Frequently Asked Questions


ECFMG Certification - Freqently Asked Questions

1. What is ECFMG Certification?

Medical schools outside the United States and Canada vary in their educational standards and curricula. The purpose of ECFMG Certification is to assess whether graduates of these schools are ready 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 education credentials, which ECFMG will verify directly with your medical school. See ECFMG Certification.

2. Why would I want to be certified by ECFMG?

If you are an international medical graduate and wish to enter an ACGME-accredited residency or fellowship program in the United States, you must be certified by ECFMG before you can enter the program. You must be certified by ECFMG if you wish to take Step 3 of the three-step United States Medical Licensing Examination (USMLE). ECFMG Certification is also one of the requirements to obtain an unrestricted license to practice medicine in the United States. 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 examination, 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 examination and for ECFMG Certification. To verify that you meet these requirements, access IMED. See ECFMG Certification.

4. I am applying for an exam for the first time. What documentation do I need to submit?

If you are a medical school graduate when you submit your first exam application, your medical education credentials must be submitted with this initial exam application.

If you are a medical school student when you submit your first exam application, you must send your medical education credentials as soon as you graduate and receive them.

If you have transferred credits to the medical school that awarded or will award your medical degree, you must document these credits when you apply for examination, regardless of whether you are a student or a graduate.

For more details on documents required at the time of application, see Applying for Examination and Provision of Credentials and Translations.

5. Can I send my credentials prior to submitting an exam application in order to determine my eligibility?

No. You may not submit your credentials to ECFMG until you apply for an exam. If you send credentials to ECFMG before you apply for an exam, they will not be processed. To determine if you are eligible for examination, see Eligibility for Examination.

6. How do I begin the certification process?

The certification process begins when you apply to ECFMG for a USMLE/ECFMG Identification Number. The information you provide during the process of obtaining a USMLE/ECFMG Identification Number will become a part of your permanent ECFMG record.

7. How do I get a USMLE/ECFMG Identification Number?

Access IWA on the ECFMG website, where you can find instructions for obtaining a number on-line. When your request for a USMLE/ECFMG Identification Number has been processed, ECFMG will send your number to the e-mail address in your ECFMG record. You can then return to IWA and use this number to apply for examination.

8. How long does the certification process take?

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 examination. 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 final medical diploma be verified by ECFMG with your medical school, you cannot complete the certification process until you graduate. The time required for some aspects of the certification process, such as the time required by your medical school to verify your medical education credentials, is beyond the control of ECFMG. See ECFMG Certification.

9. In what order do I take the exams required for ECFMG Certification?

Once you meet the eligibility requirements for examination, you can take the required exams in any order. See Eligibility for Examination.

10. Is there an age limit on applying for ECFMG Certification?

There is neither a minimum nor a maximum age requirement for applying for ECFMG Certification. To be eligible for ECFMG Certification, you must meet ECFMG's examination and medical education credential requirements. See Requirements for ECFMG Certification.

11. Is there a minimum number of years I must practice medicine before I can apply for ECFMG Certification?

No. To be eligible for ECFMG Certification, you must meet ECFMG's examination and medical education credential requirements. See Requirements for ECFMG Certification.

USMLE Step 1 and Step 2 (CK and CS)

12. How can I apply for USMLE Step 1 and Step 2 (CK and CS)?

Apply on-line using ECFMG's Interactive Web Application (IWA). For more information, see Applying for Examination and visit ECFMG's website.

13. How can I prepare for the exams?

Information on preparing for the exams is available in this booklet and in the USMLE Bulletin of Information. Orientation and practice materials for all Steps and Step Components, as well as additional information on examination content and test formats, are available on the USMLE website. If you are registered for an exam and cannot access the materials on the USMLE website, you may request a CD that contains most of the orientation and practice materials available on the USMLE website. To request a CD, submit a completed Request for USMLE® Orientation Materials CD (Form 108) to ECFMG. Form 108 is available on the Publications page of the ECFMG website. The National Board of Medical Examiners (NBME) offers web-based self-assessments to help medical students and graduates evaluate their readiness for Step 1 and Step 2 CK. See Preparation.

14. When and where can I take Step 1 and Step 2?

Step 1 and Step 2 (CK and CS) are offered continuously throughout the year. Applicants registered for these exams are assigned an eligibility period during which they must take the exam. See When to Apply and Eligibility Periods.

