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Earthquake in Haiti

(posted January 27, 2010)

ECFMG joins other organizations and individuals in expressing sympathy for those affected by the earthquake in Haiti. As a member of the international medical education community, ECFMG applauds the efforts of the many health professionals who continue to care for survivors.

ECFMG is supporting a number of initiatives, organized by staff volunteers, to collect staff donations of funds as well as much-needed personal items. It is our hope that these efforts, combined with contributions from so many others, will help to meet the urgent needs of the people of Haiti and aid in their recovery.

Several of ECFMG’s organizational members have responded to the crisis by organizing efforts to facilitate donations, volunteers, and the sharing of information and resources. For more information, visit their Haitian earthquake response web pages:

Haitian applicants for ECFMG’s programs and services who require assistance are encouraged to contact Applicant Information Services by phone at (215) 386-5900 (9:00 a.m.-5:00 p.m., Eastern Time in the United States, Monday through Friday), or by e-mail at info@ecfmg.org.

IMGs Participating in 2011 Match Should Apply for Step 2 CS Now

(posted January 25, 2010)

International medical students/graduates and graduates of Fifth Pathway programs who plan to participate in the 2011 Match (in March 2011) are reminded that they must take Step 2 CS by December 31, 2010. As published in the 2010 Step 2 Clinical Skills Schedule for Reporting Results, if you do not take Step 2 CS by December 31, 2010, your result will not be available in time to participate in the 2011 Match.

If you need to pass Step 2 CS to participate in the 2011 Match, you are strongly encouraged to apply for Step 2 CS now. If you do not register early and schedule a test date as soon as possible, you may not be able to obtain a test date in 2010.

At the time of this writing, the earliest available test date at any test center was in April 2010. It is expected that demand for testing appointments in the period from July through December will be even higher in 2010 than in past years. Additionally, test sessions at all test centers may be subject to scheduling restrictions that may limit the number of test dates available to you.

To maximize your chances of obtaining a test date in 2010,

Early registration and scheduling may offer a number of benefits. If you plan to apply for Step 2 CS, you should consider the following:

Updated information on Step 2 CS scheduling will be posted to the ECFMG website as it becomes available. Individuals planning to take Step 2 CS should monitor the ECFMG and USMLE websites for the latest information.

ECFMG, FSMB, and NBME to Co-host IAMRA 2010 Conference

(posted January 25, 2010)

The Educational Commission for Foreign Medical Graduates (ECFMG®), the Federation of State Medical Boards of the United States, Inc. (FSMB), and the National Board of Medical Examiners® (NBME®) are partnering to co-host the International Association of Medical Regulatory Authorities’ (IAMRA) 9th Biennial Conference on Medical Regulation. The conference will be held September 26–29, 2010 in Philadelphia, Pennsylvania in the United States. The first in IAMRA’s series of conferences on Best Practices in Medical Regulation, IAMRA 2010 will be a results-driven event that will begin to define best practices in three important content areas:

The host organizations have developed a conference program that will allow participants to learn from subject matter experts and from each other, acquiring knowledge and principles that can be customized to their individual needs. The program has been designed to ensure relevance to all participants, regardless of their level of expertise, resources, or the current status of their regulatory processes and infrastructure. High-engagement activities will allow participants to play an active role in developing solutions and to establish professional relationships that can support their work after the conference.

After IAMRA 2010, work will continue to refine the principles developed during the conference, with the goal of presenting the results for review and adoption by IAMRA at its next conference on Best Practices in 2012. As a result, participants in IAMRA 2010 will be at the beginning of an exciting new process that will shape the future of medical regulation.

For more detailed information on the conference, IAMRA, and the host organizations, visit the official conference website. Please check the website frequently, as additional details will be posted as they become available.

Increase in International Test Delivery Surcharges for USMLE Step 1 and Step 2 Clinical Knowledge (CK)

(posted December 23, 2009)

As announced previously, the international test delivery surcharges for USMLE Step 1 and Step 2 Clinical Knowledge (CK) will increase, effective January 1, 2010. International test delivery surcharges apply to applicants who choose a testing region other than the United States/Canada.

The new international test delivery surcharges are:

Testing Region Step 1 Step 2 CK
United States/Canada $0 $0
Africa
(For Egypt, select Middle East testing region.)
$140 $155
Asia
(For India, select India testing region.)
$140 $155
Australia $140 $155
China
(For Hong Kong, select Asia testing region.)
$140 $155
Europe $170 $190
India $140 $155
Indonesia $140 $155
Japan $330 $370
Korea $170 $190
Latin America $140 $155
Middle East
(For Israel, select Europe testing region.)
$140 $155
Taiwan $170 $190
Thailand $140 $155

The new international test delivery surcharges will be assessed for all Step 1 and Step 2 CK applications submitted to ECFMG on or after January 1, 2010.

For more information on the fees and surcharges associated with applying for USMLE exams, refer to Fees in the ECFMG Information Booklet. For more information on testing regions for USMLE Step 1 and Step 2 CK, refer to Testing Locations in the ECFMG Information Booklet.

Fee Increases for USMLE Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical Skills (CS)

(posted December 10, 2009)

Effective January 1, 2010, the fees for those applying to ECFMG for USMLE Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical Skills (CS) will increase.

The examination fees for USMLE Step 1 and Step 2 CK will increase from $710 to $740 for each exam registration.

The examination fee for Step 2 CS will increase from $1,200 to $1,295 for each exam registration.

Additionally, it is expected that Prometric™ will increase the Step 1/Step 2 CK international test delivery surcharges, which apply to applicants who choose a testing region other than the United States/Canada. ECFMG will post additional information on the increases to the international test delivery surcharges to the ECFMG website as it becomes available.

Both the new examination fees and the new test delivery surcharges will be assessed for all Step 1, Step 2 CK, and Step 2 CS applications submitted to ECFMG on or after January 1, 2010.

For more information on the fees and surcharges associated with applying for USMLE Step 1, Step 2 CK, and Step 2 CS, refer to Fees in the ECFMG Information Booklet.

