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ECFMG to Provide International Medical Schools with USMLE Performance Data on Their Students/Graduates

ECFMG may provide international medical schools with data on the performance of their students and graduates who apply to ECFMG for USMLE Step 1, USMLE Step 2 Clinical Knowledge (CK), and USMLE Step 2 Clinical Skills (CS). This applies to all exam administrations for which an examinee applies on or after November 2, 2009.

Data will be provided to medical schools electronically through the ECFMG Medical School Web Portal (EMSWP) and will include whether each examinee passed the exam administration, and, for Step 1 and Step 2 CK, the examinee’s numerical score on both two-digit and three-digit scales.

Examinees have the option to have their exam results withheld from their medical school. To have exam results withheld from his/her medical school, the examinee must submit a request through ECFMG’s Interactive Web Application (IWA).

To view information on ECFMG’s practices regarding the provision of these data to international medical schools and the process by which examinees can request to have their exam results withheld from their medical school, click here.

Beginning in early 2010, ECFMG expects to start providing medical schools with aggregate USMLE performance data on their students/graduates. Aggregate data will be provided on an annual basis to medical schools that provide ECFMG with certain information relating to their student body, curriculum, and educational programs. The information provided by schools will be used by ECFMG’s foundation, the Foundation for Advancement of International Medical Education and Research (FAIMER), in its on-going efforts to develop data resources on medical education programs throughout the world.

International medical schools have long expressed interest in obtaining USMLE performance data on their students/graduates, and we expect these opportunities to obtain such data to be mutually beneficial for the medical schools and ECFMG.

NBME^® Self-Assessments with Expanded Feedback

The National Board of Medical Examiners^® (NBME) offers web-based self-assessments to help medical students and graduates evaluate their readiness for the computer-based components of the United States Medical Licensing Examination (USMLE). The content of the Comprehensive Basic Science Self-Assessment (CBSSA) resembles the content of USMLE Step 1, while the content of the Comprehensive Clinical Science Self-Assessment (CCSSA) resembles the content of USMLE Step 2 Clinical Knowledge (CK).

The NBME is pleased to announce that it now provides expanded feedback for one form of the CBSSA and one form of the CCSSA. In addition to the performance profile and score interpretation guide available with all forms, the expanded feedback also shows the number of items answered incorrectly by content category, the average amount of time spent on each incorrect item, and the percentage of incorrect items marked during the assessment. The feedback also provides the capability to review the text of the incorrect items. The fee for expanded feedback forms is $60.00; the fee for standard forms is $45.00.

For complete information, to view a sample assessment, or to purchase an assessment, visit the NBME Self-Assessment Services website.

On-line Posting or Discussion of USMLE Content Constitutes Irregular Behavior

If you post or discuss United States Medical Licensing Examination (USMLE) examination content via the Internet, you will be in violation of the USMLE Rules of Conduct, as outlined in the USMLE Bulletin of Information. Examination content includes, but may not be limited to, questions, case content, and answers.

The Bulletin specifically advises that, “you will maintain the confidentiality of the materials, including the multiple-choice items, and the case content for Step 2 CS and Primum CCS. You will not reproduce or attempt to reproduce examination materials through memorization or any other means. Also, you will not provide information relating to examination content that may give or attempt to give unfair advantage to individuals who may be taking the examination. This includes postings regarding examination content and/or answers on the Internet.”

The USMLE program continuously monitors Internet forums and chat rooms. Examinees who post information about examination content are identified and referred to the USMLE Committee on Irregular Behavior. If the Committee finds that you posted examination content, your scores may be delayed and you may be subject to the following sanctions:

• Permanent annotation of your USMLE transcript (such annotations will read “Irregular Behavior/Security Violation” and will be seen by any entity that receives your transcript, i.e., residency training programs, state licensing authorities, etc.);
• A report to the Federation of State Medical Boards Board Action Databank (a central repository for formal actions taken against physicians and available to licensing and disciplinary boards, the military, governmental and private agencies, and organizations involved in the employment and/or credentialing of physicians);
• A bar from taking future administrations of USMLE.

A determination of irregular behavior can put your medical career in jeopardy. Do not endanger your career: Do not post information from exams you have taken and do not solicit others to provide such information.

For more information, refer to Testing Regulations and Rules of Conduct and Irregular Behavior in the USMLE Bulletin of Information, available on the USMLE website.

2010 Information Booklet / Application Materials Are Available

The ECFMG 2010 Information Booklet and exam application materials are now available. To apply for examination, use ECFMG’s Interactive Web Application (IWA).

For Step 1/Step 2 CK, you can use the 2010 application to apply for:

• available Step 1/Step 2 CK eligibility periods ending in 2009 (September 2009 – November 2009 and October 2009 – December 2009) and
  
  
• all Step 1/Step 2 CK eligibility periods ending in 2010, beginning with the November 2009 – January 2010 eligibility period.

For Step 2 CS, you can use the 2010 application to obtain a 12-month eligibility period that begins on the date that the processing of your application is completed.

If you have begun but not yet completed the on-line part of a 2009 exam application, you will be able to complete the on-line part of that saved application using the 2010 application materials. Exam applications are saved in IWA for 14 days from the date you last saved the application.

Individuals who apply for examination are required to read the USMLE Bulletin of Information, in addition to the ECFMG Information Booklet. The USMLE 2010 Bulletin of Information is available on the USMLE website.

Graphical Feedback for All Step 2 CS Examinees

Starting with Step 2 CS results reported on August 19, 2009, both failing and passing examinees will receive graphical feedback.

View full announcement on the USMLE website.

Important Announcement from the USMLE Program

Alert Regarding Optima Test Prep

A USMLE test preparation company that operates under the name “Optima University” has been sued, along with its owner, Eihab Suliman, by the National Board of Medical Examiners and the Federation of State Medical Boards for using test preparation materials that were obtained illegally. An announcement about the lawsuit was posted previously to the USMLE website.

Individuals who attended Optima's programs or are considering doing so risk having their USMLE scores delayed and/or classified as indeterminate. They may also be subject to other consequences, including charges of irregular behavior, as a result of their participation. The USMLE will post further updates concerning this matter to the USMLE website.

Step 2 CK Examination Change in Number of Items/Delay in Score Reporting

Starting on or around August 10, 2009, a transition period will begin in which the number of items in current forms of the Step 2 Clinical Knowledge (CK) examination will change from 368 items to 352 items. Although the transition will occur quickly at many test centers, it will likely take approximately 6 weeks for the transition to be completed.

Because of these changes, as well as modifications to the test item pool, there will be a delay in score reporting for most Step 2 CK examinations administered in the second half of August and September. The target date for reporting Step 2 CK scores for most examinees testing from August 10 through late September will be Wednesday, October 7, 2009.

View full announcement on the USMLE website.

