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Educational Commission for Foreign Medical Graduates

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Medical School Requirements for ECFMG Certification Eligibility Policy and Procedures
(a.k.a. “ECFMG Medical School Listing Policy”)

In order to be eligible for ECFMG Certification, an international medical graduate’s medical school must meet ECFMG’s requirements. Only individuals who graduate from international medical schools that meet ECFMG’s requirements are eligible to apply for ECFMG Certification.

I. Definitions

International Medical School: an educational facility located in a country outside of the United States and Canada with its primary campuses and main operations located in that country that offers a program of study leading to a medical degree.

International Medical Graduate or IMG: any individual who graduates from an international medical school, regardless of the individual’s citizenship.

II. Policies Regarding Medical School Requirements for the School’s Students and Graduates to Be Eligible to Apply for ECFMG Certification

  1. In addition to meeting ECFMG’s current eligibility requirements for ECFMG Certification, in order for students and graduates of a medical school to be eligible to apply to ECFMG for ECFMG Certification, the following requirements must be met:
    1. ECFMG must have, among other things, confirmation from the appropriate government authority of the medical school country that:
      1. the medical school is recognized as a medical school and permitted to operate by the government; AND
      2. the medical school meets governmental accreditation requirements if they apply; AND
      3. the degree awarded to graduates of that medical school meet the medical education eligibility requirements for licensure to practice clinical medicine in the medical school country; AND
      4. the duration of the program of study leading to the medical degree is not less than four credit years (academic years for which credit has been given toward completion of the medical curriculum) AND
      5. the medical school is an educational facility located in that country with its primary campuses and main operations located in that country.
    2. If the medical school has a branch campus in another country, ECFMG may require confirmation from the appropriate government authority in the branch campus country that:
      1. the branch campus is authorized to operate as a medical school in the branch campus country; and
      2. the medical school awards degrees that meet the medical education eligibility requirements for licensure to practice clinical medicine in the branch campus country.
    3. The medical school must, upon request, be able to demonstrate that it has the staff, policies/procedures, and facilities necessary for the school’s students and graduates to fulfill ECFMG’s requirements to become ECFMG Certified. This includes, but is not limited to, having an authorized signatory in place to accurately primary source verify diplomas, or be otherwise acceptable to ECFMG.
    4. For medical schools whose students and graduates are NOT CURRENTLY ELIGIBLE to apply to ECFMG for ECFMG Certification, ECFMG may require, in its reasonable discretion, that the medical school must be accredited by an organization recognized by an agency that meets ECFMG’s requirements.
  2. ECFMG may determine, for good cause at any time and based on credible information, that a medical school is no longer eligible for its students and graduates to apply for ECFMG Certification and may remove or modify the ECFMG Certification acceptability status of the medical school accordingly. Examples of reasons for ECFMG to remove or modify the acceptability status of the medical school include, but are not limited to:
    1. ECFMG’s determination that medical school officials or third parties on behalf of the medical school subvert or attempt to subvert ECFMG policies or provide false information to ECFMG;
    2. ECFMG’s determination that medical school officials are involved in activities associated with unauthorized access to USMLE examination content;
    3. ECFMG’s determination that the medical school provides false information concerning ECFMG Certification or the USMLE Program on its website;
    4. ECFMG’s determination that no substantial medical education instruction takes place in the host country;
    5. ECFMG’s determination that the medical school is not fully chartered/licensed as a medical school in its host country or that its graduates are not entitled to licensure as medical doctors in that country without satisfying additional educational requirements;
    6. Governmental authorities in the host country fail or refuse to respond to ECFMG’s requests for information concerning a medical school’s charter/license or its graduates’ eligibility for licensure as medical doctors in the host country; and
    7. U.S. governmental authorities advise ECFMG that medical school officials are involved in activities associated with violation of applicable immigration or visa requirements.
    8. School officials are otherwise engaged in activity that is illegal, unethical, or detrimental to its students.
    9. The school has had no recent ECFMG activity.
  3. If ECFMG has removed or modified the ECFMG Certification acceptability status of a medical school for any reason (including schools that change names and/or locations but are wholly or partially owned or managed by the same principals as a school that lost ECFMG acceptability status), prior to restoring the status to a medical school, ECFMG may, among other things:
    1. Seek additional information from a U.S. or host country official or other legitimate organization;
    2. Request that an audit be completed of a medical school’s records;
    3. Require an appropriate waiting period (length to be determined) when a delisted school is reestablished in a different jurisdiction with substantially the same ownership or principals;
    4. Require that the school be fully accredited by an organization recognized by an agency that meets ECFMG’s requirements.
  4. ECFMG staff may seek Board guidance or approval for issues impacting medical schools at any time.

