Intealth ECFMG

Educational Commission for Foreign Medical Graduates

ECFMG 2022 Information Booklet

ECFMG Certification

Requirements for ECFMG Certification

To be eligible for certification by ECFMG, international medical graduates must meet the following requirements.

Medical School Requirements

The physician’s medical school must meet requirements established by ECFMG. Schools that meet all requirements will be listed in the World Directory of Medical Schools (World Directory) with an ECFMG note stating that the school meets eligibility requirements for their students and graduates to apply to ECFMG for ECFMG Certification and examination. The ECFMG note also will include the graduation years for which the school meets these requirements. Since ECFMG is a sponsor of the World Directory, the ECFMG note is located on the “Sponsor Notes” tab of the medical school listing. If there is no ECFMG note on the Sponsor Notes tab of your medical school’s listing, you are not eligible to apply to ECFMG for ECFMG Certification and examination. To confirm that your medical school meets ECFMG’s requirements, access the World Directory at .

Important Note: Beginning in 2024 (previously 2023), individuals will be eligible to apply for ECFMG Certification—the first step in the certification process—and take the required examinations if, at the time of application, their medical school is accredited by an accrediting agency recognized by the World Federation for Medical Education (WFME). This requirement will be in addition to the requirement that the school must be listed in the World Directory with an ECFMG note stating it meets ECFMG eligibility requirements. Further details regarding the 2024 Medical School Accreditation Requirement, including eligibility guidelines, are available on the ECFMG website at International medical students and graduates interested in ECFMG Certification should continuously monitor this website section for the latest information.

Application for ECFMG Certification

To be eligible for ECFMG Certification, international medical students/graduates must submit an Application for ECFMG Certification, which confirms their intent to pursue ECFMG Certification and their understanding of the purpose of the certification program. The Application for ECFMG Certification consists of an on-line application and the Certification of Identification Form (Form 186), available via ECFMG's on-line services. Among other things, the Application for ECFMG Certification requires applicants to confirm their identity, contact information, and graduation from or enrollment in a medical school that is listed in the World Directory with an ECFMG note stating it meets ECFMG eligibility requirements. See Medical School Requirements. See Application for ECFMG Certification.

Examination Requirements

To meet the medical science examination requirement for ECFMG Certification, applicants must pass Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination (USMLE).

To meet the clinical skills requirement and communication skills requirement for ECFMG Certification, applicants must:

  • Complete an ECFMG Pathway, which includes attaining a satisfactory score on the Occupational English Test (OET) Medicine, OR
  • Have a passing performance on the former Step 2 Clinical Skills (CS) component of USMLE that is valid for ECFMG Certification.

ECFMG has established time limits and other rules for completing the examinations required for ECFMG Certification. For detailed information, see Examinations for ECFMG Certification.

Medical Education Credential Requirements

The physician’s graduation year must be included in the ECFMG note in the medical school's World Directory listing. International medical graduates 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 with an ECFMG note stating it meets ECFMG eligibility requirements. There are restrictions on credits transferred to the medical school that awards an applicant’s medical degree that can be used to meet this requirement. See ECFMG Policy on Transfer Credits in Medical Education Credentials.

Applicants must document the completion of all requirements for, and receipt of, the final medical diploma. See the Reference Guide for Medical Education Credentials on the ECFMG website for the exact title of the final medical diploma you must have earned (and must provide). ECFMG verifies every applicant’s medical school diploma with the appropriate officials of the medical school that issued the diploma and requests that the medical school provide the final medical school transcript. Verification by ECFMG with the issuing school may also be required for transcripts that are submitted to document transferred credits. See Medical Education Credentials.

Important Note: Submitting falsified or altered documents may result in a finding of irregular behavior and permanent annotation of your ECFMG record. For more information and potential consequences, see Policies and Procedures Regarding Irregular Behavior.

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[Last update: August 11, 2021]

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