ECFMG requires that international medical graduates satisfy the examination requirements for ECFMG Certification within a seven-year period. This means that once you pass an exam, you will have seven years to pass the other exam(s) required for ECFMG Certification. This seven-year period begins on the date of the first exam passed and ends exactly seven years from that date.
Important Note: Applicants who satisfy the clinical skills requirement and the communication skills requirement through a Pathway are subject to this seven-year requirement. This means that your Pathways application must be accepted within the seven-year period. If your Pathways application is not accepted within the seven-year period and you have a passing Step 1 and/or Step 2 CK score that becomes invalid for ECFMG Certification as a result, you must contact ECFMG to determine whether your invalid passing performance on Step 1 and/or Step 2 CK meets ECFMG’s requirements to be extended.
If you do not satisfy all examination requirements within a maximum of seven years, your earliest USMLE passing performance will no longer be valid for ECFMG Certification. It is your responsibility to track your progress toward meeting the exam requirements for ECFMG Certification. ECFMG will not notify you of upcoming deadlines to meet the seven-year requirement and will not notify you if one (or more) of your passing performances becomes invalid for ECFMG Certification because you failed to meet the seven-year requirement.
Examples: An international medical graduate passed Step 1 on January 20, 2015 and Step 2 CS on February 20, 2018. He has through January 20, 2022 to take and pass Step 2 CK to satisfy the remaining exam requirements for ECFMG Certification. If he does not take and pass Step 2 CK on or before January 20, 2022, his passing performance on Step 1 would no longer be valid for ECFMG Certification.
An international medical graduate passed Step 1 on November 30, 2014 and Step 2 CK on March 20, 2018. She has through November 30, 2021 to complete a Pathway to satisfy the remaining clinical skills and communication skills requirements for ECFMG Certification. If she does not complete a Pathway on or before November 30, 2021, her passing performance on Step 1 will no longer be valid for ECFMG Certification.
Under this ECFMG requirement, more than one USMLE passing performance can become invalid for ECFMG Certification.
Example: An international medical graduate passed Step 1 on April 1, 2014, and passed Step 2 CS on May 1, 2015. She had through April 1, 2021 (seven years from her Step 1 passing performance) to pass Step 2 CK, satisfying the remaining exam requirements for ECFMG Certification. She did not pass Step 2 CK by April 1, 2021, so her passing performance on Step 1 is no longer valid for ECFMG Certification. Her earliest USMLE passing performance that is valid for ECFMG Certification is now the Step 2 CS passing performance on May 1, 2015. She now has through May 1, 2022 (seven years from her Step 2 CS passing performance) to pass Step 1 and Step 2 CK, satisfying the remaining exam requirements for ECFMG Certification. If she does not pass Step 1 and Step 2 CK by May 1, 2022, her passing performance on Step 2 CS will no longer be valid for ECFMG Certification.
If you have passed a Step but this passing performance is no longer valid for ECFMG Certification, you may request an exception to retake the previously passed exam that is no longer valid. The USMLE program limits to four the total number of times an examinee can take the same Step. See Reexamination and Reapplication in The United States Medical Licensing Examination (USMLE).
Important Notes: Time limits to complete the USMLE for the purpose of U.S. medical licensure are established by state medical licensing authorities and may require completion of all Steps (including Step 3, which is not required for ECFMG Certification) within a certain number of years. Information regarding specific state requirements can be obtained on the Federation of State Medical Boards website .
Applicants who retake a previously passed Step to comply with a time limit should understand the implications of a failing retake performance on their Step 3 eligibility. See Retaking Previously Passed Steps in the USMLE Bulletin of Information.
A passing performance that is no longer valid for ECFMG Certification will still appear on a USMLE transcript.
Back to top
[Last update: August 11, 2021]