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ECFMG has received a number of inquiries in recent weeks regarding the requirements for ECFMG Certification. Inquiries have also focussed on ECFMG sponsorship requirements for the J-1 visa, the most common visa used to participate in U.S. programs of graduate medical education. The purpose of this document is to provide a brief overview of these programs, their requirements, ECFMG's role in these processes, and sources of additional information.

Requirements for ECFMG Certification

Through its program of certification, ECFMG assesses the readiness of international medical graduates to enter U.S. residency or fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). (An international medical graduate is defined as a physician who received his / her basic medical degree or qualification from a medical school located outside of the United States, Canada and Puerto Rico.) The certification program is consistent with ECFMG's overarching mission of promoting excellence in international medical education. Although ECFMG administers a variety of programs for members of the international medical education community, the certification of international medical graduates is the organization's core function, one that it has performed since its establishment more than forty years ago.

ECFMG certification assures residency program directors and the American public that graduates of medical schools with varying standards and curricula meet minimum standards for entering U.S. programs of graduate medical education. ECFMG certification also allows international medical graduates to access training that has the potential to benefit the home country health system and population. International medical graduates who wish to participate in U.S. graduate medical education programs must be certified by ECFMG. ECFMG certification is also required by most states to obtain a U.S. medical license.

The requirements for ECFMG certification include a series of examinations and direct verification of medical education credentials. Applicants for ECFMG certification must pass the following exams:

• Step 1 and Step 2 of the United States Medical Licensing Examination™ (USMLE™);



• Test of English as a Foreign Language™ (TOEFL^®); and the



• ECFMG Clinical Skills Assessment (CSA^®).

Exam applications for Step 1, Step 2 and CSA must be certified by the applicant and an official of the applicant's medical school. Applicants who have graduated from medical school may also have their applications certified by a consular official, first class magistrate or notary public. In both cases the official certifies that he/she has compared the applicant's signature and photograph on the application with those of the applicant's identification. To be admitted to the test center to take Step 1 or Step 2, applicants must present valid, government-issued identification that contains their name, signature and photograph. CSA applicants must also present valid, picture identification upon arrival at the CSA test center.

Throughout the certification process, applicants are required to provide identifying information, such as name and date of birth, completely and consistently. Applicants must resolve discrepancies in such information by providing documentation, such as copies of passports or birth certificates.

ECFMG also requires each applicant to submit a copy of his / her final medical diploma and current photographs. For each applicant, ECFMG sends the medical diploma with the applicant's photograph to officials of the medical school that issued the document to verify the authenticity of the document. ECFMG must receive this verification directly from the applicant's medical school.

ECFMG issues the Standard ECFMG Certificate to applicants who satisfy all requirements.

Additional Requirements for J-1 Visa Sponsorship

The J-1 visa is the most commonly used non-immigrant visa in U.S. clinical training programs. ECFMG is authorized by the U.S. Department of State to sponsor physicians on the J-1 visa to participate in accredited U.S. programs of graduate medical education or training. ECFMG sponsors all J-1 physicians in clinical training programs in the U.S.

To be eligible for ECFMG sponsorship, an applicant must

• Have passed USMLE Step 1 and Step 2 (or other exams acceptable for visa purposes);



• Hold a valid Standard ECFMG Certificate (US or Canadian medical school graduates are exempt from this requirement);



• Hold a contract or an official letter of offer for a position in an accredited program of graduate medical education or training; and



• Provide a statement of need from the Ministry of Health of the country of nationality or last legal permanent residence. This statement must provide written assurance that the country needs specialists in the area in which the physician will receive training. It also serves to confirm the physician's commitment to return to that country upon completion of training in the United States.

In its role as J-1 visa sponsor, ECFMG evaluates each applicant's eligibility for sponsorship, according to the preceding criteria. For eligible applicants, ECFMG issues Form IAP-66, Certificate of Eligibility for Exchange Visitor (J-1) Status. Form IAP-66 indicates that the physician is eligible to apply for the J-1 visa.

Individuals generally apply to the U.S. Department of State for the J-1 visa through U.S. embassies and consulates abroad. The Form IAP-66, issued by ECFMG, is only one of the elements considered by consular officials in determining an applicant's eligibility to enter the United States. All requirements, including the applicant's ability to prove non-immigrant intent, are evaluated by consular officials, who have broad discretion in determining whether to issue the visa. After the visa has been issued, the U.S. Immigration and Naturalization Service (INS) is responsible for reviewing required documentation at ports-of-entry into the U.S.

ECFMG tracks the status of J-1 physicians after entry to a U.S. training program. These physicians are required to renew their sponsorship with ECFMG annually. ECFMG communicates all sponsorship information to the U.S. Department of State. Throughout sponsorship, ECFMG serves as a resource to both the J-1 physician and the training program.

H-1B Visa

A physician may also use the H-1B visa to participate in U.S. clinical training programs. International medical graduates who apply for the H-1B visa must be certified by ECFMG. (Physicians who hold a full and unrestricted U.S. medical license are exempt from this requirement.) However, it is the graduate medical education program that petitions the U.S. Immigration and Naturalization Service on behalf of the physician. ECFMG is not involved in the H-1B visa application process.

Additional Information

The ECFMG Information Booklet is the definitive source of information on ECFMG Certification. Detailed information on ECFMG J-1 visa sponsorship is available in the Information Booklet and in the ECFMG Exchange Visitor Sponsorship Program Reference Guide. The Information Booklet, Reference Guide and application materials for ECFMG Certification and J-1 visa sponsorship are available on the ECFMG website at www.ecfmg.org and from ECFMG upon request.

For detailed J-1 sponsorship information see:

ECFMG's website at www.ecfmg.org
U.S. Department of State website at www.state.gov
Immigration and Naturalization Service website at www.ins.gov

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