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.

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|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.

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.

U.S. Department of State Indicates Additional Flexibility Regarding Statement of Need Letter for J-1 Visa Sponsorship

The U.S. Department of State (DOS) has indicated additional temporary flexibilities around the issuance of the home country Statement of Need (SON) for physicians seeking J-1 visa sponsorship during the COVID-19 (Coronavirus) pandemic. ECFMG sought and received temporary authorization to accept SONs issued by foreign embassies in the United States, if authorized by the respective country. In addition, SONs may now be signed electronically. The SON is a regulatory requirement for all J-1 physicians and, previously, only paper SONs signed and sealed directly by the home country’s Ministry of Health were acceptable per DOS regulation. Also, the SON letter is waived for those entering fellowship training if ECFMG has a letter on file for the related specialty. These developments mark additional positive steps toward reducing the challenges faced by the thousands of foreign national physicians who are applying for J-1 visa sponsorship to participate in U.S. programs of graduate medical education beginning July 1.

For more information on the impacts of the COVID-19 pandemic on ECFMG|FAIMER programs and what we are doing in response, please visit our COVID-19 (Coronavirus) web page.

New Trump Administration Executive Order on Immigration Does Not Impact Non-immigrant Visa Processing, Including J-1s

President Trump issued a new Executive Order (EO) on April 22, 2020 temporarily suspending the issuance of immigrant visas. Non-immigrant visa classifications, such as the J-1, are not included in the EO and are, therefore, exempt from the provisions of the order.

As previously reported, the U.S. Department of State has advised that physicians and other health care workers are deemed to be mission critical to fighting and mitigating the impacts of COVID-19 (Coronavirus). Potential J-1 applicants who have been issued Form DS-2019 by ECFMG are encouraged to review the website of their nearest embassy or consulate and request a visa appointment.

For more information on the impacts of the COVID-19 pandemic on ECFMG|FAIMER programs and what we are doing in response, please visit our COVID-19 (Coronavirus) web page.

ECFMG|FAIMER Joins Physician Coalition in Support of Protections for Health Care Workers Battling COVID-19

The Coalition for Physician Accountability on Thursday issued a statement in support of strengthened efforts to safeguard the public and protect our nation’s health care workforce during the COVID-19 (Coronavirus) pandemic.

ECFMG|FAIMER offers its strongest endorsement of the Coalition’s call for adequate personal protective equipment (PPE) and adequate testing. Both are essential to protecting our frontline health care providers and their families, and to ensuring that they can continue to care for the public.

As the agency responsible for certifying international medical graduates (IMGs) for entry to U.S. programs of graduate medical education (GME), ECFMG|FAIMER has a special connection to the IMGs that comprise one-quarter of our nation’s physician workforce. ECFMG|FAIMER also is the sole J-1 visa sponsor of foreign national physicians in U.S. GME. In this role as visa sponsor, we are currently responsible for monitoring the well-being of nearly 12,000 J-1 physicians in all levels of training at teaching hospitals across the United States.

The Coalition exemplifies the collaboration that is needed at this time of national crisis. “ECFMG|FAIMER has been working closely with Coalition members and other partners to address many of the issues now faced by physicians,” said ECFMG|FAIMER President and CEO, William W. Pinsky, MD. “Only through continued collective leadership will we be able to provide adequate support to physicians who are serving and sacrificing on the front lines.”

Advocating for Matched IMGs with U.S. Department of State

Over the past three weeks, ECFMG|FAIMER staff have been in daily communication with officials at the U.S. Department of State (DOS) to communicate specific concerns related to COVID-19 and foreign national physicians participating in, or seeking to participate in, U.S. residency and fellowship training programs. These communications directly resulted in the following developments:

