English Language Proficiency Test - General Information

Applicants for ECFMG® Certification are required to demonstrate competence in the English language. All applicants for certification, even those whose native language is English, must pass the English Language Proficiency Test.

The Test of English as a Foreign Language™ (TOEFL®) is the only exam currently administered that satisfies the English language proficiency requirement for ECFMG certification. The TOEFL is an exam of the Educational Testing Service® (ETS®). ETS offers the TOEFL in computer-based format and paper-based format.

Although the ECFMG English Test is no longer administered, ECFMG continues to accept a passing performance on this exam to fulfill the English language proficiency requirement for ECFMG Certification. Therefore, if you have passed the former ECFMG English Test, you do not need to take the TOEFL to satisfy this requirement.

For the purpose of ECFMG Certification, you can take the TOEFL, Step 1, and Step 2 Clinical Knowledge (Step 2 CK) in any order, provided you are eligible for these exams. However, you must have passed Step 1 and satisfied the English language proficiency requirement for ECFMG Certification (among other requirements) before being registered for the ECFMG Clinical Skills Assessment (CSA®). You must have a USMLE / ECFMG Identification Number before submitting your TOEFL acceptance request to ECFMG.

The date of your most recent passing performance on the English language proficiency test will appear on your Standard ECFMG Certificate. This English Test Date is valid for two years from the date passed for the purpose of entering a program of graduate medical education in the United States. If your English Test Date expires before you enter a U.S. program of graduate medical education, you must revalidate your English Test Date before you may enter such a program. You can revalidate the English Test Date for an additional two-year period by passing a subsequent TOEFL. Once you enter a program of graduate medical education in the United States, the English Test Date is no longer subject to expiration, and you may request permanent validation of your English Test Date.