Coalition Makes Announcements on UME to GME Transition and Virtual Interviews for 2021-22 Residency Season

The Coalition for Physician Accountability today announced that is has accepted the final report and recommendations of the Undergraduate Medical Education to Graduate Medical Education Review Committee (UGRC) to improve the transition from medical school to residency. In addition, the Coalition earlier this week released new guidance for medical education institutions on interviewing applicants during the 2021-22 residency season.

The Educational Commission for Foreign Medical Graduates | Foundation for Advancement of International Medical Education and Research (ECFMG|FAIMER) is a member of the Coalition, a cross-organizational group of national medical education organizations.

UME to GME Report and Recommendations

The UGRC, an independent body of stakeholders commissioned by the Coalition, submitted its final report and 34 recommendations to improve the transition from medical school to residency. The Coalition accepted the report and recommendations and has released them to the public. The release of the report marks the formal completion of the work of the UGRC.

UGRC Co-chairs Dr. Elise Lovell and Dr. George C. Mejicano released a statement in which they  thanked the Coalition for its support in conducting this important work, and thanked each member of the UGRC for their expertise, thoughtfulness, and dedication to improving the UME-to-GME transition for all.

“Over the past year, the UGRC worked tirelessly towards developing solutions to improve the UME-to-GME transition for all involved. We strove to follow a set of guiding principles that supported the public good and encouraged us to act boldly and transparently to address the challenges within the current transition. We believe the recommendations we put forward will create better organizational alignment across the transition, address inequities, enhance wellness and produce many additional positive outcomes.

The UGRC could not have completed its work without the invaluable input and feedback we received from the public and stakeholder organizations throughout the past year. The conversations we had and comments we received from students, program directors, DIOs, medical school deans, medical educators, international medical graduates, and the public had a profound impact in guiding our work and informing the final recommendations.”

The Coalition is committed to working together as each individual Coalition member organization further explores how to address moving forward with the UGRC’s recommendations, collectively and individually. Additional information will be forthcoming as progress is made on planning and implementation of the recommendations.

Recommendations on Virtual Interviews for 2021-22 Residency Season

On August 24, a working group of the Coalition released new guidance on interviewing during the 2021-22 residency season for medical education institutions considering applicants from Liaison Committee on Medical Education (LCME)-accredited, U.S. osteopathic, and non-U.S. medical schools.

The guidance was created in response to ongoing concerns about continuing risk associated with travel for residency interviews arising from the COVID-19 delta variant and its spread across the United States. Eight major national medical education organizations support an extension of the 2020-21 recommendation on interviews. The Coalition urges each medical school, sponsoring institution, specialty society, and residency program to carefully consider the recommendations and commit to working together to create an equitable, transparent, and successful residency selection cycle that prioritizes the safety of all.

ECFMG|FAIMER supports the Coalition’s recommendations, which are intended to add to, but not supersede, the independent judgment of a medical school, sponsoring institution, or residency program regarding the immediate needs of its patients and the preparation of its learners. Medical school deans have the authority and responsibility to make decisions regarding their medical students; and designated institutional officials and program directors have the authority to make decisions regarding residents in their sponsoring institutions and programs. Because students rely on predictable, common practices across schools and programs as they prepare to transition to residency, a shared response to disruptions caused by the COVID-19 pandemic will reduce unnecessary confusion, stress, and inequity among students while promoting a more successful residency selection process for all.

The latest recommendations include the following:

  • Recommendation 1: Conduct Virtual Interviews for the 2021-22 Recruitment Cycle

    Interest exists to extend a consistent approach to in-person interviews for the 2021-22 residency cycle; however, recognizing the current state of the COVID-19 pandemic and the near certainty, given insufficient national vaccination rates, that the pandemic will continue into the winter, albeit in unpredictable ways, the Working Group offers the following recommendation that we hope will minimize public health risks; mitigate inequity stemming from geographic variations in pandemic impact; and provide applicants, their advisors, and programs with guidance to promote consistency and decrease anxiety.

    Recommendation: All interviews should be conducted virtually for the 2021-22 recruitment cycle due to growing concerns about the delta variant and potential risks and disruptions from potential future variants.

  • Recommendation 2: Increase Our Understanding of Virtual Interviewing

    Recommendation: The medical education community should assess the value of virtual interviews and the concerns associated with them that were evident during the 2020-21 interview cycle.

Acknowledging that these recommendations cannot address every eventuality, they are offered to provide the best path forward to promote consistency and fairness across the country and to reinforce our commitment to an equitable process for all.

Pathway 6 On-line Application Now Open

The on-line application for Pathway 6 is now open. Pathway 6 is for applicants who do not meet the eligibility requirements for Pathway 1, 2, 3, 4, or 5 and/or have failed the former Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination® (USMLE®). Pathway 6 requires an applicant’s clinical skills to be evaluated by licensed physicians through in-person clinical encounters.

