ECFMG Certification
The Educational Commission for Foreign Medical Graduates (ECFMG), through its program of certification, assesses whether international medical graduates are ready to enter residency or fellowship programs in the United States that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). ECFMG Certification is a requirement for international medical graduates who wish to enter such programs.
ECFMG Certification assures directors of ACGME-accredited residency and fellowship programs, and the people of the United States, that international medical graduates have met minimum standards of eligibility to enter such programs. ECFMG Certification does not, however, guarantee that these graduates will be accepted into programs, since the number of applicants frequently exceeds the number of available positions.
ECFMG Certification is also one of the eligibility requirements for international medical graduates to take Step 3 of the three-step United States Medical Licensing Examination (USMLE). Medical licensing authorities in the United States require ECFMG Certification, among other requirements, to obtain an unrestricted license to practice medicine.
ECFMG and its organizational members define an international medical graduate as a physician who received his/her basic medical degree or qualification from a medical school located outside the United States and Canada*. Citizens of the United States who have completed their medical education in schools outside the United States and Canada are considered international medical graduates; non-U.S. citizens who have graduated from medical schools in the United States and Canada are not considered international medical graduates.
To be eligible for ECFMG Certification, the physician’s medical school and graduation year must be listed in the International Medical Education Directory (IMED) of the Foundation for Advancement of International Medical Education and Research (FAIMER). To verify that a particular medical school and graduation year are listed, access IMED.
Requirements for ECFMG Certification
To be eligible for certification by ECFMG, international medical graduates must meet the following examination and medical education credential requirements.
Examination Requirements
The examination requirements for ECFMG Certification include passing Step 1 and Step 2 of the USMLE. The Step 2 exam has two separately administered components, the Clinical Knowledge (CK) component and the Clinical Skills (CS) component.
To meet the examination requirements for ECFMG Certification, applicants must:
1. Satisfy the medical science examination requirement.
Step 1 and Step 2 CK of the USMLE are the exams currently administered that satisfy this requirement. To meet the medical science examination requirement for ECFMG Certification, applicants must pass both Step 1 and Step 2 CK within a specified period of time.
2. Satisfy the clinical skills requirement.
Step 2 CS of the USMLE is the exam currently administered that satisfies this requirement. Specific time limits for passing Step 2 CS for ECFMG Certification may apply.
For detailed information, including information on time limits for completing the examinations for ECFMG Certification and using a passing performance on former exams to satisfy these requirements, see Examination Requirements.
Medical Education Credential Requirements
The physician’s medical school and graduation year must be listed in the International Medical Education Directory (IMED). International medical graduates must have had at least four credit years (academic years for which credit has been given toward completion of the medical curriculum) in attendance at a medical school that is listed in IMED. There are restrictions on credits transferred to the medical school that awards an applicant’s medical degree that can be used to meet this requirement. See Transfer Credits.
IMED is maintained by the Foundation for Advancement of International Medical Education and Research (FAIMER), a nonprofit foundation of ECFMG. IMED contains information supplied by countries about their medical schools. FAIMER is not an accrediting agency.
Applicants must document the completion of all requirements for, and receipt of, the final medical diploma. ECFMG verifies every applicant’s medical school diploma with the appropriate officials of the medical school that issued the diploma and requests that the medical school provide the final medical school transcript. Verification by ECFMG with the issuing school may also be required for transcripts that are submitted by applicants to document transferred academic credits. See Medical Education Credentials.
Important Note: Submitting altered or falsified documents to ECFMG may be sufficient cause for ECFMG to bar you from an exam, to terminate your participation in an exam, to withhold and/or invalidate the results of an exam, to withhold a certificate, revoke a certificate, or to take other appropriate action. ECFMG will report instances of altered or falsified documents to the FSMB Board Action Databank, state medical licensing authorities, and directors of graduate medical education programs, among others. ECFMG may also report such instances to the USMLE Committee on Irregular Behavior and to any other organization or individual who, in the judgment of ECFMG, has a legitimate interest in such information.
In all cases when the ECFMG Medical Education Credentials Committee has made a finding of irregular behavior, a permanent annotation will be included in the individual’s ECFMG Status Report and ECFMG Certification Verification Service (CVS) Report. Additional information explaining the basis for the finding of irregular behavior and the resulting action will accompany every ECFMG Status Report and CVS Report and may also be provided to legitimately interested entities; this additional information will be provided if there is a finding of irregular behavior made on or after August 31, 2006, regardless of the date of the conduct or activity that gave rise to the finding. See Irregular Behavior in General Applicant Information and Irregular Behavior in Medical Education Credentials.
Standard ECFMG Certificate
ECFMG issues the Standard ECFMG Certificate to applicants who meet all of the examination and medical education credential requirements. Applicants must also pay any outstanding charges on their ECFMG financial accounts before their certificates are issued. Standard ECFMG Certificates are sent approximately two weeks after all of these requirements have been met. Currently, ECFMG sends the Standard ECFMG Certificate to the applicant’s address of record by Federal Express. If the address in your ECFMG record is a U.S. post office box, the certificate will be sent by certified mail.
