Educational commission for foreign medical graduates

Examinations for ECFMG Certification 

Examination Requirements

 | The United States Medical Licensing Examination (USMLE) | 

Registration and Test 

Delivery Entities

 | 

Medical Science Examination Requirement

 | 

Clinical Skills Requirement

 | 

Time Limit for 

Completing Examination Requirements

  

The United States Medical Licensing Examination (USMLE)  

The USMLE is a three-step examination for medical licensure in the United States. The USMLE provides a 

common system to evaluate applicants for medical licensure. The USMLE is sponsored by the 

Federation of State 

Medical Boards of the United States, Inc. (FSMB)

 and the 

National Board of Medical Examiners (NBME)

. The 

USMLE is governed by a committee consisting of representatives of FSMB, NBME, ECFMG, and the American 

public. If you apply for examination, you are required to read the 

USMLE Bulletin of Information

 for complete 

information on the USMLE. 

Important Note: The Comprehensive Review of USMLE (CRU) was initiated in 2004. The goal of this 

review was to determine if the mission and purpose of USMLE were effectively and efficiently 

supported by the current design, structure, and format of USMLE. This review resulted in proposed 

changes. In 2009, the proposed changes were approved by the USMLE sponsoring organizations, 

FSMB and NBME. 

Planning, research, and development efforts have been underway for the last three years. Initial 

modifications are being introduced into the upcoming exams. Regular updates on the CRU process are 

posted to the 

USMLE website

. 

Changes resulting from CRU are planned for all USMLE Steps and Step Components. These changes 

may affect both content and item formats. As changes are implemented, the orientation and practice 

materials available on the USMLE website may be updated to reflect these changes. If you plan to take 

USMLE examinations, you should monitor the 

USMLE

 and 

ECFMG

 websites for the latest information 

on changes related to CRU. 

 

 

Last updated: September 15, 2011 

 

Copyright © 2011 by the Educational Commission for Foreign Medical Graduates. All rights reserved.

 

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Examinations for ECFMG Certification 

Examination Requirements

 | 

The United States Medical Licensing Examination (USMLE)

 | Registration and Test 

Delivery Entities | 

Medical Science Examination Requirement

 | 

Clinical Skills Requirement

 | 

Time Limit for 

Completing Examination Requirements

  

Registration and Test Delivery Entities 

Step 1 and Step 2 

ECFMG serves as the registration entity for international medical students/graduates taking Step 1 and Step 2 

(CK and CS). This means that ECFMG processes your exam application and payment, determines your eligibility, 

and notifies you of the outcome of your application. The NBME serves as the registration entity for 

students/graduates of U.S. and Canadian medical school programs accredited by the 

Liaison Committee on 

Medical Education (LCME)

 and U.S. medical schools accredited by the 

American Osteopathic Association (AOA)

. 

For eligible Step 1/Step 2 CK applicants, ECFMG forwards registration information to NBME, and NBME issues 

the exam scheduling permits. Scheduling and test centers for USMLE Step 1 and Step 2 CK are provided by 

Prometric

. Prometric serves as the test delivery entity for all examinees taking Step 1/Step 2 CK. Step 1 and Step 

2 CK are delivered at Prometric test centers worldwide. ECFMG is not responsible for errors or any associated 

computer problems that may occur in issuing Step 1/Step 2 CK scheduling permits or in delivering these exams. 

These functions are the responsibility of NBME and/or Prometric. 

For eligible Step 2 CS applicants, ECFMG issues the exam scheduling permits. The Clinical Skills Evaluation 

Collaboration (CSEC), a collaboration of ECFMG and NBME, is responsible for delivery of the Step 2 CS exam. 

Step 2 CS is delivered to all examinees at regional CSEC Centers in the United States. 

NBME is responsible for determining the results of USMLE exams and for issuing the score reports. ECFMG 

notifies international medical students/graduates when their Step 1, Step 2 CK, and Step 2 CS score reports are 

available and provides them with secure, web-based access to the score reports. 

Step 3 

The FSMB serves as the registration entity for all Step 3 applicants. To be eligible for Step 3, international medical 

graduates must have passed Step 1 and Step 2 and must be certified by ECFMG, among other requirements. See 

Eligibility in the 

USMLE Bulletin of Information

. If you have not met all eligibility requirements, your application for 

Step 3 will not be accepted. For detailed information and application procedures for Step 3, contact the individual 

medical licensing authorities or the FSMB. Scheduling and test centers for Step 3 are provided by 

Prometric

, 

which serves as the test delivery entity for all Step 3 examinees. USMLE Step 3 is delivered at Prometric test 

centers in the United States. 

NBME is responsible for determining the results of USMLE exams and for issuing the score reports. FSMB notifies 

examinees when their Step 3 score reports are available and provides them with secure, web-based access to the 

score reports. 

Important Note: Step 2 CS has replaced the former ECFMG CSA. ECFMG-certified physicians, and 

physicians who have successfully completed Fifth Pathway programs, must have taken and passed 

either Step 2 CS or the CSA in order to register for Step 3. See Who Is Required to Take Step 2 CS? 

in the 

USMLE Bulletin of Information

. 

 

 

Last updated: September 15, 2011 

 

Copyright © 2011 by the Educational Commission for Foreign Medical Graduates. All rights reserved.

 

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