Match Day Adds 7,500+ International Medical Graduates to U.S. GME Programs

International Medical Graduate (IMG) Performance in the 2020 Main Residency Match
(Click to enlarge)

More than 7,500 international medical graduates (IMGs) obtained first-year residency positions in U.S. programs of graduate medical education (GME), an increase of 132 from last year, according to results of the 2021 Main Residency Match® announced Friday by the National Resident Matching Program® (NRMP®). The number of first-year residency positions offered in the 2021 Match increased by 928 (2.7%) to 35,194 over 2020.

The 7,508 IMGs who matched represent an overall IMG match rate of 57% in this highly competitive process. Of the IMGs who matched, 3,152 are U.S. citizens, a decrease of two, compared to last year. The number of positions obtained by foreign national IMGs is 4,356, an increase of 134 compared to last year. The match rates for U.S.-citizen and foreign national IMGs are 59.5% and 54.8%, respectively. An infographic on IMG performance in the 2021 Match can be found here.

The journey to the 2021 Match for IMGs was fraught with changes and challenges spurred by the COVID-19 pandemic, including worldwide disruptions to medical education and changes to the certification process for IMGs. Despite the challenges, William W. Pinsky, MD, President and CEO of the Educational Commission for Foreign Medical Graduates | Foundation for Advancement of International Medical Education and Research (ECFMG®|FAIMER®), said that he was pleased with the outcome of the Match for IMGs.

“ECFMG|FAIMER succeeded in ensuring an applicant pool of international medical graduates for the Match that was ample, diverse, and highly qualified, which is vital for the U.S. health care system,” Dr. Pinsky said. “IMGs play an important role in providing supervised patient care, contribute much needed diversity to our nation’s health care system, and help to address the nation’s growing physician shortage that is being exacerbated by the pandemic.”

ECFMG|FAIMER assesses the readiness of IMGs before they enter U.S. GME. The program for certifying IMGs is a rigorous process that includes passing components of the United States Medical Licensing Examination® (USMLE®), the same examinations required of U.S. medical school students and graduates, and demonstration of clinical and communication skills. As part of the certification process, ECFMG|FAIMER also verifies the authenticity of IMGs’ medical education credentials, including their medical diplomas, directly with the issuing medical schools. Only IMGs who are certified by ECFMG can enter accredited U.S. GME programs.

Beginning in March 2020, the pandemic forced the suspension and eventual permanent discontinuation of the Step 2 Clinical Skills (CS) component of USMLE, which had been used by IMGs to demonstrate the clinical and communication skills required for ECFMG Certification. ECFMG|FAIMER moved quickly to develop five pathways to allow qualified IMGs who had not passed Step 2 CS to meet the requirements for ECFMG Certification and participation in the 2021 Match. The pathways were critical to producing a robust IMG applicant pool for this Match. Approximately 6,000 IMGs who registered for the 2021 Match completed a pathway; this represents one-third of the total number of IMGs in the Match.

“Appropriate clinical and communication skills are essential for physicians who participate in U.S. graduate medical education,” Dr. Pinsky said. “The pathways ensure that the U.S. public and the U.S. GME community can continue to rely on ECFMG Certification as an indicator that IMGs are ready to enter U.S. GME and to provide supervised patient care.”

For the 2022 Match, ECFMG|FAIMER is expanding the pathways for IMGs to meet the requirements for ECFMG Certification. With the addition of a sixth pathway and changes to certain eligibility requirements, ECFMG|FAIMER expects that more IMGs will be eligible to pursue a pathway for the Match.

“The expansion of the pathways currently underway for the 2022 Match will ensure the continuity and integrity of ECFMG Certification and the vital service it provides to the U.S. public, the U.S. GME community, and to qualified IMGs who pursue training in our nation’s teaching hospitals,” Dr. Pinsky said.