Change in Minimum Passing Requirements for Step 1

(posted December 10, 2009)

As stated in the USMLE Bulletin of Information, the level of proficiency required to meet the recommended minimum passing level for each USMLE Step examination is reviewed periodically and may be adjusted at any time. As a result of such a review for USMLE Step 1, the Step 1 Committee decided to raise the three-digit score recommended to pass Step 1 from 185 to 188. The new minimum passing score will be applied to Step 1 examinations for which the first day of testing is on or after January 1, 2010.

View full announcement.

ECFMG’s IMG Advisors Network Expanding – New Advisors Needed

(posted December 3, 2009)

ECFMG is currently seeking international medical graduates (IMGs) to serve on a voluntary basis as advisors for the IMG Advisors Network (IAN). This unique resource connects qualifying IMGs who plan to enter U.S. graduate medical education (GME) with advisors who may be able to answer many of their questions about applying for GME positions as well as living and working in the United States.

To qualify as an advisor, you must:

The personal experience and first-hand exposure to the challenges of entering a residency program and living and working in the United States make individuals who meet these requirements uniquely qualified to provide practical advice and information.

Advisors will be listed in the on-line IAN database by name, medical specialty, U.S. GME program, location in the United States, country of origin, medical school, and other demographics. IMGs who meet certain criteria and register with the IAN program will be able to search the IAN database for the advisors most likely to be helpful in providing information and advice about relocating to the United States. Ideal advisors might be those in the same residency program or from the same country or medical school, but even less specific matches could be of great help. Advisors are provided with the e-mail addresses of the advisees who have selected them so they can begin communicating directly with the advisees via e-mail; these communications are not visible to or monitored by ECFMG unless the advisor or advisee so chooses.

Since the start of the IAN program in early 2007, most advisors have had only one or two advisees and exchanged only a few e-mails, so the advisor role has not placed excessive demand on advisors’ time. Although it is not possible to estimate how often advisors and advisees might correspond or how much time the advisor role will take on an ongoing basis, advisors are able to limit the number of advisees they accept and have the option of declining to serve as an advisor for an individual advisee. Advisors can have their names removed from the IAN database if they so choose.

Recently, the eligibility criteria for IMGs to participate in IAN as advisees were expanded to include IMGs who are participating in the Electronic Residency Application Service (ERAS) 2010 and who also have registered with the National Resident Matching Program (NRMP) for the 2010 Match. This expanded eligibility may significantly increase the number of advisees seeking advice prior to entering programs in 2010. In order to better serve this larger group of advisees, ECFMG is hoping to increase the number of advisors in the IAN program.

If you are interested in becoming an IAN advisor or would like to learn if you are eligible to participate in IAN as an advisee, you can obtain more information by visiting the IAN homepage.

ECFMG to Provide International Medical Schools with USMLE Performance Data on Their Students/Graduates

(posted April 2, 2009; updated November 2, 2009)

ECFMG may provide international medical schools with data on the performance of their students and graduates who apply to ECFMG for USMLE Step 1, USMLE Step 2 Clinical Knowledge (CK), and USMLE Step 2 Clinical Skills (CS). This applies to all exam administrations for which an examinee applies on or after November 2, 2009.

Data will be provided to medical schools electronically through the ECFMG Medical School Web Portal (EMSWP) and will include whether each examinee passed the exam administration, and, for Step 1 and Step 2 CK, the examinee’s numerical score on both two-digit and three-digit scales.

Examinees have the option to have their exam results withheld from their medical school. To have exam results withheld from his/her medical school, the examinee must submit a request through ECFMG’s Interactive Web Application (IWA).

To view information on ECFMG’s practices regarding the provision of these data to international medical schools and the process by which examinees can request to have their exam results withheld from their medical school, click here.

Beginning in early 2010, ECFMG expects to start providing medical schools with aggregate USMLE performance data on their students/graduates. Aggregate data will be provided on an annual basis to medical schools that provide ECFMG with certain information relating to their student body, curriculum, and educational programs. The information provided by schools will be used by ECFMG’s foundation, the Foundation for Advancement of International Medical Education and Research (FAIMER), in its on-going efforts to develop data resources on medical education programs throughout the world.

International medical schools have long expressed interest in obtaining USMLE performance data on their students/graduates, and we expect these opportunities to obtain such data to be mutually beneficial for the medical schools and ECFMG.

NBME® Self-Assessments with Expanded Feedback

(posted October 20, 2009)

The National Board of Medical Examiners® (NBME) offers web-based self-assessments to help medical students and graduates evaluate their readiness for the computer-based components of the United States Medical Licensing Examination (USMLE). The content of the Comprehensive Basic Science Self-Assessment (CBSSA) resembles the content of USMLE Step 1, while the content of the Comprehensive Clinical Science Self-Assessment (CCSSA) resembles the content of USMLE Step 2 Clinical Knowledge (CK).

The NBME is pleased to announce that it now provides expanded feedback for one form of the CBSSA and one form of the CCSSA. In addition to the performance profile and score interpretation guide available with all forms, the expanded feedback also shows the number of items answered incorrectly by content category, the average amount of time spent on each incorrect item, and the percentage of incorrect items marked during the assessment. The feedback also provides the capability to review the text of the incorrect items. The fee for expanded feedback forms is $60.00; the fee for standard forms is $45.00.

For complete information, to view a sample assessment, or to purchase an assessment, visit the NBME Self-Assessment Services website.

On-line Posting or Discussion of USMLE Content Constitutes Irregular Behavior

(posted September 11, 2009)

If you post or discuss United States Medical Licensing Examination (USMLE) examination content via the Internet, you will be in violation of the USMLE Rules of Conduct, as outlined in the USMLE Bulletin of Information. Examination content includes, but may not be limited to, questions, case content, and answers.

The Bulletin specifically advises that, “you will maintain the confidentiality of the materials, including the multiple-choice items, and the case content for Step 2 CS and Primum CCS. You will not reproduce or attempt to reproduce examination materials through memorization or any other means. Also, you will not provide information relating to examination content that may give or attempt to give unfair advantage to individuals who may be taking the examination. This includes postings regarding examination content and/or answers on the Internet.”

