Requirements for ECFMG Certification for 2022 Match

Pathway 3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME)

Pathway 4: Medical School Accredited by Agency that Has Received a Determination of Comparability by National Committee on Foreign Medical Education and Accreditation (NCFMEA)

Pathway 5: Medical School Issues Degree Jointly with a U.S. Medical School Accredited by Liaison Committee on Medical Education (LCME)

Who Should Apply

Pathways 3, 4, and 5 are intended for applicants who have not yet obtained a license/registration to practice medicine without supervision (Pathway 1) and who have not already passed an acceptable standardized clinical skills exam for medical licensure (Pathway 2). An applicant to Pathway 3, 4, or 5 must be a student or recent graduate of a medical school that meets eligibility requirements established by ECFMG.

Applicants who failed the Step 2 Clinical Skills (CS) Component of the United States Medical Licensing Examination® (USMLE®) one or more times are not eligible to apply to Pathway 3, 4, or 5. 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. The application process for Pathway 6 is expected to open in July. Please monitor this website for the steps that you can take to prepare for Pathway 6 before July.

Important Note: Applicants who already have satisfied the clinical and communication skills requirements for ECFMG Certification do not need to (and are not eligible to) pursue a Pathway to meet the requirements for ECFMG Certification or for participation in the 2022 Match. These individuals include:

  • IMGs who have a passing performance on Step 2 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 2021 Pathways application.

If you applied to a Pathway for the 2021 Match, please see Important Information for 2021 Pathway Applicants before applying to a Pathway for the 2022 Match.

Eligibility Requirements

Requirements for all applicants to Pathways 3, 4, and 5:

Pathway-specific medical school requirements:

To determine whether a medical school’s students and recent graduates are eligible to apply to Pathway 3, 4, or 5, search the list of Medical Schools Eligible for 2022 Pathways. Please note: Schools that meet the eligibility requirements for both Pathways 3 and 4 will be listed as eligible for Pathway 3 only, and applicants from that school will be required to apply to Pathway 3.

If ECFMG determines that additional medical schools meet the requirements for Pathway 3, 4, or 5, they will be added to the list accordingly.

If you believe your medical school meets the requirements listed above and is not included on the list of eligible schools, please contact ECFMG.

In addition to the requirements listed above, the applicant must meet the requirements in General Eligibility for All Pathways and Assessment of Communication Skills, Including English Language Proficiency, as well as all other eligibility requirements for ECFMG Certification.

Application Timing

If you meet the eligibility requirements for Pathway 3, 4, or 5, you may apply now using the on-line Application for Pathways for ECFMG Certification for 2022 Match.

Your application must be submitted no later than December 15, 2021

In order for you to participate in the 2022 Match, ECFMG must determine the outcome of your Pathway application; determine your overall eligibility for the 2021 Match, including verifying your passing performance on Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination® (USMLE®); then report your eligibility status to the National Resident Matching Program® (NRMP®) by the NRMP Rank Order List Certification deadline. ECFMG will not determine the outcome of your Pathway application until all required supporting documentation and/or verification(s) have been received. Therefore, the time needed to complete the processing of your application is contingent upon receipt of all supporting documentation and verifications, including the Clinical Skills Attestation by your medical school. See Applicant Instructions below for more information and deadlines.

Please plan the timing of your application accordingly.

Application Instructions
  1. Access the Application for Pathways for ECFMG Certification for 2022 Match and determine general eligibility.
    • To begin the application, you will need to log in with your USMLE/ECFMG ID and ECFMG On-line Services password. Once you begin the application, you will have five days to complete and submit it. If the application is not submitted within five days, it will be deleted, and you will need to begin a new application if you wish to apply to a Pathway.
    • After you log in, the application will indicate whether you meet the eligibility requirements that pertain to all Pathways.
    • If you have failed Step 2 CS one or more times, the application will indicate that you will be required to apply to Pathway 6. The application process for Pathway 6 is expected to open in July. Please monitor this website for the steps that you can take to prepare for Pathway 6 before July.
  2. If you meet the general eligibility requirements, you will proceed to questions regarding your eligibility for the specific Pathways. If you do not meet the eligibility requirements for Pathway 1 or 2, the system will automatically determine your eligibility to apply to Pathway 3, 4, or 5, based on the information in your ECFMG record.
    • If you are eligible to apply to Pathway 3, 4, or 5, your medical school will be required to attest to your clinical skills, as described in Clinical Skills Attestation by Medical School below.
    • If the application indicates that you are not eligible for Pathway 3, 4, or 5, you will be required to apply to Pathway 6. The application process for Pathway 6 is expected to open in July.
    • If the application indicates you are ineligible for Pathway 3, 4, or 5 and you believe your ECFMG record is incorrect, please contact us for assistance.
  3. Complete and submit the application. After your eligibility to apply to Pathway 3, 4 or 5 is confirmed, you will be asked to certify your application, provide payment, and submit your application to ECFMG.

Once your application is received, ECFMG will evaluate it. A case manager will contact you if there are any issues with your application or if we require additional information.

Clinical Skills Attestation by Medical School

In order to meet the requirements for Pathway 3, 4, or 5, your medical school must attest to your clinical skills. After you submit your Pathways application, the Application Summary will indicate the method your school must use to attest to your clinical skills.

If your medical school participates in using the ECFMG Medical School Web Portal (EMSWP):

If your medical school does not participate in the ECFMG Medical School Web Portal (EMSWP):

Important Information on Documentation Submitted in Support of Your Application
Fees and Payment

The fee for applying to a Pathway is $900. Full payment is due when you submit your application. If the application is not submitted within five days of when you begin it, it will be deleted, and you will need to begin a new application if you wish to apply to a Pathway.

You must use a Visa, MasterCard, Discover, or American Express credit card with a security code; credit available in your ECFMG Financial Account cannot be used to pay for a Pathway application.

Fees related to your application are not refundable. If you submit a Pathway application and ECFMG determines that you are ineligible for the Pathway, your application will be rejected and the fee will not be refunded. In addition, if ECFMG does not receive all required documentation in support of your application, as well as any required verifications of submitted documentation from the issuing authority, your application will not be complete, and the application fee will not be refunded.

Application Processing Time

Once your application has been submitted, you can use the on-line Application for Pathways for ECFMG Certification for 2022 Match to check the status of your application. The following guidelines may be helpful:

The time needed to complete the processing of your application is contingent upon receipt of all supporting documentation and verifications.

The preceding information is current as of April 27, 2021 and is subject to change. Please visit the ECFMG website frequently for updates regarding these requirements.