ECFMG Pathway 6 (updated June 27, 2021)

Who should use pathway 6 for ecfmg certification?
  • Those who do not fit in pathway 1-5
  • Those who failed Step 2 CS
  • This is apart from the general requirements required for pathway approval like completion of step 1, step 2 ck, oet.
 
Process
  • Applicants need to get an acceptable score in each of the four components of Mini-CEX for Pathway 6: Medical Interviewing Skills, Physical Examination Skills, Professionalism/Communication Skills, and Clinical Reasoning & Judgment.
  • Applicant will have to take 6 mini cex exams, average of which will be considered
  • Each physician cant conduct more than 2 of the 6 of Mini-CEX evaluations, meaning atleast three physicians will have to evaluate each applicant 
 
Who can conduct your Mini-CEX and how
  • By a physician who is:
  1. Holds full, unrestricted license to practice without supervision for min of 5 years or more
  2. Not be related to you as a spouse, child, grandchild, parent, grandparent, sibling, uncle, aunt, nephew, niece, and/or cousin.
3)    Setting/ patient encounters must be real(not standardized patients) primary care/general practice such as general internal medicine, family medicine, pediatrics, or obstetrics and gynecology in nature and not subspecialized.(never said doctor must not be subspecialized but encounter or the patient that you are seeing shouldnt be subspecialized)
What to do next
  • Applications open in August and Mini-CEX should be taken only after that.
  • Complete other requirements like step1, ck, oet, credential verification.
  • Contact and find minimum of 3 physicians who meet the above criteria and who can conduct your mini-cex as soon as applications open up in August
  • Once applications open up and more information flows in august complete the mini-cex and ask the physician to submit them online(paper evaluations not accepted)
 
FAQ’s
 
Q) Should the physician be from the U.S/U.S licensed or can be from anywhere?
  • The details provided by ECFMG have not clearly specified if a US physician or Forigen physician can evaluate your Mini-CEX. However until more clarity is obtained it is better to plan to get the evaluations done from three separate U.S physicians in the U.S healthcare setting.
 
Q) What if I fail in Mini-CEX?
  • Evaluations will be sent to the Pathway 6 Review Committee for review, Committee will then consider both scores and reasons for the scores provided by your physician evaluators to finally determine your eligibility.  You will also have the ability to appeal the decision of the Committee
 
Q) Can the evaluations be done remotely?
  • No they need to be in-person
 
Q) First date and last date for pathway 6?
  • No earlier than August(no exact date specified) and no later than december 31st
 
Q) I have failed CS but got pathway approval during 2021 match cycle(last year cycle). I have gone unmatched, do i need to go through pathway 6 now?
  • All pathway approvals and ecfmg certifications obtained in 2021 match cycle are valid for 2022 cycle as well. So you need not apply again now
 
Q) Any additional fee for pathway 6 and Mini-CEX?
  • The fee for applying to a Pathway is $900 like for any other pathway which is to be paid at the time of submitting the application.
  • The physician evaluating your mini-cex should not be additionally compensated by you or a third party other than what is provided as their salary or wage from the institution

ECFMG Pathways 1-5 (updated June 2020)

  • In response to the suspension of Step 2 CS for the next 12-18 months, ECFMG has provided pathways that will allow qualified IMGs who have NOT passed Step 2 CS to meet the requirements for ECFMG Certification.
  • These pathways are directed ONLY towards IMGs who intend to enter the 2020 - 2021 Match and have completed Step 1 and CK (with no more than 2 or more attempts in each exam).
  • This pathway does NOT apply to Applicants who have passed Step 2 CS and/or are certified by ECFMG.
  • It is mandatory to attain a satisfactory score on an English proficiency assessment to be ELIGIBLE for any of the 5 pathways mentioned by ECFMG.
  • Details regarding which English Language Proficiency it will be has NOT been disclosed currently. It should be announced very soon.
  • Unlike previous ECFMG certificate that do not have an expiry date this “Provisional Certificate” has a few stipulations.
    1. Applicant must participate in the 2020 - 2021 Match by purchasing a 2021 ERAS Token and register with the AAMC (MyERAS).
    2. Enter an ACGME-accredited GME program for the 2021-2022 academic year – meaning Match on Match day (PreMatch/Outside the Match).
    3.  Complete the first year of ACGME-accredited training.
  • If a candidate meets ALL the above mentioned criteria. He/She will NO longer have to take CS again and their certificate is no longer subject to expiration.
  • Let us summarize the eligibility for ALL pathways
  • Not passed Step 2 CS
  • Are not barred by ECFMG.
    1. Are not barred by USMLE from taking a Step from August 1 to January 31, 2021.
    2. Have not failed any USMLE Steps two or more times.
    3. Only applicants who have taken or been registered for any USMLE Step since January 1, 2018 are eligible.
  • Applicants must meet ALL requirements I have just summarized and meet ALL requirements listed under a Pathway that applies to the candidate.
 
