Requirements for ECFMG Certification for 2022 Match
The requirements for ECFMG Certification include passing examinations in the medical sciences, clinical skills, and communications skills. Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination® (USMLE®) are the exams currently administered that satisfy the medical science examination requirement.
Prior to its suspension by the USMLE program in early 2020, the former USMLE Step 2 Clinical Skills (CS) exam was the exam that satisfied the clinical and communication skills requirements for ECFMG Certification. In response to the suspension and subsequent discontinuation of Step 2 CS by the USMLE program, ECFMG|FAIMER has offered pathways to allow international medical graduates (IMGs) to meet the clinical and communication skills requirements. ECFMG|FAIMER first offered the pathways to IMGs participating in the 2021 Match and is continuing and expanding the pathways for IMGs participating in the 2022 Match.
The pathways allow ECFMG Certification to continue to perform its critical function of providing assurance to the public and U.S. graduate medical education (GME) programs that IMGs are ready to enter supervised training. They also allow qualified IMGs to continue to pursue ECFMG Certification and to compete for positions in U.S. GME.
The pathways for the 2022 Match outlined below expand on the pathways offered for the 2021 Match. Pathways 1, 2, 3, 4, and 5 will continue to be offered with some modifications, and a sixth pathway has been added. Additionally, there have been changes to the general eligibility requirements for all pathways.
There will be no exceptions to the eligibility requirements for the pathways.
If you applied to a pathway for the 2021 Match or familiarized yourself with the 2021 pathway requirements, you should review the 2022 pathway information carefully to ensure an understanding of 2022 pathway eligibility and requirements. You also should review the Important Information for 2021 Pathway Applicants.
If you satisfy the clinical and communication skills requirements for ECFMG Certification through a pathway, you also must:
- Have passed Step 1 and Step 2 CK to participate in the 2022 Match, and
- Satisfy all other requirements for ECFMG Certification to be certified by ECFMG.
Who Should Use the Pathways?
The pathways outlined below are directed toward IMGs who intend to participate in the 2022 Match and who need to meet the clinical and communication skills requirements for ECFMG Certification.
Important Note: Applicants who already have satisfied the clinical and communication skills requirements for ECFMG Certification do not need to pursue a pathway to meet the requirements for ECFMG Certification or to participate in the 2022 Match. These individuals include:
- IMGs who have a passing performance on Step 2 CS that is valid for ECFMG Certification,
- IMGs who are certified by ECFMG, and
- IMGs with an approved pathways 2021 application.
If you applied to a pathway for the 2021 Match, please see the Important Information for 2021 Pathway Applicants.
Assessment of Communication Skills, Including English Language Proficiency
Applicants who pursue one of the pathways are required to attain a satisfactory score on the Occupational English Test (OET) Medicine to satisfy the communication skills requirement for ECFMG Certification. All pathway applicants, regardless of citizenship or native language, must satisfy this requirement.
OET Medicine is designed specifically for physicians, in consultation with physicians. The test assesses the health care-specific English language competency and communication skills of physicians. It is more than a test of English language proficiency, emphasizing the type of language physicians will need to communicate effectively in a clinical setting with peers and patients.
To meet ECFMG’s requirement, applicants must attain a minimum score of 350 (Grade B) on each of the four measured components of OET Medicine: Listening, Reading, Writing, and Speaking.
The minimum score of 350 (Grade B) on each of the four measured components must be achieved in one test administration. Applicants who do not attain the minimum score on one or more of the measured components must retake all OET Medicine components (Listening, Reading, Writing, and Speaking) and achieve the minimum score on all components in a single test administration to meet ECFMG’s English language proficiency requirement.
There is no limit on the number of times you can retake the test, subject to scheduling availability.
Preparation for OET Medicine is key, even for those with a high level of English proficiency. OET Medicine is not a multiple-choice test, and the test tasks are designed to be challenging.
OET offers a variety of preparation materials. OET’s Education team emphasizes the importance of becoming familiar with both the test construct and the assessment criteria. Applicants are advised to prepare thoroughly before attempting OET Medicine.
OET Medicine currently is available in paper-based format at test venues around the world, including the United States. Computer-based testing at Prometric centers is expected to be available beginning in the second quarter of 2021 and to increase in availability throughout the remainder of the year. OET@Home, a version of the test that certain applicants can take at home through remote proctoring, also will be available on a limited basis in 2021; due to the limited availability of OET@Home, applicants should plan to take a paper- or computer-based test at a physical test center to ensure that they test in time to meet pathways requirements for participation in the 2022 Match.
For more information on OET, please visit the ECFMG|FAIMER page on the OET website.
Obtaining Permanent ECFMG Certification
ECFMG Certificates issued to applicants who satisfy the clinical and communication skills requirements for ECFMG Certification through a pathway will be valid for entry to positions beginning in 2021 and 2022 at U.S. GME programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). Once the applicant successfully completes the first year of ACGME-accredited training, the ECFMG Certificate will no longer be subject to expiration.
If the applicant does not enter an ACGME-accredited training program in 2021 or 2022, the ECFMG Certificate will expire. Should the applicant wish to enter an accredited U.S. GME program in the future, the applicant will then be required to revalidate the ECFMG Certificate using the process required at that time.
