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2009 Information Booklet / Application Materials Are Available

The ECFMG 2009 Information Booklet and exam application materials are now available. To apply for examination, use ECFMG’s Interactive Web Application (IWA).

For Step 1/Step 2 CK, you can use the 2009 application to apply for:

• available Step 1/Step 2 CK eligibility periods ending in 2008 (September 2008 – November 2008 and October 2008 – December 2008) and
  
  
• all Step 1/Step 2 CK eligibility periods ending in 2009, beginning with the November 2008 – January 2009 eligibility period.

For Step 2 CS, you can use the 2009 application to obtain a 12-month eligibility period that begins on the date that the processing of your application is completed.

Exam applications are saved in IWA for 14 days from the date you last saved the application. If you have begun but not yet completed the on-line part of a 2008 exam application, you will be able to complete the on-line part of that saved application using the 2009 application materials.

Individuals who apply for examination are required to read the USMLE Bulletin of Information, in addition to the ECFMG Information Booklet. The USMLE 2009 Bulletin of Information is available on the USMLE website.

Important Notice Regarding Calculator Function in New Test Delivery Software for USMLE

USMLE recently began the migration of the Step 2 CK examination to new test delivery software... however, a problem has been identified with the calculator function...

View full announcement on the USMLE website.

Soft Foam Earplugs May Now Be Used During Computer-based Examinations

USMLE has decided, effective immediately, to begin allowing examinees to bring and use soft-foam earplugs during the Step 1, 2 CK, and 3 examinations under certain conditions.

View full announcement on the USMLE website.

Important Notice on New Restrictions for Transferred Credits

One of the medical education credential requirements for ECFMG Certification is that an international medical graduate 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 the International Medical Education Directory (IMED). A change to ECFMG’s medical education credentials policy restricts transfer credits that may be used to meet this requirement.

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:

• Credits must be transferred from one IMED-listed medical school to another IMED-listed medical school.
• Credits must be for courses taken at one medical school within seven years of the date of graduation at the medical school that accepts the transferred courses.
• Credits must be for courses that were passed at the medical school at which the course was taken.

All applicants who have transferred credits to the medical school that awarded or will award their medical degree must document these credits when they apply to ECFMG for examination, regardless of when the credits were earned. This documentation must be in the form of two photocopies of an official transcript issued by the school or institution at which the course was taken; failure to provide appropriate documentation of transfer credits will prevent exam registration. Further instructions will be provided at the time of application.

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.

An international medical student/graduate whose transferred credits do not meet all the criteria listed above may request an exception from the ECFMG Medical Education Credentials Committee.

New Software for Computer-based USMLE

A new version of the software used to deliver the computer-based USMLE™ Step examinations is scheduled to be introduced in mid-August 2008. Migration to the new version will occur first in the Step 2 Clinical Knowledge (CK) examination. The migration is expected to begin at a small number of test centers on August 14, and will then be phased in at remaining test centers throughout the remainder of August and into September. If you plan to take the Step 2 CK examination in mid-August 2008 or later, you should familiarize yourself with both the current test delivery software and the new version.

Orientation and practice materials using both the current and new versions of the software are available for downloading:

www.usmle.org/Orientation/2008/menu.html

If you obtained the 2008 orientation and practice materials in CD format from your registration entity, please note that the CD includes Step 2 CK practice materials using only the current version of the software. To obtain Step 2 CK practice materials using the new version of the software, use the link above.

The change to the test delivery software will be accounted for in scoring the examination results, so that scores will be comparable to those of exams using the older software. Because of this change, as well as routine modifications to the test item pool, it will be necessary to delay the reporting of scores for some examinees. The normal turnaround time for reporting scores to Step 2 CK examinees is three to four weeks. The target date for reporting Step 2 CK scores for most examinees testing from mid-August through late September will be Wednesday, October 8, 2008.

Note to Step 1 and Step 3 examinees: Migration of Step 1 and Step 3 to the new test delivery software will occur in 2009. Please monitor the USMLE and ECFMG websites to check for changes in test delivery software, and to access orientation and practice materials.

