Step 2 CS Examinees Will Be Required to Type Patient Notes on a Computer Beginning July 17, 2011

As of July 17, 2011, all examinees taking the Step 2 Clinical Skills (CS) examination will be required to type the patient note. Examinees will not be permitted to handwrite the note unless technical difficulties make the patient note typing program unavailable. A simulation of the computerized patient note program, which examinees may use to practice typing the patient note, is available on the USMLE website.

View full announcement.

(posted March 24, 2010; updated January 20, 2011, April 19, 2011)

Delay in USMLE Step 1 Score Reporting

Most score reporting of Step 1 results occurs within four weeks of testing. However, because of necessary modifications to the test item pool, there will be a delay in reporting for some examinees testing beginning in mid-May 2011. The target date for reporting Step 1 scores for most examinees testing from May 17 through late June will be Wednesday, July 13, 2011.

Examinees should monitor the USMLE website for the latest information.

Comprehensive Review of USMLE (CRU): March 2011 Update

Updated information on the Comprehensive Review of USMLE (CRU) is available. Access the March 2011 update on the USMLE website.

CRU was initiated in 2004. The goal of this review was to determine whether the mission and purpose of USMLE are effectively and efficiently supported by the current design, structure, and format of the USMLE. This review resulted in recommendations for changes. In 2009, the proposed changes were approved by the USMLE parent organizations, the National Board of Medical Examiners (NBME) and the Federation of State Medical Boards of the United States, Inc. (FSMB). Research, planning, and implementation of the changes have begun.

Changes resulting from CRU are planned for all USMLE Steps and Step Components. These changes may affect both content and item formats. As changes are implemented, the orientation and practice materials available on the USMLE website at may be updated to reflect these changes.

If you plan to take USMLE examinations, you should monitor the USMLE and ECFMG websites for the latest information on changes related to CRU. Comprehensive information on CRU is available on the USMLE website at

(posted June 30, 2010; updated April 1, 2011, October 20, 2011)

IMG Performance in the 2011 Match

For the ninth consecutive year, the number of first-year (PGY-1) residency positions offered through the Match increased. A total of 23,421 first-year positions were offered in the 2011 Match, held earlier this month. This represents an increase of 612 positions compared to last year and an increase of more than 2,800 positions since 2002.

The number of IMGs, including Fifth Pathway participants, who matched to first-year positions decreased by 60 compared to 2010. Of the 10,477 IMGs who participated in the 2011 Match, 4,626 (44.2%) matched. In the 2010 Match, 4,686 (42.4%) IMGs were matched to first-year positions.

Of the 6,659 IMG participants who were not U.S. citizens, 2,721 (40.9%) obtained first-year positions. The number of non-U.S. citizen IMGs who obtained positions in 2011 decreased by 160 compared to last year.

Of the 3,769 U.S. citizen IMG participants, 1,884 (50.0%) were matched to first-year positions, an increase of 135 over last year. This is the eighth consecutive year that there has been an increase in the number of U.S. citizen IMGs matching to first-year positions.

Of the 49 Fifth Pathway participants in the Match, 21 (42.9%) were matched to first-year positions.

It is important to note that the total number of IMGs who will fill PGY-1 positions for the 2011-2012 academic year will be higher than the number obtaining positions through the 2011 Match. Although the majority of PGY-1 positions in the United States are filled through the Match, a significant number of IMG applicants obtain positions outside of the Match. For example, while 4,796 IMGs obtained PGY-1 positions through the 2009 Match, 7,335 IMGs entered PGY-1 for the 2009-2010 academic year.

The 7,335 IMGs entering PGY-1 for the 2009-2010 academic year is an increase of 59 over the prior year and an increase of 1,262 since the 2002-2003 academic year.

About the Match

The annual NRMP Match is the system by which applicants are matched with available residency positions in U.S. programs of graduate medical education (GME). Participants submit to the NRMP a list of residency programs, in order of preference. Ranked lists of preferred residency candidates are likewise submitted by U.S. GME programs with available positions. The matching of applicants to available positions is performed by computer algorithm. The Match results announced in March of each year are typically for GME programs beginning the following July.

