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There are approximately 1,600 medical schools outside of the United States and Canada, each with varying educational standards and curricula. The Educational Commission for Foreign Medical Graduates (ECFMG), through its program of certification, evaluates the qualifications of physicians graduating from these schools before they enter programs of graduate medical education in the United States.
This Fact Sheet is intended to provide international medical school students and graduates (IMGs) interested in graduate medical education in the United States with basic information on ECFMG certification, as well as next steps and additional resources for those who are ready to begin the certification process.
The definitive resource on ECFMG certification is the ECFMG Information Booklet. The definitive resource on the United States Medical Licensing Examination™ (USMLE™) is the USMLE Bulletin of Information. Before applying for examination and certification, you must read the appropriate editions of these publications. In the event that information in this Fact Sheet differs from the corresponding information in the ECFMG Information Booklet / USMLE Bulletin of Information, the latter publications will contain the most current and accurate information.
ECFMG Certification
The purpose of ECFMG certification is to assess the readiness of IMGs to enter U.S. residency and fellowship programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). If you wish to enter such a program, you must be certified by ECFMG before you can start the program. ECFMG certification is also required before applying to take Step 3 of the United States Medical Licensing Examination™ (USMLE™). In the United States, to obtain a license to practice medicine, physicians must apply directly to the jurisdiction where they plan to practice medicine. U.S. licensing jurisdictions require that IMGs applying for licensure be certified by ECFMG.
To be certified by ECFMG, you must satisfy ECFMG's medical education credential requirements. You must also pass a series of exams. Applicants who satisfy all requirements are issued ECFMG's Standard ECFMG Certificate.
Eligibility & Requirements
To apply for ECFMG certification, you must be an international medical student or graduate. This means that your medical school is located outside of the United States and Canada. U.S. citizens who graduate from such schools are considered IMGs and are eligible to apply for ECFMG certification. Non-U.S. citizens who graduate from schools in the United States and Canada are not considered IMGs and are not eligible for ECFMG certification.
Additionally, your medical school must also 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 graduate, your graduation year must be included in your school's IMED listing. If you are a student, the "Graduation Years" in IMED for your medical school must be listed as "Current." You can access IMED on this website.
To be eligible for certification, you must graduate from a medical school that meets the requirements described above, and fulfill the following additional medical education credential requirements:
- You must have had at least four credit years (academic years for which credit has been given toward completion of the medical curriculum) at a medical school listed in IMED.
- You must supply ECFMG with copies of your medical diploma, and ECFMG must receive verification of your medical diploma directly from your medical school. The exact name of the medical credential you must supply is listed in ECFMG's Reference Guide for Medical Education Credentials.
Applicants for ECFMG certification must also pass the following exams:
- USMLE Step 1 and Step 2. Applicants register for these exams with ECFMG and take these exams worldwide at test centers of Prometric®, part of the Thomson Corporation. These are the same exams taken by graduates of U.S. and Canadian medical schools. More information and sample test materials for the USMLE are available on the USMLE website.
- Test of English as a Foreign Language™ (TOEFL®). Applicants register for the TOEFL exam with the Educational Testing Service® (ETS®) and take the exam in Prometric test centers worldwide. For more information and application materials, visit the TOEFL website.
- ECFMG Clinical Skills Assessment (CSA®). Applicants register for the CSA with ECFMG and take the CSA at one of ECFMG's test centers in the United States. For more information, refer to the CSA Candidate Orientation Manual.
Refer to the websites indicated for information on exam eligibility, fees, application, scheduling, and preparation.
Applying for ECFMG Certification
The certification process begins when you send your first exam application to ECFMG. Before applying for examination, you must read the appropriate edition of the ECFMG Information Booklet. Before applying for USMLE Step 1 or Step 2, you must also read the appropriate edition of the USMLE Bulletin of Information. Both publications are available on this website. You can apply for USMLE Step 1/Step 2 and the CSA online, or you can download paper application materials. Detailed instructions accompany each application.
