News

ECFMG to Require Medical School Accreditation for International Medical School Graduates Seeking Certification Beginning in 2023

In July 2010, ECFMG® determined that, effective in 2023, physicians applying for ECFMG Certification will be required to graduate from a medical school that has been appropriately accredited. To satisfy this requirement, an applicant’s medical school must be accredited through a formal process that uses criteria comparable to those established for U.S. medical schools by the Liaison Committee on Medical Education (LCME) or that uses other globally accepted criteria, such as those put forth by the World Federation for Medical Education (WFME).

View full announcement.

ECFMG Policy on Forfeiture of Funds

Effective July 1, 2010, funds in an applicant’s ECFMG financial account will be available for a period of two years to pay for requested services. Any funds not used during a two-year period will be forfeited to ECFMG; this means that the applicant will lose those funds. The two-year period will be calculated from the date that funds are received at ECFMG. For funds already in an applicant’s account on the July 1, 2010 effective date, the two-year period will be calculated from this effective date. If an applicant has funds in his/her account and makes a service request, ECFMG will use the funds with the earliest receipt date to pay for the service requested.

EXAMPLES: An applicant makes a payment of $295 to his ECFMG financial account on July 2, 2010. He makes another payment of $2,000 on July 10, 2010. On July 28, 2010, he submits an application for USMLE Step 2 CS, which costs $1,295. The $295 from his earlier payment and $1,000 from his later payment are used to pay for this exam registration. The applicant now has until July 9, 2012 to either use the remaining $1,000 balance or request a refund. If he does not, these funds will be forfeited to ECFMG.

An applicant has a balance of $1,700 in her ECFMG financial account when this policy takes effect on July 1, 2010. On December 15, 2010, the applicant submits an application for USMLE Step 1 and Step 2 CK, which costs a total of $1,480. The applicant has until June 30, 2012 to either use the remaining $220 balance or request a refund. If she does not, these funds will be forfeited to ECFMG.

It is your responsibility to monitor the status of your ECFMG financial account. You can check the status of your account, including dates on which payments were made to your account, using OASIS. A refund request should be made to claim any funds that will not be used prior to the expiration of the two-year period. Refund requests must be made in writing. (See Communicating with ECFMG in the ECFMG Information Booklet.)

Sharing or Discussion of USMLE Content Constitutes Irregular Behavior

Examinees are advised in the USMLE Bulletin of Information that USMLE policies and procedures governing examinations have been established to ensure that no examinee or group of examinees receives unfair advantage on the examination, inadvertently or otherwise, thus jeopardizing the standard conditions and the principles on which the examinations are developed and scored. Provision of information relating to examination content by examinees may provide such advantage to individuals who have yet to take the examination. Examinees are directed to maintain the confidentiality of the Step examinations and are directed not to provide information relating to examination content that may give or attempt to give unfair advantage to individuals who may be taking the examination.

The following is a statement from an examinee who disseminated content from a Step 1 examination and, as a result, was determined to have engaged in irregular behavior.

To Whom It May Concern:

As a student at American University of the Caribbean School of Medicine, I received excellent training and direction as a future physician. I was taught the importance of medicine academically, but failed to realize its importance professionally.

After having taken my USMLE Step 1, I made a nearly career-ending mistake. I returned home, went through my study aid book, and noted from memory any question topics and specific test questions I could remember to help my friends prepare for their upcoming exams. Earlier that morning, I had signed a document stating I will not reproduce, by any means, secure USMLE content. Through my actions, I failed to uphold the integrity of our profession, not appreciating the importance of my signature to the USMLE pre-exam agreement.

After having done so, I was called before the USMLE Committee on Irregular Behavior for a review of my case. I faced a lifetime ban from ever taking a USMLE exam again. I was fortunate enough to be banned for two years, however with permanent annotation of my USMLE transcript of Irregular Behavior, as well as notification to ECFMG and FSMB. I am genuinely grateful for the lesson I have learned. However, I wish I did not have to learn my lesson in this way. My transgression had the potential of undermining the validity of other examinees’ Step 1 scores and, on a broader scale, licensing and other decisions made based on those scores. While I thought I was simply helping my friends, I was actually doing them and our profession a disservice.

I want to bring this to your attention, so as to emphasize adherence to the rules, with preservation of integrity and professionalism. I want to remind all AUC students to take USMLE’s rules regarding the integrity of its testing process seriously for failure to do so, as in my case, could have dire consequences on your future as a physician.

 
Sincerely,
Recent AUC Graduate

Important Announcement Regarding Fifth Pathway Certificates and USMLE Step 3

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.

(posted March 27, 2008; updated August 26, 2008, May 4, 2010)

NBME® Self-Assessments with Expanded Feedback

The National Board of Medical Examiners® (NBME) offers web-based self-assessments to help medical students and graduates evaluate their readiness for the computer-based components of the United States Medical Licensing Examination (USMLE). The content of the Comprehensive Basic Science Self-Assessment (CBSSA) resembles the content of USMLE Step 1, while the content of the Comprehensive Clinical Science Self-Assessment (CCSSA) resembles the content of USMLE Step 2 Clinical Knowledge (CK).

