News

ECFMG|FAIMER Responds to Suspension of USMLE Step 2 CS Testing, Commits to Uninterrupted Pathway for IMGs to ECFMG Certification

The May 26 announcement by the United States Medical Licensing Examination® (USMLE®) program that it will suspend Step 2 Clinical Skills (CS) testing for an additional 12-18 months creates a major disruption to the education and assessment of all medical students and graduates who seek to train and practice in the United States. The impact of the USMLE program’s decision is significant and immediate for international medical students and graduates (IMGs) who have relied on Step 2 CS to meet the clinical skills requirement for ECFMG® Certification, to participate in the National Resident Matching Program (“the Match”), and to enter U.S. programs of graduate medical education (GME).

ECFMG|FAIMER is committed to the continued smooth operation of its certification program and the ability of qualified IMGs to pursue and participate in U.S. GME without interruption. We are engaged in the following activities in response to the suspension of Step 2 CS testing.

  • Identifying alternatives to Step 2 CS that can be available now to allow IMGs to meet the clinical skills requirement for ECFMG Certification and providing an update on these alternatives in the very immediate future;
  • Collaborating with organizations involved in the recruitment and training of medical school graduates in the United States to mitigate disruptions; and
  • Advocating forcefully for the interests of IMGs as plans develop for the continued training of physicians during the COVID-19 (Coronavirus) pandemic.

This commitment underscores the vital importance of ECFMG Certification, which has served the U.S. medical education and regulatory communities, IMGs, and the public for almost 70 years. ECFMG’s program of certification provides assurance that the IMGs who enter U.S. GME are ready to do so and ensures an adequate and qualified pool of IMG applicants—trainees who will join the next generation of physicians.

ECFMG Certification also provides the pathway for the best and brightest physicians from around the world to train in the United States. Across our nation, IMGs fill gaps in training and practice that otherwise would remain empty, thereby ensuring a sufficient number of physicians to care for our population. IMGs also bring important international perspectives and much-needed diversity to our physician workforce.

We are committed to ECFMG Certification as a core component of our mission to promote quality medical education and health care. We will continue to support and advocate for IMGs because we know that our nation’s ability to provide accessible, quality health care depends on the continued contributions of IMGs in both U.S. training and practice.

We recognize that many IMGs have questions and concerns, and we are mindful of the need to provide you with effective and prompt answers and solutions in support of your educational plans.

Please stay well and monitor the ECFMG website for updates in the coming weeks.

USMLE COVID-19 Update: A Phased Approach for Expanding Step 1, Step 2 CK, and Step 3 Testing

On May 15, the United States Medical Licensing Examination® (USMLE®) program published a weekly COVID-19 update on its website. Topics include:

  • Expanding Testing Capacity for Step 1, Step 2 CK, and Step 3
  • Delaying Step 1 and Step 2 CK Content Changes

Examinees should read the full announcement on the USMLE website.

On May 18, the the USMLE program published an announcement that a pilot will begin next week for phase one of the approach for expanding testing capacity: regional testing centers at U.S. medical schools.

On May 20, the USMLE program published an update on regional and event-based testing at U.S. medical schools.

Examinees should monitor the USMLE website frequently for updates.

(posted May 20, 2020; updated May 21, 2020)

ECFMG|FAIMER Supports Recommendations for Medical School Graduates Entering PGY-1 Residency Positions in Coming Months

On May 18, the Coalition for Physician Accountability, of which ECFMG®|FAIMER® is a member, released the final report of its work group on Learner Transitions from Medical Schools to Residency Programs in 2020. The report provides important and timely recommendations to mitigate the effects of pandemic-related disruption in the transition from undergraduate medical education to graduate medical education (GME) for more than 30,000 medical school graduates who will begin first-year (PGY-1) residency positions in the United States in the coming months.

ECFMG|FAIMER was represented on the work group, which considered the entire population of incoming PGY-1 residents, including more than 7,000 international medical graduates (IMGs), and the institutions and programs where they will train. The recommendations acknowledge that the pandemic may present elevated risks to the well-being of all PGY-1 residents and that IMGs may face unique challenges.

ECFMG|FAIMER strongly endorses the report’s recommendations, which include:

  • Accommodation of delayed arrival at residency programs due to reasons that include international travel, health concerns, visa issues, or licensure delays
  • Orientation to infection protection, including the provision of personal protective equipment and training in its use
  • Augmented relocation assistance in the form of referrals for services such as health care, housing, legal assistance, transportation, and child care
  • Augmented assessment and monitoring of resident well-being throughout the academic year
  • Enhanced cultural and community support for IMGs, in recognition of their increased risk for social isolation and other unique circumstances

For complete information, please read the final report.