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

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.

• The Comprehensive Basic Science Self-Assessment (CBSSA), which is built to the same content specifications as Step 1, covers material in basic science medical education courses. There are six unique CBSSA forms available, each featuring 200 multiple-choice questions divided into four sections.
• The Comprehensive Clinical Science Self-Assessment (CCSSA), which is built to the same content specifications as Step 2 CK, covers material in core clinical clerkships. There are four unique CCSSA forms available, each featuring 184 multiple-choice questions divided into four sections.
• The Comprehensive Clinical Medicine Self-Assessment (CCMSA), which is built to the same content specifications as the multiple-choice component of Step 3, features content that reflects patient-centered clinical encounters. There is one CCMSA form available, with 180 multiple-choice questions divided into five sections.

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.

ERAS 2009 Application Season Has Begun

Information on the Electronic Residency Application Service (ERAS) 2009 application season is now available. If you plan to apply for U.S. residency positions that begin in 2009, visit the ECFMG ERAS Support Services website for important information. Most medical specialties participate in ERAS. If you apply to programs in participating specialties, you must apply to these programs using ERAS.

At ECFMG’s ERAS Support Services website, you will be able to:

• Obtain an ERAS Token, which will allow you to access the MyERAS website to work on your residency applications.
• Review policies and procedures that are new for ERAS 2009.
• Find instructions for submitting your supporting documents, such as letters of recommendation and transcripts, to ERAS Support Services for scanning and transmission to the ERAS PostOffice.
• Subscribe to ECFMG-ERAS News, a free e-mail newsletter that provides international medical students and graduates who use ERAS with important, updated information as it becomes available.

ERAS was developed by the Association of American Medical Colleges (AAMC) to allow medical school students and graduates to apply electronically for first- and second-year (PGY-1 and PGY-2) residency positions in U.S. programs of graduate medical education. ECFMG serves as the designated Dean’s office for all international medical students and graduates, including participants in Fifth Pathway Programs, who use ERAS. Detailed information on ERAS 2009 is also available on the AAMC website at www.aamc.org/eras.

2008 and 2009 Schedules for Reporting Step 2 CS Results

Step 2 CS 2008 Reporting Schedule
Testing Period	Reporting Period
For examinees who test	Reporting start date	Reporting close date
Jan 1 through Feb 23	Mar 26	Apr 23
Feb 24 through Mar 22	Apr 23	May 21
Mar 23 through May 17	Jun 18	Jul 16
May 18 through Jul 5*	Aug 6	Sep 3
Jul 13 through Sep 6*	Oct 8	Nov 5
Sep 7 through Nov 1	Dec 3	Dec 31
Nov 2 through Dec 31	Jan 28, 2009	Feb 25, 2009
* There will be no Step 2 CS examinations delivered July 6 through July 13. Additional testing sessions were added during the two weeks before and after this shutdown.

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

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. However, it is important to note that there will likely be a small number of examinees for whom scoring and quality assurance are not completed by the first day of the reporting period; 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, and 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.”

Step 1 - Change in Number of Items / Delay in Scoring

Starting on or around May 15, 2008, a transition period will begin in which the number of items in current forms of the Step 1 examination will change. As a result of this, as well as modifications to the test item pool and the processing load caused by a heavy volume of test takers, there will be a delay in score reporting for most Step 1 examinations administered in the second half of May and June.

View announcement on the USMLE website.

Step 1 to Include Media Clips Starting in May 2008

A small number of multiple-choice items with associated audio and/or video clips will be introduced into the USMLE Step 1 Examination beginning in May 2008.

View announcement on the USMLE website.

IMGs Participating in 2009 Match Should Register for Step 2 CS Now

International medical students/graduates, including participants/graduates of Fifth Pathway programs, who need to pass Step 2 Clinical Skills (CS) to participate in the 2009 Match (in March 2009) are strongly encouraged to register now for Step 2 CS.