The NBME is pleased to announce that it now provides expanded feedback for four forms of the CBSSA and one form of the CCSSA. In addition to the performance profile and score interpretation guide available with all forms, the expanded feedback also shows the number of items answered incorrectly by content category, the average amount of time spent on each incorrect item, and the percentage of incorrect items marked during the assessment. The feedback also provides the capability to review the text of the incorrect items. The fee for expanded feedback forms is $60.00; the fee for standard forms is $50.00.

For complete information, to view a sample assessment, or to purchase an assessment, visit the NBME Self-Assessment Services website.

(posted October 20, 2009; updated September 15, 2011)

On-line Posting or Discussion of USMLE Content Constitutes Irregular Behavior

If you post or discuss United States Medical Licensing Examination (USMLE) examination content via the Internet, you will be in violation of the USMLE Rules of Conduct, as outlined in the USMLE Bulletin of Information. Examination content includes, but may not be limited to, questions, case content, and answers.

The Bulletin specifically advises that, “you will maintain the confidentiality of the materials, including the multiple-choice items, and the case content for Step 2 CS and Primum CCS. You will not reproduce or attempt to reproduce examination materials through memorization or any other means. Also, you will not provide information relating to examination content that may give or attempt to give unfair advantage to individuals who may be taking the examination. This includes postings regarding examination content and/or answers on the Internet.”

The USMLE program continuously monitors Internet forums and chat rooms. Examinees who post information about examination content are identified and referred to the USMLE Committee on Irregular Behavior. If the Committee finds that you posted examination content, your scores may be delayed and you may be subject to the following sanctions:

  • Permanent annotation of your USMLE transcript (such annotations will read “Irregular Behavior/Security Violation” and will be seen by any entity that receives your transcript, i.e., residency training programs, state licensing authorities, etc.);
  • A report to the Federation of State Medical Boards Board Action Databank (a central repository for formal actions taken against physicians and available to licensing and disciplinary boards, the military, governmental and private agencies, and organizations involved in the employment and/or credentialing of physicians);
  • A bar from taking future administrations of USMLE.

A determination of irregular behavior can put your medical career in jeopardy. Do not endanger your career: Do not post information from exams you have taken and do not solicit others to provide such information.

For more information, refer to Testing Regulations and Rules of Conduct and Irregular Behavior in the USMLE Bulletin of Information, available on the USMLE website.

Reminder: Time Limit for Completing Examination Requirements for ECFMG Certification

ECFMG would like to remind applicants that they are required to pass those United States Medical Licensing Examination (USMLE) Steps and Step Components required for ECFMG Certification within a seven-year period. This means that once an applicant passes a Step or Step Component, the applicant will have seven years to pass the other Step(s) or Step Component(s) required for ECFMG Certification. (For complete information on the examination requirements for ECFMG Certification, see Examination Requirements in the ECFMG Information Booklet.)

This seven-year period begins on the exam date for the first Step or Step Component passed and ends exactly seven years from this exam date. If an applicant does not pass all required Steps and Step Components within a maximum of seven years, the applicant’s earliest USMLE passing performance will no longer be valid for ECFMG Certification.

EXAMPLE: An applicant took his first Step or Step Component on October 1, 2006 and passed. The applicant has through October 1, 2013 to take and pass all other Step(s) and Step Component(s) required for ECFMG Certification. If he does not take and pass all other required Step(s) and Step Component(s) on or before October 1, 2013, his passing performance on the October 1, 2006 exam would no longer be valid for ECFMG Certification.

This seven-year limit does not apply to the former ECFMG Clinical Skills Assessment (CSA) because the CSA was not a USMLE Step or Step Component. Applicants who satisfied the clinical skills requirement for ECFMG Certification by passing the CSA are required to pass only Step 1 and Step 2 Clinical Knowledge (CK) within a seven-year period for ECFMG Certification. For these applicants, the seven-year period begins on the exam date for the first USMLE Step or Step Component passed, regardless of when the CSA was passed.

On June 14, 2004, USMLE Step 2 Clinical Skills (CS) became a requirement for ECFMG Certification, replacing the ECFMG CSA as the exam that satisfies the clinical skills requirement. As part of the USMLE, Step 2 CS may be subject to the seven-year time limit for ECFMG Certification as described below:

  • If an applicant’s earliest USMLE passing performance that is valid for ECFMG Certification took place on or after June 14, 2004, the applicant is required to pass Step 1, Step 2 CK, and, if required for ECFMG Certification, Step 2 CS within a seven-year period for ECFMG Certification.
  • If an applicant’s earliest USMLE passing performance that is valid for ECFMG Certification took place before June 14, 2004, the applicant is required to pass only Step 1 and Step 2 CK within a seven-year period for ECFMG Certification; if required for ECFMG Certification, Step 2 CS can be passed outside the seven-year period.

The policies outlined above apply only to ECFMG Certification. The USMLE program recommends to U.S. state medical licensing authorities that they require applicants to pass the full USMLE sequence (including Step 3, which is not required for ECFMG Certification) within a seven-year period. See Time Limit and Number of Attempts Allowed to Complete All Steps and Retakes in the USMLE Bulletin of Information.

