Educational commission for foreign medical graduates



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

 

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Eligibility for Examination 

Medical School Students

 | 

Medical School Graduates



 | Reverification of Eligibility | 

Fifth Pathway Participants

  

Reverification of Eligibility 

ECFMG reserves the right to reverify your eligibility for examination at any time during the application and 

registration process. If your medical school informs ECFMG that your status has changed, and ECFMG 

determines you are no longer eligible for examination, your registration will be canceled. 

For medical school students, this may include reverification of your status as a student officially enrolled in medical 

school. When a medical school does not participate in the 

ECFMG Medical School Web Portal (EMSWP)

ECFMG’s reverification of the status of the school’s students may include ECFMG sending a written request for 



reverification by postal mail to the medical school. If such reverification is requested by ECFMG, ECFMG may 

cancel your registration or withhold your score report until ECFMG has received reverification of your status 

directly from the medical school. If your registration is canceled, you may be required to reapply. 

For medical school graduates, this may include reverification of your medical education credentials with the 

issuing medical school. If such reverification is requested by ECFMG, you will be registered for examination only 

after ECFMG has received reverification of your credentials directly from the medical school. If reverification is 

requested by ECFMG after you have been registered for examination, ECFMG may cancel your registration or 

withhold your score report until ECFMG has received reverification of your medical education credentials directly 

from the issuing school. If your registration is canceled, you may be required to reapply. 

 

 



Last updated: September 15, 2011 

 

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



 

32



Eligibility for Examination 

Medical School Students

 | 

Medical School Graduates



 | 

Reverification of Eligibility

 | Fifth Pathway Participants  

Fifth Pathway Participants 

The Fifth Pathway, created by the 

American Medical Association (AMA)

 in 1971, has allowed certain students who 

attended four years at an international medical school to complete their supervised clinical work at a U.S. medical 

school, to become eligible for entry to U.S. residency training, and ultimately to obtain a license to practice in the 

United States. The AMA’s Council on Medical Education no longer supports the Fifth Pathway as a mechanism for 

eligibility to enter the first year of ACGME-accredited graduate medical education programs. The last Fifth 

Pathway program class supported was the class that began in January 2009 and ended in December 2009. 

Individuals who pursued the Fifth Pathway completed the four-year didactic curriculum at the international medical 

school, but they did not complete the internship and/or social service requirement for the final medical diploma. 

Instead, they completed a Fifth Pathway program, which was one year of supervised clinical work at a U.S. 

medical school. Since they did not complete the internship and/or social service requirement, they did not receive 

the final medical diploma and, therefore, are not eligible for ECFMG Certification. However, these individuals may 

apply to ECFMG for examination, provided that they hold a Fifth Pathway certificate issued on or before 

December 31, 2009. 



Important Note: Currently, the USMLE program accepts either a valid Standard ECFMG Certificate or 

a valid Fifth Pathway certificate (issued through December 31, 2009) from international medical 

graduates for the purpose of meeting Step 3 eligibility requirements. The USMLE program will cease 

acceptance of Fifth Pathway certificates for the purpose of meeting Step 3 eligibility requirements

effective January 1, 2017. Individuals who hold valid Fifth Pathway certificates, and are otherwise 

eligible, may use their Fifth Pathway certificates to meet Step 3 eligibility requirements, and may apply 

for Step 3, through December 31, 2016. Individuals holding Fifth Pathway certificates that are not 

accepted by the USMLE program for purposes of meeting Step 3 eligibility will be required to obtain 

ECFMG Certification in order to be eligible for Step 3. 

 

 



Last updated: September 15, 2011 

 

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



 

33



Applying for Examination 

Application for USMLE | 

Medical School Students

 | 


Medical School Graduates

 | 


When to Apply

 | 


Exam Fees

 | 


Examinees Who Require Personal Items in the Testing Room

 | 


Examinees with Disabilities Requesting Test 

Accommodations

 | 

Testing Locations



 | 

Step 1/Step 2 CK Eligibility Periods

 | 

Step 2 CS Eligibility Periods



 | 

Reexamination and Reapplication

  

Application for USMLE 

Before applying for USMLE, international medical students/graduates must: 

submit an Application for ECFMG Certification. See 



Application for ECFMG Certification

.  


read the appropriate edition of the 

ECFMG Information Booklet

 and the 

USMLE Bulletin of Information

.  


To apply for USMLE Step 1, Step 2 CK, and/or Step 2 CS, use ECFMG's 

Interactive Web Applications (IWA)

. A 

complete application consists of the on-line part, which you complete using IWA; the Certification of Identification 



Form (Form 186) or Certification Statement (Form 183), which you obtain through IWA; and any other required 

documents, as outlined in IWA and in this publication. 

Detailed 

instructions

 accompany the application for examination. Follow the instructions carefully and answer all 

questions completely. You should review the instructions before you begin working on the application. Some of 

the necessary items require advance planning. These items may include photographs, official signatures, and 

additional documents, such as photocopies of your medical diploma if you are a medical school graduate. If your 

application is not complete, it will be rejected. 

ECFMG will notify you by e-mail when your application is received. You can check the status of your application 

on-line using 

OASIS


ECFMG will process your exam application and determine your eligibility to take the exam(s) you requested. 

ECFMG processes exam applications typically within three weeks of receipt of the complete application. If you are 

a student enrolled in a medical school that participates in 

EMSWP

 or if you are a graduate of a medical school that 



participates in EMSWP and your medical education credentials have not been primary-source verified by ECFMG, 

ECFMG cannot complete the processing of your application until your medical school verifies your status through 

EMSWP. ECFMG will make your record available to your medical school and request verification typically within 

three weeks of receipt of a complete application. The time needed to complete the processing of your application 

is contingent upon your medical school's response to the EMSWP verification request. See 

Medical School 

Students

 or 


Medical School Graduates

 in Applying for Examination

Once your exam application has been processed, ECFMG will notify you of the outcome of your application. For 

eligible applicants, important information about scheduling and taking the exams will be issued. 



Important Note: Applications and other requests for services will not be processed if it is determined 

that doing so would be considered violative of any applicable federal laws or regulations. 

 

 

Last updated: September 15, 2011 



 

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

 

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