As the J-1 visa sponsor for all foreign national physicians in U.S. GME, ECFMG|FAIMER is committed to the well-being of these physicians as they train in the United States. We welcome the Coalition’s coordinated and collaborative approach to protect all learners, as well as the broader health care workforce, patients, and the public.

ECFMG Medical School Accreditation Requirement Moved to 2024

ECFMG previously announced that, starting in 2023, applicants for ECFMG Certification will be required to be a student or graduate of a medical school that is appropriately accredited. More specifically, the medical school must be accredited by an agency recognized by the World Federation for Medical Education (WFME). To date, 21 accrediting agencies have received WFME recognition, with many others in process. We are energized by the commitment to quality improvement demonstrated in response to this initiative.

At the same time, we recognize that many countries have been forced to suspend or limit their accreditation efforts due to COVID-19 (Coronavirus). As such, we are moving the implementation of the requirement to 2024. We will announce an effective date as we approach 2024; we will also continue to reassess this timeline as needed.

Further information regarding this change will be provided in the coming weeks on our website at www.ecfmg.org/accreditation.

ECFMG On-line Services Unavailable May 15-17

Due to scheduled maintenance, ECFMG’s on-line services are expected to be unavailable beginning at approximately 7:00 p.m. on Friday, May 15, 2020. Services are expected to be restored by 6:00 p.m. on Sunday, May 17, 2020. All times are calculated using Eastern Time in the United States.

During this maintenance period, you will be unable to access most ECFMG on-line services, including the following:

  • IWA—Interactive Web Applications
  • OASIS—On-line Applicant Status and Information System
  • Step 2 CS Calendar and Scheduling
  • IAN—IMG Advisors Network
  • EMSWP—ECFMG Medical School Web Portal, and its programs for medical schools and other institutions:
    • Status Verification
    • Credentials Verification
    • Performance Data
    • EMSWP ERAS
    • GEMxSM for Partner Institutions
  • CVS ON-LINE—Certification Verification Service On-line
  • EVNet—Exchange Visitor Network (for staff of U.S. training programs that host ECFMG-sponsored exchange visitor physicians)
  • EPICSM—Electronic Portfolio of International Credentials
    • Physician Portal
    • Report Portal
  • GEMx on-line services for students
  • MyECFMG mobile app

The World Directory of Medical Schools also will be unavailable during this maintenance period.

Thank you for your patience and cooperation as we work to maintain high-quality on-line services.

ECFMG|FAIMER Endorses Recommendations and Resources for Medical Students, Trainees, and Physicians during COVID-19

On May 11, the Coalition for Physician Accountability, of which ECFMG®|FAIMER® is a member, released final reports from two work groups that examined critical issues facing medical students, residents, medical educators, and medical regulators during the COVID-19 (Coronavirus) pandemic.

ECFMG|FAIMER membership on the work groups represented the unique needs and perspectives of international medical students/graduates (IMGs). ECFMG|FAIMER plays key roles in the transition of IMGs from undergraduate medical education to U.S. graduate medical education (GME)—certifying the readiness of IMGs to enter U.S. GME; serving as the designated “Dean’s Office” for IMGs using the Electronic Residency Application Service® (ERAS®) to apply to U.S. GME programs; and sponsoring foreign national physicians for the J-1 visa to participate in such programs. ECFMG|FAIMER also is a leading expert on the medical credentials issued to physicians by medical schools and other institutions around the world. These credentials are a core component of establishing the qualifications of physicians.

ECFMG|FAIMER strongly endorses the work groups’ recommendations.

  • Medical Students in the Class of 2021: Moving Across Institutions for Post Graduate Training

The current health care crisis presents new challenges for medical students/graduates, trainees, and U.S. GME programs. This work group considered three major issues in preparation for the 2020-2021 residency cycle during the COVID-19 pandemic: away rotations, in-person interviews for residency, and the ERAS timeline. The recommendations, detailed in the following documents, will provide a consistent approach to disruptions caused by the COVID-19 pandemic, greatly reducing unnecessary confusion, stress, and inequity among students, and promoting a more successful residency selection process for all.

  • Maintaining Quality and Safety Standards Amid COVID-19

The pandemic has created a public health emergency that is rapidly altering the provision of health care services across the country. Physicians and other clinicians have responded with offers to provide care outside of their previously licensed jurisdiction and beyond their typical scope of practice. This work group has developed the following guidance and resources for the deployment of physicians, physicians in training (interns, residents, and fellows), and retired or inactive physicians, to ensure the safe delivery of quality clinical care during this unprecedented emergency.

The Coalition work groups exemplify the collaboration required to create the best solutions for all stakeholders impacted by the pandemic. ECFMG|FAIMER looks forward to continuing to join with Coalition members and other partners to find those solutions.