Step 1 and Step 2 CK are offered worldwide at test centers of PrometricTM. For information on Prometric test centers offering USMLE, visit the Prometric website. Step 2 CS is administered at test centers in Atlanta, Chicago, Houston, Los Angeles, and Philadelphia in the United States. For all exams, see Testing Locations.

15. How do I fulfill the clinical skills requirement for ECFMG Certification?

USMLE Step 2 CS is the exam currently administered that satisfies the clinical skills requirement for ECFMG Certification. If you have passed the former ECFMG Clinical Skills Assessment (CSA®), you will not be required to pass Step 2 CS for ECFMG Certification. See Clinical Skills Requirement.

16. Do I need to graduate from medical school before taking the exams?

Both students and graduates may take the exams. To take the exams, medical school students must have completed at least two years of medical school. This eligibility requirement means that students must have completed the basic medical science component of the medical school curriculum. Other eligibility requirements apply to both students and graduates. See Eligibility for Examination.

17. What if I cannot take an exam once I have registered? Are my exam fees refundable?

Once registered, you cannot cancel or postpone your registration (except as described below for Step 1/Step 2 CK). If you do not take the exam, you will not receive a refund or credit of your exam fee(s). For detailed information on ECFMG's payment policy, see Payment.

Although you cannot cancel your registration, there are options that provide flexibility. Registered applicants can change their test date and/or test center, subject to availability. See Rescheduling. If you are unable to take Step 1/Step 2 CK during your assigned eligibility period, you can request an extension of your eligibility period for a fee. See Eligibility Period Extension. If you are unable to obtain the appropriate visa to enter the United States to take Step 2 CS, you may request a full refund of the exam fee. See Refunds.

18. Is there a limit to the number of times I can take an exam?

For the purpose of ECFMG Certification, there is no limit on the number of times you can take a Step or Step Component you have not passed. If you fail or do not complete a Step or Step Component, you may retake it, but you must reapply and pay the appropriate fee(s). Certain restrictions apply when retaking the same Step or Step Component. Once you pass a Step or Step Component, you may not repeat it, and you will have seven years to pass the other Step(s) or Step Component(s) required for ECFMG Certification. See Time Limit for Completing Examination Requirements and Reexamination and Reapplication.

For the purpose of medical licensure, the USMLE program recommends to state medical licensing authorities that they require applicants to pass the full USMLE sequence (including Step 3, which is not required for ECFMG Certification) within a seven-year period. The USMLE program also recommends to state medical licensing authorities a limit on the number of attempts allowed to pass each Step or Step Component. See Time Limit and Number of Attempts Allowed to Complete All Steps and Retakes in the USMLE Bulletin of Information. Most state medical licensing authorities accept the USMLE-recommended limits, but some do not. You should contact the FSMB for general information and the medical licensing authority of the jurisdiction where you plan to apply for licensure for definitive information, since licensure requirements vary among jurisdictions.

ECFMG Medical School Web Portal (EMSWP)

19. What is EMSWP?

The ECFMG Medical School Web Portal (EMSWP) is an on-line service for international medical schools. Through EMSWP schools have access to a free, web-based program that enables them to verify the status of their students and graduates who apply to ECFMG for examination. In late 2009, international medical schools will also be able to use EMSWP to obtain data on the performance of their students and graduates who take USMLE. ECFMG is currently working to expand EMSWP to allow for the web-based primary-source verification of medical education credentials and the electronic submission by international medical schools of certain supporting documents for their students and graduates who participate in the Electronic Residency Application Service (ERAS).

Participation in EMSWP is open to all international medical schools; however, participation is voluntary and is at the discretion of the officials of the individual medical schools.

Interactive Web Application (IWA)

20. What is a Certification of Identification Form (Form 186)?

The Certification of Identification Form (Form 186) is the paper certification required by ECFMG for applicants who are medical school graduates or are students enrolled in medical schools that participate in EMSWP. Form 186 requires that an authorized official certify the applicant's identity. Once accepted by ECFMG, Form 186 remains valid for five years. During this five-year period, eligible students and graduates may submit on-line exam applications and requests to extend Step 1 and Step 2 CK eligibility periods without completing another paper certification. See Applying for Examination.

21. What is the difference between a Certification Statement (Form 183) and a Certification of Identification Form (Form 186)?