Reminder: All Applicants Must Document Transfer Credits When Applying for Examination

Applicants are reminded that they are required to disclose and document all transfer credits when they apply to ECFMG for examination, regardless of when the credits were earned. Failure to disclose and document these credits may have a number of negative consequences, including delaying exam registration and certification by ECFMG. Such delays may prevent you from starting a residency program. Additionally, failure to disclose and document these credits may result in a finding of irregular behavior. See Irregular Behavior in the ECFMG Information Booklet.

Transfer credits are credits earned for a course taken at one institution (such as a medical school) that are accepted by another medical school toward meeting its degree requirements. For example, a student attends a medical school for one year and earns credits for 12 courses. The student transfers to another medical school, which accepts the credits for those 12 courses toward meeting its degree requirements. The credits for those 12 courses are then referred to as transfer credits. The applicant must inform ECFMG of these transfer credits at the time of application.

Additionally, there are restrictions on transfer credits that can be used to meet ECFMG’s certification requirement that an applicant must have been awarded credit for at least four credit years (academic years for which credit has been given toward completion of the medical curriculum) by a medical school that is listed in the International Medical Education Directory (IMED). For the purpose of ECFMG Certification, credits earned on or after January 1, 2008 that are transferred to the medical school that awarded or will award an applicant’s medical degree must meet all of the following criteria:

• Credits must be transferred from one IMED-listed medical school to another IMED-listed medical school.
• Credits must be for courses taken at one medical school within seven years of the date of graduation at the medical school that accepts the transferred courses.
• Credits must be for courses that were passed at the medical school at which the course was taken.

Applicants whose transferred credits do not comply with the policy outlined above will not meet the requirements to be registered by ECFMG for examination or the requirements for ECFMG Certification. Applicants whose transferred credits do not meet all the criteria listed above may request an exception from the ECFMG Medical Education Credentials Committee.

See Credentials for Exam Registration in the ECFMG Information Booklet for instructions on how to submit transcripts to document transfer credits.

Biometric Identity Management System

Beginning on or about July 8, 2009, the USMLE program will begin using the Biometric Identity Management System (BIMS) in many test center locations as part of standard test day procedures for computer-based Step examinations. The BIMS is designed to improve the security and integrity of the testing process.

View full announcement on the USMLE website.

IMGs Participating in 2010 Match Should Register for Step 2 CS Now

International medical students/graduates and participants/graduates of Fifth Pathway programs who need to pass Step 2 Clinical Skills (CS) to participate in the 2010 Match (in March 2010) are reminded that they must take Step 2 CS by December 31, 2009. As indicated in the 2009 Schedule for Reporting Step 2 CS Results, if you do not take Step 2 CS by December 31, 2009, your result will not be available in time to participate in the 2010 Match.

At the time of this writing, the earliest available test date at any test center was in September 2009. Demand for the Step 2 CS examination is already heavy for test dates in the latter part of 2009. Additionally, test sessions at all test centers may be subject to scheduling restrictions that limit the number of test dates available to you.

All test sessions for the remainder of 2009 have been opened and no new test sessions will be added through the end of the year. To maximize your chances of obtaining a 2009 test date,

• Apply for Step 2 CS now, provided you meet the eligibility requirements.
• Once registered, schedule your testing appointment immediately.
• If you cannot obtain a testing appointment at your preferred test center, check for availability at other test centers.

Registering and scheduling now offer a number of benefits:

• Applicants registered for Step 2 CS can schedule immediately if a preferred testing appointment is available.
• Applicants who schedule a testing appointment can change the testing appointment without cost, provided they give more than 14 days’ notice. See Rescheduling in the ECFMG Information Booklet.

If you are planning to take Step 2 CS but are not planning to participate in the 2010 Match, please consider scheduling a Step 2 CS testing appointment that is after December 31, 2009. This will maximize the number of testing appointments available for those who must take Step 2 CS by December 31, 2009 to obtain their results in time to participate in the 2010 Match.

Updated information on Step 2 CS scheduling will be posted to the ECFMG website as it becomes available. Individuals planning to take Step 2 CS should monitor the ECFMG and USMLE websites for the latest information.

Preparing for the ERAS 2010 Application Season

Information on the Electronic Residency Application Service (ERAS) 2010 application season is now available. If you plan to apply for U.S. residency positions that begin in July 2010, visit the ECFMG ERAS Support Services website for important information. Most medical specialties participate in ERAS. If you apply to programs in participating specialties, you must apply to these programs using ERAS.

At ECFMG’s ERAS Support Services website, you will be able to:

• Obtain an ERAS Token, which will allow you to access the MyERAS website to work on your residency applications.
• Review policies and procedures that are new for ERAS 2010.
• Find instructions for submitting your supporting documents, such as letters of recommendation and transcripts, to ERAS Support Services for transmission to the ERAS PostOffice.
• Subscribe to ECFMG-ERAS News, a free e-mail newsletter that provides international medical students and graduates who use ERAS with important, updated information as it becomes available.

ERAS was developed by the Association of American Medical Colleges (AAMC) to allow medical school students and graduates to apply electronically for first- and second-year (PGY-1 and PGY-2) residency positions in U.S. programs of graduate medical education. ECFMG serves as the designated Dean’s office for all international medical students/graduates and participants/graduates of Fifth Pathway Programs who use ERAS. Detailed information on ERAS 2010 is also available on the AAMC website.

2009 and 2010 Schedules for Reporting Step 2 CS Results

Step 2 CS 2009 Reporting Schedule
Testing Period	Reporting Period
For examinees who test	Reporting start date	Reporting close date
Jan 1 through Feb 28	Apr 1	Apr 29
Mar 1 through Mar 28	Apr 29	May 27
Mar 29 through May 23	Jun 24	Jul 22
May 24 through Jul 18	Aug 19	Sep 16
Jul 19 through Sep 12	Oct 14	Nov 11
Sep 13 through Nov 7	Dec 9	Jan 6, 2010
Nov 8 through Dec 31	Feb 3, 2010	Feb 24, 2010

Step 2 CS 2010 Reporting Schedule
Testing Period	Reporting Period
For examinees who test	Reporting start date	Reporting close date
Jan 1 through Feb 27	Mar 31	Apr 28
Mar 1 through Mar 27	Apr 21	May 19
Mar 28 through May 15	Jun 16	Jul 14
May 16 through Jul 17*	Aug 18	Sep 15
Jul 18 through Sep 11	Oct 13	Nov 10
Sep 12 through Nov 6	Dec 8	Jan 5, 2011
Nov 7 through Dec 31	Feb 2, 2011	Feb 23, 2011
* There will be no Step 2 CS examinations delivered May 16 through 22.