Both medical school students and graduates can begin the certification process. You can apply for the required exams as soon as you meet the exam eligibility requirements. All of the required exams are offered continuously throughout the year. However, since one of the requirements for ECFMG certification is verification of your medical diploma with your medical school, you cannot complete the process until you graduate and receive your medical diploma.
There is no time limit for completing the certification process. However, there are specific time requirements for completing certain exams for ECFMG certification, entry into graduate medical education programs and medical licensure. These requirements are described in the ECFMG Information Booklet and USMLE Bulletin of Information.
The academic year for U.S. graduate medical education programs typically begins in July. You must be certified by ECFMG before your program's start date, although you can apply to programs before becoming certified. In planning the timing of your exam application and scheduling, you should also consider deadlines imposed by the programs to which you plan to apply, the National Resident Matching Program, and the Electronic Residency Application Service. See Applying to Graduate Medical Education Programs.
Applying to Graduate Medical Education Programs
The Graduate Medical Education Directory, published by the American Medical Association (AMA), is recognized as the official list of ACGME-accredited graduate medical education programs. For each medical specialty, the Directory provides general and special requirements and specific information on each program in that specialty. You can order the Directory on the AMA website. Application deadlines vary among programs. You should contact programs directly for information on their deadlines.
Most programs require applicants to submit their applications using the Electronic Residency Application Service (ERAS®). ERAS was developed by the Association of American Medical Colleges (AAMC) to transmit residency applications via the Internet. Information on ERAS is available on the AAMC ERAS website. ECFMG coordinates the ERAS application process for IMGs. Additional ERAS information for IMGs is available on the ECFMG website. Programs that do not participate in ERAS require applicants to use paper application materials. You should contact programs directly for their requirements.
The National Resident Matching Program (NRMP), also known as "the Match," matches applicants with available residency positions in the programs to which they have applied. If you wish to participate, you must register with the NRMP. Refer to the NRMP website for requirements and deadlines, as well as information on the numbers of IMGs who have obtained residency positions through the Match in recent years.
Obtaining a Visa
IMGs who are not U.S. citizens or permanent residents must obtain an appropriate visa to participate in U.S. graduate medical education programs. The most common visa employed for this purpose is the J-1 visa. ECFMG is authorized by the U.S. Department of State to sponsor foreign national physicians for the J-1 visa. Information on eligibility and deadlines is available from ECFMG's Exchange Visitor Sponsorship Program. Additional information is available from the U.S. Department of State and from the Bureau of Citizenship and Immigration Services.
Resources
ECFMG Certification
The ECFMG website provides access to important updates, application materials, and publications, including:
ECFMG Information Booklet
USMLE Bulletin of Information
International Medical Education Directory
The ECFMG Reporter - ECFMG's free e-mail newsletter for IMGs interested in ECFMG certification. Subscribe
Applying to Graduate Medical Education Programs
Graduate Medical Education Directory
AAMC ERAS website
ERAS for IMGs
ECFMG-ERAS News - ECFMG's free e-mail newsletter for IMGs participating in ERAS. Subscribe
National Resident Matching Program
Visas
ECFMG Exchange Visitor Sponsorship Program
U.S. Department of State
Bureau of Citizenship and Immigration Services
Additional Information
ECFMG representatives are available to answer your questions by
email at info@ecfmg.org, or
phone at (215) 386-5900 from 9:00 am to 5:00 pm, eastern time in the United States, Monday through Friday.
ECFMG
ECFMG is a private, non-profit organization committed to promoting excellence in international medical education. ECFMG's aims and missions include providing information to IMGs regarding entry into graduate medical education and health care systems in the United States, evaluating the qualifications of IMGs, and providing international access to testing and evaluation programs.
ECFMG is sponsored by the following major medical organizations:
American Board of Medical Specialties
American Medical Association
Association of American Medical Colleges
Association for Hospital Medical Education
Federation of State Medical Boards of the United States, Inc.
National Medical Association
[Last update: 22 April 2003]
Copyright © 2002-2003 by the Educational Commission for Foreign Medical Graduates. All rights reserved.