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Comprehensive Review of USMLE (CRU)

The United States Medical Licensing Examination® (USMLE®) is a three-step examination for medical licensure in the United States. USMLE is sponsored by the Federation of State Medical Boards (FSMB) of the United States, Inc., and the National Board of Medical Examiners® (NBME®). The USMLE is governed by a committee consisting of representatives of FSMB, NBME, ECFMG, and the American public. Results of USMLE are reported to individual medical licensing authorities in the United States for use in granting the initial license to practice medicine. To obtain ECFMG Certification, international medical graduates (IMGs) must pass portions of USMLE.

The Comprehensive Review of USMLE (CRU) was initiated in 2004. The goal of this review was to determine if the purpose of USMLE was being effectively and efficiently supported by the current design, structure, and format. This review resulted in recommendations that have been carefully reviewed by the staff and governing bodies of ECFMG, FSMB, and NBME and have led to a series of modifications to test content representation, to changes in a number of existing test formats, and to developmental efforts intended to expand the types of competencies addressed by USMLE. Up-to-date information on the current status of this process is posted to the USMLE website at

As changes to the examinations are implemented, the practice materials available on the USMLE website may be updated to reflect these changes. If you plan to take USMLE examinations, you should monitor the USMLE and ECFMG websites for the latest information on changes related to CRU.

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ECFMG Fast Facts

  • Established in 1956
  • Private, nonprofit organization
  • Headquartered in Philadelphia, Pennsylvania
  • Employs more than 800 people

ECFMG issued the first Standard ECFMG Certificates in 1958. Since then, it has certified more than 320,000 international medical graduates.

Areas of Expertise:

  • Evaluating the qualifications of international medical graduates
  • International medical schools
  • Physician credentials related to medical education, training, and licensure
  • Assessing clinical skills
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Last updated September 12, 2012.
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