The USMLE program continuously monitors Internet forums and chat rooms. Examinees who post information about examination content are identified and referred to the USMLE Committee on Irregular Behavior. If the Committee finds that you posted examination content, your scores may be delayed and you may be subject to the following sanctions:

A determination of irregular behavior can put your medical career in jeopardy. Do not endanger your career: Do not post information from exams you have taken and do not solicit others to provide such information.

For more information, refer to Testing Regulations and Rules of Conduct and Irregular Behavior in the USMLE Bulletin of Information, available on the USMLE website.

Important Announcement from the USMLE Program

(posted July 29, 2009)
Alert Regarding Optima Test Prep

A USMLE test preparation company that operates under the name “Optima University” has been sued, along with its owner, Eihab Suliman, by the National Board of Medical Examiners and the Federation of State Medical Boards for using test preparation materials that were obtained illegally. An announcement about the lawsuit was posted previously to the USMLE website.

Individuals who attended Optima's programs or are considering doing so risk having their USMLE scores delayed and/or classified as indeterminate. They may also be subject to other consequences, including charges of irregular behavior, as a result of their participation. The USMLE will post further updates concerning this matter to the USMLE website.

Reminder: All Applicants Must Document Transfer Credits When Applying for Examination

(posted July 16, 2009)

Applicants are reminded that they are required to disclose and document all transfer credits when they apply to ECFMG for examination, regardless of when the credits were earned. Failure to disclose and document these credits may have a number of negative consequences, including delaying exam registration and certification by ECFMG. Such delays may prevent you from starting a residency program. Additionally, failure to disclose and document these credits may result in a finding of irregular behavior. See Irregular Behavior in the ECFMG Information Booklet.

Transfer credits are credits earned for a course taken at one institution (such as a medical school) that are accepted by another medical school toward meeting its degree requirements. For example, a student attends a medical school for one year and earns credits for 12 courses. The student transfers to another medical school, which accepts the credits for those 12 courses toward meeting its degree requirements. The credits for those 12 courses are then referred to as transfer credits. The applicant must inform ECFMG of these transfer credits at the time of application.

Additionally, there are restrictions on transfer credits that can be used to meet ECFMG’s certification requirement that an applicant must have been awarded credit for at least four credit years (academic years for which credit has been given toward completion of the medical curriculum) by a medical school that is listed in the International Medical Education Directory (IMED). For the purpose of ECFMG Certification, credits earned on or after January 1, 2008 that are transferred to the medical school that awarded or will award an applicant’s medical degree must meet all of the following criteria:

Applicants whose transferred credits do not comply with the policy outlined above will not meet the requirements to be registered by ECFMG for examination or the requirements for ECFMG Certification. Applicants whose transferred credits do not meet all the criteria listed above may request an exception from the ECFMG Medical Education Credentials Committee.

See Credentials for Exam Registration in the ECFMG Information Booklet for instructions on how to submit transcripts to document transfer credits.

IMGs Participating in 2010 Match Should Register for Step 2 CS Now

(posted June 18, 2009)

International medical students/graduates and participants/graduates of Fifth Pathway programs who need to pass Step 2 Clinical Skills (CS) to participate in the 2010 Match (in March 2010) are reminded that they must take Step 2 CS by December 31, 2009. As indicated in the 2009 Schedule for Reporting Step 2 CS Results, if you do not take Step 2 CS by December 31, 2009, your result will not be available in time to participate in the 2010 Match.

At the time of this writing, the earliest available test date at any test center was in September 2009. Demand for the Step 2 CS examination is already heavy for test dates in the latter part of 2009. Additionally, test sessions at all test centers may be subject to scheduling restrictions that limit the number of test dates available to you.

All test sessions for the remainder of 2009 have been opened and no new test sessions will be added through the end of the year. To maximize your chances of obtaining a 2009 test date,

Registering and scheduling now offer a number of benefits:

If you are planning to take Step 2 CS but are not planning to participate in the 2010 Match, please consider scheduling a Step 2 CS testing appointment that is after December 31, 2009. This will maximize the number of testing appointments available for those who must take Step 2 CS by December 31, 2009 to obtain their results in time to participate in the 2010 Match.

Updated information on Step 2 CS scheduling will be posted to the ECFMG website as it becomes available. Individuals planning to take Step 2 CS should monitor the ECFMG and USMLE websites for the latest information.

2009 and 2010 Schedules for Reporting Step 2 CS Results

(posted June 4, 2008; updated June 27, 2008, June 16, 2009)

Step 2 CS 2009 Reporting Schedule

Testing Period

Reporting Period

For examinees who test

Reporting start date

Reporting close date

Jan 1 through Feb 28

Apr 1

Apr 29

Mar 1 through Mar 28

Apr 29

May 27

Mar 29 through May 23

Jun 24

Jul 22

May 24 through Jul 18

Aug 19

Sep 16

Jul 19 through Sep 12

Oct 14

Nov 11

Sep 13 through Nov 7

Dec 9

Jan 6, 2010

Nov 8 through Dec 31

Feb 3, 2010

Feb 24, 2010

Step 2 CS 2010 Reporting Schedule

Testing Period

Reporting Period

For examinees who test

Reporting start date

Reporting close date

Jan 1 through Feb 27

Mar 31

Apr 28

Mar 1 through Mar 27

Apr 21

May 19

Mar 28 through May 15

Jun 16

Jul 14

May 16 through Jul 17*

Aug 18

Sep 15

Jul 18 through Sep 11

Oct 13

Nov 10

Sep 12 through Nov 6

Dec 8

Jan 5, 2011

Nov 7 through Dec 31

Feb 2, 2011

Feb 23, 2011

* There will be no Step 2 CS examinations delivered May 16 through 22.

The first results for a given testing period will be issued on the first day of the corresponding reporting period, and it is expected that results for the vast majority of examinees who take the exam during the testing period will be reported on this date. Over the past three years, results for 98%-99% of examinees who take the exam during the testing period were reported by the third reporting date. For a small percentage of examinees (1%-2%), it is important to note that scoring and quality assurance may not be completed in time for these examinees to be reported by the first three reporting dates; these will typically be examinees who took the exam in the latter part of the testing period. Results for these examinees will be reported each week throughout the reporting period, and should be reported no later than the last day of the score reporting period.