Update on Pathways for ECFMG Certification for 2022 Match

As announced on January 26, 2021, ECFMG®|FAIMER® will offer expanded pathways for international medical graduates (IMGs) to meet the requirements for ECFMG Certification and to participate in the 2022 National Resident Matching Program® (NRMP®) Main Residency Match® (The Match®). On February 16, 2021, ECFMG|FAIMER published additional information on the 2022 pathways, including:

  • information on who should use the pathways;
  • general eligibility requirements for all pathways;
  • information on the individual pathways, including the new sixth pathway;
  • expected availability of the on-line application; and
  • important information for 2021 pathway applicants.

To access the updated information, visit Requirements for ECFMG Certification for 2022 Match.

Additional information, including detailed eligibility requirements and application instructions, will be published as it becomes available. Please monitor the ECFMG website for updates.

ECFMG|FAIMER Will Offer Expanded Pathways for 2022 Match

ECFMG®|FAIMER® will expand its pathways for international medical graduates (IMGs) to meet the requirements for ECFMG Certification and to participate in the 2022 National Resident Matching Program® (NRMP®) Main Residency Match® (The Match®). The pathways evaluate IMGs’ clinical and communication skills—skills that are critically important to participate in U.S. graduate medical education (GME) and to provide supervised patient care.

Until mid-March 2020, IMGs were required to pass Step 2 Clinical Skills (CS) of the United States Medical Licensing Examination® (USMLE®) to satisfy the clinical and communication skills requirements for ECFMG Certification. The USMLE program suspended Step 2 CS in March of last year due to the COVID-19 pandemic and subsequently indicated that it would take 12-18 months to bring back a modified Step 2 CS exam. In June 2020, ECFMG|FAIMER established five pathways to allow IMGs who had not passed Step 2 CS to meet ECFMG’s clinical and communication requirements and to participate in the 2021 Match (in March 2021). On January 26, 2021, the USMLE program announced that it had decided to discontinue the Step 2 CS exam.

In establishing the pathways, ECFMG|FAIMER has ensured that ECFMG Certification continues to perform the critical role for which the program was established more than 60 years ago—assessing the readiness of IMGs to enter U.S. GME. Clinical and communication skills are essential components of this readiness, and an evaluation of these skills always has been required for ECFMG Certification due to the variety in medical education systems at more than 3,000 medical schools around the world. The pathways ensure that the U.S. public and the U.S. GME community can continue to rely on ECFMG Certification as an indicator that IMGs are ready to enter U.S. GME and to provide supervised patient care.

The ECFMG|FAIMER pathways for the 2021 Match succeeded in producing an IMG applicant pool that is ample, diverse, and highly qualified. ECFMG expects to certify approximately 5,000 IMGs based on one of these pathways leading up to the July 1, 2021 start date for U.S. GME programs. Overall, more than 19,000 IMGs have applied to residency positions beginning in 2021 through the Electronic Residency Application Service® (ERAS®).

The expansion of the pathways currently underway for the 2022 Match ensures the continuity and integrity of ECFMG Certification and the vital service it provides to the U.S. public, the U.S. GME community, and to qualified IMGs who pursue training in our nation’s teaching hospitals.

The pathways for IMGs planning to participate in the 2022 Match (in March 2022) will expand on the pathways that were established for the 2021 Match. The existing five pathways will continue to be offered with some modifications. ECFMG|FAIMER has identified an additional pathway for evaluation of clinical skills. As a result of the addition of this sixth pathway and changes to certain eligibility requirements, we expect more IMGs to be eligible to pursue a pathway for the 2022 Match. Detailed information on eligibility is not yet available; please monitor the ECFMG website since we expect to publish guidelines very soon.

Consistent with the requirements for the existing pathways, IMGs who pursue one of the six pathways for the 2022 Match will be required to pass the Occupational English Test (OET) Medicine to satisfy pathway requirements. OET Medicine is designed specifically for physicians, in consultation with physicians. The test assesses the health care-specific English language competency of physicians. It emphasizes the type of language physicians will need to communicate effectively in a clinical setting with peers and patients, including the ability to show empathy and to break down complex medical terminology and procedures into simpler language.