The first results for a given testing period will be issued on the first day of the corresponding reporting period, and it is expected that results for the vast majority of examinees who take the exam during the testing period will be reported on this date. Over the past three years, results for 98%-99% of examinees who take the exam during the testing period were reported by the third reporting date. For a small percentage of examinees (1%-2%), it is important to note that scoring and quality assurance may not be completed in time for these examinees to be reported by the first three reporting dates; these will typically be examinees who took the exam in the latter part of the testing period. Results for these examinees will be reported each week throughout the reporting period, and should be reported no later than the last day of the score reporting period.

This schedule allows USMLE staff to enhance the quality assurance and data collection/scoring procedures performed prior to score reporting. Additionally, it provides examinees, as well as others who rely on Step 2 CS results, with guidelines regarding when a result will be reported for a given exam date. These guidelines allow examinees to plan their exam registration and scheduling in order to have their results in time to meet specific deadlines, such as those related to graduation or participation in the National Resident Matching Program (NRMP), or “the Match.”

Information about USMLE and Influenza

The World Health Organization (WHO) pandemic influenza alert is at phase 6. The Composite Committee and USMLE parent organizations continue to monitor the situation closely and are prepared to take appropriate measures as warranted to protect the health and safety of examinees and the public. As noted previously, USMLE examinees planning to test in the near future, who have concerns about their ability to test safely, may reschedule USMLE computer-based testing appointments or Clinical Skills appointments. In most instances, examinees should be able to use the standard procedures to make changes, without additional fees, by following procedures described in the USMLE Bulletin of Information.

While the pandemic influenza alert is at WHO phase 6, concerned examinees who would like to receive an eligibility period extension for an upcoming Step examination can do so, without additional fees, by contacting ECFMG by phone at (215) 386-5900 or by e-mail at info@ecfmg.org to explain the circumstances. This waiver of the eligibility period extension fee will be in effect while the WHO influenza alert remains at phase 6. Examinees should monitor the USMLE and ECFMG websites for any change to this fee waiver.

The USMLE program continues to monitor this situation closely for any significant changes that might result in a need to suspend the USMLE program until testing can be safely resumed. Please be sure to monitor the USMLE and ECFMG websites for updates to this announcement. Of course, if you personally are experiencing flu-like symptoms, or believe that you may have been recently exposed to an influenza patient, you should reschedule your examination.

Application Process Modified for Medical School Graduates

On or about May 20, 2009, ECFMG will modify the USMLE application process and the process for requesting Step 1/Step 2 CK eligibility period extensions for international medical graduates.

Once this change takes effect, ECFMG will not register an international medical graduate for USMLE, or extend his/her eligibility period, before receiving verification of the applicant’s status as a medical school graduate directly from his/her medical school. This status will be verified in one of three ways:

• ECFMG receives primary-source verification of the applicant’s medical education credentials; or
• The medical school verifies the applicant’s graduate status through the ECFMG Medical School Web Portal (EMSWP); or
• The medical school verifies the applicant’s graduate status through the applicant’s Certification of Identification Form (Form 186).

If your medical education credentials have been primary-source verified by ECFMG, your status as a graduate is considered verified and your medical school will not be required to reverify your graduate status in order for you to be registered for examination.

If your medical education credentials have not been primary-source verified by ECFMG, your status as a graduate must be verified before you will be registered for examination. The process by which your medical school will verify your graduate status varies depending on whether the medical school from which you graduated participates in EMSWP.

If the medical school from which you graduated participates in EMSWP, the medical school must verify your status as a graduate through EMSWP. Follow the instructions for applying for examination in Graduates of Medical Schools That Participate in EMSWP, below. ECFMG will make your record available to your medical school and request verification of your graduate status typically within three weeks of receipt of your 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. You will not be registered for examination until your medical school verifies your status.

If the medical school from which you graduated does not participate in EMSWP, the medical school must verify your status as a graduate through your Form 186. You will be required to complete a new Form 186, even if you previously had a valid Form 186 on file with ECFMG. Follow the instructions for applying for examination and submitting Form 186 in Graduates of Medical Schools That Do Not Participate in EMSWP, below. Once your new Form 186 is accepted by ECFMG, it will remain valid for five years. During this five-year period, you will be able to complete the exam application process entirely on-line.

You can check the status of your medical education credentials and the validity of your Form 186 via ECFMG’s OASIS. You will be able to determine if your medical school participates in EMSWP when you complete the on-line part of the exam application using ECFMG’s Interactive Web Application (IWA). At this time, IWA will produce the appropriate version of Form 186, which you will be able to print.

Graduates of Medical Schools That Participate in EMSWP
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, you must print a Certification of Identification Form (Form 186) after completing the on-line part of the application. Form 186 must be completed by you and certified by an authorized official of your medical school. Each medical school has been requested to provide ECFMG with a list of the officials authorized by the school to certify Form 186. Your Form 186 must be certified by an official on this list. Contact your medical school to determine the officials authorized by your medical school for this purpose; ECFMG will not provide this information to applicants. If you cannot have your Form 186 certified by an authorized official of your medical school, it can be certified by a Consular Official, Notary Public, First Class Magistrate, or Commissioner of Oaths. In either case, this certification must be current; the official must have signed the form within four months of its receipt by ECFMG.

If your Form 186 is certified by an official of your medical school, the original, signed Form 186 must be sent to ECFMG from the office of the medical school official who certifies the form. If there are additional documents required to complete your application, they must be sent to ECFMG with your Form 186; for detailed instructions, refer to Applying for Examination in the ECFMG Information Booklet. ECFMG must be able to determine that your Form 186 was sent directly from the office of this official. If ECFMG, in its judgment, determines that the form may not have been sent directly from the office of the medical school official who certified the form, the form will not be accepted.

Once accepted by ECFMG, Form 186 remains valid for on-line applications and requests to extend Step 1 and Step 2 CK eligibility periods received during the following five-year period. Applications and requests submitted during this period can be completed entirely on-line.

Your application will not be considered complete until the completed Form 186 (if you do not have a valid Form 186 on file with ECFMG) and any other required documents are received at ECFMG. To complete the processing of your application, your medical school must verify your status as a graduate of that medical school through EMSWP. ECFMG will make your record available to your medical school and request verification of your graduate status typically within three weeks of receipt of your 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. You will not be registered for examination until your medical school verifies your status.

Graduates of Medical Schools That Do Not Participate in EMSWP
If you are a graduate of a medical school that does not participate in EMSWP and your medical education credentials have not been primary-source verified by ECFMG, you must print a Certification of Identification Form (Form 186) after completing the on-line part of the application. Form 186 must be completed by you and certified by an authorized official of your medical school. Each medical school has been requested to provide ECFMG with a list of the officials authorized by the school to certify Form 186. Your Form 186 must be certified by an official on this list. Contact your medical school to determine the officials authorized by your medical school for this purpose; ECFMG will not provide this information to applicants. This certification must be current; the official must have signed the form within four months of its receipt by ECFMG.