Detailed information on Pathway 6, including criteria for acceptable clinical encounters, criteria for acceptable evaluators, and instructions for applicants, is available at Pathway 6: Evaluation of Clinical Patient Encounters by Licensed Physicians. Detailed information and instructions for physician evaluators are available at Information for Physician Evaluators for Pathway 6.

About the Pathways

The 2022 Pathways allow qualified IMGs who have not passed the former USMLE Step 2 CS exam to meet the clinical and communication skills requirements for ECFMG Certification and for participation in the National Resident Matching Program® (NRMP®) 2022 Main Residency Match® (The Match®).

Detailed Information on Pathway 6 Now Available for Applicants and Physician Evaluators

Detailed information is now available on the ECFMG website for individuals planning to apply to Pathway 6 and for the physicians who will be evaluating their clinical skills. This new information includes step-by-step instructions for applicants and comprehensive information and instructions for physician evaluators. The on-line application process for Pathway 6 will open in August. Applicants should prepare now by reviewing this information carefully, identifying their physician evaluators if they have not already done so, and directing their physician evaluators to review the newly published information.

About the Pathways
The 2022 Pathways allow qualified international medical graduates who have not passed the former Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination® (USMLE®) to meet the clinical and communication skills requirements for ECFMG Certification and for participation in the National Resident Matching Program® (NRMP®) 2022 Main Residency Match® (The Match®). Pathway 6 is for applicants who do not meet the eligibility requirements for Pathway 1, 2, 3, 4, or 5 and/or have failed Step 2 CS one or more times. Pathway 6 requires an applicant’s clinical skills to be evaluated by licensed physicians through in-person clinical encounters.

Additional Information on Pathway 6 Is Available

Prospective Pathway 6 Applicants Should Begin to Identify Evaluators Now

Additional information is now available on applying to Pathway 6, which requires an applicant’s clinical skills to be evaluated by licensed physicians through in-person clinical encounters. This new information includes criteria for both the physician evaluators and for the clinical encounters. If you plan to apply to Pathway 6, you should review this information and begin to identify your physician evaluators now. There also is new information on the availability of the on-line application for Pathway 6, now scheduled for August; application deadlines; and application processing times.

About the Pathways
The 2022 Pathways allow qualified international medical graduates who have not passed the Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination® (USMLE®) to meet the clinical and communication skills requirements for ECFMG Certification and for participation in the National Resident Matching Program® (NRMP®) 2022 Main Residency Match® (The Match®). Pathway 6 is for applicants who do not meet the eligibility requirements for Pathway 1, 2, 3, 4, or 5 and/or have failed Step 2 CS one or more times.

ERAS 2022 Program Information for IMGs Now Available

Information for international medical students/graduates (IMGs) on the Electronic Residency Application Service® (ERAS®) 2022 application season is now available. If you plan to apply for U.S. residency positions that begin in July 2022, please visit the following sections of the ECFMG website for important information.

Most U.S. residency programs participate in ERAS. If you apply to participating programs, you must use ERAS to do so.

At the ERAS Support Services section of the ECFMG website, you will be able to:

  • See an overview of the Application Process and Timeline.
  • View instructions on how to obtain an ERAS Token, which will enable you to register at the MyERAS website of the Association of American Medical Colleges (AAMC) and work on your residency applications.
  • Find instructions for submitting your supporting documents, such as letters of recommendation and transcripts.

ERAS Support Services will transmit your supporting documents to your ERAS application. All supporting documents must be submitted electronically. For more details, please refer to the “Upload Your Documents Now” e-mail that will be sent to you after you have registered at MyERAS.

Residency Tokens for the ERAS 2022 application season are expected to be available through ECFMG’s On-line Applicant Status and Information System (OASIS) beginning June 24, 2021. You can use a 2022 Token to register with AAMC’s MyERAS beginning June 24, 2021.

INPUT REQUESTED: Recommendations on the Transition to U.S. Graduate Medical Education

The Coalition for Physician Accountability, of which ECFMG|FAIMER is a member, has released its Initial Summary Report and Preliminary Recommendations of the Undergraduate Medical Education to Graduate Medical Education Review Committee (UGRC) and opened a 30-day public comment period, through May 26, seeking feedback on the report. The report offers 42 recommendations on how to improve the transition to U.S. graduate medical education for medical school graduates, teaching hospitals, and the patients they serve.

The mission of the Coalition is to advance health care and promote professional accountability by improving the quality, efficiency, and continuity of the education, training, and assessment of physicians. The Coalition’s members are the national organizations responsible for the oversight, education, and assessment of medical students and physicians throughout their medical careers.