This schedule allows USMLE staff to enhance the quality assurance and data collection/scoring procedures performed prior to score reporting. Additionally, it provides examinees, as well as others who rely on Step 2 CS results, with guidelines regarding when a result will be reported for a given exam date. These guidelines allow examinees to plan their exam registration and scheduling in order to have their results in time to meet specific deadlines, such as those related to graduation or participation in the National Resident Matching Program (NRMP), or “the Match.”

Information about USMLE and Influenza

(posted April 29, 2009; updated May 7, 2009, June 16, 2009)

The World Health Organization (WHO) pandemic influenza alert is at phase 6. The Composite Committee and USMLE parent organizations continue to monitor the situation closely and are prepared to take appropriate measures as warranted to protect the health and safety of examinees and the public. As noted previously, USMLE examinees planning to test in the near future, who have concerns about their ability to test safely, may reschedule USMLE computer-based testing appointments or Clinical Skills appointments. In most instances, examinees should be able to use the standard procedures to make changes, without additional fees, by following procedures described in the USMLE Bulletin of Information.

While the pandemic influenza alert is at WHO phase 6, concerned examinees who would like to receive an eligibility period extension for an upcoming Step examination can do so, without additional fees, by contacting ECFMG by phone at (215) 386-5900 or by e-mail at info@ecfmg.org to explain the circumstances. This waiver of the eligibility period extension fee will be in effect while the WHO influenza alert remains at phase 6. Examinees should monitor the USMLE and ECFMG websites for any change to this fee waiver.

The USMLE program continues to monitor this situation closely for any significant changes that might result in a need to suspend the USMLE program until testing can be safely resumed. Please be sure to monitor the USMLE and ECFMG websites for updates to this announcement. Of course, if you personally are experiencing flu-like symptoms, or believe that you may have been recently exposed to an influenza patient, you should reschedule your examination.

Application Process Modified for Medical School Graduates

(posted May 20, 2009)

On or about May 20, 2009, ECFMG will modify the USMLE application process and the process for requesting Step 1/Step 2 CK eligibility period extensions for international medical graduates.

Once this change takes effect, ECFMG will not register an international medical graduate for USMLE, or extend his/her eligibility period, before receiving verification of the applicant’s status as a medical school graduate directly from his/her medical school. This status will be verified in one of three ways:

If your medical education credentials have been primary-source verified by ECFMG, your status as a graduate is considered verified and your medical school will not be required to reverify your graduate status in order for you to be registered for examination.

If your medical education credentials have not been primary-source verified by ECFMG, your status as a graduate must be verified before you will be registered for examination. The process by which your medical school will verify your graduate status varies depending on whether the medical school from which you graduated participates in EMSWP.

If the medical school from which you graduated participates in EMSWP, the medical school must verify your status as a graduate through EMSWP. Follow the instructions for applying for examination in Graduates of Medical Schools That Participate in EMSWP, below. ECFMG will make your record available to your medical school and request verification of your graduate status typically within three weeks of receipt of your complete application. The time needed to complete the processing of your application is contingent upon your medical school’s response to the EMSWP verification request. You will not be registered for examination until your medical school verifies your status.

If the medical school from which you graduated does not participate in EMSWP, the medical school must verify your status as a graduate through your Form 186. You will be required to complete a new Form 186, even if you previously had a valid Form 186 on file with ECFMG. Follow the instructions for applying for examination and submitting Form 186 in Graduates of Medical Schools That Do Not Participate in EMSWP, below. Once your new Form 186 is accepted by ECFMG, it will remain valid for five years. During this five-year period, you will be able to complete the exam application process entirely on-line.

You can check the status of your medical education credentials and the validity of your Form 186 via ECFMG’s OASIS. You will be able to determine if your medical school participates in EMSWP when you complete the on-line part of the exam application using ECFMG’s Interactive Web Application (IWA). At this time, IWA will produce the appropriate version of Form 186, which you will be able to print.

Graduates of Medical Schools That Participate in EMSWP
If you are a graduate of a medical school that participates in EMSWP and your medical education credentials have not been primary-source verified by ECFMG, you must print a Certification of Identification Form (Form 186) after completing the on-line part of the application. Form 186 must be completed by you and certified by an authorized official of your medical school. Each medical school has been requested to provide ECFMG with a list of the officials authorized by the school to certify Form 186. Your Form 186 must be certified by an official on this list. Contact your medical school to determine the officials authorized by your medical school for this purpose; ECFMG will not provide this information to applicants. If you cannot have your Form 186 certified by an authorized official of your medical school, it can be certified by a Consular Official, Notary Public, First Class Magistrate, or Commissioner of Oaths. In either case, this certification must be current; the official must have signed the form within four months of its receipt by ECFMG.

If your Form 186 is certified by an official of your medical school, the original, signed Form 186 must be sent to ECFMG from the office of the medical school official who certifies the form. If there are additional documents required to complete your application, they must be sent to ECFMG with your Form 186; for detailed instructions, refer to Applying for Examination in the ECFMG Information Booklet. ECFMG must be able to determine that your Form 186 was sent directly from the office of this official. If ECFMG, in its judgment, determines that the form may not have been sent directly from the office of the medical school official who certified the form, the form will not be accepted.

Once accepted by ECFMG, Form 186 remains valid for on-line applications and requests to extend Step 1 and Step 2 CK eligibility periods received during the following five-year period. Applications and requests submitted during this period can be completed entirely on-line.

Your application will not be considered complete until the completed Form 186 (if you do not have a valid Form 186 on file with ECFMG) and any other required documents are received at ECFMG. To complete the processing of your application, your medical school must verify your status as a graduate of that medical school through EMSWP. ECFMG will make your record available to your medical school and request verification of your graduate status typically within three weeks of receipt of your complete application. The time needed to complete the processing of your application is contingent upon your medical school’s response to the EMSWP verification request. You will not be registered for examination until your medical school verifies your status.

Graduates of Medical Schools That Do Not Participate in EMSWP
If you are a graduate of a medical school that does not participate in EMSWP and your medical education credentials have not been primary-source verified by ECFMG, you must print a Certification of Identification Form (Form 186) after completing the on-line part of the application. Form 186 must be completed by you and certified by an authorized official of your medical school. Each medical school has been requested to provide ECFMG with a list of the officials authorized by the school to certify Form 186. Your Form 186 must be certified by an official on this list. Contact your medical school to determine the officials authorized by your medical school for this purpose; ECFMG will not provide this information to applicants. This certification must be current; the official must have signed the form within four months of its receipt by ECFMG.

