Currently, the USMLE program accepts either a valid Standard ECFMG Certificate or a valid Fifth Pathway certificate (issued through December 31, 2009) from international medical graduates for purposes of meeting Step 3 eligibility requirements. The governing committee of the USMLE program and the USMLE parent organizations (the Federation of State Medical Boards and the National Board of Medical Examiners) have determined that the USMLE program will cease acceptance of Fifth Pathway certificates for the purpose of meeting Step 3 eligibility requirements, effective January 1, 2017. Individuals who hold valid Fifth Pathway certificates, and are otherwise eligible, may use their Fifth Pathway certificates to meet Step 3 eligibility requirements, and may apply for Step 3, through December 31, 2016.
Individuals holding Fifth Pathway certificates that are not accepted by the USMLE program for purposes of meeting Step 3 eligibility will be required to obtain ECFMG certification in order to be eligible for Step 3.
If you hold a valid Fifth Pathway certificate but have not completed the full USMLE sequence, you should remain mindful of the December 31, 2016 deadline, after which use of your Fifth Pathway certificate to meet Step 3 eligibility requirements will not be permitted.
Information on Step 3 eligibility requirements is found at the USMLE website.
About the Fifth Pathway
The Fifth Pathway, created by the American Medical Association (AMA) in 1971, has allowed certain students who attended four years at an international medical school to complete their supervised clinical work at a U.S. medical school, to become eligible for entry to U.S. residency training, and ultimately to obtain a license to practice in the United States.
Individuals who pursued the Fifth Pathway completed the four-year didactic curriculum at the international medical school, but they did not complete the internship and/or social service requirement for graduation. Instead, they completed a Fifth Pathway program, which was one year of supervised clinical work at a U.S. medical school. Since they did not complete the internship and/or social service requirement, they did not receive the final medical diploma, and, therefore, are not eligible for ECFMG Certification.
The AMA’s Council on Medical Education has withdrawn its support of the Fifth Pathway as a mechanism for eligibility to enter the first year of ACGME-accredited graduate medical education programs. The last Fifth Pathway program class supported was the January 2009 entering class, which ended in December 2009.