ECFMG|FAIMER President and CEO William W. Pinsky, MD said he appreciated the important work of the Coalition and said the report includes important information for those entering graduate medical education, those involved in training the next generation of physicians, and the patients they serve.

“The report includes important information for house staff as well as patients,” Dr. Pinsky said. “There are issues specific to international medical graduates, both foreign nationals and U.S citizens. We are mindful of these specific issues and look forward to receiving your feedback.”

Before you begin the survey, we encourage you to review the supporting materials below to provide you with additional background information and context about the work of the UGRC to find solutions to identified challenges in the transition from undergraduate medical education (UME) to graduate medical education (GME).

1.) Initial Report and Preliminary Recommendations of the UGRC

2.) Glossary of Terms Used in UGRC Report, Recommendations and Survey

3.) Composite Ideal State of UME to GME Transition

To provide comments, please access the survey at https://www.research.net/r/UGRC. The deadline to submit your feedback to the UGRC’s preliminary recommendations is May 26. If you have questions or need assistance, please e-mail CoalitionUGRC@gmail.com.

Update: Pathways for ECFMG Certification for 2022 Match

Detailed Information, On-line Application for Pathways 1-5 Now Available

The 2022 Pathways application process for Pathways 1-5 is now open. Qualified international medical graduates (IMGs) who need to meet the clinical and communication skills requirements for ECFMG® Certification and who intend to participate in the 2022 National Resident Matching Program® (NRMP®) Main Residency Match® (The Match®) can apply to a Pathway to meet these requirements for ECFMG Certification and the requirements for Match participation.

The information available on ECFMG’s website includes:

As announced previously, ECFMG|FAIMER has added a sixth Pathway for 2022. The application process for Pathway 6 is expected to open in July. Preliminary information on Pathway 6 is available now, and additional details and instructions for meeting the requirements for Pathway 6 will be provided as soon as they are available. Please monitor the ECFMG website for the steps that applicants can take before July to prepare for Pathway 6.

Recognition of Non-Standard Training for Exchange Visitor (J-1) Physicians to Transition to the ACGME

Today, the Educational Commission for Foreign Medical Graduates (ECFMG®), American Board of Medical Specialties (ABMS®), and Accreditation Council for Graduate Medical Education (ACGME®) announced a change in the process for recognition of non-standard training as it relates to the J-1 visa program administered by ECFMG. The term “non-standard training” refers to advanced clinical subspecialty disciplines or pathways for which there is no ACGME accreditation and/or ABMS Member Board certification available. Currently, all non-standard disciplines must be endorsed by an appropriate ABMS Member Board to be considered for J-1 sponsorship. The role of the ABMS Member Boards in providing this approval is detailed in federal regulation 22 CFR §62.27(e)(4)(i).

While the ABMS and its Member Boards have historically played a role in recognizing non-standard disciplines, ABMS initiated discussions several years ago with ECFMG about relinquishing that role. The rationale is that oversight of non-standard training does not fit with the mission of the ABMS and its Member Boards, which are responsible for certification of individuals; and, as such, the Member Boards are not structured to provide oversight of training programs and institutions. It was the consensus of the two organizations that the ACGME, as the primary national accreditor of graduate medical education programs and the institutions that sponsor them, is well suited to provide recognition of Sponsoring Institutions offering non-standard training opportunities to exchange visitor (J-1) physicians. At the request of the ECFMG and ABMS, the ACGME agreed to assume this responsibility. The ECFMG, ABMS, and ACGME jointly submitted a proposal to the United States Department of State (DOS) to substitute Sponsoring Institution “recognition” by the ACGME for the current ABMS endorsement role, with a transition period during which either organization’s recognition process may be honored based on criteria currently being developed. With publication of a Federal Register Notice on April 19, 2021, the DOS officially acknowledges the administrative change proposed by the ECFMG, ABMS, and ACGME.

Under the new model, the ACGME will offer recognition of Sponsoring Institutions that offer non-standard training programs for exchange visitor physicians. This recognition has been designed to ensure that institutions are providing appropriate oversight of the non-standard training program(s) they offer. The ACGME will not recognize individual non-standard training programs. A working group has been formed to develop Recognition Requirements and, upon ACGME Board approval of those Requirements, a new Recognition Committee will be formed to review and monitor institutions seeking to achieve and maintain this recognition.

Detailed information regarding the ACGME recognition process will be provided in the coming months, including notification when the proposed Recognition Requirements are posted on the ACGME website for a 45-day public comment period.