If you cannot have your Form 186 certified by an authorized official of your medical school, it can be certified by a Consular Official, Notary Public, First Class Magistrate, or Commissioner of Oaths. An authorized official of your medical school, as defined above, must then complete the second part of the Form 186 to verify your status as a graduate of the medical school. Both the certification and the verification must be current; the officials must have signed the form within four months of its receipt by ECFMG.

The original, signed Form 186 must be sent to ECFMG from the office of the medical school official who certifies or verifies the form. This means that, if your Form 186 is certified by a Consular Official, Notary Public, First Class Magistrate, or Commissioner of Oaths, you must send your certified Form 186 to your medical school for verification and your medical school must then send your Form 186 to ECFMG. If there are additional documents required to complete your application, they must be sent to ECFMG with your Form 186; for detailed instructions, refer to Applying for Examination in the ECFMG Information Booklet. ECFMG must be able to determine that the form was sent directly from the office of the medical school official. If ECFMG, in its judgment, determines that the form may not have been sent directly from the office of the medical school official who certified or verified the form, the form will not be accepted.

Once accepted by ECFMG, Form 186 remains valid for on-line applications and requests to extend Step 1 and Step 2 CK eligibility periods received during the following five-year period. Applications and requests submitted during this period can be completed entirely on-line.

Your application will not be considered complete until the completed Form 186 (if you do not have a valid Form 186 on file with ECFMG) and any other required documents are received at ECFMG.

Reminder: Time Limit for Completing Examination Requirements for ECFMG Certification

(posted April 23, 2009)

ECFMG would like to remind applicants that they are required to pass those United States Medical Licensing Examination (USMLE) Steps and Step Components required for ECFMG Certification within a seven-year period. This means that once an applicant passes a Step or Step Component, the applicant will have seven years to pass the other Step(s) or Step Component(s) required for ECFMG Certification. (For complete information on the examination requirements for ECFMG Certification, see Examination Requirements in the ECFMG Information Booklet.)

This seven-year period begins on the exam date for the first Step or Step Component passed and ends exactly seven years from this exam date. If an applicant does not pass all required Steps and Step Components within a maximum of seven years, the applicant’s earliest USMLE passing performance will no longer be valid for ECFMG Certification.

Example: An applicant took his first Step or Step Component on October 1, 2006 and passed. The applicant has through October 1, 2013 to take and pass all other Step(s) and Step Component(s) required for ECFMG Certification. If he does not take and pass all other required Step(s) and Step Component(s) on or before October 1, 2013, his passing performance on the October 1, 2006 exam would no longer be valid for ECFMG Certification.

This seven-year limit does not apply to the former ECFMG Clinical Skills Assessment (CSA) because the CSA was not a USMLE Step or Step Component. Applicants who satisfied the clinical skills requirement for ECFMG Certification by passing the CSA are required to pass only Step 1 and Step 2 Clinical Knowledge (CK) within a seven-year period for ECFMG Certification. For these applicants, the seven-year period begins on the exam date for the first USMLE Step or Step Component passed, regardless of when the CSA was passed.

On June 14, 2004, USMLE Step 2 Clinical Skills (CS) became a requirement for ECFMG Certification, replacing the ECFMG CSA as the exam that satisfies the clinical skills requirement. As part of the USMLE, Step 2 CS may be subject to the seven-year time limit for ECFMG Certification as described below:

The policies outlined above apply only to ECFMG Certification. The USMLE program recommends to U.S. state medical licensing authorities that they require applicants to pass the full USMLE sequence (including Step 3, which is not required for ECFMG Certification) within a seven-year period. See Time Limit and Number of Attempts Allowed to Complete All Steps and Retakes in the USMLE Bulletin of Information.

Many state medical licensing authorities accept the USMLE recommendation, but some do not. You should contact the Federation of State Medical Boards of the United States, Inc., (FSMB) for general information and the medical licensing authority of the jurisdiction where you plan to apply for licensure for definitive information, since licensure requirements vary among jurisdictions.

Additionally, applicants who retake a previously passed Step or Step Component to comply with a time limit should understand the implications for Step 3 eligibility of a failing attempt on a retake. See Official Performance of Record for Examinees Retaking a Previously Passed Step in the USMLE Bulletin of Information.

2009 Match Performance — Number of IMGs Matching Increases

(posted April 2, 2009)

For the seventh consecutive year, the number of first-year (PGY-1) residency positions offered through the Match increased. A total of 22,427 first-year positions were offered in the 2009 Match, held last month. This represents an increase of 187 positions compared to last year and an increase of 1,825 positions since 2002.

The number of IMGs, including Fifth Pathway participants, who matched to first-year positions increased by 98 compared to 2008. Of the 10,980 IMGs who participated in the 2009 Match, 4,796 (43.7%) matched. In the 2008 Match, 4,698 (45.2%) IMGs were matched to first-year positions.

There was an increase in the number of matches for U.S. citizen IMGs, IMGs who are citizens of other countries, and Fifth Pathway participants.

Of the 7,484 IMG participants who were not U.S. citizens, 3,112 (41.6%) obtained first-year positions. The number of non-U.S. citizen IMGs who obtained positions in 2009 increased by 4 compared to last year.

Of the 3,390 U.S. citizen IMG participants, 1,619 (47.8%) were matched to first-year positions, an increase of 78 over last year. This is the sixth consecutive year that there has been an increase in the number of U.S. citizen IMGs matching to first-year positions.

Of the 106 Fifth Pathway participants in the Match, 65 (61.3%) were matched to first-year positions, an increase of 16 over last year. This is the third consecutive year that there has been an increase in the number of Fifth Pathway participants matching to first-year positions.