At the time of this writing, the earliest available test date at any test center was in September 2008. As indicated in the 2008 Step 2 Clinical Skills Schedule for Reporting Results, if you do not take Step 2 CS by December 31, 2008, your result will not be available in time to participate in the 2009 Match.

Demand for the Step 2 CS examination is already heavy for test dates in the latter part of 2008. Additionally, test sessions at all test centers may be subject to scheduling restrictions that limit the number of test dates available to you. To maximize your chances of obtaining a 2008 test date,

• Apply for Step 2 CS now, provided you meet the eligibility requirements.
• Once registered, schedule your testing appointment immediately.
• If you cannot obtain a testing appointment at your preferred test center, check for availability at other test centers.

Registering and scheduling now offer a number of benefits:

• Applicants registered for Step 2 CS can schedule immediately if a preferred testing appointment is available.
• Applicants who schedule a testing appointment can change the testing appointment without cost, provided they give more than 14 days’ notice. See Rescheduling in the ECFMG Information Booklet.

If you are planning to take Step 2 CS but are not planning to participate in the 2009 Match, please consider scheduling a Step 2 CS testing appointment that is after December 31, 2008. This will maximize the number of testing appointments available for those who must take Step 2 CS by December 31, 2008 in order to obtain their results in time to participate in the 2009 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.

USMLE Statement on the Fifth Pathway Program and Step 3 Eligibility

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.

2008 Match Performance -- Number of IMGs Matching Increases

For the sixth consecutive year, the number of first-year (PGY-1) residency positions offered through the Match increased. A total of 22,240 first-year positions were offered in the 2008 Match, held earlier this month. This represents an increase of 395 positions compared to last year and an increase of 1,638 positions since 2002.

The number of IMGs who matched to first-year positions increased by 122 compared to 2007. Of the 10,304 IMGs who participated in the 2008 Match, 4,649* (45.1%) matched. In the 2007 Match, 4,527 (46.7%) IMG participants were matched to first-year positions.

There was a decrease in the number of matches for non-U.S. citizen IMGs and an increase in the number of matches for U.S. citizen IMGs.

Of the 7,335 IMG participants who were not U.S. citizens, 3,108 (42.4%) obtained first-year positions. The number of non-U.S. citizen IMGs who obtained positions in 2008 decreased by 72 compared to last year. This is the first year that there has been a decrease in the number of non-U.S. citizen IMGs matching to first-year positions since 2001.

Of the 2,969 U.S. citizen IMG participants, 1,541 (51.9%) were matched to first-year positions, an increase of 194 over last year. This is the fifth consecutive year that there has been an increase in the number of U.S. citizen IMGs matching to first-year positions.

*Note: The total number of IMGs who will fill PGY-1 positions for the 2008-2009 academic year will be higher than this number, since a significant number of IMGs obtain PGY-1 positions outside of the Match.

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 2008 Main Residency Match compiled by the NRMP. These tables provide detailed information on the positions offered and filled by the Match in 2008 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.

New ECFMG Acculturation Program Section of ECFMG Website Launches

ECFMG is pleased to announce that it has launched a new section of its website dedicated to the ECFMG Acculturation Program. This section can be accessed through the ECFMG homepage or directly at www.ecfmg.org/acculturation. Building on its tradition of identifying and meeting the acculturation needs of international medical graduates (IMGs), ECFMG launched the Acculturation Program in 2006 with the goal of assisting newly arriving IMGs with the transition to working and living in the United States. The Acculturation Program is developing a spectrum of resources designed to help IMGs as they learn about the U.S. medical system in which they will be training during their graduate medical education (GME). Several of these resources are now available through this new section of the ECFMG website, including:

• The IMG Advisors Network (IAN), a free service currently in its second year of operation that allows IMGs applying to ECFMG for initial J-1 visa sponsorship to connect with advisors who can answer questions about working and living in the United States. Detailed information and instructions on how to participate as either an advisor or an advisee are provided on the website.
• The One Dozen Most Important Things You May Not Have Known, Understood, or Realized About American Medicine, a series of modules designed to introduce IMGs to such topics as the doctor-patient relationship, the role of the patient’s family, the U.S. health care team, U.S. GME system, and confidentiality. Each module includes an overview of the topic, a video, commentary on the video, discussion questions regarding the video, and a transcript of the video.
• A glossary of U.S. “Medicalese,” which includes terms, phrases, and abbreviations that are particular to U.S. medicine. Many of these terms may be new and initially confusing to IMGs, even those who come from countries where the language of instruction is English and who speak and comprehend English quite well. It is our hope that this glossary will facilitate understanding of these terms when they are used by others.