  • Working in partnership with the National Resident Matching Program® (NRMP®) in response to DOS’ temporary suspension of routine visa processing around the world, including the J-1 and H-1B, we provided information to DOS about the number of foreign national physicians who matched to U.S. training programs and the country of citizenship for those who matched. As a result, DOS instructed consular posts around the world to resume visa processing for medical professionals.
  • Following the Accreditation Council for Graduate Medical Education’s (ACGME’s) posting of its Response to Pandemic Crisis, ECFMG|FAIMER asked that DOS confirm that J-1 physicians are permitted to engage in any/all clinical assignments and training activities permissible under the new ACGME guidelines. DOS provided confirmation.
  • DOS also confirmed that it would “push a two-month extension to program end dates in the government database [SEVIS] on active records with a program end date between April 1-May 31, 2020 in order to provide exchange visitors the opportunity to complete either their educational or training programs, or continue to finalize travel plans to return home.” DOS further indicated that it will continue to review this issue and will make the same provisions for those J-1 physicians whose programs end in June and July, if necessary.
  • We sought and received authorization from DOS to begin accepting electronic Statements of Need (SONs) from home country governments. The SON is a regulatory requirement for all J-1 physicians and, previously, only original letters signed and sealed from the home country’s Ministry of Health were permitted per DOS regulation.

We have been sending direct communications to representatives at training institutions and to currently sponsored exchange visitor physicians, as developments warrant. We have made a number of updates to the ECFMG website and continue to maintain an active presence on Twitter @ECFMG_J1. We’ve also conducted two webinars for teaching hospital personnel and members of the Association of American Medical Colleges (AAMC) Group on Resident Affairs (GRA) to answer COVID-19 related questions. The first two webinars attracted hundreds of attendees.

For more information on the impacts of the COVID-19 pandemic on ECFMG|FAIMER programs and what we are doing in response, please visit our COVID-19 (Coronavirus) web page.

Issuance of Interim ECFMG Certificates

One of the requirements for ECFMG Certification is verification of the authenticity of an applicant’s medical education credentials, including the final medical school diploma, with the issuing medical school. ECFMG is prepared to issue Interim Certificates to IMGs who have matched to U.S. residency positions that start in July if their medical schools are unable to provide their final medical education credentials. The Interim Certificates will allow these individuals to begin their programs on time and to receive Standard ECFMG Certificates after verification of their final credentials is complete.

For more information on the impacts of the COVID-19 pandemic on ECFMG|FAIMER programs and what we are doing in response, please visit our COVID-19 (Coronavirus) web page.

Department of State Signals Visa Processing for Medical Professionals Will Move Forward

ECFMG|FAIMER Continues Focus on Obstacles to IMGs Entering U.S. Training

In a communication today, the U.S. Department of State (DOS) signaled that it would resume processing of J and H visa applications for medical professionals seeking to enter the United States. In its communication, DOS encouraged individuals with an approved U.S. non-immigrant or immigrant visa petition (I-129, I-140, or similar) or a certificate of eligibility in an approved exchange visitor program (DS-2019) to review the website of their nearest embassy or consulate for procedures to request a visa appointment.

The communication follows a March 18 announcement that the United States was suspending routine visa processing for immigrant and non-immigrant visas, including the J and H visas, at embassies and consulates worldwide due to the COVID-19 (Coronavirus) pandemic.

Since the March 18 announcement, ECFMG|FAIMER has been in close contact with DOS to raise awareness of the impact of the suspension in visa issuance on the 4,200+ foreign national physicians selected in the March 20 Match to participate in U.S. programs of graduate medical education (GME) beginning July 1. The addition of these physicians to health care teams at teaching hospitals across the United States is critical to meeting our health care needs and combating the current COVID-19 health care crisis.

“We are encouraged that our close relationship and communications with DOS on this issue have resulted in this positive development,” said ECFMG|FAIMER President and CEO William W. Pinsky, MD. “There are still significant obstacles to getting these physicians here, and we can now shift our focus to addressing these other issues.”

The J and H are the most common visa classifications used by foreign national physicians to participate in U.S. GME programs. ECFMG|FAIMER is designated by DOS as the sole J-1 visa sponsor of foreign national physicians in U.S. GME programs. Currently, ECFMG|FAIMER sponsors close to 12,000 physicians at teaching hospitals across the nation, where they engage in medical specialty training and provide supervised patient care.

For more information on the impacts of the COVID-19 pandemic on ECFMG|FAIMER programs and what we are doing in response, please visit our COVID-19 (Coronavirus) web page.