It is important to note that the total number of IMGs, including Fifth Pathway participants, who will fill PGY-1 positions for the 2009-2010 academic year will be higher than the number obtaining positions through the 2009 Match. Although the majority of PGY-1 positions in the United States are filled through the Match, a significant number of IMG applicants obtain positions outside of the Match. For example, while 4,563 IMGs obtained PGY-1 positions through the 2007 Match, 7,225 IMGs entered PGY-1 for the 2007-2008 academic year.

The 7,225 IMGs entering PGY-1 for the 2007-2008 academic year is an increase of 306 over the prior year and an increase of 1,152 since the 2002-2003 academic year.

About the Match

The annual NRMP Match is the system by which applicants are matched with available residency positions in U.S. programs of graduate medical education (GME). Participants submit to the NRMP a list of residency programs, in order of preference. Ranked lists of preferred residency candidates are likewise submitted by U.S. GME programs with available positions. The matching of applicants to available positions is performed by computer algorithm. The Match results announced in March of each year are typically for GME programs beginning the following July.

Additional Resources on the Match and Match Results

The preceding data are taken from the Advance Data Tables for the 2009 Main Residency Match compiled by the NRMP. These tables provide detailed information on the positions offered and filled by the Match in 2009 and prior years. To access these tables, or to obtain further information on the NRMP, visit www.nrmp.org.

The June issue of Academic Medicine, the journal of the Association of American Medical Colleges, usually offers an analysis of Match results from the preceding March. For more information, visit your medical school's library or www.academicmedicine.org.

The September issue of JAMA: The Journal of the American Medical Association traditionally provides an in-depth analysis of graduate medical education in the United States. This analysis includes the number of IMGs entering and continuing in U.S. GME programs and a breakdown of IMG resident physicians by specialty and subspecialty. Visit your medical school's library or http://jama.ama-assn.org.

IMGs Participating in 2010 Match Should Take Step 2 CS by August 2009

(posted December 16, 2008)

International medical students/graduates and participants/graduates of Fifth Pathway programs who need to pass Step 2 Clinical Skills (CS) to participate in the 2010 Match (in March 2010) are strongly encouraged to take Step 2 CS by August 2009.

Traditionally, there has been high demand for testing appointments in the period from September through December. For 2009, demand for testing appointments in the period from September through December is expected to be even higher than in past years.

At the time of this writing, the earliest available test date at any test center was in March 2009. Additionally, test sessions at all test centers may be subject to scheduling restrictions that may limit the number of test dates available to you.

To maximize your chances of obtaining a 2009 test date,

If you do not register early and schedule as soon as possible for a test date before September 2009, it is possible that you will not be able to obtain a test date in 2009. As published in the 2009 Step 2 Clinical Skills Schedule for Reporting Results, if you do not take Step 2 CS by December 31, 2009, your result will not be available in time to participate in the 2010 Match.

Early registration and scheduling may offer a number of benefits. If you plan to apply for Step 2 CS, you should consider the following:

Updated information on Step 2 CS scheduling will be posted to the ECFMG website as it becomes available. Individuals planning to take Step 2 CS should monitor the ECFMG and USMLE websites for the latest information.

An Announcement Regarding Fraudulent Letters of Recommendation

(posted July 18, 2007; updated September 30, 2008)

Applicants are reminded that the submission of fraudulent letters of recommendation to ECFMG constitutes irregular behavior, as defined by ECFMG.

View full announcement.

NBME® Self-Assessments for Individuals Planning to Take Step 1, Step 2 CK, and Step 3

(posted May 8, 2003, updated August 14, 2003, November 3, 2003, August 6, 2004, January 13, 2005, February 9, 2006, March 14, 2007, July 22, 2008, August 26, 2008)

The National Board of Medical Examiners® (NBME®) offers web-based self-assessments to help medical students and graduates evaluate their readiness for the computer-based components of the United States Medical Licensing Examination® (USMLE®). Self-assessments are currently available for USMLE Step 1, Step 2 CK, and Step 3.

All questions have appeared previously in the USMLE, and no questions are duplicated across forms. Users can choose to take the self-assessments under two timing conditions: standard USMLE pacing or self-pacing. The assessments are available for $45.00 (USD) per form.

Users receive immediate performance feedback in the form of a performance profile showing content areas of strength and weakness. For the CBSSA (Step 1) and CCSSA (Step 2 CK), feedback also includes a table that “translates” the self-assessment score to an approximate score on the USMLE scale; this feature is not yet available for the CCMSA (Step 3).

For complete information, to view a sample assessment, or to purchase an assessment, visit the NBME Self-Assessment Services website.

USMLE Statement on the Fifth Pathway Program and Step 3 Eligibility

(posted March 27, 2008; updated August 26, 2008)

Currently, for international medical graduates who wish to take USMLE Step 3, the USMLE program accepts either a valid Standard ECFMG Certificate or a valid Fifth Pathway certificate for purposes of meeting Step 3 eligibility requirements. In November 2007, the American Medical Association (AMA) determined that it would withdraw its support of the Fifth Pathway program. Per the AMA, the last Fifth Pathway program class to be supported will be the January 2009 entering class, which will be supported until its completion in December 2009.

The USMLE Composite Committee and the USMLE parent organizations (the Federation of State Medical Boards and the National Board of Medical Examiners) have determined that the USMLE program will cease acceptance of Fifth Pathway certificates issued after December 31, 2009 for the purpose of meeting Step 3 eligibility requirements. For valid Fifth Pathway certificates issued through December 31, 2009, the USMLE program has not yet determined whether they will be accepted indefinitely for purposes of meeting Step 3 eligibility criteria or whether a cut-off date will be imposed. The USMLE program will work closely with the Accreditation Council for Graduate Medical Education (ACGME) and the AMA in an effort to ensure that policies relating to Fifth Pathway certificates issued through December 31, 2009 are consistent among these organizations.

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.

Information and updates about the Fifth Pathway program and USMLE will be posted to the USMLE and ECFMG websites.

AAMC Service for Applicants Seeking Residency Positions

(posted March 14, 2007)

Offered by the Association of American Medical Colleges (AAMC), FindAResident® is a web-based search tool for finding open residency and fellowship positions in a variety of accredited specialties.