If you cannot have your Form 186 certified by an authorized official of your medical school, it can be certified by a Consular Official, Notary Public, First Class Magistrate, or Commissioner of Oaths. An authorized official of your medical school, as defined above, must then complete the second part of the Form 186 to verify your status as a graduate of the medical school. Both the certification and the verification must be current; the officials must have signed the form within four months of its receipt by ECFMG.

The original, signed Form 186 must be sent to ECFMG from the office of the medical school official who certifies or verifies the form. This means that, if your Form 186 is certified by a Consular Official, Notary Public, First Class Magistrate, or Commissioner of Oaths, you must send your certified Form 186 to your medical school for verification and your medical school must then send your Form 186 to ECFMG. If there are additional documents required to complete your application, they must be sent to ECFMG with your Form 186; for detailed instructions, refer to Applying for Examination in the ECFMG Information Booklet. ECFMG must be able to determine that the form was sent directly from the office of the medical school official. If ECFMG, in its judgment, determines that the form may not have been sent directly from the office of the medical school official who certified or verified the form, the form will not be accepted.

Once accepted by ECFMG, Form 186 remains valid for on-line applications and requests to extend Step 1 and Step 2 CK eligibility periods received during the following five-year period. Applications and requests submitted during this period can be completed entirely on-line.

Your application will not be considered complete until the completed Form 186 (if you do not have a valid Form 186 on file with ECFMG) and any other required documents are received at ECFMG.

N. Emmanuel G. Cassimatis, M.D., Selected as ECFMG’s Next President and Chief Executive Officer

N. Emmanuel G. Cassimatis, M.D., has been selected as ECFMG's next President and Chief Executive Officer. In this role, Dr. Cassimatis will also serve as Chair of the Foundation for Advancement of International Medical Education and Research (FAIMER®), ECFMG’s nonprofit foundation. Dr. Cassimatis will assume his new position on July 1, 2009, succeeding James A. Hallock, M.D., who is retiring from the position he has held since February 2001.

Dr. Cassimatis has been with the Uniformed Services University of the Health Sciences (USU) in Bethesda, Maryland since 1995, currently serving as Vice President for Affiliations and International Affairs. He is also Associate Dean for Clinical Affairs and Professor of Psychiatry at the F. Edward Hébert School of Medicine of USU. Dr. Cassimatis has had a long and distinguished career in medicine with the U.S. Army. Prior to joining USU in 1995, Dr. Cassimatis held a number of positions with the U.S. Army’s Office of the Surgeon General and with U.S. Army hospitals in Germany and the United States, including Walter Reed Army Medical Center in Washington, D.C.

In recent years, Dr. Cassimatis served as Chair of the Accreditation Council for Graduate Medical Education and the American Medical Association’s Council on Medical Education. For more than a decade, he represented the Association of Military Surgeons of the United States in the AMA’s House of Delegates.

Dr. Cassimatis earned his medical degree from Harvard Medical School and is certified in Psychiatry by the American Board of Psychiatry and Neurology. He is a Distinguished Fellow of the American Psychiatric Association and has been the recipient of many other honors, including the Nancy C. A. Roeske Certificate of Recognition for Excellence in Medical Student Education from the American Psychiatric Association (2004), The Defense Superior Service Medal from the Department of Defense (2001), and the Year 2000 “Young at Heart” Award from the AMA Young Physicians’ Section, “in recognition of invaluable support and guidance to the Section and Young Physicians.”

Ian Krantz, M.D., Chair of the ECFMG Board of Trustees, says of Dr. Cassimatis’ appointment, “The selection of Dr. Cassimatis marks the culmination of a thoughtful search that began last year by ECFMG’s Board to identify a leader who will continue the traditions of excellence and innovation demonstrated by ECFMG and FAIMER. On behalf of the members of ECFMG’s Board, I would like to express our sense of excitement about the excellent outcome of the search process and the contributions that Dr. Cassimatis will make as ECFMG’s next President and Chief Executive Officer and the next Chair of FAIMER’s Board of Directors.”

Reminder: Time Limit for Completing Examination Requirements for ECFMG Certification

ECFMG would like to remind applicants that they are required to pass those United States Medical Licensing Examination (USMLE) Steps and Step Components required for ECFMG Certification within a seven-year period. This means that once an applicant passes a Step or Step Component, the applicant will have seven years to pass the other Step(s) or Step Component(s) required for ECFMG Certification. (For complete information on the examination requirements for ECFMG Certification, see Examination Requirements in the ECFMG Information Booklet.)

This seven-year period begins on the exam date for the first Step or Step Component passed and ends exactly seven years from this exam date. If an applicant does not pass all required Steps and Step Components within a maximum of seven years, the applicant’s earliest USMLE passing performance will no longer be valid for ECFMG Certification.

Example: An applicant took his first Step or Step Component on October 1, 2006 and passed. The applicant has through October 1, 2013 to take and pass all other Step(s) and Step Component(s) required for ECFMG Certification. If he does not take and pass all other required Step(s) and Step Component(s) on or before October 1, 2013, his passing performance on the October 1, 2006 exam would no longer be valid for ECFMG Certification.

This seven-year limit does not apply to the former ECFMG Clinical Skills Assessment (CSA) because the CSA was not a USMLE Step or Step Component. Applicants who satisfied the clinical skills requirement for ECFMG Certification by passing the CSA are required to pass only Step 1 and Step 2 Clinical Knowledge (CK) within a seven-year period for ECFMG Certification. For these applicants, the seven-year period begins on the exam date for the first USMLE Step or Step Component passed, regardless of when the CSA was passed.

On June 14, 2004, USMLE Step 2 Clinical Skills (CS) became a requirement for ECFMG Certification, replacing the ECFMG CSA as the exam that satisfies the clinical skills requirement. As part of the USMLE, Step 2 CS may be subject to the seven-year time limit for ECFMG Certification as described below:

• If an applicant’s earliest USMLE passing performance that is valid for ECFMG Certification took place on or after June 14, 2004, the applicant is required to pass Step 1, Step 2 CK, and, if required for ECFMG Certification, Step 2 CS within a seven-year period for ECFMG Certification.


• If an applicant’s earliest USMLE passing performance that is valid for ECFMG Certification took place before June 14, 2004, the applicant is required to pass only Step 1 and Step 2 CK within a seven-year period for ECFMG Certification; if required for ECFMG Certification, Step 2 CS can be passed outside the seven-year period.

The policies outlined above apply only to ECFMG Certification. The USMLE program recommends to U.S. state medical licensing authorities that they require applicants to pass the full USMLE sequence (including Step 3, which is not required for ECFMG Certification) within a seven-year period. See Time Limit and Number of Attempts Allowed to Complete All Steps and Retakes in the USMLE Bulletin of Information.