The Standard ECFMG Certificate includes:
- The name of the applicant;
- The applicant’s USMLE/ECFMG Identification Number;
- The dates that the examination requirements were met;
- The date that the certificate was issued; and
- If applicable, the dates through which the passing performances on certain exams remain valid for the purpose of entry into graduate medical education. (See Validity of Examinations for Entry into Graduate Medical Education.)
Applicants may use the Standard ECFMG Certificate to enter an accredited program of graduate medical education in the United States.
Validity of Examinations for Entry into Graduate Medical Education
Clinical Skills Examinations
For applicants who satisfy the clinical skills requirement for ECFMG Certification by passing Step 2 CS, this passing performance is not subject to expiration for the purpose of entering programs of graduate medical education.
For applicants who satisfied the clinical skills requirement for ECFMG Certification by passing the former ECFMG CSA and an English language proficiency test, passing performance on the CSA may be subject to expiration for the purpose of entering graduate medical education, as described below.
- Passing performances on CSA administrations that took place on or after June 14, 2001 are not subject to expiration for the purpose of entering graduate medical education programs. If you are certified by ECFMG and your Standard ECFMG Certificate lists a “valid through” date for an administration of the CSA that took place on or after June 14, 2001, you may request a permanent validation sticker that you can affix to your certificate. To request a sticker, access OASIS or complete a Special Request for Permanent Validation Sticker (Form 295) and submit it to ECFMG.
- Passing performances on CSA administrations that took place before June 14, 2001 are valid for three years from the date passed for the purpose of entering graduate medical education programs. The date through which passing performance on the CSA remains valid for entry into graduate medical education (the CSA “valid through” date) will be listed on the applicant’s Standard ECFMG Certificate. If the applicant entered a program before expiration of the valid through date, the applicant may request permanent validation. This means that the CSA date is no longer subject to expiration. To request permanent validation, the applicant and an authorized official of the training institution must complete a Request for Permanent Validation (Form 246). On receipt of this form, ECFMG will provide a permanent validation sticker to be affixed to the certificate. If an applicant who passed CSA before June 14, 2001 did not enter a program within three years of the CSA pass date, the applicant’s CSA passing performance has expired for the purpose of entering graduate medical education. Before entering a program, these applicants must pass Step 2 CS. Passing performance on Step 2 CS does not expire for the purpose of entry into graduate medical education.
English Examinations
Passing performances on the English language proficiency test formerly required by ECFMG (such as the TOEFL® exam or the former ECFMG English Test) are not subject to expiration for the purpose of entering graduate medical education programs, regardless of the date passed. If you are certified by ECFMG and your Standard ECFMG Certificate lists a “valid through” date for an English language proficiency test, you may request a permanent validation sticker on-line using OASIS or by completing a Special Request for Permanent Validation Sticker (Form 295) and submitting it to ECFMG.
Requesting Duplicate Permanent Validation Stickers
If you lost or did not receive your permanent validation sticker(s), you may request duplicates by completing a Request for Duplicate Permanent Validation Sticker (Form 296).
Important Note: The preceding discussion of validity and expiration of examinations, and the “valid through” and “valid indefinitely” designations on the Standard ECFMG Certificate (if applicable), are relevant only for the purpose of entry into programs of graduate medical education in the United States. They do not pertain to eligibility for USMLE Step 3 or to any time limits imposed by medical licensing authorities or other entities for the completion of all USMLE Steps.
Confirmation of ECFMG Certification Status – ECFMG’s Certification Verification Service
ECFMG’s Certification Verification Service provides primary-source confirmation of the ECFMG certification status of international medical graduates. The Joint Commission, the organization that evaluates and accredits U.S. health care organizations and programs, has determined that direct verification with ECFMG of a physician’s certification status satisfies The Joint Commission’s requirement for primary-source verification of medical school completion for graduates of international medical schools.
ECFMG will confirm your certification status when a request is received from a medical licensing authority, residency program director, hospital, or other organization that, in the judgment of ECFMG, has a legitimate interest in such information. For status reports sent to medical licensing authorities, the request can also be made by you. Requesting organizations must normally secure and retain your signed authorization to obtain certification information. Please note that there may be a fee for this service.
Requests for confirmation must contain your name, date of birth, USMLE/ECFMG Identification Number, and name and address of the organization to which the confirmation should be sent. To obtain the appropriate request form or to make an on-line request, visit the CVS home page. Confirmations are sent to the requesting organization within approximately two weeks. Confirmations are not sent to applicants directly.
If the requesting organization does not receive the report, ECFMG will honor requests for duplicate reports at no additional cost up to 90 days after the date that the original report was processed.
If you apply to residency programs through ERAS, ECFMG will send an electronic ECFMG Status Report automatically to all of the programs to which you apply. If your ECFMG certification status changes during the ERAS application process, ECFMG will send an updated status report automatically to all programs to which you have applied.
* The United States and Canada refer to the geographic locations where citizens are issued passports by the governments of either the United States or Canada.