Open year-round, FindAResident is an effective resource for residency candidates who:

By registering with this online service, candidates can post their resume, test scores, photo, curriculum vitae, and other pertinent information for programs to view. Users can also search a database of open training positions by post-graduate year level, specialty, and geographic preference. Programs are able to directly update vacancy information at any time, so the unfilled position information remains accurate and current.

FindAResident complements both the Electronic Residency Application Service (ERAS®) and the National Resident Matching Program (NRMP); it does not replace these services. FindAResident offers additional benefits to applicants participating in ERAS. ERAS participants can import information from their certified ERAS Common Application Form (CAF) directly into FindAResident.

Use of this service requires registration and a subscription fee; active ERAS users receive a discount on that fee. Subscriptions begin on the date of purchase and conclude at the end of the FindAResident season (September 14). For more information or to subscribe, visit FindAResident on the Web.

Important Information for Step 2 CS Registrants Attempting to Schedule or Reschedule a Testing Appointment

(posted November 21, 2006, updated December 7, 2006)

It has come to our attention that some Step 2 CS registrants have offered to exchange their scheduled testing appointments for those of other registrants who must take Step 2 CS by specific deadlines. The exchange of testing appointments between applicants is not consistent with the “first-come, first-served” basis on which Step 2 CS testing appointments are offered. It is also highly unlikely to be successful. If you are registered for Step 2 CS, you should know that:

The best way for registered applicants to monitor the availability of testing appointments is to indicate their preferences for dates/centers using the pilot Step 2 CS Scheduling Email Notification System. To indicate your preferences, access Step 2 CS Calendar and Scheduling, and follow the link “Add/Edit Scheduling Email Notifications.”

For detailed information on policies and procedures related to Step 2 CS scheduling and rescheduling, refer to the ECFMG Information Booklet and USMLE Bulletin of Information.

Step 2 CS Rescheduling Policy Allows Early Scheduling, Flexibility in Changing Testing Appointments

(posted June 22, 2005, updated December 1, 2005, March 28, 2006, December 7, 2006)

There are no Step 2 CS rescheduling fees for applicants who cancel scheduled testing appointments more than 14 days before the scheduled test date. Rescheduling fees do apply to applicants who cancel within 14 days of their scheduled test date and those who miss their scheduled test date without canceling.

This policy allows applicants registered for Step 2 CS to schedule their testing appointments early, while retaining the flexibility to reschedule at no cost, with a minimal period of notice. Applicants are strongly encouraged to register early and schedule testing appointments for the earliest possible date. If you have registered or plan to register for Step 2 CS, you should be familiar with the requirements and fees associated with rescheduling a Step 2 CS testing appointment.

Registered applicants can check which test dates are available to them at any time by accessing Step 2 CS Calendar and Scheduling. For complete information on Step 2 CS rescheduling policies, refer to Rescheduling in the ECFMG Information Booklet.

Step 2 CS Scheduling Restrictions

(posted December 21, 2004, updated February 16, 2005, March 18, 2005, December 1, 2006, March 3, 2006, December 7, 2006)

Demand for the Step 2 CS examination is expected to be heavy at all clinical skills evaluation centers at certain times throughout the year. The CS scheduling system is designed to handle the expected high volume, while maximizing the likelihood that most examinees can meet requirements and deadlines. This system also provides a representative mix of examinees at most testing sessions, which is helpful in maintaining a high quality assessment system both within and across test centers.

Spaces within test sessions may be allocated based on a variety of factors, including time of year, location of the test center and whether the examinee's institution of undergraduate medical education is located within the US or Canada, or is an international medical school. These controls on spaces for each test session will remain in place until 60 days before the test date, at which time all testing spaces that have not been filled will be available to all registered applicants on a first come, first served basis. Scheduling patterns and demand will be monitored, and allotment of spaces may be changed as needed.

Applicants rescheduling into newly-available testing spaces will not be charged a rescheduling fee, provided they cancel existing testing appointments with more than 14 days' notice. However, applicants who cancel with notice of 14 or fewer days will be charged a rescheduling fee of $150.

Scheduling Guidelines for Applicants

If you plan to take Step 2 CS, you should consider the following:

Important Information on Your Clinical Skills Examination History and Eligibility for USMLE Step 3

(posted December 20, 2004, updated August 31, 2006)

The USMLE Bulletin of Information outlines policies regarding an applicant’s clinical skills examination history and eligibility for Step 3. Important information for international medical graduates on this topic has been posted to this website. If you are an applicant for ECFMG Certification, it is important that you review and understand this information, since it explains:

View full announcement.

Important Announcement for State Licensing Boards Concerning CSA® Performance History for International Medical Students or Graduates

(posted July 30, 2004)

For international medical students and graduates (IMGs) who have taken the ECFMG Clinical Skills Assessment (CSA), the USMLE transcript now includes a note indicating that the individual has prior CSA history. This note, which is included in transcripts effective July 1, 2004, appears as follows:

NOTE: The Educational Commission for Foreign Medical Graduates (ECFMG) records include prior history for the ECFMG Clinical Skills Assessment (CSA) for this examinee. Details cannot be released by the ECFMG without written authorization from the examinee.

An IMG's CSA performance history may be obtained by requesting an "Official ECFMG CSA History Chart". The Chart provides the individual's complete CSA history, including the date and performance results for each CSA taken.

IMGs applying to State Licensing Boards should be advised to request the Chart from ECFMG. To receive an Official ECFMG CSA History Chart or to have it sent to a State Licensing Board, IMGs should complete a Request for an Official ECFMG® CSA® History Chart (Form 297) and submit it to ECFMG.

If you have any questions about how to obtain the CSA History Chart, contact ECFMG by e-mail at info@ecfmg.org.

Important Changes to Standard ECFMG Certificate

(posted June 14, 2004)

Graduates of medical schools outside the United States and Canada, international medical graduates (IMGs), must have a valid Standard ECFMG Certificate as one of the prerequisites to enter U.S. programs of graduate medical education (GME) that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). On June 14, 2004, policy changes affecting the validity of the Standard ECFMG Certificate for entry into GME will take effect. This announcement contains important information on these changes to ECFMG's policy for revalidating and permanently validating the Standard ECFMG Certificate for entry into GME.

View the full announcement.

