2003 IB: Frequently-Asked Questions

There are nearly 1,600 medical schools outside of the United States and Canada, each with varying educational standards and curricula. The purpose of ECFMG certification is to assess the readiness of graduates of these schools to enter U.S. residency and fellowship programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). To be certified by ECFMG, you must pass a series of exams; you must also fulfill ECFMG's medical education credential requirements. These requirements include providing ECFMG with copies of your medical diploma, which ECFMG will verify directly with your medical school. See ECFMG Certification.

If you are an international medical graduate and wish to enter an ACGME-accredited residency or fellowship program in the U.S., you must be certified by ECFMG before you can enter the program. You must also be certified by ECFMG if you wish to take Step 3 of the three-step United States Medical Licensing Examination (USMLE). Most states in the U.S. also require ECFMG certification, among other requirements, to obtain a license to practice medicine. See ECFMG Certification.

3. How can I find out if students / graduates of my medical school are eligible for ECFMG certification?

To be eligible for certification by ECFMG (among other requirements), your medical school must be listed in the International Medical Education Directory (IMED) of the Foundation for Advancement of International Medical Education and Research (FAIMER^®). If you are a medical school student and you want to apply for USMLE Step 1 / Step 2 or the ECFMG CSA, your medical school must be listed in IMED and your medical school's "Graduation Years" must be listed as "Current," both at the time you apply for the exam and at the time you take the exam. If you are a medical school graduate, your medical school and graduation year must be listed in IMED to be eligible for these exams and for ECFMG certification. To verify that you meet these requirements, access IMED on this website. See ECFMG Certification.

The certification process begins when you submit your first application for examination to ECFMG. At this time, ECFMG will assign you an identification number that you will use throughout the certification process. See USMLE / ECFMG Identification Number.

The time required to complete the certification process is different for each applicant. You may apply for the required exams as soon as you meet the eligibility requirements for the respective exams. All of the exams required for ECFMG certification are offered continuously throughout the year.

Both medical school students and graduates may begin the certification process. However, since one of the requirements for ECFMG certification is that your medical diploma be independently verified by ECFMG with your medical school, you cannot complete the certification process until you graduate and receive your diploma. The time required for some aspects of the certification process, such as the time required by your medical school to verify your medical diploma, are beyond the control of ECFMG. See ECFMG Certification.

To be eligible for ECFMG certification, you must, among other requirements, pass USMLE Step 1, USMLE Step 2, the Test of English as a Foreign Language™ (TOEFL) and the ECFMG Clinical Skills Assessment (CSA). See Requirements for ECFMG Certification.

You can take Step 1, Step 2 and the TOEFL exam in any order, provided you meet the respective eligibility requirements for these exams. However, you must have a USMLE / ECFMG Identification Number before submitting your TOEFL acceptance request to ECFMG. You must have passed Step 1 and satisfied the English language proficiency requirement for ECFMG certification before you can be registered for the CSA. You can take Step 2 either before or after you take the CSA. See Eligibility for Step 1 / Step 2, English Language Proficiency Test and Eligibility for CSA.

7. How can I have ECFMG confirm to a medical licensing authority or residency / fellowship program that I am ECFMG-certified?

ECFMG will confirm your certification status when it receives a written request directly from a medical licensing authority, residency / fellowship program official, or other appropriate organization. For status reports sent to medical licensing authorities, the request can also be sent to ECFMG by you. Approximately two weeks are required for the confirmation to be completed. Please note that there may be a fee for this service.

If you apply to residency programs through ERAS, ECFMG will send an electronic ECFMG status report automatically to all of the programs to which you applied. See Confirmation of ECFMG Certification Status.

You can apply on-line for Step 1 and / or Step 2 using ECFMG's Interactive Web Application (IWA). You can also download the paper application materials for USMLE Step 1 / Step 2 from this website. If you do not have access to the Internet, you can request a single copy of these materials from ECFMG. See How To Obtain This Publication.

Step 1 and Step 2 are offered continuously throughout the year. You can apply for these exams as soon as you meet the respective eligibility requirements. When you apply, you select the three-month period, known as your eligibility period, during which you want to take the exam. Once you receive your scheduling permit, you can schedule an appointment to take the exam on any day that it is offered during your assigned eligibility period. See Eligibility Period.

Step 1 and Step 2 are offered at Prometric test centers worldwide. These test centers are distributed among fourteen testing regions. When you apply, you select the testing region where you want to take the exam. You may take the exam at any test center in your assigned testing region, provided there is space available at the center on the date that you choose. Although you must select a testing region when you apply, you do not need to choose a particular test center within that region until you schedule your testing appointment. See Testing Region. For a list of the Prometric test centers expected to be available for eligibility periods ending in 2003, see Step 1 / Step 2 Testing Regions and Test Centers.

11. Do I need to graduate from medical school before taking Step 1 and Step 2?

Both students and graduates may take Step 1 and Step 2. To take Step 1, students must have completed at least two years of medical school by the beginning of the eligibility period selected. To take Step 2, students must be within twelve months of completing the full didactic curriculum at their medical school by the beginning of the eligibility period selected. Other eligibility requirements apply to both students and graduates. Refer to Eligibility for Step 1 / Step 2.

