Previously the requirements for ECFMG Certification included passing USMLE Step 1, Step 2 CK and Step 2 CS. Step 2 CS was the exam that satisfied the clinical and communication skills requirements for ECFMG Certification.

After suspension of Step 2 CS, ECFMG has offered Pathways to allow IMGs to meet the clinical and communication skills requirements for ECFMG Certification. ECFMG first offered the Pathways to IMGs participating in the 2021 match and will also be using  them for the 2023 Match.

OET is still being used as a test to assess the communication skills for the match 2023.

Applicants who pursue one of the Pathways are required to attain a satisfactory score on the Occupational English Test (OET) Medicine to satisfy the communication skills requirement for ECFMG Certification. All Pathway applicants, regardless of citizenship or native language, should attain a satisfactory score on OET Medicine on or after January 1, 2021.

In addition to OET, Pathway applicants also must meet all requirements for the Pathway to which they apply. Previously the requirements for ECFMG Certification included passing USMLE Step 1, Step 2 CK and Step 2 CS. Step 2 CS was the exam that satisfied the clinical and communication skills requirements for ECFMG Certification.

After suspension of Step 2 CS, ECFMG has offered Pathways to allow IMGs to meet the clinical and communication skills requirements for ECFMG Certification. ECFMG first offered the Pathways to IMGs participating in the 2021 match and will also be using  them for the 2023 Match.

OET is still being used as a test to assess the communication skills for the match 2023.

Applicants who pursue one of the Pathways are required to attain a satisfactory score on the Occupational English Test (OET) Medicine to satisfy the communication skills requirement for ECFMG Certification. All Pathway applicants, regardless of citizenship or native language, should attain a satisfactory score on OET Medicine on or after January 1, 2021.

In addition to OET, Pathway applicants also must meet all requirements for the Pathway to which they apply.
Pathway 1: Already Licensed to Practice Medicine in Another Country

For the 2023 Pathways, applicants to Pathway 1 must currently hold, or have held, a full, unrestricted license to practice medicine issued at any time on or after January 1, 2018. The date of initial licensure/registration may be prior to January 1, 2018, but the license/registration still must have been valid on or after January 1, 2018.

Other Requirement:- 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 in order to meet the clinical and communication skills requirements for ECFMG Certification

IMGs from India will have to pursue pathway 1 in order to be ECFMG certifiedPathway 1: Already Licensed to Practice Medicine in Another Country

For the 2023 Pathways, applicants to Pathway 1 must currently hold, or have held, a full, unrestricted license to practice medicine issued at any time on or after January 1, 2018. The date of initial licensure/registration may be prior to January 1, 2018, but the license/registration still must have been valid on or after January 1, 2018.

Other Requirement:- 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 in order to meet the clinical and communication skills requirements for ECFMG Certification

IMGs from India will have to pursue pathway 1 in order to be ECFMG certified
Pathway 2: Already Passed an Objective Structured Clinical Examination (OSCE) for Medical Licensure Administered by an Acceptable Medical School

Pathway 2 will be for applicants who have not yet obtained a license/registration to practice medicine without supervision (Pathway 1), but who attend or have graduated from a medical school that administers an OSCE specifically required for medical licensure in that country

​Applicants to Pathway 2 must have a medical school graduation date on or after January 1, 2021. 
​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)
Pathways 3, 4, and 5 are for applicants who have not yet obtained a license/registration to practice medicine without supervision (Pathway 1) and who have not already passed an acceptable standardized clinical skills exam for medical licensure (Pathway 2). 

To determine whether a medical school’s students and recent graduates are eligible to apply to Pathway 3, 4, or 5, search the list of Medical Schools Eligible for 2022 Pathways 
(https://www.ecfmg.org/certification-requirements-2022-match/pathway-schools.php) 
​
Medical Schools from India are not included in the list (as of now)
For the 2023 Pathways, applicants to Pathways 3, 4, and 5 must have a medical school graduation date on or after January 1, 2021.
Pathway 6: Evaluation of Clinical Patient Encounters by Licensed Physicians
Pathway 6 is for applicants who do not meet the eligibility requirements for Pathway 1, 2, 3, 4, or 5 and/or have failed the former USMLE Step 2 Clinical Skills (CS) one or more times.
To meet the requirements for Pathway 6, the applicant’s clinical skills must be observed and evaluated by licensed physicians in six real, in-person clinical encounters using the ECFMG Mini-Clinical Evaluation Exercise (Mini-CEX) for Pathway 6. 
Each physician evaluator will be able to submit evaluations for no more than 10 applicants.
Some important takeaway points:
  • OET is still being used as a test to assess the communication skills for the match 2023
  • ECFMG Certificates issued to applicants through the 2021 or 2022 Pathways will be valid through December 31, 2024.
  • All 2021 and 2022 Pathways applications that are incomplete by the time the 2023 Pathways application opens will be rejected.
  •  Applicants to the 2021 or 2022 Pathways whose application is rejected will be able to reapply to the 2023 Pathways when the application becomes available.
  • The ability to apply to the 2023 Pathways is available now. Students can start applying.
  •  If you were certified by ECFMG based on a 2021 or 2022 Pathway and your ECFMG Certificate lists an   expiration date in 2021 or 2022, this expiration date will be extended through December 31, 2024

​IMGs from India will have to pursue pathway 1 in order to be ECFMG certified

ECFMG Pathway 6

ECFMG Pathways 1-5