The main pathway for
international medical graduates who wish to be licensed as a physician in the
United States is to complete a U.S.
residency hospital program. The general method to apply for residency programs is through the
National Resident Matching Program (abbreviated NRMP, but also called "the Match"). To participate in the NRMP, an IMG is required to have an ECFMG certification by the "rank order list certification deadline" time (usually in February of the year of the match). To acquire an ECFMG certification, the candidate must meet these requirements: • Examination Requirement: Completion of
USMLE Step 1 and
USMLE Step 2 Clinical Knowledge • Meet the clinical and communication skills requirements (see section) • Medical education credential requirements: A medical diploma of
medical education taken at an institution registered in the
World Directory of Medical Schools (WDOM). The official source to confirm that a medical school meets ECFMG's requirements, is the World Directory at www.wdoms.org. Schools that meet the requirements will have an ECFMG note stating this in the schools’ World Directory listing. In comparison, regular graduates from medical schools in the United States need to complete USMLE Steps 1 and 2 as well, but can participate in the NRMP while still doing their final year of medical school before acquiring their medical diplomas. In effect, taking regular administrative delays into account, and with residency programs starting around July, there is a gap of at least half a year for IMGs between graduation from medical school and beginning of a residency program.
Clinical and communication skills requirements The
COVID-19 global pandemic has brought some changes to the ECFMG certification process. First as AAMC suspended temporarily and later eliminated the
Step 2 CS examination, ECFMG moved to a pathways model for verification of clinical skills. IMGs who have already taken Step 2 CS may still use it to fulfill this requirement. All other IMGs will need: • Assessment of communication skills, including English language proficiency through the
Occupational English Test Medicine exam • Meet the requirements for one of the pathways below:
Certification expiration As of April 2021, ECFMG certifications obtained by fulfilling the clinical and communication skills requirements through a pathway will expire in 2022 if the applicant does not enter an ACGME-accredited training program in 2021 or 2022. If the applicant enters a training program they become permanent after one year of residency. After completion of this pilot project, ECFMG now allows all medical schools to register for free. Expected to be implemented in late 2024, a notable development is anticipated in medical education application procedures. ECFMG Status Reports will be integrated into Electronic Residency Application Service (ERAS) submissions, offering vital information for institutions assessing applicants. These reports will specifically indicate whether the candidate's medical school meets the Recognized Accreditation Policy, determined by accreditation from agencies recognized by the World Federation for Medical Education or the National Committee on Foreign Medical Education and Accreditation. This enhancement aims to streamline the evaluation of medical school credentials, enhancing transparency and efficiency in the residency application process. However, IMGs will still be able to pursue ECFMG Certification even if their medical school doesn't meet the Recognized Accreditation Policy, as long as their school meets ECFMG's current requirements. The accrediting agencies that are WFME recognized are: ==Communication==