Step 1 and Step 2 are different exams. You must take these exams on different days. The testing day for Step 1 lasts about eight hours. The testing day for Step 2 lasts about nine hours.

Although you must take these exams on different days, you can apply for Step 1 and Step 2 at the same time (provided you meet the eligibility requirements for both exams), or you can apply separately. The eligibility periods you select for these exams can be the same or different.

After taking one Step, you do not need to wait before taking the other Step. You can schedule your testing appointments for Step 1 and Step 2 as close together as you wish, as long as the dates you select fall within the eligibility periods assigned for each exam. However, there are certain restrictions on retaking the same Step. See Reexamination and Reapplication.

You should select your eligibility period and scheduled test date carefully. Once registered, you cannot cancel or postpone your registration (except as described below). If you do not take the Step, you will not receive a refund or credit of your exam fee(s). For detailed information on ECFMG's payment policy, refer to Payment.

Although you cannot cancel your registration, there are options that provide registered applicants with flexibility regarding the date of their testing appointments. To change a scheduled testing appointment to another date within your assigned eligibility period, contact Prometric. See Rescheduling Your Testing Appointment. If you are unable to take the exam during your assigned eligibility period, you can request an extension of your eligibility period for a fee. See Eligibility Period Extension.

For the purpose of ECFMG certification, there is no limit on the number of times you can take a Step until you have passed that Step. If you fail a Step, you may retake it, but you must reapply and pay the appropriate fee(s). Certain restrictions apply when retaking the same Step. Once you pass a Step, you may not repeat it, and you will have seven years to pass the other Step. See Reexamination and Reapplication.

15. How do I fulfill the English language proficiency requirement for ECFMG certification?

You must achieve at least the minimum score acceptable to ECFMG on the TOEFL exam and send a TOEFL Acceptance Request Form and the appropriate fee to ECFMG. You may also use a passing performance on the former ECFMG English Test to satisfy this requirement. See English Language Proficiency Test.

Yes. All applicants for ECFMG certification must demonstrate their proficiency in English by achieving a score acceptable to ECFMG on the TOEFL exam.

Passing performance on the English language proficiency test is valid for two years from the date passed for the purpose of entering an accredited program of graduate medical education in the U.S. If your English test date has expired, you may not enter such a program until you revalidate your English test date. You can revalidate your English test date for an additional two-year period by achieving a score acceptable to ECFMG on the TOEFL exam and submitting a TOEFL Acceptance Request Form with the appropriate fee to ECFMG. See Revalidation of the Certificate.

You can apply on-line for the CSA using ECFMG's Interactive Web Application (IWA). You can also download the paper application materials for the CSA from this website. If you do not have access to the Internet, you can request a single copy of these materials from ECFMG. See How To Obtain This Publication.

You should plan carefully the timing of your CSA application and scheduling of your assessment date. Once registered, you cannot cancel or postpone your registration. Once you have scheduled a date for your assessment, you cannot change it. If you do not meet the deadlines for scheduling and taking the CSA described below, you will not receive a refund or credit of your assessment fee. For detailed information on ECFMG's payment policy, refer to Payment.

Although you cannot change your registration or scheduled assessment date, registered applicants have flexibility in scheduling their assessment dates. Once registered, you will have four months from the date indicated on your notification of registration to schedule your CSA. You can take the assessment on any available date during the twelve-month period following the date indicated on your notification of registration. (See Scheduling.) If you are unable to obtain the appropriate visa to enter the U.S. to take the CSA, you may request a full refund of the assessment fee. Other requests for exceptions are considered on a case-by-case basis.

Passing performance on the CSA is valid for three years from the date passed for the purpose of entering an accredited program of graduate medical education in the United States. If your CSA date has expired, you may not enter such a program until you revalidate your CSA date. You can revalidate your CSA date for an additional three-year period by passing a subsequent CSA. See Revalidation of the Certificate.

22. How will I know if ECFMG has received verification of my medical diploma from my medical school?

ECFMG will send you a letter on the date that it sends the request for verification of your medical diploma to your medical school. After ECFMG receives the verification from your medical school, ECFMG will send you another letter to let you know that the verification was received. You can check the status of your medical education credentials using OASIS. See Verification of Credentials.

23. What medical specialties are participating in the Electronic Residency Application Service (ERAS) in 2003?

Most specialties participate in ERAS. For the list of participating specialties, visit the ERAS website of the Association of American Medical Colleges (AAMC) at www.aamc.org/eras. Programs participating in ERAS will, in principle, no longer accept paper applications. However, there may be exceptions by individual program directors. You should contact the programs directly for their policies.

If you apply for an exam or request a service on-line, you can pay the required fees on-line with a credit card (Visa, MasterCard or Discover) or with an electronic payment from your U.S. checking account. If you submit a paper exam application or request for service and you have a USMLE / ECFMG Identification Number, you can pay in advance using OASIS. All applicants submitting paper applications / requests can pay by credit card, check, or wire transfer by completing the payment section of the application / request form. Payment for all services is due at the time of application. If you do not include full payment, your application / request for service will not be accepted. See Payment.

[Last update: 29 August 2003]

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Portions reprinted, with permission, from the USMLE 2003 Bulletin of Information. Copyright © 2002 by the Federation of State Medical Boards of the United States, Inc., and the National Board of Medical Examiners® (NBME®).