Resources developed by the Acculturation Program can be used by IMGs at any time while planning for or after entry into U.S. GME programs. They can also be used by staff of GME training programs, hospitals, and other health care institutions who are responsible for orienting new IMG residents and introducing them to U.S. medical culture.

These resources represent just the first of the Acculturation Program’s anticipated offerings. It is intended that the new Acculturation Program section of the ECFMG website will continue to grow and become a clearinghouse for a range of materials, programs, and resources that may be useful to IMGs and those with whom they work and interact. Consistent with the program’s objectives, ECFMG will make these resources widely available by posting them to the ECFMG website.

Feedback, comments, and suggestions on these resources and on other materials you feel would be helpful are welcome and can be e-mailed to the Acculturation Program at acculturation@ecfmg.org.

ECFMG Introduces Medical School Web Portal

ECFMG is pleased to announce the introduction of the ECFMG Medical School Web Portal (EMSWP), a significant addition to ECFMG’s on-line offerings and the first exclusively for international medical schools. Through EMSWP, international medical schools have access to a free, web-based program that enables them to verify the status of their students and graduates who have applied to ECFMG for the United States Medical Licensing Examination™ (USMLE™).

ECFMG requires that international medical schools verify the status of their students who apply to ECFMG for USMLE examinations. Prior to the launch of EMSWP, ECFMG verified student status through a paper Certification Statement, completed by the student and his/her medical school for each USMLE application. Now, for a student whose medical school participates in EMSWP, a paper Certification Statement is no longer required for each exam application; instead, the student and his/her medical school will complete a paper Certification of Identification Form. Once it is accepted by ECFMG, the Certification of Identification Form remains valid for all exam applications submitted during the following five-year period. During this period, the student will be able to complete the exam application process entirely on-line using ECFMG’s Interactive Web Application (IWA), and the medical school will verify the student’s status on-line using EMSWP in response to each exam application. For students from non-participating schools, ECFMG will continue to require a completed Certification Statement for each exam application. Students will be able to determine if their medical school participates in EMSWP and obtain the appropriate form (Certification of Identification Form or Certification Statement) after completing the on-line part of the exam application using IWA.

Following a year of development, EMSWP represents a major investment by ECFMG to increase use of the Internet to benefit international medical students/graduates and international medical schools who use ECFMG’s services. To educate medical schools about the portal, ECFMG held a number of web-based seminars featuring a demonstration of the EMSWP prototype and the verification program. More than 140 medical school representatives took part in the seminars and provided ECFMG with feedback and suggestions. Participants were enthusiastic about the program and indicated it will significantly streamline the amount of work required of them in the verification process. To date, more than 400 international medical schools have begun the process of establishing EMSWP accounts. These schools represent more than 80% of the students registered for USMLE by ECFMG in 2007.

Verification of the student/graduate status of USMLE applicants is the first of a series of web-based services that ECFMG plans to make available through EMSWP. This year, ECFMG will begin development of EMSWP functionality that will allow for web-based primary-source verification of the medical education credentials required for ECFMG Certification.

ECFMG’s IMG Advisors Network Seeking New Advisors

ECFMG is pleased to announce the continuation of the IMG Advisors Network (IAN) for international medical graduates (IMGs). Introduced on a pilot basis in December 2006, IAN is a free service that connects qualified IMGs entering U.S. graduate medical education (GME) with advisors who may be able to answer many of their questions about living and working in the United States. ECFMG is currently seeking IMGs to serve on a voluntary basis as advisors for this unique resource.