Who Should Use the Pathways?

The six pathways for the 2022 Match are intended for IMGs who need to meet the clinical and communication skills requirements for ECFMG Certification and who plan to participate in the 2022 Match (in March 2022).

IMGs who applied to a pathway for the 2021 Match and whose 2021 application was rejected can reapply to a pathway for the 2022 Match. Please see “Important Information for 2021 Pathways Applicants,” below.

The following individuals already have satisfied the clinical and communication skills requirements for ECFMG Certification and therefore do not need to pursue a pathway to meet these requirements or to participate in the 2022 Match:

  • 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.

 Application to the pathways for the 2022 Match is not yet available. Please monitor the ECFMG website for information on the availability of the on-line application for the expanded pathways.

Important Information for 2021 Pathways Applicants

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.

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. Please monitor the ECFMG website for information on the timeline to reapply.

More Information on Pathways for 2022 Match

ECFMG|FAIMER is developing detailed information on eligibility and application procedures, including documentation requirements. ECFMG also is preparing the on-line pathways application to accept applications from IMGs who plan to participate in the 2022 Match. Please monitor the ECFMG website, since updates will be posted as they become available.

Please contact the USMLE Program with any questions on its decision to discontinue Step 2 CS and any other USMLE-related inquiries.

USMLE Program Discontinues Step 2 CS

The United States Medical Licensing Examination® (USMLE®) program announced today that it has discontinued work to relaunch a modified Step 2 Clinical Skills (CS) examination. In the spring of 2020, the USMLE program suspended Step 2 CS due to the COVID-19 pandemic and announced that it would take 12-18 months to bring back a modified Step 2 CS exam. In today’s announcement, the USMLE program indicated that it has no plans to bring back Step 2 CS and that it would use this change in direction to take additional time to partner with the medical education and medical board community to better develop innovative ways to assess the breadth of clinical skills in medicine. Please contact the USMLE Program with any questions on this decision and with any other USMLE-related inquiries.

Prior to the suspension of Step 2 CS, IMGs were required to pass this exam to meet the clinical and communication skills requirements for ECFMG Certification and to pursue U.S. graduate medical education (GME). Today, ECFMG®|FAIMER® announced that it is expanding its pathways that allow qualified IMGs to meet these requirements for ECFMG Certification and to continue to pursue U.S. GME. Detailed information is under development and will be posted on ECFMG’s website very soon. Please monitor the 2022 pathways web page on the ECFMG website for the latest information.

Fee Increases for 2021

Effective January 1, 2021, fees for the following ECFMG applications/service requests will increase:

  • The fee for Application for ECFMG Certification will be $150.
  • The examination fees for United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) will be $975 for each exam registration.
  • The fee for a Certification Verification Service (CVS) request will be $60.
  • The fee for an application for J-1 visa sponsorship will be $360.
  • The fee to establish an Electronic Portfolio of International Credentials (EPICSM) account and confirm identity will be $130.
  • The fee to verify a credential through EPIC will be $100.
  • The fee to request an EPIC Report will be $50.
    • For credentials submitted to EPIC on or after January 10, 2018, the first report requested for each credential will remain free.
    • For credentials submitted to EPIC prior to January 10, 2018, the first report requested for each credential will remain $15.
    • For a previously verified credential, reports will be $50.

The new fees will be assessed for all applications/requests submitted to ECFMG on or after January 1, 2021 (Eastern Time in the United States). All fees are listed in U.S. dollars.

For more information on the fees associated with applying for ECFMG Certification and for USMLE Step 1 and Step 2 CK, refer to the ECFMG 2021 Information Booklet and the Fees page of the ECFMG website.

For more information on the fees associated with EPIC, refer to the Fees page on the EPIC website.

ECFMG|FAIMER Is Planning Requirements for ECFMG Certification for 2022 Match

In a podcast released today, the United States Medical Licensing Examination® (USMLE®) program provided updates on the Step 2 Clinical Skills (CS) exam, which has been suspended since March 2020. The podcast does not provide, at this time, a specific time for launch of the modified exam.

