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According to the
US Department of Education The United States Department of Education is a Cabinet-level department of the United States government. It began operating on May 4, 1980, having been created after the Department of Health, Education, and Welfare was split into the Department ...
, the Educational Commission for Foreign Medical Graduates is "the authorized credential evaluation and guidance agency for non-U.S. physicians and graduates of non-U.S. medical schools who seek to practice in the United States or apply for a U.S. medical residency program. It provides comprehensive information and resources on licensure, the U.S. Medical Licensure Examination (USMLE), residencies, and recognition." Through its program of certification, the Educational Commission for Foreign Medical Graduates (ECFMG) assesses the readiness of international
medic A medic is a person involved in medicine such as a medical doctor, medical student, paramedic or an emergency medical responder. Among physicians in the UK, the term "medic" indicates someone who has followed a "medical" career path in postgra ...
al graduates to enter residency or fellowship programs in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...
that are
accredited Accreditation is the independent, third-party evaluation of a conformity assessment body (such as certification body, inspection body or laboratory) against recognised standards, conveying formal demonstration of its impartiality and competence to ...
by the Accreditation Council for Graduate Medical Education (ACGME). ECFMG acts as the registration and score-reporting agency for the
USMLE The United States Medical Licensing Examination (USMLE) is a three-step examination program for medical licensure in the United States sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). ...
for foreign medical students/ graduates, or in short, it acts as the designated Dean's office for International Medical Graduates (IMGs) in contrast to the American Medical Graduates (AMGs). Medical schools in
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...
that award the
M.D. Doctor of Medicine (abbreviated M.D., from the Latin ''Medicinae Doctor'') is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the M.D. denotes a professional degree. ...
are not assessed by ECFMG, because the
Liaison Committee on Medical Education The Liaison Committee on Medical Education (LCME) is an accrediting body for educational programs at schools of medicine in the United States and Canada.''Glossary.'' ACGME website. The LCME is sponsored by the Association of American Medical Co ...
historically accredited M.D.-granting institutions in both the U.S. and Canada (today, Canada has its own accrediting body that generally follows U.S. standards). M.D. graduates of American and Canadian institutions are not considered IMGs in either country.


History

ECFMG was founded in 1956, in response to the increase need for the evaluation of the readiness of international medical graduates entering the physician workforce during the 1950 expansion of US healthcare system. Its initial name was Evaluation Service for Foreign Medical Graduates (ESFMG). Later that year, it was renamed Educational Council for Foreign Medical Graduates. In conjunction with NBME, it created what became known as the ECFMG certification which included examinations and assessments of English language proficiency. In 1974, it merged with the Commission on Foreign Medical Graduates and changed its name to its current name Educational Commission for Foreign Medical Graduates.


Certification

The main pathway for
international medical graduate An international medical graduate (IMG), earlier known as a foreign medical graduate (FMG), is a physician who has graduated from a medical school outside of the country where he or she intends to practice. The term non-local medical graduate may be ...
s who wish to be licensed as a physician in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...
is to complete a U.S. residency hospital program. The general method to apply for residency programs is through the
National Resident Matching Program The National Resident Matching Program (NRMP), also called The Match, is a United States-based private non-profit non-governmental organization created in 1952 to place U.S. medical school students into residency training programs located in Uni ...
(abbreviated NRMP, but also called "the Match"). To participate in the NRMP, an IMG is required to have an ECFMG certification by the "rank order list certification deadline" time (usually in February of the year of the match). To acquire an ECFMG certification, the candidate must meet these requirements: *Examination Requirement: Completion of
USMLE Step 1 The USMLE Step 1 (more commonly just Step 1 or colloquially, The Boards) is the first part of the United States Medical Licensing Examination. It aims to assess whether medical school students or graduates can apply important concepts of the found ...
and
USMLE Step 2 Clinical Knowledge The USMLE-Step 2-CK ("Clinical Knowledge") is the nine-hour-long multiple-choice portion of the second part of the United States Medical Licensure Examination. It assesses clinical knowledge through a traditional, multiple-choice examination. In c ...
*Meet the clinical and communication skills requirements (see section) *Medical education credential requirements: A medical diploma of
medical education Medical education is education related to the practice of being a medical practitioner, including the initial training to become a physician (i.e., medical school and internship) and additional training thereafter (e.g., residency, fellowship, ...
taken at an institution registered in the
World Directory of Medical Schools The World Directory of Medical Schools is a public database of institutions that provide medical education. There are over 3,600 medical schools listed in the directory. The directory is published as a collaboration of the World Federation for Med ...
(WDOM). The official source to confirm that a medical school meets ECFMG’s requirements, is the World Directory at www.wdoms.org. Schools that meet the requirements will have an ECFMG note stating this in the schools’ World Directory listing. In comparison, regular graduates from medical schools in the United States need to complete USMLE Steps 1 and 2 as well, but can participate in the NRMP while still doing their final year of medical school before acquiring their medical diplomas. In effect, taking regular administrative delays into account, and with residency programs starting around July, there is a gap of at least half a year for IMGs between graduation from medical school and beginning of a residency program.


Clinical and communication skills requirements

The
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was identified in Wuhan, China, in December 2019. The disease quickly ...
global pandemic has brought some changes to the ECFMG certification process. First as AAMC suspended temporarily and later eliminated the
Step 2 CS Step 2 Clinical Skills (Step 2 CS) of the United States Medical Licensing Examination (USMLE) was an exam administered to medical students/graduates who wish to become licensed physicians in the U.S. It is similar to the COMLEX-USA Level 2-PE ex ...
examination, ECFMG moved to a pathways model for verification of clinical skills. IMGs who have already taken Step 2 CS may still use it to fulfill this requirement. All other IMGs will need: *Assessment of communication skills, including English language proficiency through the
Occupational English Test The Occupational English Test (also known as OET) is an English language test for healthcare professionals recognised by various regulatory healthcare bodies. It assesses the language communication skills of healthcare professionals who wish to ...
Medicine exam *Meet the requirements for one of the pathways below:


Certification expiration

As of April 2021, ECFMG certifications obtained by fulfilling the clinical and communication skills requirements through a pathway will expire in 2022 if the applicant does not enter an ACGME-accredited training program in 2021 or 2022. If the applicant enters a training program they become permanent after one year of residency.


Projects

A pilot project was started in 2012 for an electronic verification system of medical credentials from international medical schools, with participation from approximately 20 international medical schools. After completion of this pilot project, ECFMG now allows all medical schools to register for free. Effective in 2024, the ECFMG will restrict eligibility to USMLE and employment as a doctor in the United States to graduates from medical schools accredited by an agency which is recognized by the World Federation for Medical Education or to an equivalent standard. The accrediting agencies that meet these requirements are:


Communication

International medical schools can send Medical Student Performance Evaluations (MSPEs), medical school transcripts, and letters of recommendation (LoRs) on behalf of their students and graduates to ECFMG by means of mail, or through digital documents by the ECFMG Medical School Web Portal (EMSWP).ERAS Support Services for International Medical Schools
on the ECFMG homepage. Retrieved April 2021


References


External links


Education Commission for Foreign Medical GraduatesUnited States Medical Licensing Examination
{{authority control Medical associations based in the United States Medical and health organizations based in Pennsylvania