Additional Resources on the Match and Match Results

The preceding data are taken from the Advance Data Tables for the 2011 Main Residency Match compiled by the NRMP. These tables provide detailed information on the positions offered and filled by the Match in 2011 and prior years. To access these tables, or to obtain further information on the NRMP, visit

The June issue of Academic Medicine, the journal of the Association of American Medical Colleges, usually offers an analysis of Match results from the preceding March. For more information, visit your medical school’s library or

The September issue of JAMA: The Journal of the American Medical Association traditionally provides an in-depth analysis of graduate medical education in the United States. This analysis includes the number of IMGs entering and continuing in U.S. GME programs and a breakdown of IMG resident physicians by specialty and subspecialty. Visit your medical school’s library or

IMGs Participating in 2012 Match Should Apply for Step 2 CS Now

International medical students/graduates and graduates of Fifth Pathway programs who plan to participate in the 2012 Main Residency Match (in March 2012) are reminded that they must take Step 2 Clinical Skills (CS) by December 31, 2011. As published in the 2011 Schedule for Reporting Step 2 CS Results, if you do not take Step 2 CS by December 31, 2011, your result will not be available in time to participate in the 2012 Match.

IMPORTANT NOTE: This deadline applies only to participation in the 2012 Main Residency Match. For updated information on deadlines to participate in the Supplemental Offer and Acceptance Program (SOAP), which is expected to replace the post-Match Scramble in 2012, monitor the NRMP website and the ECFMG website.

If you need to pass Step 2 CS to participate in the 2012 Match, you are strongly encouraged to apply for Step 2 CS now. If you do not register early and schedule a test date as soon as possible, you may not be able to obtain a test date in 2011.

At the time of this writing, the earliest available test date at any test center is in March 2011. It is expected that demand for testing appointments in the period from June through December will be high. Additionally, test sessions at all test centers may be subject to scheduling restrictions that may limit the number of test dates available to you.

To maximize your chances of obtaining a test date in 2011,

  • Apply for Step 2 CS now, provided you meet the eligibility requirements.
  • Once registered, schedule your testing appointment as soon as possible. Scheduling conditions are expected to be most favorable from March through June.

Early registration and scheduling may offer a number of benefits. If you plan to apply for Step 2 CS, you should consider the following:

  • All Step 2 CS sessions are opened 12 months in advance.
  • Applicants registered for Step 2 CS can schedule and take the exam during the 12-month eligibility period that follows their registration. By registering early, applicants increase the likelihood they will be able to obtain a testing appointment for a preferred date/test center.
  • Applicants who schedule a testing appointment can change the testing appointment without cost, provided they give more than 14 days’ notice. See Rescheduling in the ECFMG Information Booklet.
  • Applicants who take Step 2 CS earlier in the year and receive a failing result are more likely to have the opportunity to retake the exam in 2011 and receive their result in time to participate in the 2012 Match.

Updated information on Step 2 CS scheduling will be posted to the ECFMG website as it becomes available. Individuals planning to take Step 2 CS should monitor the ECFMG and USMLE websites for the latest information.

UPDATE: New Fees for Changing Appointments at Prometric Test Centers Effective January 1, 2011

Effective January 1, 2011, Prometric will charge a fee if USMLE examinees change testing appointments (e.g., reschedule, cancel, change test center location) at Prometric Test Centers thirty or fewer days before their scheduled test date. No fee is charged for changing testing appointments 31 or more days prior to the first day of the scheduled test.

The date that you change your appointment, using local time at the Regional Registration Center for the Prometric Testing Region, will determine whether you pay a fee and the amount of this fee:

  • If you change your appointment 31 or more days before (but not including) the first day of your scheduled test date, there is no fee.
  • If you change your appointment fewer than 31 days but more than 5 days before (but not including) the first day of your scheduled test date, there is a $50 fee.
  • If you change your appointment 5 or fewer days before (but not including) the first day of your scheduled test date, there is a higher fee. This fee varies by Prometric Testing Region and by exam.

For complete information and a schedule of fees, visit the USMLE website.

This policy applies only to appointments for USMLE Step 1, Step 2 Clinical Knowledge (CK), and Step 3. For information on the fees associated with changing testing appointments for Step 2 Clinical Skills (CS), refer to Rescheduling in the ECFMG Information Booklet.

(posted December 22, 2010; updated December 29, 2010)

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.

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)