Important Announcement for State Licensing Boards Concerning Changes to Standard ECFMG Certificate

(posted May 18, 2004)

By Stephen S. Seeling, J.D.
Vice President of Operations
Educational Commission for Foreign Medical Graduates

Graduates of medical schools outside the United States and Canada, international medical graduates (IMGs), must have a valid Standard ECFMG Certificate as one of the prerequisites to enter graduate medical education (GME). Medical licensing boards in the United States require ECFMG Certification, among other requirements, to obtain a license to practice medicine.

On June 14, 2004, policy changes affecting the validity of the Standard ECFMG Certificate for entry into GME will take effect. This announcement contains important information on these upcoming changes to ECFMG's revalidation and permanent validation policies.

Current Policy Through June 13, 2004
Currently, two of the exam dates on the Standard ECFMG Certificate are subject to expiration for the purpose of entering GME.

IMGs who enter an ACGME-accredited program (on or before the expiration dates of the English test and CSA) may request permanent validation. This means that the English test and CSA dates are no longer subject to expiration. To request permanent validation, the IMG and program director must complete the Request for Permanent Validation of Standard ECFMG Certificate (Form 246) and submit it to ECFMG. After ECFMG receives and verifies the information on the Form 246, ECFMG sends a sticker, indicating valid indefinitely status, to eligible IMGs.

New Policy Effective June 14, 2004
Two changes to ECFMG policy concerning revalidation and permanent validation will take effect on June 14, 2004. The two changes are:

This means that the English test "valid through" date on the Standard ECFMG Certificate can be disregarded for IMGs who are entering GME on or after June 14, 2004, the effective date of the changes. Additionally, the CSA "valid through" date can be disregarded for IMGs who passed the CSA on or after June 14, 2001.

After the effective date of these changes on June 14, 2004, ECFMG will provide eligible IMGs with a sticker, to be affixed to their Standard ECFMG Certificate, to indicate that their English test date (and CSA date, if applicable) is no longer subject to expiration. Please note that not all eligible applicants who are beginning programs in July 2004 may receive these stickers prior to the start date of their programs.

IMGs Whose CSA Pass Date is Prior to June 14, 2001
IMGs who passed the CSA prior to June 14, 2001, and enter an ACGME-accredited program on or before the CSA "valid through" date on their Standard ECFMG Certificates, may request permanent validation. After entering the program, the IMG and program director must complete the Request for Permanent Validation of Standard ECFMG Certificate (Form 246) and submit it to ECFMG. After ECFMG receives and verifies the information on the Form 246, ECFMG will send a sticker, indicating valid indefinitely status, to eligible IMGs.

IMGs who passed the CSA prior to June 14, 2001 and do not enter an ACGME-accredited program on or before the CSA "valid through" date on their Standard ECFMG Certificates must pass USMLE Step 2 CS to revalidate their Certificates. Passing performance on Step 2 CS does not expire for the purpose of entry into GME.

State Medical Licensing Boards are encouraged to verify an applicant's ECFMG certification status through the ECFMG Certification Verification Service (CVS). You can request verification using CVS ON-LINE.

If you have any questions, please contact me. My email address is sseeling@ecfmg.org and my telephone number is (215) 823-2107.

Important Announcement for Program Directors Concerning Changes to Standard ECFMG Certificate

(posted March 26, 2004)

By Gerald P. Whelan, M.D.
Vice President of Assessment Services
Educational Commission for Foreign Medical Graduates

Graduates of medical schools outside the United States and Canada, international medical graduates (IMGs), must have a valid Standard ECFMG Certificate as one of the prerequisites to enter graduate medical education (GME). On June 14, 2004, policy changes affecting the validity of the Standard ECFMG Certificate for entry into GME will take effect. This announcement contains important information for program directors on these upcoming changes to ECFMG's revalidation and permanent validation policies.

Current Policy Through June 13, 2004
Currently, two of the exam dates on the Standard ECFMG Certificate are subject to expiration for the purpose of entering GME.

IMGs who enter an ACGME-accredited program (on or before the expiration dates of the English test and CSA) may request permanent validation. This means that the English test and CSA dates are no longer subject to expiration. To request permanent validation, the IMG and program director must complete the Request for Permanent Validation of Standard ECFMG Certificate (Form 246) and submit it to ECFMG. After ECFMG receives and verifies the information on the Form 246, ECFMG sends a sticker, indicating valid indefinitely status, to eligible IMGs.

New Policy Effective June 14, 2004
Two changes to ECFMG policy concerning revalidation and permanent validation will take effect on June 14, 2004. The two changes are:

This means that you can disregard the English test "valid through" date on the Standard ECFMG Certificate for IMGs who are entering your program on or after June 14, 2004, the effective date of the changes. Additionally, you can disregard the CSA "valid through" date for IMGs who passed the CSA on or after June 14, 2001.

After the effective date of these changes on June 14, 2004, ECFMG will provide eligible IMGs with a sticker, to be affixed to their Standard ECFMG Certificate, to indicate that their English test date (and CSA date, if applicable) is no longer subject to expiration. Please note that not all eligible applicants who are beginning programs in July 2004 may receive these stickers prior to the start date of their programs.

IMGs Whose CSA Pass Date is Prior to June 14, 2001
IMGs who passed the CSA prior to June 14, 2001, and enter an ACGME-accredited program on or before the CSA "valid through" date on their Standard ECFMG Certificates, may request permanent validation. After entering the program, the IMG and program director must complete the "Request for Permanent Validation of Standard ECFMG Certificate" (Form 246) and submit it to ECFMG. After ECFMG receives and verifies the information on the Form 246, ECFMG will send a sticker, indicating valid indefinitely status, to eligible IMGs.

IMGs who passed the CSA prior to June 14, 2001 and do not enter an ACGME-accredited program on or before the CSA "valid through" date on their Standard ECFMG Certificates must pass USMLE Step 2 CS to revalidate their Certificates. Passing performance on Step 2 CS does not expire for the purpose of entry into GME.

Graduate medical education programs are encouraged to verify an applicant's ECFMG certification status through the ECFMG Certification Verification Service (CVS). This service is free for directors of ACGME-accredited graduate medical education programs. You can request verification using CVS ON-LINE.

[last update: January 27, 2010]