Requirements for ECFMG Certification for 2021 Match


To be certified by ECFMG, international medical graduates (IMGs) have been required to pass Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical Skills (CS) of the United States Medical Licensing Examination® (USMLE®). In response to the suspension of Step 2 CS by the USMLE program, we have identified pathways that will allow qualified IMGs who have not passed Step 2 CS to meet the requirements for ECFMG Certification. These pathways allow ECFMG Certification to continue to perform its critical function of providing assurance to the public and U.S. graduate medical education (GME) programs that IMGs are ready to enter supervised training.

These pathways are directed toward IMGs who intend to enter the 2021 Match. Pathway applicants must meet all other requirements for ECFMG Certification.

Please note: ECFMG is no longer accepting new pathway applications for the 2021 Match. The deadline for submission of a pathway application was December 31, 2020. You can check the status of your pathway application using the Application for Pathways for ECFMG Certification for 2021 Match. If your pathway application is currently under review, ECFMG will determine its outcome in time for you to participate in the 2021 Match provided all of the following are true:

  • ECFMG received all supporting documents by January 31, 2021;
  • ECFMG receives your passing OET score result by February 16, 2021; and
  • You have met all general eligibility requirements for the pathways, including passing performance on Step 1 and Step 2 CK.

For information on 2022 pathways and eligibility requirements for ECFMG Certification and for the 2022 Match, see Requirements for ECFMG Certification for 2022 Match.

Please note: Applicants who have a passing performance on USMLE Step 2 CS that is valid for ECFMG Certification and/or are certified by ECFMG are ineligible for the pathways. These individuals do not need to pursue the pathways to meet the requirements for ECFMG Certification or to participate in the 2021 Match, and they do not need to read the following information.

English Language Proficiency Assessment

Applicants who pursue one of the following pathways will be required to attain a satisfactory score on an English language proficiency assessment. All applicants, regardless of citizenship, will be required to satisfy this requirement. ECFMG will accept the Occupational English Test (OET) Medicine to satisfy the English language proficiency requirement.

See the English Language Proficiency Assessment page for more information.

Obtaining Permanent ECFMG Certification

ECFMG Certificates based on one of the pathways listed below will expire if the applicant does not enter a U.S. GME program accredited by the Accreditation Council for Graduate Medical Education (ACGME) for the 2021-2022 academic year. Once the applicant successfully completes the first year of ACGME-accredited training, the certificate is no longer subject to expiration.

Eligibility for All Pathways

Applicants who are eligible to pursue ECFMG Certification based on one of the pathways include those who:


In addition to meeting the requirements in Eligibility for All Pathways above, pathway applicants also must meet all requirements for the pathway to which they apply. Please refer to the detailed eligibility requirements for each pathway at the links below.


ECFMG will consider exceptions to certain pathway eligibility requirements for limited and specific reasons.

See the Exceptions page for more information.

The preceding information is current as of February 4, 2021 and is subject to change. Please visit the ECFMG website frequently for updates regarding these requirements.