ECFMG History

Examination History

ECFMG administers its first exam, known as the American Qualification Exam (AMQ), in March 1958, to 298 examinees at 17 test centers in the U.S.

In September 1958, the AMQ is administered to 844 candidates at 57 test centers in the U.S. and foreign countries.

The AMQ was based on test items from the National Board of Medical Examiners (NBME) Part I and II exams, taken by students of American and Canadian medical schools. It also included an ECFMG English Examination, requiring candidates to write a short case history in English.

Name of AMQ Examination is changed to the ECFMG Examination.

ECFMG English Examination is revised. New format consists of objective, multiple-choice questions.

ECFMG English Examination is changed to a modified version of the Test of English as a Foreign Language (TOEFL), prepared by the Educational Testing Service (ETS).

The new exam focuses on an examinee's ability to comprehend spoken English, use simple sentence structure properly, and demonstrate a knowledge of non-medical vocabulary.

In response to the Health Professions Educational Assistance Act (PL 94-484), which requires Exchange Visitors to pass an examination equivalent to NBME Part I and II, the Visa Qualifying Examination (VQE) is developed by NBME and administered by ECFMG for the purposes of its certification.

The VQE is approved by the Secretary of Health, Education & Welfare to meet the requirements of PL 94-484.

The Federation Licensing Examination (FLEX) is accepted for ECFMG Certification.

TOEFL scores for applicants who have previously taken the ECFMG English Test are accepted to meet the English language proficiency requirement for ECFMG Certification.

Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS) replaces the one-day ECFMG Examination and the VQE for international medical graduates. FMGEMS, a two-day exam developed cooperatively by NBME and ECFMG, is administered semi-annually and includes testing in the basic medical and clinical sciences.

ECFMG begins administering NBME Part I and Part II examinations, thus giving applicants an alternative to FMGEMS for meeting the medical science examination requirement for ECFMG Certification and qualifying for a visa under PL 94-484.

First administration of the United States Medical Licensing Examination (USMLE), a single, three-step examination for medical licensure in the United States, takes place.

USMLE was developed by the Federation of State Medical Boards (FSMB) and the NBME. USMLE replaces FLEX and the NBME Part examination sequence.

Last administration of the NBME Part examinations takes place.

Last administration of FMGEMS takes place.

On July 1, 1998, ECFMG's Clinical Skills Assessment (CSA) becomes a requirement for ECFMG Certification and the first administration of CSA takes place on this date.

Last paper and pencil administration of USMLE Step 1 takes place in October 1998.

Last paper and pencil administration of USMLE Step 2 takes place in March 1999. Computer-based testing for all Steps of USMLE begins.

Last administration of ECFMG English Test takes place in March 1999. TOEFL becomes the only currently administered exam that satisfies the English language proficiency requirement for ECFMG Certification.

USMLE Steps 1 and 2 are the only exams currently administered that meet the medical science examination requirement for ECFMG Certification.

Although no longer administered, the former one-day ECFMG Examination, the former two-day Visa Qualifying Examination (VQE), the former Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS), and the former NBME Part I and Part II exams are currently accepted for ECFMG Certification. The former three-day Federation Licensing Examination (FLEX), if taken prior to June 1985, is also accepted for ECFMG Certification, provided a score of 75 or higher on each of the three days of a single administration is achieved.

International medical students/graduates who pass Step 1 and Step 2 of USMLE or who have passed the former VQE, FMGEMS, or NBME Part I and Part II will meet the medical science examination requirement under the provisions of United States Public Law 94-484, as amended, to obtain a visa, if needed, to enter the United States.