The Certification Statement (Form 183) is the paper certification required by ECFMG for applicants who are students enrolled in medical schools that do not participate in EMSWP. A new Form 183 is generated with each on-line application. See Applying for Examination.

The Certification of Identification Form (Form 186) is the paper certification required by ECFMG for applicants who are medical school graduates or are students enrolled in medical schools that participate in EMSWP. Once accepted by ECFMG, Form 186 remains valid for five years. During this five-year period, eligible students and graduates may submit on-line exam applications and requests to extend Step 1 and Step 2 CK eligibility periods without completing another paper certification. See Applying for Examination.

22. Do I have to complete a new Certification of Identification Form (Form 186) every time I apply for an examination?

No. Once the Certification of Identification Form (Form 186) is accepted by ECFMG, it is valid for five years. Applicants with a valid Form 186 can apply for exams or request Step 1 and Step 2 CK eligibility period extensions using IWA by completing only the on-line part of the application.

23. What is a clinical clerkship?

The term clinical clerkship refers to that period in your medical education in the clinical disciplines during which, as a medical student, you gain practical experience in hospitals or clinics through rotations, pregraduate internships, etc.

Medical Education Credentials

24. What is a final medical school transcript?

The final medical school transcript is an official document that is the record of the graduate's medical education, issued by the medical school or university, upon or after graduation.

The format of the final medical school transcript may vary among institutions. The final medical school transcript contains the name of the medical school or university and the name of the graduate. Other items that may be contained in the final medical school transcript include, but are not limited to, the dates of attendance, courses taken, credits for each course, grade in each course, summary of transfer credits accepted and the name of the institution from which the credits were accepted, title of the degree awarded, date degree was awarded, program of study (i.e., medicine), and date the transcript was issued.

25. Do I need to send my final medical school transcript to ECFMG?

When ECFMG sends your medical diploma to your medical school for verification, ECFMG will request the medical school to include your final medical school transcript when the school returns the verification of your medical diploma to ECFMG. If ECFMG is unable to obtain your final medical school transcript directly from your medical school, ECFMG will contact you and request that you submit to ECFMG two photocopies of your final medical school transcript. You must also send two photocopies of the final medical school transcript to ECFMG if ECFMG has previously verified your medical diploma with your medical school but not the final medical school transcript. In these instances, ECFMG will then send a copy of your final medical school transcript to your medical school for verification. See Provision of Credentials and Translations.

26. What are transfer credits?

Transfer credits are credits earned for a course taken at one institution (such as a medical school) that are accepted by another medical school toward meeting its degree requirements. For example, a student attends a medical school for one year and earns credits for 12 courses. The student transfers to another medical school, which accepts the credits for those 12 courses toward meeting its degree requirements. The credits for those 12 courses are then referred to as transfer credits.

27. I transferred credits from one medical school to the medical school that awarded my medical degree. I earned these credits prior to January 1, 2008. Must I document these credits when I apply to ECFMG for examination?

Yes. All applicants who have transferred credits to the medical school that awarded or will award their medical degree must document these credits when they apply to ECFMG for examination, regardless of when the credits were earned. To document these credits, you must send to ECFMG two photocopies of an official transcript issued by the medical school or institution at which the course was taken. For instructions, see Transfer Credits and Provision of Credentials and Translations.

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

ECFMG will notify you when it sends the request for verification of your medical education credentials to your medical school. After ECFMG receives the verification of your diploma and/or your final medical school transcript from your medical school and evaluates it, ECFMG will send you another notification. You can check the status of your medical education credentials using OASIS. See Verification of Credentials.

Fifth Pathway Program

29. What if I am attending or have completed a Fifth Pathway program?

If you are attending or have completed a Fifth Pathway program, see The Fifth Pathway Program.

Payment

30. What are the exam fees and how do I pay them?

For all exams, there is an examination fee. For Step 1 and Step 2 CK, there is an additional international test delivery surcharge, if you choose a testing region other than the United States/Canada. For the current exam fees and international test delivery surcharges, refer to the ECFMG website.

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 request for service and you have a USMLE/ECFMG Identification Number, you can make an advance on-line payment through OASIS using one of the payment methods described above. All applicants submitting paper requests can pay by credit card or check with their paper request forms. Payment for all services is due at the time of application. If you do not include full payment, your application/request for service will be rejected. See Payment.

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