III. Procedure for Designating a Medical School’s Eligibility Status for ECFMG Certification

    1. Schools that meet all requirements will be listed in the World Directory of Medical Schools (World Directory) with an ECFMG note stating that the school meets eligibility requirements for its students and graduates to apply to ECFMG for ECFMG Certification and examination only after ECFMG receives and accepts all applicable documentation that ECFMG’s requirements have been met. The ECFMG World Directory Sponsor Note also will include the graduation years for which the school meets these requirements.
    2. If ECFMG has determined that a medical school is no longer eligible for its students and graduates to apply for ECFMG Certification, ECFMG may remove or modify the ECFMG World Directory Sponsor Note at any time and will provide notice as appropriate.
    3. In instances in which ECFMG has received information that a medical school has engaged in fraudulent activity, provided false information to ECFMG, been involved in activities associated with unauthorized access to USMLE examination content, been involved in activities associated with violation of applicable immigration or visa requirements, or is otherwise engaged in activities which are illegal, unethical, or detrimental to its students and that medical school has active students and graduates in ECFMG programs and services, ECFMG staff will review the information and will assess whether there is sufficient evidence of irregular behavior. When indicated and feasible, staff will conduct a follow-up investigation to gather additional information.
    4. ECFMG may, for good cause and in its sole discretion, determine to withhold services, including but not limited to ECFMG Certification, to the students and graduates of the medical school, during the investigation and up until the matter is fully reviewed and adjudicated.
    5. If ECFMG staff finds that there exists a reasonable basis to conclude that a medical school may have engaged in behavior that warrants modification of its eligibility status, the matter will be referred to the Medical Education Credentials Committee.
    6. Using the medical school’s official address of ECFMG record, the medical school will be advised in writing of the nature of the alleged irregular behavior and will be provided with a copy of the Medical School Requirements for ECFMG Certification Eligibility Policy and Procedures. The medical school will be given an opportunity to provide written explanation and to present other relevant information. Any such written explanation or other relevant information must be received by ECFMG by the deadline set forth in ECFMG’s writing to the medical school. Submissions received after the deadline will be considered by the Medical Education Credentials Committee at its discretion. The medical school may also request the opportunity to appear in person before the Medical Education Credentials Committee, and may be represented by legal counsel, if it so wishes. In instances in which the medical school appears in person before the Medical Education Credentials Committee, a stenographic or audio recording will be made of that portion of the proceedings during which the school is in attendance. Any statements made by the medical school during an appearance before the Medical Education Credentials Committee will be under oath. All hearings will be held in English and interpreters will not be permitted.
    7. Medical schools with a matter pending before the ECFMG Committee who wish to request a deferral of the ECFMG Committee’s review of the matter must (1) submit the request in writing and (2) provide the reason for the request. If ECFMG staff determine that the granting of the request could have a material impact on the medical school’s opportunity to refute the allegations then staff, at its discretion, can grant the request and defer an ECFMG action for up to six (6) months. Unless the medical school can demonstrate compelling circumstances, ECFMG staff should not grant more than one deferral request.
    8. All pertinent information regarding the matter, including any explanation or other information that the medical school may provide, will be provided to the Medical Education Credentials Committee. The Medical Education Credentials Committee, based on the information available to it, will determine whether the preponderance of the evidence indicates that the medical school’s ECFMG Certification eligibility status should be modified or removed. If the Medical Education Credentials Committee determines to modify or remove the school’s status, the Medical Education Credentials Committee will also determine what additional action(s) will be taken as a result. ECFMG will notify the medical school of the Medical Education Credentials Committee’s determination.
    9. The Medical Education Credentials Committee’s determination and any action(s) taken pursuant thereto (a “decision” of the Medical Education Credentials Committee) may be appealed to the Review Committee for Appeals if the medical school has a reasonable basis to believe the Medical Education Credentials Committee did not act in compliance with the Medical Education Credentials Committee Policies and Procedures or that the Medical Education Credentials Committee’s decision was clearly contrary to the weight of the evidence before it. The notice of appeal must be received by ECFMG within thirty (30) days of the date on which the notification advising the medical school of the Medical Educational Credentials Committee’s decision was mailed to the individual. The appeal of a decision of the Medical Education Credentials Committee is governed by the Rules of Appellate Procedure.

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[Last update: December 2, 2022]

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