USMLE Update on Resuming Testing

Resuming United States Medical Licensing Examination (USMLE®) testing remains the USMLE program’s top priority. Below, please read several key updates.

Status of Prometric Testing
Testing resumed at select Prometric centers on Friday, May 1 in accordance with state and local social distancing guidelines. Although hundreds of examinees successfully tested, the overall examinee experience is not meeting expectations. The USMLE program continues to exert pressure on Prometric to rectify all issues in a timely manner. The USMLE program is working daily with Prometric and they have dedicated resources to both resume USMLE testing and address the quality of the examinee experience.

The USMLE program understands that when Prometric test centers reopened, some examinees with confirmed slots traveled to test centers only to find them closed, leading to increased confusion during an already difficult situation. The USMLE program has been disappointed with Prometric’s failure to fulfill its obligations to examinees and to the USMLE program. The USMLE program has emphasized to Prometric the importance of their obligations to examinees and the harm that their failures have caused.

Examinees who have suffered direct out-of-pocket monetary losses due to Prometric’s lack of communication or miscommunication regarding test center closures should submit a written claim directly to Prometric at prometric.com/contact-us.

In March 2020, in response to the suspension in testing, the USMLE program extended eligibility periods to December 2020 for all examinees who had a Step 1, Step 2 Clinical Knowledge (CK), or Step 3 scheduling permit with an unexpired eligibility period with an end date in 2020. To help alleviate some of the pressure examinees may be feeling, USMLE will further extend eligibility periods through June 2021.

  • Note: Eligibility period extensions will be processed approximately over the next eight to twelve weeks.

Alternate Delivery of USMLE Step 1, Step 2 CK, and Step 3
To resume testing, the USMLE program has already identified several options for proctored testing outside of Prometric centers. The USMLE program is expecting to begin testing at some medical school campuses this month. USMLE is committed to offering a broader distribution of testing at medical schools; it is working through technological challenges in order to do so. While this solution will not completely address the testing backlog, it will provide additional USMLE-specified slots within Prometric’s overall capacity, which is increasing. Schools are being considered based on geographic location and a willingness to serve as a regional testing site. Because the USMLE program is not able to scale this solution to all schools, it plans to deliver other solutions as well. The USMLE program will ramp-up testing as we institute new systems and processes.

The USMLE program continues to aggressively explore remote proctoring and expects to have progress to report on the timeline for that project in the next week.

Validity, Reliability, and Fairness
The USMLE program recognizes the burden that reduced testing capacity places on schools and examinees. As the USMLE program moves forward with solutions to alleviate this burden, it must also evaluate the fairness of any test administration method. The USMLE program needs to ensure that its test administration models allow all test takers to reliably and validly demonstrate their skills and maximize, to the extent possible, fairness, access, security, and reliability. Increasing capacity by deploying exam administrations to schools may create differential geographic access. Similarly, with respect to remote proctoring, the USMLE program recognizes that not all schools or individuals have equal access to high-speed internet, a computer that meets the technology requirements for remote proctoring, or dedicated space in which to take the test.

Given these issues of fairness and bias, the USMLE program will continue to work with organizations in the medical education and the medical regulatory community to identify temporary changes to policy and requirements such as relaxing requirements for promotion, graduation, or licensing decisions. The USMLE program is committed to continuing its focus on delivering safe testing and fair test results for examinees.

Step 2 CS
As announced previously, Step 2 Clinical Skills (CS) testing has been suspended due to the COVID-19 (coronavirus) pandemic, and the USMLE program is pursuing testing solutions to ensure the health and safety of examinees and test center staff. After careful consideration, the USMLE program has determined that it cannot resume the exam in its current format without unacceptable risk to examinees and staff.

Prior to COVID-19, the USMLE program was in the very early stages of exploring alternate formats and methods for delivery of the Step 2 CS exam, as part of overall efforts to enhance the USMLE. As a result of COVID-19, these plans have been accelerated and are focused on a testing solution that employs a telehealth model, where examinees and standardized patients would interact on-line, via a web browser. The USMLE program is aggressively assessing this solution, which will require significant redesign of the exam’s content and delivery. Expediting such changes to the exam format and delivery will help result in a safe and effective assessment for all involved.

At this time, Step 2 CS testing is expected to resume after July.

Please know that the USMLE program is doing everything it can to address the challenges of this new environment quickly, and that it will continue to provide you with updates on its progress.

A Message from the Leaders of NBME and ECFMG|FAIMER

Dear International Medical School Educators, Students, and Graduates:

We recognize that the disruptions to USMLE testing present an extraordinary challenge for all of you. Finding a means to restore USMLE testing is a top organizational priority. Our goal is to collaborate with you as we determine how to assure rapid and safe resumption of testing across a variety of venues. We recognize the impact on both U.S. domestic students as well as those of you in our international community.