Many state medical licensing authorities accept the USMLE recommendation, but some do not. You should contact the Federation of State Medical Boards of the United States, Inc., (FSMB) for general information and the medical licensing authority of the jurisdiction where you plan to apply for licensure for definitive information, since licensure requirements vary among jurisdictions.

Additionally, applicants who retake a previously passed Step or Step Component to comply with a time limit should understand the implications for Step 3 eligibility of a failing attempt on a retake. See Official Performance of Record for Examinees Retaking a Previously Passed Step in the USMLE Bulletin of Information.

2009 Match Performance — Number of IMGs Matching Increases

For the seventh consecutive year, the number of first-year (PGY-1) residency positions offered through the Match increased. A total of 22,427 first-year positions were offered in the 2009 Match, held last month. This represents an increase of 187 positions compared to last year and an increase of 1,825 positions since 2002.

The number of IMGs, including Fifth Pathway participants, who matched to first-year positions increased by 98 compared to 2008. Of the 10,980 IMGs who participated in the 2009 Match, 4,796 (43.7%) matched. In the 2008 Match, 4,698 (45.2%) IMGs were matched to first-year positions.

There was an increase in the number of matches for U.S. citizen IMGs, IMGs who are citizens of other countries, and Fifth Pathway participants.

Of the 7,484 IMG participants who were not U.S. citizens, 3,112 (41.6%) obtained first-year positions. The number of non-U.S. citizen IMGs who obtained positions in 2009 increased by 4 compared to last year.

Of the 3,390 U.S. citizen IMG participants, 1,619 (47.8%) were matched to first-year positions, an increase of 78 over last year. This is the sixth consecutive year that there has been an increase in the number of U.S. citizen IMGs matching to first-year positions.

Of the 106 Fifth Pathway participants in the Match, 65 (61.3%) were matched to first-year positions, an increase of 16 over last year. This is the third consecutive year that there has been an increase in the number of Fifth Pathway participants matching to first-year positions.

It is important to note that the total number of IMGs, including Fifth Pathway participants, who will fill PGY-1 positions for the 2009-2010 academic year will be higher than the number obtaining positions through the 2009 Match. Although the majority of PGY-1 positions in the United States are filled through the Match, a significant number of IMG applicants obtain positions outside of the Match. For example, while 4,563 IMGs obtained PGY-1 positions through the 2007 Match, 7,225 IMGs entered PGY-1 for the 2007-2008 academic year.

The 7,225 IMGs entering PGY-1 for the 2007-2008 academic year is an increase of 306 over the prior year and an increase of 1,152 since the 2002-2003 academic year.

About the Match

The annual NRMP Match is the system by which applicants are matched with available residency positions in U.S. programs of graduate medical education (GME). Participants submit to the NRMP a list of residency programs, in order of preference. Ranked lists of preferred residency candidates are likewise submitted by U.S. GME programs with available positions. The matching of applicants to available positions is performed by computer algorithm. The Match results announced in March of each year are typically for GME programs beginning the following July.

Additional Resources on the Match and Match Results

The preceding data are taken from the Advance Data Tables for the 2009 Main Residency Match compiled by the NRMP. These tables provide detailed information on the positions offered and filled by the Match in 2009 and prior years. To access these tables, or to obtain further information on the NRMP, visit www.nrmp.org.

The June issue of Academic Medicine, the journal of the Association of American Medical Colleges, usually offers an analysis of Match results from the preceding March. For more information, visit your medical school's library or www.academicmedicine.org.

The September issue of JAMA: The Journal of the American Medical Association traditionally provides an in-depth analysis of graduate medical education in the United States. This analysis includes the number of IMGs entering and continuing in U.S. GME programs and a breakdown of IMG resident physicians by specialty and subspecialty. Visit your medical school's library or http://jama.ama-assn.org.

Migration of Step 1 Examination to New Software for Computer-Based USMLE in May 2009

A new version of the software used to deliver the computer-based USMLE Step examinations was introduced in mid-August 2008. The Step 1 Examination is scheduled to be migrated to the new version in May 2009.

The migration is expected to begin on or about May 15, 2009 at a small number of test centers, and will then be phased in at remaining test centers over a period of several weeks. If you plan to take the Step 1 examination in May 2009 or later, you should familiarize yourself with both the current test delivery software (FREDv1) and the new (FREDv2) version.

Orientation and practice materials using both the current and new versions of the software are available for downloading:

www.usmle.org/Orientation/2009/menu.html

If you obtained the 2009 orientation and practice materials in CD format from your registration entity, please note that the CD includes Step 1 practice materials using both the current and new versions of the software.

The change to the test delivery software will be accounted for in scoring the examination results, so that scores will be comparable to those of exams using the older software. Because of this change, as well as routine modifications to the test item pool, it will be necessary to delay the reporting of scores for some examinees. The normal turnaround time for reporting scores to Step 1 examinees is 3 to 4 weeks. However, during this transition, turnaround time for some examinees may be as long as 6 to 8 weeks.

The target date for reporting Step 1 scores for most examinees testing from mid-May through late June will be Wednesday, July 15, 2009.

Important Reminder to Check Headphones and Sound Levels During Computer-based Examination Tutorials

USMLE strongly encourages examinees taking computer-based examinations to check headphones and sound levels during the headphone section of the tutorial.

View full announcement on the USMLE website.

IMGs Participating in 2010 Match Should Take Step 2 CS by August 2009

International medical students/graduates and participants/graduates of Fifth Pathway programs who need to pass Step 2 Clinical Skills (CS) to participate in the 2010 Match (in March 2010) are strongly encouraged to take Step 2 CS by August 2009.

Traditionally, there has been high demand for testing appointments in the period from September through December. For 2009, demand for testing appointments in the period from September through December is expected to be even higher than in past years.

At the time of this writing, the earliest available test date at any test center was in March 2009. Additionally, test sessions at all test centers may be subject to scheduling restrictions that may limit the number of test dates available to you.

To maximize your chances of obtaining a 2009 test date,

• Apply for Step 2 CS now, provided you meet the eligibility requirements.
• Once registered, schedule your testing appointment as soon as possible for a date before September 2009. Scheduling conditions are expected to be most favorable from May through July.

If you do not register early and schedule as soon as possible for a test date before September 2009, it is possible that you will not be able to obtain a test date in 2009. As published in the 2009 Step 2 Clinical Skills Schedule for Reporting Results, if you do not take Step 2 CS by December 31, 2009, your result will not be available in time to participate in the 2010 Match.

Early registration and scheduling may offer a number of benefits. If you plan to apply for Step 2 CS, you should consider the following:

• All Step 2 CS sessions are opened 12 months in advance.
• Applicants registered for Step 2 CS can schedule and take the exam during the 12-month eligibility period that follows their registration. By registering early, applicants increase the likelihood they will be able to obtain a testing appointment for a preferred date/test center.
• Applicants who schedule a testing appointment can change the testing appointment without cost, provided they give more than 14 days’ notice. See Rescheduling in the ECFMG Information Booklet.
• Applicants who take Step 2 CS early in the year and receive a failing result are more likely to have the opportunity to retake the exam in 2009 and receive their result in time to participate in the 2010 Match.

