PATHWAYS TO ECFMG certification and nrmp match 2024

International medical graduates (IMGs) who need to meet the clinical and communication skills requirements for ECFMG Certification through the Pathways and plan to participate in the 2024 National Resident Matching Program® (NRMP®) Main Residency Match® (The Match®) must submit a 2024 Pathways application by 6:00 p.m. on December 31, 2023. 

If you are an IMG who needs to meet the clinical and communication skills requirements for ECFMG Certification, and you intend to participate in the 2024 Match, you must apply to one of the 2024 Pathways.

PATHWAY 3 would apply to most Caribbean Medical School Graduates whose schools are accredited by an agency recognized by WFME. 

Individuals who already have satisfied the clinical and communication skills requirements for ECFMG Certification include:

• IMGs who have a passing performance on USMLE Step 2 Clinical Skills (CS) that is valid for ECFMG Certification (even if they previously failed Step 2 CS),
• IMGs who are certified by ECFMG, and
• IMGs with an approved application to the 2021, 2022, or 2023 Pathways.

As part of the Pathways, applicants are required to attain a satisfactory score on the Occupational English Test (OET) Medicine to satisfy the communication skills requirement for ECFMG Certification. All Pathways applicants, regardless of native language, language of instruction at medical school, or citizenship, must satisfy this requirement in addition to meeting the requirements of a specific Pathway. 

Pathway 1: Already Licensed to Practice Medicine in Another Country

Pathway 1 is for applicants who currently hold or have recently held a license/registration to practice medicine without supervision. Applicants who meet the eligibility requirements for Pathway 1 must apply to Pathway 1 in order to meet the clinical and communication skills requirements for ECFMG Certification, unless they failed Step 2 CS; see Important Note.

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 eligibility requirements for Pathway 1, but who attend or have graduated from a medical school that administers an OSCE specifically required for medical licensure by the medical regulatory authority (MRA) in that country. The medical school must meet certain ECFMG requirements and the applicant must have successfully completed the OSCE.

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 do not meet the eligibility requirements for Pathway 1 and are students or recent graduates of a medical school that meets eligibility requirements established by ECFMG for Pathway 3, 4, or 5.

See the page for Pathways 3, 4, and 5 for more information, including eligible graduation dates.

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. To meet the requirements for Pathway 6, the applicant’s clinical skills must be evaluated by licensed physicians using ECFMG’s Mini-Clinical Evaluation Exercise (Mini-CEX) for Pathway 6.

 If you do not enter an eligible U.S. GME training program by the time your ECFMG Certificate expires, and you wish to enter a U.S. GME training program in the future, you will be required to meet the clinical and communication skills requirements for ECFMG Certification in place at that time in order to revalidate your ECFMG Certificate. 

Requirements for all applicants to Pathways 3, 4, and 5:

• Date of medical school graduation must be on or after January 1, 2022.
• An authorized official of your medical school must attest to the applicant’s clinical skills.
• 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. For information on applying to Pathway 6, see the Pathway 6 page.

Pathway-specific medical school requirements:

• Pathway 3. Applicant’s medical school is currently accredited by an agency recognized by the World Federation for Medical Education (WFME).
• Pathway 4. Applicant’s medical school is currently accredited by an agency that has received a determination of comparability by the National Committee on Foreign Medical Education and Accreditation (NCFMEA).
• Pathway 5. Applicant’s medical school grants an MD degree issued jointly with a U.S. medical school accredited by the Liaison Committee on Medical Education (LCME).