Status on Prometric Testing

We are receiving reports that several Prometric test centers are erroneously listed as open, and some examinees with confirmed slots were met with closed centers when Prometric resumed limited testing on May 1st. This has led to a confusing and difficult situation for examinees. We are deeply disturbed by the experience you may be having and are working to immediately find resolution to these issues.

Prometric CEO, Roy Simrell, is aware of our shared dissatisfaction with the current situation and the need for a clear and immediate plan to rectify the problems experienced by examinees. We have been, and continue to be, in daily contact with Prometric to represent the needs of the examinees and faculty to improve the execution of the safe resumption of testing and Prometric’s communication with examinees. We have emphasized the impact their actions have on this critical community and the need to ensure examinees are provided timely and reliable information.

We expect capacity constraints and challenges to continue. For this reason, we are working hard to design and deliver solutions even outside of Prometric test centers.

Alternate Delivery of USMLE Step 1, Step 2 CK, and Step 3

We have several efforts underway to resume testing and to address testing backlog and capacity constraints. We have incorporated the suggestions and ideas we have received from medical students, medical school faculty, state medical boards, and our international partners in this work, and will seek to partner even more closely as we move forward with implementation. We expect to have better insight on feasible alternatives and associated requirements within the next week. We will continue to provide at least weekly updates of our progress at usmle.org and ecfmg.org.

Step 2 CS

We are dedicated to finding a testing solution for Step 2 CS that assures the safety of examinees and standardized patients as our top priority. We have a dedicated team exploring innovative and disruptive solutions to resume Step 2 CS examinations. This includes options that alleviate the need to travel to examination centers. We expect to have more news next week.

Partnership

Working together, we can respond to the challenges wrought by the COVID pandemic and ensure the continued excellence of America’s future physicians.

Peter J. Katsufrakis, M.D., M.B.A.
President and CEO, National Board of Medical Examiners
William W. Pinsky, M.D., FAAP, FACC
President and CEO, ECFMG|FAIMER
Chair, Board of Trustees, FAIMER
Professor (Hon.), University of Queensland

A Message to Applicants—ECFMG|FAIMER is Open and Processing Your Applications

We are pleased to confirm that ECFMG|FAIMER programs and services continue to operate. Our staff members are working to process your applications and service requests, and our representatives are answering phone and e-mail inquiries as quickly as possible.

Physicians who use our programs and services should continue to submit applications and other service requests as they would normally. This will help ensure sufficient processing time and your readiness for next steps, as they become available, in pursuing ECFMG Certification, J-1 visa sponsorship (if applicable), and U.S. graduate medical education (GME).

ECFMG Certification

ECFMG continues to process Applications for ECFMG Certification and applications for the United States Medical Licensing Examination® (USMLE®) step components required for Certification, and to verify medical education credentials.

  • USMLE Step 1 and Step 2 Clinical Knowledge (CK): Prometric test centers around the world are open or are beginning to reopen. We are aware that Prometric has provided inaccurate information about the status of some of its test centers, causing confusion and additional difficulties for some examinees. The leadership of the USMLE program and ECFMG are in daily contact with Prometric to ensure an immediate resolution to this situation. More >>
  • USMLE Step 2 Clinical Skills (CS): Work is underway to formalize a plan to resume USMLE Step 2 CS testing, and applicants with canceled testing appointments are receiving regular e-mail updates.
  • We continue to verify medical education credentials with international medical schools, although there are some pockets of service disruptions. To support institutions that are working remotely, ECFMG is leveraging electronic communications to stay connected, facilitate the verification process, and minimize disruption of services for our applicants.
  • Applicants seeking an ECFMG Certificate to begin U.S. GME programs in summer 2020 should expect their certificate to be issued in time to start their programs. ECFMG has been in contact with medical schools to ensure that individuals who meet ECFMG Certification requirements will be issued an ECFMG Certificate.

ECFMG Exchange Visitor (J-1 Visa) Sponsorship

ECFMG is actively processing applications for J-1 visa sponsorship for participation in U.S. GME programs that begin in summer 2020.

  • U.S. embassies and consulates worldwide have resumed processing of applications and visa appointments for medical professionals, including the J-1 Visa. More >>
  • The U.S. Department of State has provided additional flexibility regarding the Statement of Need letter for J-1 Visa sponsorship. More >>
  • President Trump’s Presidential Proclamation issued on April 22, 2020 does not affect physicians or their dependents who are on or applying for J-1 Visa sponsorship. More >>
  • Applicants who experience challenges during the application process should contact the Exchange Visitor Sponsorship Department at EVSP-support@ecfmg.org or +215-823-2121 for assistance.