Intealth ECFMG

Educational Commission for Foreign Medical Graduates

Eligibility for Examination


To satisfy the medical science examination requirement for ECFMG Certification, international medical graduates (IMGs) must pass Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination (USMLE). The eligibility requirements for examination differ depending on whether the applicant is an international medical school student or an international medical school graduate.

International Medical School Students


To be eligible for Step 1 and Step 2CK, a medical school student must be officially enrolled in a medical school that is listed in the World Directory of Medical Schools (World Directory) with an ECFMG note stating it meets eligibility requirements for its students and graduates to apply to ECFMG for ECFMG Certification and examination, both at the time of application for examination and on the test day. In addition, the “Graduation Years” in the ECFMG note on the Sponsor Notes tab of the World Directory listing for the student’s medical school must be listed as “Current” at the time of application for examination and on the test day. For more information on the ECFMG Sponsor Note, see Information on Sponsor Notes in the World Directory of Medical Schools.

An authorized official of the student’s medical school must certify the applicant’s current enrollment status; instructions are provided at the time of application for examination.

In addition to being currently enrolled as described above, to be eligible for Step 1 and Step 2 CK, a medical school student must have completed at least two years of medical school. This eligibility requirement means that the student must have completed the basic medical science component of the medical school curriculum by the beginning of the examination eligibility period.

Although a medical school student may apply for and take the examinations after completing the basic medical science component of the medical school curriculum, completion of the core clinical clerkships, including actual patient contact, before taking Step 2 CK, is recommended.

International Medical School Graduates


To be eligible for Step 1 and Step 2 CK, a medical school graduate must have graduated from a medical school that is listed in the World Directory with an ECFMG note stating it meets eligibility requirements for its students and graduates to apply to ECFMG for ECFMG Certification and examination. The applicant’s graduation year must be included in the “Graduation Years” listed in the ECFMG note on the Sponsor Notes tab of the medical school’s World Directory listing. For more information on the ECFMG Sponsor Note, see Information on Sponsor Notes in the World Directory of Medical Schools. Additionally, the 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 World Directory as meeting ECFMG eligibility requirements.

An authorized official of the graduate’s medical school must certify the applicant’s status as a graduate of the school; instructions are provided at the time of application for examination.

For detailed information, including how to apply for the examinations required for ECFMG Certification, refer to the ECFMG Information Booklet.

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[Last update: August 21, 2023]

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