To qualify as an advisor, you must:

• be certified by ECFMG,
• either be in or have completed training in an ACGME-accredited program in the United States,
• be licensed to practice medicine (training or permanent license) in at least one state or jurisdiction in the United States,
• have ready access to e-mail, and
• be willing to reply to inquiries from advisees in an honest and timely manner.

Advisors who are selected 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. Incoming 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.

Eligible advisees are certified by ECFMG and should have a contract for a U.S. residency position, among other requirements. Therefore, questions about ECFMG Certification and applying to residency programs should be limited. Additionally, 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 from how many advisees an advisor might receive inquiries, how often they might correspond, or how much time it would 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.

As IAN moves into its second year, the database of qualified advisors will consist of: advisors from last year’s pilot program who wish to continue; advisees who participated in the pilot program who have been recruited to serve in an advisory capacity; and newly recruited IMGs who meet the advisor qualifications.

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 IMG Advisors Network homepage.

IMGs Participating in 2009 Match Should Take Step 2 CS by August 2008

International medical students/graduates, including participants/graduates of Fifth Pathway programs, who need to pass Step 2 Clinical Skills (CS) to participate in the 2009 Match (in March 2009) are strongly encouraged to take Step 2 CS by August 2008.

Traditionally, there has been high demand for testing appointments in the period from September through December. For 2008, 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 May 2008. 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 2008 test date,

• Apply for Step 2 CS now, provided you meet the eligibility requirements.
• Once registered, schedule your testing appointment as soon as possible for a date before September 2008. Scheduling conditions are expected to be most favorable from May through July.

If you do not register early and schedule as soon as possible for a test date before September 2008, it is possible that you will not be able to obtain a test date in 2008. As published in the 2008 Step 2 Clinical Skills Schedule for Reporting Results, if you do not take Step 2 CS by December 31, 2008, your result will not be available in time to participate in the 2009 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:

• Applicants registered for Step 2 CS can schedule and take the exam during the 12-month eligibility period that follows their registration. By registering early, applicants can schedule immediately if a preferred testing appointment becomes available.
• Applicants registered for Step 2 CS can use the E-mail Notification feature of on-line Step 2 CS Calendar and Scheduling. The E-mail Notification feature allows registered applicants to indicate their preferred test dates/centers and receive e-mail notification when testing appointments that match their preferences become available.
• Applicants who schedule a testing appointment can change the testing appointment without cost, provided they give more than 14 days' notice. See Rescheduling in the ECFMG Information Booklet.
• Applicants who take Step 2 CS early in the year and receive a failing result are more likely to have the opportunity to retake the exam in 2008 and receive their result in time to participate in the 2009 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.

All watches to be prohibited during Step 2 CS testing – starting January 1, 2008

View announcement on the USMLE website.

An Announcement Regarding Fraudulent Letters of Recommendation

International medical students/graduates, including Fifth Pathway participants, who participate in the Electronic Residency Application Service (ERAS®) are reminded that the submission of fraudulent letters of recommendation to ECFMG constitutes irregular behavior, as defined by ECFMG.

View full announcement.

AAMC Service for Applicants Seeking Residency Positions

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:

• experienced an unsuccessful match through the National Resident Matching Program (NRMP) or post-Match Scramble,
• are looking for off-cycle positions or specialties not featured in ERAS, or
• want to change specialties, locations, or residency or fellowship programs.

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

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 Step 2 CS Calendar and Scheduling system does not allow an applicant to reserve his/her scheduled testing appointment for another applicant, nor does it allow the transfer of a testing appointment from one applicant to another. When an applicant cancels a scheduled appointment, the appointment returns to the pool of available testing appointments where it can be claimed by other registrants.
  
  
• At any given time, there are many applicants registered for Step 2 CS who may be attempting to schedule or reschedule testing appointments. It is common for appointments that become available to be claimed immediately by another applicant.
  
