Pathways ECFMG 2023

The ECFMG® has announced that, effective in 2024 (previously 2023), physicians applying for ECFMG Certification will be required to graduate from a medical school that has been appropriately accredited. To satisfy this requirement, the physician’s medical school must be accredited by an accrediting agency recognised by WFME.

The WFME Recognition Programme is the only programme accepted by ECFMG at the current time for the recognition of medical school accrediting agencies.

In the United States, international medical graduates (IMGs) comprise one-quarter of the physician workforce. Through its program of IMG certification, ECFMG assesses whether these physicians are ready to enter U.S. graduate medical education. ECFMG Certification is also one of the eligibility requirements for IMGs to take Step 3 of the United States Medical Licensing Examination® (USMLE®) and to obtain an unrestricted license to practice medicine in the United States.

For more and up-to-date information regarding the ECFMG 2024 requirement, please follow the website www.ecfmg.org/accreditation/.

Written by Nina Madjer, MD

Now that the ERAS application has opened up for the 2023 match, many international medical students are trying to navigate their way through not only ERAS, but also the ECFMG certification process via “Pathways”. 

The Pathways for ECFMG certification are how IMGs can meet clinical and communication skills requirements if they plan to participate in the NRMP Match cycle. Regardless of which pathway criteria you may fit into, you must meet the clinical and communication skills requirements. 

I have sifted through the latest available information on the ECFMG website to break down the General Eligibility Requirements, Pathway 1-6 criteria, and important upcoming dates that may make understanding this process a little bit easier. 

However, the “Pathways” is how to fulfill clinical and communication skills requirements UNLESS you fit into one of these three categories, so be sure that these exceptions do not apply to you before applying. 

  1. You have passed USMLE Step 2 CS

  2. You are already certified by ECFMG

  3. You have an approved Pathways application from 2021 or 2022

General Eligibility

To be eligible to apply to an ECFMG certification pathway, you must meet each of the following criteria:

  1. You must not have already met the clinical and communication skills requirements for ECFMG Certification. (If you have a passing performance on Step 2 CS that is valid for ECFMG Certification, or if you have a previously approved Pathways application, you have already met the clinical and communication skills requirements for ECFMG Certification and are not currently eligible to pursue a Pathway.)

  2. You must not be barred by ECFMG from pursuing certification.

  3. You must not have already submitted an Application for ECFMG Certification.

  4. You must not have previously been registered for a USMLE Step or Step Component. This means that, if you have never been registered to take a USMLE Step or Step Component, you must apply for and be registered for a USMLE exam before you can submit a Pathways application.

  5. You must fulfill the Medical Science Examination Requirement.

    1. Passed USMLE Step 1 and Step 2 CK

  6. You must fulfill the Clinical Skills Requirement.

      1. Apply to Pathways https://pathways.ecfmg.org/Prepare yourself for the application fee which is $925

  7. You must fulfill the Communication Skills Requirement.

    1. Apply to Pathways https://pathways.ecfmg.org/

      1. Prepare yourself for the application fee which is $925

    2. Attain a satisfactory score on each of the four sub-tests of the Occupational English Test (OET). These four sub-tests include: Listening, Reading, Writing, and Speaking.

    3. Release your OET scores to ECFMG

If after reading the above criteria, you find that you are eligible to apply for ECFMG certification via one of the pathways, you need to find out which pathway you are eligible to apply for. Below are the criteria for applying to Pathways 1-6. 

Pathway 1: Already Licensed to Practice Medicine in Another Country

This pathway is for applicants who currently hold a license to practice medicine without supervision. 

Pathway 2: Already Passed an Objective Structured Clinical Examination (OSCE) for Medical Licensure Administered by an Acceptable Medical School

This pathway is for applicants who do not meet the criteria for Pathway 1, but who have graduated from a medical school that administers an OSCE that is approved by the medical regulatory authority in that country. 

Pathway 3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME)

Pathway 4: Medical School Accredited by Agency that Has Received a Determination of Comparability by National Committee on Foreign Medical Education and Accreditation (NCFMEA) 

Pathway 5: Medical School Issues Degree Jointly with a U.S. Medical School Accredited by Liaison Committee on Medical Education (LCME)

The following requirements apply to all applicants applying to Pathways 3, 4, and 5.

  1. The date of your medical school graduation must be on or after January 1, 2021.

  2. An authorized official of your medical school must attest to the applicant’s clinical skills.

  3. The applicant has not failed the Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination® (USMLE®) one or more times. Applicants who failed Step 2 CS one or more times must apply to Pathway 6 to meet the clinical and communication skills requirements for ECFMG Certification.

To find out if your school fits the criteria for Pathways 2, 3, 4, or 5, check out this link: https://www.ecfmg.org/certification-requirements-2023-match/pathway-schools.php 

Pathway 6: Evaluation of Clinical Patient Encounters by Licensed Physicians

This pathway is for applicants that do not meet the requirements for Pathways 1-5. The one differing requirement for Pathway 6 is that the applicant’s clinical skills must be evaluated by licensed physicians using ECFMG’s Mini-Clinical Evaluation Exercise (Mini-CEX). To get a blank copy of this form follow this link, although the real form must be submitted electronically: https://www.ecfmg.org/certification-requirements-2023-match/minicex-p6.pdf 

Important Upcoming Dates:

To ensure that your application is processed on time and that it fits the time frame for applying to the NRMP Match 2023 cycle, please keep the following dates in mind. 

  1. Take OET before December 2022.

  2. Release OET scores to ECFMG before January 31st, 2023.

  3. Submit Pathway application before January 31st, 2023.

***All of this information was obtained directly from the ECFMG website and is current as of May 12th, 2022. ***

When can you apply for ECFMG pathway?

Determine your eligibility to apply to a Pathway by reviewing all information on this website carefully. If you believe you are eligible to apply to a Pathway, complete and submit your Application for Pathways for ECFMG Certification for 2023 Match. Your application must be submitted by January 31, 2023.

Are ECFMG pathways open?

Applications to 2022 Pathways ECFMG is no longer accepting new Pathways applications for applicants who wish to participate in the 2022 Match. If you submitted a 2022 Pathways application, you can continue to check its status using the on-line application.

Will an Indian medical Graduate be able to apply for the USMLE after ECFMG 2023?

So even if you join MBBS in India in 2021, you would still be eligible to take USMLE once you complete your MBBS. If you start your course in 2021, as it is a 5 and 1/2 year course, you will complete it by 2026 approximately. So you cannot take USMLE in 2023 but can take it after you complete the course.

What is Pathway 3 in ECFMG?

Pathway 3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME) Pathway 4: Medical School Accredited by Agency that Has Received a Determination of Comparability by National Committee on Foreign Medical Education and Accreditation (NCFMEA)