ECFMG|FAIMER is partnering with the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB)—co-sponsors of USMLE—on this critical project and monitoring developments carefully. We continue to advocate for the interests and needs of international medical students and graduates (IMGs). Prior to the suspension, IMGs relied on Step 2 CS to meet the clinical skills requirement for ECFMG Certification, in order to participate in the National Resident Matching Program (“the Match”) 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 planning actively for the requirements for ECFMG Certification for the 2022 Match (March 2022) and will publish detailed information as soon as it is available.

For the 2021 Match (March 2021), thousands of IMGs are in the process of completing the  requirements for ECFMG Certification, including approximately 5,500 IMGs pursuing requirements for one of five pathways that ECFMG|FAIMER developed to allow IMGs who have not passed Step 2 CS to meet the clinical skills requirement for ECFMG Certification. More than 1,100 ECFMG Certificates have been issued to IMGs who have satisfied the clinical skills requirement for ECFMG Certification based on a pathway. These successful pathway applicants are in addition to the IMGs we continue to certify on an ongoing basis.

We recognize that many IMGs continue to have questions and concerns, and we are mindful of the need to provide you with additional information on the requirements for ECFMG Certification for the 2022 Match as soon as possible so that you can plan and prepare.

In the interim, ECFMG|FAIMER encourages IMGs to continue to pursue the other continuing requirements for ECFMG Certification, such as passing Step 1 and Step 2 Clinical Knowledge (CK), and to monitor the ECFMG website for updates.

IMGs Eligible for Pathways Under Expanded Requirements Can Apply Now

Details on the expanded eligibility requirements and instructions for Pathways 1, 2, and 4 are now available in the Requirements for ECFMG Certification for 2021 Match section of the ECFMG website. International medical graduates (IMGs) who believe they are eligible under the expanded requirements can apply using the on-line Application for Pathways for ECFMG Certification for 2021 Match.

For an overview of the changes to Pathways 1, 2, and 4, please see the previous announcement. Other eligibility requirements apply to specific pathways, and all applicants who apply to a pathway must meet all other requirements for ECFMG Certification.

If you are just beginning your pathways application based on the expanded eligibility criteria, you are strongly encouraged to apply to the Electronic Residency Application Service (ERAS) now and to complete your ERAS application as soon as possible.

Eligibility Requirements for Pathways Expanded, More IMGs May Be Eligible

ECFMG|FAIMER has expanded the eligibility requirements for certain pathways used to meet the Requirements for ECFMG Certification for 2021 Match, and additional international medical graduates (IMGs) may be eligible to apply to the pathways. Details on the expanded eligibility requirements and instructions are under development and will be posted to ECFMG’s website as soon as possible. We also are updating the on-line Application for Pathways for ECFMG Certification for 2021 Match to allow newly eligible applicants to apply. Please monitor the ECFMG website for the status of the updated information and on-line application.

We are providing this preliminary information now so that individuals who may be eligible under these expanded requirements can make decisions regarding their applications to residency programs for 2021. Program directors can begin downloading residency applications through the Electronic Residency Application Service (ERAS) on October 21.

If you want to apply to a pathway and believe you are eligible based on the expanded eligibility criteria outlined below, you are strongly encouraged to apply to ERAS now and to complete your ERAS application as soon as possible.

Eligibility requirements have been expanded for Pathways 1, 2, and 4, and the changes are highlighted below. Other eligibility requirements apply to specific pathways, and all applicants who apply to a pathway must meet all other requirements for ECFMG Certification.

Pathway 1:

The types of licenses that satisfy the requirements for Pathway 1 have been expanded. The following has been added as acceptable:

  • Applicant has held a license/registration to participate in postgraduate medical education (i.e., a provisional or training license/registration for postgraduate training) in any country at any time on or after January 1, 2015.
    • The license does not need to permit unsupervised practice.
    • A provisional or training license/registration for the purpose of participating in pregraduate clinical training does not meet the requirements for Pathway 1.