Updated information on Step 2 CS scheduling will be posted to the ECFMG website as it becomes available. Individuals planning to take Step 2 CS should monitor the ECFMG and USMLE websites for the latest information.

An Announcement Regarding Fraudulent Letters of Recommendation

Applicants are reminded that the submission of fraudulent letters of recommendation to ECFMG constitutes irregular behavior, as defined by ECFMG.

View full announcement.

NBME® Self-Assessments for Individuals Planning to Take Step 1, Step 2 CK, and Step 3

The National Board of Medical Examiners® (NBME®) offers web-based self-assessments to help medical students and graduates evaluate their readiness for the computer-based components of the United States Medical Licensing Examination® (USMLE®). Self-assessments are currently available for USMLE Step 1, Step 2 CK, and Step 3.

• The Comprehensive Basic Science Self-Assessment (CBSSA), which is built to the same content specifications as Step 1, covers material in basic science medical education courses. There are six unique CBSSA forms available, each featuring 200 multiple-choice questions divided into four sections.
• The Comprehensive Clinical Science Self-Assessment (CCSSA), which is built to the same content specifications as Step 2 CK, covers material in core clinical clerkships. There are four unique CCSSA forms available, each featuring 184 multiple-choice questions divided into four sections.
• The Comprehensive Clinical Medicine Self-Assessment (CCMSA), which is built to the same content specifications as the multiple-choice component of Step 3, features content that reflects patient-centered clinical encounters. There is one CCMSA form available, with 180 multiple-choice questions divided into five sections.

All questions have appeared previously in the USMLE, and no questions are duplicated across forms. Users can choose to take the self-assessments under two timing conditions: standard USMLE pacing or self-pacing. The assessments are available for $45.00 (USD) per form.

Users receive immediate performance feedback in the form of a performance profile showing content areas of strength and weakness. For the CBSSA (Step 1) and CCSSA (Step 2 CK), feedback also includes a table that “translates” the self-assessment score to an approximate score on the USMLE scale; this feature is not yet available for the CCMSA (Step 3).

For complete information, to view a sample assessment, or to purchase an assessment, visit the NBME Self-Assessment Services website.

USMLE Statement on the Fifth Pathway Program and Step 3 Eligibility

Currently, for international medical graduates who wish to take USMLE Step 3, the USMLE program accepts either a valid Standard ECFMG Certificate or a valid Fifth Pathway certificate for purposes of meeting Step 3 eligibility requirements. In November 2007, the American Medical Association (AMA) determined that it would withdraw its support of the Fifth Pathway program. Per the AMA, the last Fifth Pathway program class to be supported will be the January 2009 entering class, which will be supported until its completion in December 2009.

The USMLE Composite Committee and the USMLE parent organizations (the Federation of State Medical Boards and the National Board of Medical Examiners) have determined that the USMLE program will cease acceptance of Fifth Pathway certificates issued after December 31, 2009 for the purpose of meeting Step 3 eligibility requirements. For valid Fifth Pathway certificates issued through December 31, 2009, the USMLE program has not yet determined whether they will be accepted indefinitely for purposes of meeting Step 3 eligibility criteria or whether a cut-off date will be imposed. The USMLE program will work closely with the Accreditation Council for Graduate Medical Education (ACGME) and the AMA in an effort to ensure that policies relating to Fifth Pathway certificates issued through December 31, 2009 are consistent among these organizations.

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.

Information and updates about the Fifth Pathway program and USMLE will be posted to the USMLE and ECFMG websites.

AAMC Service for Applicants Seeking Residency Positions

Offered by the Association of American Medical Colleges (AAMC), FindAResident® is a web-based search tool for finding open residency and fellowship positions in a variety of accredited specialties.

Open year-round, FindAResident is an effective resource for residency candidates who:

• experienced an unsuccessful match through the National Resident Matching Program (NRMP) or post-Match Scramble,
• are looking for off-cycle positions or specialties not featured in ERAS, or
• want to change specialties, locations, or residency or fellowship programs.

By registering with this online service, candidates can post their resume, test scores, photo, curriculum vitae, and other pertinent information for programs to view. Users can also search a database of open training positions by post-graduate year level, specialty, and geographic preference. Programs are able to directly update vacancy information at any time, so the unfilled position information remains accurate and current.

FindAResident complements both the Electronic Residency Application Service (ERAS®) and the National Resident Matching Program (NRMP); it does not replace these services. FindAResident offers additional benefits to applicants participating in ERAS. ERAS participants can import information from their certified ERAS Common Application Form (CAF) directly into FindAResident.

Use of this service requires registration and a subscription fee; active ERAS users receive a discount on that fee. Subscriptions begin on the date of purchase and conclude at the end of the FindAResident season (September 14). For more information or to subscribe, visit FindAResident on the Web.

Important Information for Step 2 CS Registrants Attempting to Schedule or Reschedule a Testing Appointment

It has come to our attention that some Step 2 CS registrants have offered to exchange their scheduled testing appointments for those of other registrants who must take Step 2 CS by specific deadlines. The exchange of testing appointments between applicants is not consistent with the “first-come, first-served” basis on which Step 2 CS testing appointments are offered. It is also highly unlikely to be successful. If you are registered for Step 2 CS, you should know that:

• The Step 2 CS Calendar and Scheduling system does not allow an applicant to reserve his/her scheduled testing appointment for another applicant, nor does it allow the transfer of a testing appointment from one applicant to another. When an applicant cancels a scheduled appointment, the appointment returns to the pool of available testing appointments where it can be claimed by other registrants.
  
  
• At any given time, there are many applicants registered for Step 2 CS who may be attempting to schedule or reschedule testing appointments. It is common for appointments that become available to be claimed immediately by another applicant.
  
  
• The Step 2 CS Scheduling Email Notification System allows registered applicants to indicate their preferences for test dates and centers. When a testing appointment is canceled, all applicants participating in the email notification system who have expressed a preference for this date/center are notified immediately by email.

The best way for registered applicants to monitor the availability of testing appointments is to indicate their preferences for dates/centers using the pilot Step 2 CS Scheduling Email Notification System. To indicate your preferences, access Step 2 CS Calendar and Scheduling, and follow the link “Add/Edit Scheduling Email Notifications.”

For detailed information on policies and procedures related to Step 2 CS scheduling and rescheduling, refer to the ECFMG Information Booklet and USMLE Bulletin of Information.

Step 2 CS Rescheduling Policy Allows Early Scheduling, Flexibility in Changing Testing Appointments

There are no Step 2 CS rescheduling fees for applicants who cancel scheduled testing appointments more than 14 days before the scheduled test date. Rescheduling fees do apply to applicants who cancel within 14 days of their scheduled test date and those who miss their scheduled test date without canceling.

