Pathway 6-ECFMG’s Mini-Clinical Evaluation Exercise (Mini-CEX) - IMGPrep

Pathway 6-ECFMG’s Mini-Clinical Evaluation Exercise (Mini-CEX)

April 29, 2021

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ECFMG Mini-CEX for Pathway 6

The Mini-CEX is a well-studied workplace-based assessment tool used to evaluate an individual’s clinical skills in a variety of clinical settings. The ECFMG has chosen the Mini-CEX as the clinical assessment exam for Pathway 6.

Who is eligible for ECFMG Pathway 6?

  • Applicant does not meet the eligibility requirements for Pathways 1-5; and/or
  • Applicant has failed Step 2 CS one or more times

IMPORTANT Applicant Timing Pathway 6

  • The Pathway 6 online application is expected to become available in August
  • The application must be submitted no later than December 15, 2021
  • All six completed Mini-CEX evaluations must be received by ECFMG no later than December 31, 2021.

Pathway 6 is for applicants who do not meet the eligibility requirements for Pathways 1-5 and/or have failed the Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination® (USMLE®) one or more times.

Where can I complete the Mini Cex Exam?

The direct in-person evaluation must be completed in a formal clinical setting such as an outpatient office, an urgent care clinic, an emergency room, or a hospital. The setting must be primary care/general practice in nature, and not subspecialized.

What are the Requirements for ECFMG 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.

  • The applicant’s clinical skills must be observed and evaluated by licensed physicians in six real, in-person clinical encounters using the ECFMG’s Mini-CEX for Pathway 6.
  • Each encounter must be evaluated by an individual licensed physician that meets the Criteria for Acceptable Physician Evaluators.

How many Physician Evaluations are required for Pathway 6?

Applicants must provide the ECFMG with the names and email addresses of licensed physicians who agree to observe and evaluate the applicant in six separate clinical encounters. Each Physician Evaluator may evaluate the applicant on a maximum of two encounters. Applicants must provide the ECFMG with a minimum of three or a maximum of six physicians in order to meet the requirements.

Who can be a Physician Evaluator for Pathway 6?

To be a Pathway 6 Physician Evaluator, the physician is required to have had an unrestricted license to practice medicine, without supervision, for a minimum of 5 years.

The direct in-person evaluation of the in-person clinical encounter must occur in a jurisdiction where the evaluator is authorized to perform the Mini-CEX. The evaluator must agree to directly observe and evaluate the applicant during an in-person clinical encounter and provide an accurate assessment of the applicant’s clinical skills to the ECFMG using the ECFMG’s Mini-CEX for Pathway 6. Telemedicine and standardized patient encounters will not be accepted.

Where can I complete the Mini Cex Exam?

The direct in-person evaluation must be completed in a formal clinical setting such as an outpatient office, an urgent care clinic, an emergency room, or a hospital. The setting must be primary care/general practice in nature, and not subspecialized.

There are restrictions on who can serve as an evaluating physician for the ECFMG’s Mini-Cex for Pathway 6.

First, the evaluating physician must NOT be compensated by any parties for the evaluation.

Second, the evaluating physician must not be a relative. For the purposes of this evaluation,the ECFMG has defined  “relative” as a spouse, child, grandchild, parent, grandparent, sibling, uncle, aunt, nephew, niece, and/or cousin.

Third, evaluating physicians must provide the applicant approval to share their names and e-mail addresses with the ECFMG.

Fourth, applicants will be required to attest that each physician evaluator meets these criteria at the time they submit the physician’s information to the ECFMG.

An electronic ECFMG Mini-CEX for Pathway 6 must be submitted to the ECFMG for each clinical encounter by the evaluating physician. The on-line process for completing and submitting the Mini-CEX is expected to be available in August.

The Mini-CEX encounter should focus on the diagnosis and treatment of acute and/or chronic illnesses in a primary care setting, where the components of the Mini-CEX can be assessed.

The four components of the Mini-CEX evaluation are: Medical Interviewing Skills, Physical Examination Skills, Professionalism/Communication Skills, Clinical Reasoning & Judgment.

The applicant must obtain an acceptable average score in each of the four evaluated categories AND have no single score below the level of a medical school graduate in the category of Professionalism/Communication Skills on any of the six Mini-CEX evaluations.

Applicants must not complete their clinical encounters before they apply to Pathway 6. The application process for Pathway 6 is expected to open in August. Please see: Application Timing

What are the Fees for Applying to Pathway 6 for the ECFMG?

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.

Fees related to your application are not refundable. If you submit a Pathway application and the ECFMG determines that you are ineligible for the Pathway, your application will be rejected and the fee will not be refunded. In addition, if the 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.

Information is current as of June 25, 2021 and subject to change.

Please visit the ECFMG website frequently for updates regarding these requirements.

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