Pathway 2:

There is now an additional option for satisfying the requirements for Pathway 2. The new option is:

  • Applicant attends or has graduated from a medical school in a country where the medical regulatory authority requires an Objective Structured Clinical Examination (OSCE) for licensure of IMGs but does not mandate that same licensure requirement for graduates of domestic medical schools.
    • Students/graduates of medical schools in Malaysia will satisfy the requirements for this new option. These schools will be added to the list of schools eligible for Pathway 2 as soon as possible.

Pathway 4:

The requirements for Pathway 4 have been expanded to include the following:

  • Applicant attends or has graduated from a medical school that is accredited by an agency that has received a determination of comparability by the National Committee on Foreign Medical Education and Accreditation (NCFMEA).
    • Schools that are accredited by the following agencies meet the new requirements:
      • Czech Republic – National Accreditation Bureau for Higher Education
      • Dominican Republic – Ministry of Higher Education, Science and Technology
      • Hungary – Hungarian Accreditation Committee
      • Israel – Council for Higher Education
      • Poland – Polish Accreditation Committee
      • United Kingdom – General Medical Council
    • The schools that meet the new requirements will be added to the list of schools eligible for Pathway 4 as soon as possible. If you are unsure if your school is accredited by an agency listed above, please contact your school or the accrediting agency.

More information will be made available as soon as possible. Please monitor the ECFMG website for updates.

ECFMG’s 2021 Information Booklet on ECFMG Certification and Application Materials Now Available

ECFMG’s 2021 Information Booklet on ECFMG Certification and the 2021 exam application materials for international medical students/graduates (IMGs) are now available on the ECFMG website. The ECFMG Information Booklet is the definitive source of information on ECFMG Certification and is required reading for applicants.

To meet the examination requirements for ECFMG Certification, IMGs have been required to pass Step 1, Step 2 Clinical Knowledge (CK), and Step 2 Clinical Skills (CS) of the United States Medical Licensing Examination® (USMLE®). The USMLE program has suspended administration of Step 2 CS until at least June 2021. ECFMG has established pathways that will allow qualified IMGs who have not passed Step 2 CS to meet the requirements for ECFMG Certification. These pathways are directed toward individuals who intend to apply to accredited graduate medical education programs in the United States for the 2021-2022 academic year. Information on the Requirements for ECFMG Certification for 2021 Match is available now on the ECFMG website.

Availability of 2021 Eligibility Periods for USMLE Step 1/Step 2 CK

Applicants can use the 2021 Information Booklet and 2021 exam application materials to apply for all available Step 1/Step 2 CK eligibility periods that end in 2021.

As announced previously by the USMLE program, all currently registered examinees who have a Step 1 or Step 2 CK scheduling permit with an unexpired eligibility period with an end date in 2020 will be extended through June 2021. ECFMG expects to complete these automatic extensions by the end of October.

Please monitor the ECFMG website, and follow ECFMG on Facebook and Twitter for updates and important information.

(published August 27; updated September 30)

Application for Pathways for ECFMG Certification for 2021 Match Now Available

The on-line Application for Pathways for ECFMG Certification for 2021 Match is now available. Qualified international medical students/graduates (IMGs) who intend to participate in the 2021 Main Residency Match® and are unable to take Step 2 Clinical Skills (CS) of the United States Medical Licensing Examination® (USMLE®) due to the suspension of that exam may be able to meet the requirements for ECFMG Certification through one of five pathways.

Eligibility requirements and detailed instructions for applying to the pathways, including information on required documentation, application timing, fees, and a limited exceptions process, are available on the ECFMG website.

In order to ensure adequate time to address any technical issues that may arise with the new pathways application, please note that it may be unavailable between the hours of 7:00 p.m. and 10:00 p.m., U.S. Eastern Time, Monday through Friday, in the coming business days if updates are necessary.