ECFMG 2012 Information Booklet

Eligibility for Examination

Medical School Students | Medical School Graduates | Reverification of Eligibility | Fifth Pathway Participants

Fifth Pathway Participants

The Fifth Pathway, created by the American Medical Association (AMA) in 1971, has allowed certain students who attended four years at an international medical school to complete their supervised clinical work at a U.S. medical school, to become eligible for entry to U.S. residency training, and ultimately to obtain a license to practice in the United States. The AMA’s Council on Medical Education no longer supports the Fifth Pathway as a mechanism for eligibility to enter the first year of ACGME-accredited graduate medical education programs. The last Fifth Pathway program class supported was the class that began in January 2009 and ended in December 2009.

Individuals who pursued the Fifth Pathway completed the four-year didactic curriculum at the international medical school, but they did not complete the internship and/or social service requirement for the final medical diploma. Instead, they completed a Fifth Pathway program, which was one year of supervised clinical work at a U.S. medical school. Since they did not complete the internship and/or social service requirement, they did not receive the final medical diploma and, therefore, are not eligible for ECFMG Certification. However, these individuals may apply to ECFMG for examination, provided that they hold a Fifth Pathway certificate issued on or before December 31, 2009.

Important Note: Currently, the USMLE program accepts either a valid Standard ECFMG Certificate or a valid Fifth Pathway certificate (issued through December 31, 2009) from international medical graduates for the purpose of meeting Step 3 eligibility requirements. The USMLE program will cease acceptance of Fifth Pathway certificates for the purpose of meeting Step 3 eligibility requirements, effective January 1, 2017. Individuals who hold valid Fifth Pathway certificates, and are otherwise eligible, may use their Fifth Pathway certificates to meet Step 3 eligibility requirements, and may apply for Step 3, through December 31, 2016. Individuals holding Fifth Pathway certificates that are not accepted by the USMLE program for purposes of meeting Step 3 eligibility will be required to obtain ECFMG Certification in order to be eligible for Step 3.

Last updated: September 15, 2011

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