This policy allows applicants registered for Step 2 CS to schedule their testing appointments early, while retaining the flexibility to reschedule at no cost, with a minimal period of notice. Applicants are strongly encouraged to register early and schedule testing appointments for the earliest possible date. If you have registered or plan to register for Step 2 CS, you should be familiar with the requirements and fees associated with rescheduling a Step 2 CS testing appointment.

• If you cancel more than fourteen calendar days before (but not including) your scheduled test date, there is no fee to reschedule.
• If you cancel during the fourteen-day period before (but not including) your scheduled test date, your fee will be $150 when you reschedule.
• If you miss your scheduled testing appointment without canceling, your fee will be $400 when you reschedule.

Registered applicants can check which test dates are available to them at any time by accessing Step 2 CS Calendar and Scheduling. For complete information on Step 2 CS rescheduling policies, refer to Rescheduling in the ECFMG Information Booklet.

Step 2 CS Scheduling Restrictions

Demand for the Step 2 CS examination is expected to be heavy at all clinical skills evaluation centers at certain times throughout the year. The CS scheduling system is designed to handle the expected high volume, while maximizing the likelihood that most examinees can meet requirements and deadlines. This system also provides a representative mix of examinees at most testing sessions, which is helpful in maintaining a high quality assessment system both within and across test centers.

Spaces within test sessions may be allocated based on a variety of factors, including time of year, location of the test center and whether the examinee's institution of undergraduate medical education is located within the US or Canada, or is an international medical school. These controls on spaces for each test session will remain in place until 60 days before the test date, at which time all testing spaces that have not been filled will be available to all registered applicants on a first come, first served basis. Scheduling patterns and demand will be monitored, and allotment of spaces may be changed as needed.

Applicants rescheduling into newly-available testing spaces will not be charged a rescheduling fee, provided they cancel existing testing appointments with more than 14 days' notice. However, applicants who cancel with notice of 14 or fewer days will be charged a rescheduling fee of $150.

Scheduling Guidelines for Applicants

If you plan to take Step 2 CS, you should consider the following:

• Applicants for Step 2 CS are encouraged to register and schedule their testing appointments as soon as possible.
• Registered applicants are encouraged to schedule a testing appointment, even if they are uncertain that they will be able keep the testing appointment. You will be able to cancel an existing appointment without incurring a rescheduling fee, provided that you give more than 14 days' notice.
• Registered applicants can check which test dates are available to them at any time by accessing Step 2 CS Calendar and Scheduling from the website of their registration entity.

Important Information on Your Clinical Skills Examination History and Eligibility for USMLE Step 3

The USMLE Bulletin of Information outlines policies regarding an applicant’s clinical skills examination history and eligibility for Step 3. Important information for international medical graduates on this topic has been posted to this website. If you are an applicant for ECFMG Certification, it is important that you review and understand this information, since it explains:

• how USMLE policies affect your eligibility for Step 3, based on your clinical skills examination history, and
• how taking or retaking Step 2 Clinical Skills (Step 2 CS) may affect your Step 3 eligibility.

View full announcement.

Important Announcement for State Licensing Boards Concerning CSA® Performance History for International Medical Students or Graduates

For international medical students and graduates (IMGs) who have taken the ECFMG Clinical Skills Assessment (CSA), the USMLE transcript now includes a note indicating that the individual has prior CSA history. This note, which is included in transcripts effective July 1, 2004, appears as follows:

NOTE: The Educational Commission for Foreign Medical Graduates (ECFMG) records include prior history for the ECFMG Clinical Skills Assessment (CSA) for this examinee. Details cannot be released by the ECFMG without written authorization from the examinee.

An IMG's CSA performance history may be obtained by requesting an "Official ECFMG CSA History Chart". The Chart provides the individual's complete CSA history, including the date and performance results for each CSA taken.

IMGs applying to State Licensing Boards should be advised to request the Chart from ECFMG. To receive an Official ECFMG CSA History Chart or to have it sent to a State Licensing Board, IMGs should complete a Request for an Official ECFMG® CSA® History Chart (Form 297) and submit it to ECFMG.

If you have any questions about how to obtain the CSA History Chart, contact ECFMG by e-mail at info@ecfmg.org.

Important Changes to Standard ECFMG Certificate

Graduates of medical schools outside the United States and Canada, international medical graduates (IMGs), must have a valid Standard ECFMG Certificate as one of the prerequisites to enter U.S. programs of graduate medical education (GME) that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). On June 14, 2004, policy changes affecting the validity of the Standard ECFMG Certificate for entry into GME will take effect. This announcement contains important information on these changes to ECFMG's policy for revalidating and permanently validating the Standard ECFMG Certificate for entry into GME.

View the full announcement.

Important Announcement for State Licensing Boards Concerning Changes to Standard ECFMG Certificate

By Stephen S. Seeling, J.D.
Vice President of Operations
Educational Commission for Foreign Medical Graduates

Graduates of medical schools outside the United States and Canada, international medical graduates (IMGs), must have a valid Standard ECFMG Certificate as one of the prerequisites to enter graduate medical education (GME). Medical licensing boards in the United States require ECFMG Certification, among other requirements, to obtain a license to practice medicine.

On June 14, 2004, policy changes affecting the validity of the Standard ECFMG Certificate for entry into GME will take effect. This announcement contains important information on these upcoming changes to ECFMG's revalidation and permanent validation policies.

Current Policy Through June 13, 2004
Currently, two of the exam dates on the Standard ECFMG Certificate are subject to expiration for the purpose of entering GME.

• The English test date is valid for 2 years from the most recent date of passing performance. This means that an IMG must enter an ACGME-accredited program on or before the expiration date of the English test. If the IMG does not enter an ACGME-accredited program before the expiration date of the English test, the IMG must revalidate the expired date by retaking and passing the English test, so that the ECFMG Certificate is valid on the program start date. The Test of English as a Foreign Language™ (TOEFL®) is the exam currently administered that satisfies the English test and English test date revalidation requirements.
• The ECFMG Clinical Skills Assessment (CSA) date is valid for 3 years from the most recent date of passing performance. This means that an IMG must enter an ACGME-accredited program on or before the expiration date of the CSA. If the IMG does not enter an ACGME-accredited program before the expiration date of the CSA, the IMG must revalidate the expired date by retaking the CSA, so that the ECFMG Certificate is valid on the program start date.

IMGs who enter an ACGME-accredited program (on or before the expiration dates of the English test and CSA) may request permanent validation. This means that the English test and CSA dates are no longer subject to expiration. To request permanent validation, the IMG and program director must complete the Request for Permanent Validation of Standard ECFMG Certificate (Form 246) and submit it to ECFMG. After ECFMG receives and verifies the information on the Form 246, ECFMG sends a sticker, indicating valid indefinitely status, to eligible IMGs.