Many state medical licensing authorities accept the USMLE recommendation, but some do not. You should contact the Federation of State Medical Boards of the United States, Inc., (FSMB) for general information and the medical licensing authority of the jurisdiction where you plan to apply for licensure for definitive information, since licensure requirements vary among jurisdictions.

Additionally, applicants who retake a previously passed Step or Step Component to comply with a time limit should understand the implications for Step 3 eligibility of a failing attempt on a retake. See Official Performance of Record for Examinees Retaking a Previously Passed Step in the USMLE Bulletin of Information.

AAMC Service for Applicants Seeking Residency Positions

Offered by the Association of American Medical Colleges (AAMC), FindAResident® is a web-based search tool for finding open residency and fellowship positions in a variety of accredited specialties.

Open year-round, FindAResident is an effective resource for residency candidates who:

  • experienced an unsuccessful match through the National Resident Matching Program (NRMP) or post-Match Scramble,
  • are looking for off-cycle positions or specialties not featured in ERAS, or
  • want to change specialties, locations, or residency or fellowship programs.

By registering with this online service, candidates can post their resume, test scores, photo, curriculum vitae, and other pertinent information for programs to view. Users can also search a database of open training positions by post-graduate year level, specialty, and geographic preference. Programs are able to directly update vacancy information at any time, so the unfilled position information remains accurate and current.

FindAResident complements both the Electronic Residency Application Service (ERAS®) and the National Resident Matching Program (NRMP); it does not replace these services. FindAResident offers additional benefits to applicants participating in ERAS. ERAS participants can import information from their certified ERAS Common Application Form (CAF) directly into FindAResident.

Use of this service requires registration and a subscription fee; active ERAS users receive a discount on that fee. Subscriptions begin on the date of purchase and conclude at the end of the FindAResident season (September 14). For more information or to subscribe, visit FindAResident on the Web.

Step 2 CS Scheduling Restrictions

Demand for the Step 2 CS examination is expected to be heavy at all clinical skills evaluation centers at certain times throughout the year. The CS scheduling system is designed to handle the expected high volume, while maximizing the likelihood that most examinees can meet requirements and deadlines. This system also provides a representative mix of examinees at most testing sessions, which is helpful in maintaining a high quality assessment system both within and across test centers.

Spaces within test sessions may be allocated based on a variety of factors, including time of year, location of the test center and whether the examinee’s institution of undergraduate medical education is located within the US or Canada, or is an international medical school. These controls on spaces for each test session will remain in place until 60 days before the test date, at which time all testing spaces that have not been filled will be available to all registered applicants on a first come, first served basis. Scheduling patterns and demand will be monitored, and allotment of spaces may be changed as needed.

Applicants rescheduling into newly-available testing spaces will not be charged a rescheduling fee, provided they cancel existing testing appointments with more than 14 days’ notice. However, applicants who cancel with notice of 14 or fewer days will be charged a rescheduling fee of $150.

Scheduling Guidelines for Applicants

If you plan to take Step 2 CS, you should consider the following:

  • Applicants for Step 2 CS are encouraged to register and schedule their testing appointments as soon as possible.
  • Registered applicants are encouraged to schedule a testing appointment, even if they are uncertain that they will be able keep the testing appointment. You will be able to cancel an existing appointment without incurring a rescheduling fee, provided that you give more than 14 days’ notice.
  • Registered applicants can check which test dates are available to them at any time by accessing Step 2 CS Calendar and Scheduling from the website of their registration entity.

(posted December 21, 2004, updated February 16, 2005, March 18, 2005, December 1, 2006, March 3, 2006, December 7, 2006)

Step 2 CS Rescheduling Policy Allows Early Scheduling, Flexibility in Changing Testing Appointments

There are no Step 2 CS rescheduling fees for applicants who cancel scheduled testing appointments more than 14 days before the scheduled test date. Rescheduling fees do apply to applicants who cancel within 14 days of their scheduled test date and those who miss their scheduled test date without canceling.

This policy allows applicants registered for Step 2 CS to schedule their testing appointments early, while retaining the flexibility to reschedule at no cost, with a minimal period of notice. Applicants are strongly encouraged to register early and schedule testing appointments for the earliest possible date. If you have registered or plan to register for Step 2 CS, you should be familiar with the requirements and fees associated with rescheduling a Step 2 CS testing appointment.

  • If you cancel more than fourteen calendar days before (but not including) your scheduled test date, there is no fee to reschedule.
  • If you cancel during the fourteen-day period before (but not including) your scheduled test date, your fee will be $150 when you reschedule.
  • If you miss your scheduled testing appointment without canceling, your fee will be $400 when you reschedule.

Registered applicants can check which test dates are available to them at any time by accessing Step 2 CS Calendar and Scheduling. For complete information on Step 2 CS rescheduling policies, refer to Rescheduling in the ECFMG Information Booklet.

(posted June 22, 2005, updated December 1, 2005, March 28, 2006, December 7, 2006)