If you were certified by ECFMG based on a 2021 pathway and your ECFMG Certificate lists an expiration date in 2021, this expiration date has been extended through December 31, 2022. Please see the Important Information for 2021 Pathway Applicants for more information.
General Eligibility for All Pathways
Applicants who are eligible to pursue ECFMG Certification based on one of the pathways include those who:
- Have not already met the clinical skills requirement for ECFMG Certification. (If you have a passing performance on Step 2 CS that is valid for ECFMG Certification or your pathways application for the 2021 Match was approved, you are not eligible to pursue a pathway.)
- Are not barred by ECFMG from pursuing ECFMG Certification.
- Have not been barred by USMLE from taking a Step or Step Component from August 1, 2020 to January 31, 2022.
- Have completed an Application for ECFMG Certification.
In addition to meeting the requirements in General Eligibility for All Pathways, pathway applicants also must meet all requirements for the pathway to which they apply. Detailed eligibility requirements and application instructions for each of the following pathways will be published as they become available.
Important Note: Applicants who failed Step 2 CS one or more times must apply to Pathway 6 in order to meet the clinical and communication skills requirements for ECFMG Certification, regardless of whether they meet the eligibility requirements for other Pathways.
- Pathway 1: Already Licensed to Practice Medicine in Another Country
Pathway 1 is intended for applicants who currently hold or have recently held a license/registration to practice medicine without supervision. Applicants who meet the eligibility requirements for Pathway 1 must apply to Pathway 1 in order to meet the clinical and communication skills requirements for ECFMG Certification, unless they failed Step 2 CS; see Important Note.
Pathway 2: Already Passed a Standardized Clinical Skills Exam for Medical Licensure
This pathway is intended for applicants who do not currently hold, or have not recently held, a license/registration to practice medicine without supervision (Pathway 1), but who successfully completed a secure, standardized clinical skills exam as a requirement for medical licensure or registration in a country other than the United States.
- Pathway 3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME)
- Pathway 4: Medical School Accredited by Agency that Has Received a Determination of Comparability by National Committee on Foreign Medical Education and Accreditation (NCFMEA)
- Pathway 5: Medical School Issues Degree Jointly with a U.S. Medical School Accredited by Liaison Committee on Medical Education (LCME)
Pathways 3, 4, and 5 are intended for applicants who have not yet obtained a license/registration to practice medicine without supervision (Pathway 1) and who have not already passed an acceptable standardized clinical skills exam for medical licensure (Pathway 2). An applicant to Pathway 3, 4, or 5 must be a student or a recent graduate of a medical school that meets eligibility requirements established by ECFMG.
Pathway 6: Evaluation of Clinical Patient Encounters by Licensed Physicians
Pathway 6 is intended for applicants who do not meet the eligibility requirements for Pathway 1, 2, 3, 4, and 5 and/or have failed Step 2 CS one or more times. To meet the requirements for Pathway 6, the applicant’s clinical skills must be evaluated by licensed physicians using ECFMG’s Mini-Clinical Evaluation Exercise (Mini-CEX). Additional details and instructions for meeting the requirements for Pathway 6 will be provided as soon as they are available.
The on-line application process for Pathways 1, 2, 3, 4, and 5 is expected to open in April 2021.
The on-line application process for Pathway 6 is expected to open in July 2021.
Important Information for 2021 Pathway Applicants
If you applied to a pathway for the 2021 Match, please review the following information before applying to a pathway for the 2022 Match.
- If your pathway application for the 2021 Match is approved and you do not enter U.S. GME in 2021, you will not be required to apply for a pathway for the 2022 Match. Your previously accepted pathway application will remain valid for the 2022 Match and for entry to U.S. GME in 2022.
- If you are certified by ECFMG based on a pathway for the 2021 Match, you do not need to apply to a pathway in order to participate in the 2022 Match or to enter U.S. GME in 2022. If your ECFMG Certificate lists an expiration date in 2021, this expiration date has been extended through December 31, 2022.
- If your pathway application for the 2021 Match is not yet complete, ECFMG will retain your application and continue to process it, as required items are received. If your incomplete application ultimately is approved, the approved application will be valid for the 2022 Match and for entry to U.S. GME through December 31, 2022.
- If you applied to a pathway for the 2021 Match and your application is rejected, you can pursue a pathway for the 2022 Match, provided you meet all eligibility requirements, but you will be required to reapply.
- ECFMG is no longer accepting new pathway applications for the 2021 Match. To access information on the 2021 pathways and eligibility requirements for ECFMG Certification and for the 2021 Match, see Requirements for ECFMG Certification for 2021 Match.
- Step 2 CS Exam History & USMLE Transcripts
The information included in USMLE transcripts is determined by the USMLE program, not by ECFMG. If you have questions about your USMLE transcript, including whether a failing attempt at Step 2 CS will appear on your transcript, please contact the USMLE program.
The preceding information is current as of March 22, 2021 and is subject to change. Please visit the ECFMG website frequently for updates regarding these requirements.