Questions regarding the release of the proposed Recognition Requirements should be directed to either Kathy Malloy, ACGME vice president, Accreditation Standards (312.755.5061 or kmalloy@acgme.org) or Tracy Wallowicz, assistant vice president, US Graduate Medical Education Services (215.823.2120 or twallowicz@ecfmg.org).

Questions regarding the recognition process should be directed to Paul Johnson, ACGME executive director, Institutional Accreditation (312.755.5005 or pjohnson@acgme.org).

Sincerely,

William W. Pinsky, MD, FAAP, FACC
President and Chief Executive Officer, ECFMG

Richard E. Hawkins, MD
President and Chief Executive Officer, ABMS

Thomas J. Nasca, MD, MACP
President and Chief Executive Officer, ACGME

Matched Foreign National Physicians Seeking J-1 Visa Sponsorship for the 2021-2022 Academic Year

ECFMG|FAIMER remains ready to serve foreign national physicians seeking initial J-1 visa sponsorship to enter U.S. programs of graduate medical education (GME) in July 2021. According to results of the 2021 Main Residency Match®, 4,356 foreign national physicians matched to first-year residency positions. As the 2021 J-1 visa application season begins, below are a few reminders:

  • The Statement of Need (SON) is a regulatory requirement for all J-1 physicians. In 2020, ECFMG received authorization to accept electronically signed SONs. Applicants for J-1 visa sponsorship are encouraged to pursue this expedient option. Learn more on the SON webpage.
  • The U.S. Department of State (DOS) announced in April 2020 that U.S. embassies and consulates would resume visa services for medical professionals with an approved Form DS-2019. If requests for a J-1 visa interview are not accommodated, please e-mail EVSP-support@ecfmg.org with the applicant’s name, USMLE Identification Number, and the city/country of the consulate or embassy in question. ECFMG|FAIMER will work in partnership with DOS to help mitigate these issues.
  • The Accreditation Council for Graduate Medical Education (ACGME) has published a library of guidance and resources related to the COVID-19 pandemic. Current and prospective J-1 physicians and their training programs are encouraged to review and monitor this important information.
  • ECFMG|FAIMER collaborated with other national leaders in GME and medical school student leaders to develop a new toolkit of resources to support medical school graduates and U.S. GME programs in the transition to the first year of GME during the COVID-19 pandemic.

ECFMG|FAIMER is committed to supporting training programs and foreign national physicians throughout the 2021 visa application season and to ensuring J-1 physicians can join their programs on time in July. The ECFMG|FAIMER Exchange Visitor Sponsorship Program (EVSP) will communicate with all relevant stakeholders about any new immigration or COVID-19-related issues that may impact J-1 physicians and their training programs.

ECFMG|FAIMER, Other GME Leaders Collaborate on Toolkit for Transition to Residency

Transition in a Time of Disruption: Practical Guidance to Support the Move from Undergraduate Medical Education to Graduate Medical EducationECFMG|FAIMER President and CEO William W. Pinsky, MD recently joined forces with other national leaders in graduate medical education (GME) and medical school student leaders to develop a new toolkit of resources to support medical school graduates and U.S. GME programs in the transition to the first year of GME during the COVID-19 pandemic. The final product, titled Transition in a Time of Disruption: Practical Guidance to Support the Move from Undergraduate Medical Education to Graduate Medical Education, was announced Wednesday as a follow-up to last Friday’s Main Residency Match®.

The toolkit of resources is designed to support residents and their residency programs in delivering safe, high-quality patient care during the pandemic and beyond. In addition to ECFMG|FAIMER, the toolkit was developed by the American Association of Colleges of Osteopathic Medicine (AACOM), the Association of American Medical Colleges (AAMC), and the Accreditation Council for Graduate Medical Education (ACGME). FAIMER President Jeanette Mladenovic, MD, and Tracy Wallowicz, Assistant Vice President for U.S. Graduate Medical Education Services at ECFMG|FAIMER, joined Dr. Pinsky on the committee developing the toolkit.

“The COVID-19 global pandemic has disrupted almost all aspects of life and medical education has been no exception,” Dr. Pinsky said. “Supporting the well-being, professional development, and equitable treatment of incoming residents is critical as they begin their journey to the independent practice of medicine, especially during this time of disruption. These resources will help with that transition.”

This toolkit is divided into three sections:

  • Section I provides a framework and list of questions medical schools, residencies, and learners should review during this transition.
  • Section II provides a matrix of possible activities to help learners and residency programs implement a successful transition.
  • Section III provides a compendium of resources to support the transition for both learners and programs.

“The primary goal of the toolkit is to facilitate a successful and seamless transition from medical school to residency, and to create the necessary conditions to fully support young physicians’ early professional development during unprecedented times,” Dr. Pinsky said. “Investing in supporting all incoming physicians can help to facilitate their success throughout the entire residency.”