  • What are these 5 different pathways?
    1. Pathway #1: Already Licensed to Practice Medicine in Another Country
§  Applicant has held a full, unrestricted license or registration to practice medicine in any country at any time on or after January 1, 2015. License does not need to be currently valid.
§  The license or registration has not been subject to disciplinary action.
§  There are a lot of unanswered questions regarding this pathway. As this applies to IMGs from India and Pakistan.
§  Additional details and specific instructions regarding this pathway will be provided by ECFMG soon but we will try our best to answer your questions to the best of our ability.
2.      Pathway #2: Already Passed a Standardized Clinical Skills Exam for Medical Licensure
§  Has completed the standardized clinical skills exams of UK, Australia, Canada, New Zealand, or Ireland.
§  Date of examination must be on or after July 1, 2018.
3.      Pathway #3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME)
§  Graduated from a Medical School on or after Jan 1st, 2018 that is accredited by an agency recognized by World Federation for Medical Education (WFME).
§  You must obtain an authorized letter on an ECFMG form that can attest to your clinical skills.
§  Unfortunately, if you have graduated from a Medical school in India or Pakistan. This pathway does not apply to you.
4.      Pathway #4: Medical School Participates in U.S. Federal Student Loan Program
§  Does not apply to IMGs
5.      Pathway #5: Medical School Issues Degree Jointly with a U.S. Medical School Accredited by Liaison Committee on Medical Education (LCME)
§  Does not apply to IMGs unless the IMG has graduated or is a student from the mentioned Medical schools in Qatar or Singapore.

  • With that said let us answer some frequently posed questions by our students
 FAQ
  1. Considering that an English proficiency test is required, should I book a TOEFL date?
    • ECFMG has not released what these exams will be. It is premature at this moment to book a date.
    • There are several English Language Proficiency exams like OET, IELTS, TOEFL. Either one of them or all of them might be chosen. We do not know at this moment.
  2. Do you know if Indian MBBS is considered eligible for pathway #1 or is there a separate licensing exam needed?
    • With respect to India: A candidate who graduates from Medical school is provided with a provisional certificate to practice until he/she completes their mandatory 12 months of Internship.
    • At which point you receive an unrestricted license to practice from Medical council of India.
    • As far as I know you do NOT have to take an additional exam to obtain an unrestricted license (provided one has completed their 12 months of internship).
  3. ECFMG should blank out CS results (Pass/Fail/Pending).
    • This falls under the purview of USMLE. USMLE transcripts contain your examination history and will include all attempts: passed, failed, pending.
  4. 2019 graduate from Europe. Am I eligible to get certified under Pathway #1? My Medical school is NOT Accredited by an agency recognized by World Federation for Medical Education (WFME). I have taken Step 1 and CK.
    • If you hold a full, unrestricted license to practice in home country and plan on applying for Match 2020 – 2021 you are eligible for Pathway #1 (provided you meet the English Language Proficiency requirements set forth by ECFMG).
  5. Do we have to renew our ECFMG certificates?
    • If you are already ECFMG certified, you do not have to renew it. It currently does not have an expiry date.
  6. What about people who passed Spoken English Proficiency (SEP) component of Step2 CS and failed one of the other two? Do they still need to take an English proficiency test?
    • Yes. According to the current guidelines as mentioned above. 

ECFMG Pathway 6

ECFMG Pathways 1-5