The requirements for ECFMG Certification include passing examinations in the medical sciences, clinical skills, and communications skills. Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination® (USMLE®) are the exams currently administered that satisfy the medical science examination requirement.

Prior to its suspension by the USMLE program in early 2020, the former USMLE Step 2 Clinical Skills (CS) exam was the exam that satisfied the clinical and communication skills requirements for ECFMG Certification.

In response to the suspension and subsequent discontinuation of Step 2 CS by the USMLE program, ECFMG|FAIMER has offered pathways to allow international medical graduates (IMGs) to meet the clinical and communication skills requirements.

ECFMG|FAIMER first offered the pathways to IMGs participating in the 2021 Match and is continuing and expanding the pathways for IMGs participating in the 2022 Match.

The pathways allow ECFMG Certification to continue to perform its critical function of providing assurance to the public and U.S. graduate medical education (GME) programs that IMGs are ready to enter supervised training.

They also allow qualified IMGs to continue to pursue ECFMG Certification and to compete for positions in U.S. GME.

In addition pathway applicants also must meet all requirements for the pathway to which they apply.

Detailed eligibility requirements and application instructions for each of the following pathways will be published as they become available.

Important Note: Applicants who failed Step 2 CS one or more times must apply through Pathway 6 regardless of whether they meet the eligibility requirements for other Pathways.

• Pathway 1: Already Licensed to Practice Medicine in Another Country
  
  Pathway 1 is intended for applicants who currently hold or have recently held a license/registration to practice medicine without supervision. Applicants who meet the eligibility requirements for Pathway 1 must apply to Pathway 1 unless they failed Step 2 CS.

• Pathway 2: Already Passed a Standardized Clinical Skills Exam for Medical Licensure
  
  This pathway is intended for applicants who are not eligible for Pathway 1, but who successfully completed a secure, standardized clinical skills exam as a requirement for medical licensure or registration in a country other than the United States.

• Pathway 3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME)
• Pathway 4: Medical School Participates in U.S. Federal Student Loan Program or Is Accredited by an Agency that Has Received a Determination of Comparability by the National Committee on Foreign Medical Education and Accreditation (NCFMEA)
• Pathway 5: Medical School Issues Degree Jointly with a U.S. Medical School Accredited by Liaison Committee on Medical Education (LCME)
  
  Pathways 3, 4, and 5 are intended for applicants who have not yet obtained a license/registration to practice medicine without supervision (Pathway 1) and who have not already passed an acceptable standardized clinical skills exam for medical licensure (Pathway 2). An applicant to Pathway 3, 4, or 5 must be a student or a recent graduate of a medical school that meets eligibility requirements established by ECFMG.

• Pathway 6: Evaluation of Clinical Patient Encounters by Licensed Physicians
  
  Pathway 6 is intended for applicants who do not meet the eligibility requirements for Pathway 1, 2, 3, 4, and 5 and/or have failed Step 2 CS one or more times. To meet the requirements for Pathway 6, the applicant’s clinical skills must be evaluated by licensed physicians using ECFMG’s Mini-Clinical Evaluation Exercise (Mini-CEX). Additional details and instructions for meeting the requirements for Pathway 6 will be provided as soon as they are available.

Exceptions

ECFMG will consider exceptions to certain pathway eligibility requirements for limited and specific reasons.

Application Timing

The on-line application process for Pathways 1, 2, 3, 4, and 5 is expected to open in April 2021.

The on-line application process for Pathway 6 is expected to open in July 2021.