New Policy Effective June 14, 2004
Two changes to ECFMG policy concerning revalidation and permanent validation will take effect on June 14, 2004. The two changes are:

• IMGs who have passed an English test will not be required to revalidate expired English test dates in order to enter GME; all passing performances on the English test will be valid for the purpose of entry into GME, regardless of the length of time that has passed since the test date.
• IMGs who have passed the ECFMG CSA during the 3-year period before the implementation of USMLE Step 2 Clinical Skills (Step 2 CS) on June 14, 2004 will not be required to revalidate expired CSA dates before entering GME. These individuals may enter GME regardless of the length of time that has passed between their passing performance on the CSA and their program start date.

This means that the English test "valid through" date on the Standard ECFMG Certificate can be disregarded for IMGs who are entering GME on or after June 14, 2004, the effective date of the changes. Additionally, the CSA "valid through" date can be disregarded for IMGs who passed the CSA on or after June 14, 2001.

After the effective date of these changes on June 14, 2004, ECFMG will provide eligible IMGs with a sticker, to be affixed to their Standard ECFMG Certificate, to indicate that their English test date (and CSA date, if applicable) is no longer subject to expiration. Please note that not all eligible applicants who are beginning programs in July 2004 may receive these stickers prior to the start date of their programs.

IMGs Whose CSA Pass Date is Prior to June 14, 2001
IMGs who passed the CSA prior to June 14, 2001, and enter an ACGME-accredited program on or before the CSA "valid through" date on their Standard ECFMG Certificates, may request permanent validation. After entering the program, the IMG and program director must complete the Request for Permanent Validation of Standard ECFMG Certificate (Form 246) and submit it to ECFMG. After ECFMG receives and verifies the information on the Form 246, ECFMG will send a sticker, indicating valid indefinitely status, to eligible IMGs.

IMGs who passed the CSA prior to June 14, 2001 and do not enter an ACGME-accredited program on or before the CSA "valid through" date on their Standard ECFMG Certificates must pass USMLE Step 2 CS to revalidate their Certificates. Passing performance on Step 2 CS does not expire for the purpose of entry into GME.

State Medical Licensing Boards are encouraged to verify an applicant's ECFMG certification status through the ECFMG Certification Verification Service (CVS). You can request verification using CVS ON-LINE.

If you have any questions, please contact me. My email address is sseeling@ecfmg.org and my telephone number is (215) 823-2107.

Important Announcement for Program Directors Concerning Changes to Standard ECFMG Certificate

By Gerald P. Whelan, M.D.
Vice President of Assessment Services
Educational Commission for Foreign Medical Graduates

Graduates of medical schools outside the United States and Canada, international medical graduates (IMGs), must have a valid Standard ECFMG Certificate as one of the prerequisites to enter graduate medical education (GME). On June 14, 2004, policy changes affecting the validity of the Standard ECFMG Certificate for entry into GME will take effect. This announcement contains important information for program directors on these upcoming changes to ECFMG's revalidation and permanent validation policies.

Current Policy Through June 13, 2004
Currently, two of the exam dates on the Standard ECFMG Certificate are subject to expiration for the purpose of entering GME.

• The English test date is valid for 2 years from the most recent date of passing performance. This means that an IMG must enter an ACGME-accredited program on or before the expiration date of the English test. If the IMG does not enter an ACGME-accredited program before the expiration date of the English test, the IMG must revalidate the expired date by retaking and passing the English test, so that the ECFMG Certificate is valid on the program start date. The Test of English as a Foreign Language (TOEFL) is the exam currently administered that satisfies the English test and English test date revalidation requirements.
• The ECFMG Clinical Skills Assessment (CSA) date is valid for 3 years from the most recent date of passing performance. This means that an IMG must enter an ACGME-accredited program on or before the expiration date of the CSA. If the IMG does not enter an ACGME-accredited program before the expiration date of the CSA, the IMG must revalidate the expired date by retaking the CSA, so that the ECFMG Certificate is valid on the program start date.

IMGs who enter an ACGME-accredited program (on or before the expiration dates of the English test and CSA) may request permanent validation. This means that the English test and CSA dates are no longer subject to expiration. To request permanent validation, the IMG and program director must complete the Request for Permanent Validation of Standard ECFMG Certificate (Form 246) and submit it to ECFMG. After ECFMG receives and verifies the information on the Form 246, ECFMG sends a sticker, indicating valid indefinitely status, to eligible IMGs.

New Policy Effective June 14, 2004
Two changes to ECFMG policy concerning revalidation and permanent validation will take effect on June 14, 2004. The two changes are:

• IMGs who have passed an English test will not be required to revalidate expired English test dates in order to enter GME in the United States; all passing performances on the English test will be valid for the purpose of entry into GME, regardless of the length of time that has passed since the test date.
• IMGs who have passed the ECFMG CSA during the 3-year period before the implementation of USMLE Step 2 Clinical Skills (Step 2 CS) on June 14, 2004 will not be required to revalidate expired CSA dates before entering GME. These individuals may enter GME regardless of the length of time that has passed between their passing performance on the CSA and their program start date.

This means that you can disregard the English test "valid through" date on the Standard ECFMG Certificate for IMGs who are entering your program on or after June 14, 2004, the effective date of the changes. Additionally, you can disregard the CSA "valid through" date for IMGs who passed the CSA on or after June 14, 2001.

After the effective date of these changes on June 14, 2004, ECFMG will provide eligible IMGs with a sticker, to be affixed to their Standard ECFMG Certificate, to indicate that their English test date (and CSA date, if applicable) is no longer subject to expiration. Please note that not all eligible applicants who are beginning programs in July 2004 may receive these stickers prior to the start date of their programs.

IMGs Whose CSA Pass Date is Prior to June 14, 2001
IMGs who passed the CSA prior to June 14, 2001, and enter an ACGME-accredited program on or before the CSA "valid through" date on their Standard ECFMG Certificates, may request permanent validation. After entering the program, the IMG and program director must complete the "Request for Permanent Validation of Standard ECFMG Certificate" (Form 246) and submit it to ECFMG. After ECFMG receives and verifies the information on the Form 246, ECFMG will send a sticker, indicating valid indefinitely status, to eligible IMGs.

IMGs who passed the CSA prior to June 14, 2001 and do not enter an ACGME-accredited program on or before the CSA "valid through" date on their Standard ECFMG Certificates must pass USMLE Step 2 CS to revalidate their Certificates. Passing performance on Step 2 CS does not expire for the purpose of entry into GME.

Graduate medical education programs are encouraged to verify an applicant's ECFMG certification status through the ECFMG Certification Verification Service (CVS). This service is free for directors of ACGME-accredited graduate medical education programs. You can request verification using CVS ON-LINE.

[last update: November 20, 2009]

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