  
• The Step 2 CS Scheduling Email Notification System allows registered applicants to indicate their preferences for test dates and centers. When a testing appointment is canceled, all applicants participating in the email notification system who have expressed a preference for this date/center are notified immediately by email.

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

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.

• If you cancel more than fourteen calendar days before (but not including) your scheduled test date, there is no fee to reschedule.
• If you cancel during the fourteen-day period before (but not including) your scheduled test date, your fee will be $150 when you reschedule.
• If you miss your scheduled testing appointment without canceling, your fee will be $400 when you reschedule.

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

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:

• Applicants for Step 2 CS are encouraged to register and schedule their testing appointments as soon as possible.
• Registered applicants are encouraged to schedule a testing appointment, even if they are uncertain that they will be able keep the testing appointment. You will be able to cancel an existing appointment without incurring a rescheduling fee, provided that you give more than 14 days' notice.
• Registered applicants can check which test dates are available to them at any time by accessing Step 2 CS Calendar and Scheduling from the website of their registration entity.

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

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:

• how USMLE policies affect your eligibility for Step 3, based on your clinical skills examination history, and
• how taking or retaking Step 2 Clinical Skills (Step 2 CS) may affect your Step 3 eligibility.

View full announcement.

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

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

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

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.

• The English test date is valid for 2 years from the most recent date of passing performance. This means that an IMG must enter an ACGME-accredited program on or before the expiration date of the English test. If the IMG does not enter an ACGME-accredited program before the expiration date of the English test, the IMG must revalidate the expired date by retaking and passing the English test, so that the ECFMG Certificate is valid on the program start date. The Test of English as a Foreign Language™ (TOEFL®) is the exam currently administered that satisfies the English test and English test date revalidation requirements.
• The ECFMG Clinical Skills Assessment (CSA) date is valid for 3 years from the most recent date of passing performance. This means that an IMG must enter an ACGME-accredited program on or before the expiration date of the CSA. If the IMG does not enter an ACGME-accredited program before the expiration date of the CSA, the IMG must revalidate the expired date by retaking the CSA, so that the ECFMG Certificate is valid on the program start date.

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:

• IMGs who have passed an English test will not be required to revalidate expired English test dates in order to enter GME; all passing performances on the English test will be valid for the purpose of entry into GME, regardless of the length of time that has passed since the test date.
• IMGs who have passed the ECFMG CSA during the 3-year period before the implementation of USMLE Step 2 Clinical Skills (Step 2 CS) on June 14, 2004 will not be required to revalidate expired CSA dates before entering GME. These individuals may enter GME regardless of the length of time that has passed between their passing performance on the CSA and their program start date.

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

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.

• The English test date is valid for 2 years from the most recent date of passing performance. This means that an IMG must enter an ACGME-accredited program on or before the expiration date of the English test. If the IMG does not enter an ACGME-accredited program before the expiration date of the English test, the IMG must revalidate the expired date by retaking and passing the English test, so that the ECFMG Certificate is valid on the program start date. The Test of English as a Foreign Language (TOEFL) is the exam currently administered that satisfies the English test and English test date revalidation requirements.
• The ECFMG Clinical Skills Assessment (CSA) date is valid for 3 years from the most recent date of passing performance. This means that an IMG must enter an ACGME-accredited program on or before the expiration date of the CSA. If the IMG does not enter an ACGME-accredited program before the expiration date of the CSA, the IMG must revalidate the expired date by retaking the CSA, so that the ECFMG Certificate is valid on the program start date.

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:

• IMGs who have passed an English test will not be required to revalidate expired English test dates in order to enter GME in the United States; all passing performances on the English test will be valid for the purpose of entry into GME, regardless of the length of time that has passed since the test date.
• IMGs who have passed the ECFMG CSA during the 3-year period before the implementation of USMLE Step 2 Clinical Skills (Step 2 CS) on June 14, 2004 will not be required to revalidate expired CSA dates before entering GME. These individuals may enter GME regardless of the length of time that has passed between their passing performance on the CSA and their program start date.

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: August 28, 2008]

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