What is the ECFMG Certificate?
Let’s start at the beginning. The ECFMG®, the Educational Commission for Foreign Medical Graduates (www.ecfmg.org), is a private, nonprofit organization, employing more than 800 people. Headquartered in Philadelphia, Pennsylvania, it was established in 1956 and issued the first Standard ECFMG Certificates two years later. Since then, it has certified more than 320,000 international medical graduates (IMGs).
The mission statement of the ECFMG begins with this: “The ECFMG promotes quality health care for the public by certifying international medical graduates for entry into U.S. graduate medical education…”
As an IMG, or a student working toward graduation with an interest in practicing in the U.S., it is important to familiarize yourself with the ECFMG Certificate and how to obtain it. It is required to qualify for residency and fellowship programs in the U.S. that are accredited by the Accreditation Council for Graduate Medical Education (www.acgme.org). The ACGME describes itself as, “a private, 501(c)(3), not-for-profit organization that sets standards for US graduate medical education (residency and fellowship) programs and the institutions that sponsor them, and renders accreditation decisions based on compliance with these standards.”
The ECFMG Certificate is also required before applying to take Step 3 of the United States Medical Licensing Examination® (https://www.usmle.org) in order to obtain an unrestricted license to practice medicine in the U.S. The USMLE is a joint program of the Federation of State Medical Boards (FSMB) and National Board of Medical Examiners® (NBME®).
The USMLE has typically been composed of Step 1, Step 2 – Clinical Skills (CS), Step 2 – Clinical Knowledge (CK), and Step 3. To accommodate COVID-19, there have been changes to the procedure, especially as relates to the current suspension of Step 2 – Clinical Skills (CS). We will discuss this important change later in this article and explain how to keep up-to-date with such changes as they occur.
How does the ECFMG define “IMG”?
An international medical graduate (IMG) is defined as, “a physician who received his/her basic medical degree from a medical school located outside the United States and Canada.” Note that it is the same whether you are a U.S. citizen or not—if you graduated from a school outside the U.S. and Canada you are an IMG; and similarly, regardless of your citizenship, if the medical school you graduated from is in the U.S. or Canada, you are not an IMG. You might find it encouraging to know that IMGs already make up almost 25% of the physicians in the U.S.
What is the eligibility For ECFMG Certification?
The answer to this question depends on whether you are a medical school student or a medical school graduate.
For International Medical Students Eligibility For ECFMG Certification:
As a student, to be able to take the Step 1 and Step 2 Clinical Knowledge (CK), you must be officially enrolled in a medical school outside the United States and Canada with a listing in the World Directory of Medical Schools, often referred to as “World Directory” (https://www.wdoms.org). This indicates that the school meets the requirements for eligibility that enable its students and graduates to apply to the ECFMG for certification and examination both at the time of filing the examination application and on the day of the test. Further, there is a note by the ECFMG in the World Directory, on the Sponsor Notes tab, in which the “Graduation Years” for your medical school must be shown as “Current” at the time of both the application being filed and upon taking the test.
Your current enrollment status must be certified by an authorized official of your medical school, following the instructions provided upon filing the application for examination.
Further, upon completion of at least two years of your medical school curriculum, including the basic medical science component, by the beginning of your eligibility period for the examination, you become eligible for Step 1 and Step 2 CK. However, it is recommended to additionally complete the clinical clerkships and experience working directly with patients before taking Step 2 CK.
For International Medical Graduates Eligibility For ECFMG Certification:
Eligibility for USMLE Step 1 and USMLE Step 2 CK requires graduation from a medical school outside the U.S. and Canada with a listing in the World Directory of Medical Schools, often referred to as “World Directory” (https://www.wdoms.org). This indicates that the school meets the requirements for eligibility that enable its students and graduates to apply to the ECFMG for certification and examination. Further, there is a note by the ECFMG in the World Directory, on the Sponsor Notes tab, in which the “Graduation Years” for your medical school must include your graduation year. Further, you must have received official credit for a minimum of four academic years toward completion of the medical curriculum by a medical school which, as mentioned above, is listed as meeting the ECFMG eligibility requirements in the World Directory.
Your status as a graduate must be certified by an authorized official of your medical school, following the instructions provided upon filing the application for examination.
Who can become ECFMG Certified?
In addition to graduation from a properly accredited medical school, certification typically has required IMGs to pass Step 1, Step 2 – Clinical Knowledge (CK), and Step 2 – Clinical Skills (CS) of the USMLE. Since Step 2 (CS) is currently suspended due to COVID-19 protocol, if you have not already passed Step 2 (CS), there are now pathways for allowing ECFMG Certification to continue.
Note that if you already have passed the USMLE Step 2 CS suitably for ECFMG Certification you are not eligible for and do not need to pursue the pathways to meet the requirements for ECFMG Certification.
Eligible IMGs can now apply for the pathways here: https://pathways.ecfmg.org
How do I become ECFMG Certified? Here’s the STEP-BY-STEP PROCESS:
ECFMG Certification Fact Sheet: https://www.ecfmg.org/forms/certfact.pdf
USMLE Step 3 Eligibility Requirements During the Step 2 Clinical Skills Suspension:
Important Links to the various required and useful documents including and in addition to those mentioned above can be found at https://www.ecfmg.org/resources/publications.html#ib
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