Meeting the clinical and communication skills requirements for ECFMG Certification through a Pathway also is subject to this seven-year requirement. This means that your Pathways application must be accepted within the seven-year period. If your Pathways application is not accepted within the seven-year period and you have a passing Step 1 and/or Step 2 CK score that becomes invalid for ECFMG Certification as a result, you must contact ECFMG to determine whether your invalid passing performance on Step 1 and/or Step 2 CK meets ECFMG’s requirements to be extended.
Please note that it is your responsibility to track your progress toward meeting these 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.
The preceding information is current as of May 17, 2023 and is subject to change. Please visit the ECFMG website frequently for updates regarding these requirements.
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