Requirements for ECFMG Certification for 2022 Match

ECFMG is no longer accepting new Pathways applications for applicants who wish to participate in the 2022 Match. If you submitted a Pathways application, you can continue to check its status using the on-line application. For information for 2023 Match participants, please monitor the ECFMG News page.

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. For more information on OET, please visit the ECFMG|FAIMER page on the OET website.

Passing Requirement

To meet ECFMG’s requirements, applicants must attain a minimum score of 350 (Grade B) on each of the four measured sub-tests of OET Medicine (Listening, Reading, Writing, and Speaking) in one test administration. Applicants who do not attain the minimum score on one or more of the measured sub-tests must retake all OET Medicine sub-tests (Listening, Reading, Writing, and Speaking) and achieve the minimum score on all sub-tests in a single test administration.

There is no limit on the number of times you can retake OET Medicine, subject to scheduling availability.

Please note: Applicants who already have satisfied the clinical and communication skills requirements for ECFMG Certification do not need to take OET Medicine. These individuals include:

  • IMGs who have a passing performance on Step 2 CS that is valid for ECFMG Certification (even if they previously failed Step 2 CS),
  • IMGs who are certified by ECFMG, and
  • IMGs with an approved Pathways 2021 application.

Applicants to the 2022 Pathways who took OET Medicine on or after July 1, 2018 and attained the minimum passing score on each of the four components do not need to retake OET Medicine. These applicants will need to ensure that their test results are released to ECFMG. See Release of Test Results below.

Important Note: OET Medicine is only one of the requirements for completing a Pathway. Applicants also must submit an on-line application for the appropriate Pathway.

Booking OET Medicine

OET on paper and OET on computer currently are available at test venues around the world, including the United States.

OET@Home, a version of the test that can be taken at home through remote proctoring, also is available to certain applicants. OET@Home is available only to applicants who do not have a physical test venue (for paper-based or computer-based testing) in their country. Applicants with a test venue in their country should plan to take OET on paper or OET on computer at a physical test center to ensure that they test in time to meet Pathways requirements for participation in the 2022 Match. To determine whether you need to take OET Medicine on paper or on computer at a test venue, or whether you are eligible for OET@Home, visit the OET website and select your country.

If you have questions about OET@Home, please contact OET.

You must take OET Medicine on or before the last scheduled test date in December 2021.

To book your OET Medicine test, please visit the OET website.

Test Preparation

As with any high-stakes test, it is important that you familiarize yourself with OET Medicine and its requirements. OET Medicine is not a multiple-choice test, and the test tasks are designed to be challenging. All applicants should prepare thoroughly before attempting OET Medicine, including those with a high level of English language proficiency. OET’s Education team emphasizes the importance of becoming familiar with both the test construct and the assessment criteria and offers a variety of preparation materials for both non-native and native speakers of English:

Preparation for non-native speakers of English

Preparation for native speakers of English

Release of Test Results

OET Medicine results will be released to you typically 14 business days after you take the test. If you successfully pass OET Medicine in one test administration and you provided your USMLE/ECFMG ID as part of OET’s booking process, your passing score results will be electronically transmitted to ECFMG. Please allow three business days for the information to update in your Pathways application after you receive your passing results.

If you did not provide your USMLE/ECFMG ID when you booked OET Medicine, or if you are unsure whether you did, you can release your results to ECFMG by following these instructions. Please allow three business days for your results to be added to your Pathways application after you release them.

If the USMLE/ECFMG ID and/or date of birth you provided to OET does not match ECFMG records, you will receive a notification from OET and your results will not be released to ECFMG until the information matches. After you receive the notification, confirm your information is accurate in your OET profile and update the information, if necessary. If your information is accurate in your OET profile, contact ECFMG for further assistance.

For more information on OET Medicine, please refer to the Assessment of Communication Skills, Including English Language Proficiency section on the Frequently Asked Questions page.

The preceding information is current as of January 13, 2022 and is subject to change. Please visit the ECFMG website frequently for updates regarding these requirements.