Issue Two - June 8, 2001
Interview with ECFMG's New President and Chief Executive Officer, James A. Hallock, M.D.
On February 1, 2001 ECFMG welcomed James A. Hallock, M.D., as its new President and Chief Executive Officer. Dr. Hallock came to ECFMG from East Carolina University Brody School of Medicine in Greenville, North Carolina, where he had served as Dean since 1988 and as Vice Chancellor for Health Sciences since 1990. He obtained his medical degree from Georgetown University in Washington, D.C. and completed his medical training in Pediatrics at Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania in Philadelphia, Pennsylvania. Dr. Hallock is a Fellow of the Academy of Pediatrics.
Dr. Hallock has held numerous academic and administrative positions in medicine. His responsibilities during the past decade have included a variety of administrative roles with the National Board of Medical Examiners (NBME), a co-sponsor of the United States Medical Licensing Examination (USMLE), and the Association of American Medical Colleges. He has also served with the Liaison Committee on Medical Education, the body that accredits medical schools in the United States and Canada. In addition to his responsibilities at ECFMG, Dr. Hallock currently serves as a Member at Large of the NBME and as a member of the USMLE Composite Committee, which governs the USMLE.
Dr. Hallock spoke about ECFMG and its activities for this issue of The ECFMG Reporter.
Question 1:
Dr. Hallock, could you comment on the role that ECFMG plays in graduate medical education today?
ECFMG's primary role is to evaluate the qualifications of international medical graduates (IMGs) pursuing graduate medical education in the United States. This is the organization's key mission and the reason for its establishment more than forty years ago. This role is essential to the U.S. graduate medical education system and to the IMGs that receive medical training within this system.In fulfilling this role, ECFMG interacts with tens of thousands of IMGs each year. These IMGs are our clients, and providing outstanding service to them is critical. Part of this commitment is ensuring broad and easy access to information and services that IMGs need when pursuing ECFMG certification and graduate medical education in the U.S. Beyond this, we are also committed to delivering these services promptly, accurately and in the most responsive way possible. I think it's vital for IMGs to know that we take this commitment to service seriously and that it guides the daily functioning of this organization.
Question 2:
Although ECFMG's core mission is the certification program, the organization is involved in other activities related to medical education. Could you comment on these activities?
There are wonderful opportunities now for ECFMG to become more involved in international medical education and research, and we are very fortunate to have the ability to pursue these opportunities while simultaneously maintaining and improving ECFMG's core mission of certification.Some of ECFMG's programs for the international medical community, such as our fellowship programs for medical school faculty, have existed for many years, while others have a more recent history. To support such programs, ECFMG recently formed a separate foundation, the Foundation for Advancement of International Medical Education and Research (FAIMER). FAIMER will unify these programs and support research that examines medical education issues within the context of healthcare outcomes and planning. The ECFMG Board of Trustees meeting in July 2001 will be dedicated to planning and setting priorities for the newly-formed foundation.
Question 3:
What is your impression of how IMGs perform when pursuing graduate medical education in the U.S.?
After being in this position for several months, I am very impressed with the performance of IMGs. As is evident in the following "Update on IMG Performance," IMGs are performing well on the exams required for ECFMG certification. In 2000, the pass rate for IMGs taking Step 1 for the first time was 65.3%, while 73.2% of first time Step 2 takers passed the exam. Currently, approximately 80% of examinees taking the Clinical Skills Assessment meet the passing standard. Additionally, the percentage of IMGs who succeed in obtaining residency positions through the National Resident Matching Program continues to increase. In short, qualified IMGs are performing well on the required exams and are meeting with increasing success in the residency position matching process.
Update on IMG Performance: USMLE, CSA and NRMP
International Medical Graduates (IMGs) seeking ECFMG certification and entry into ACGME-accredited training programs fared well over the last year.
Although the number of registrants for the USMLE Step examinations has been considerably lower during the last two years compared to preceding years, IMGs taking the examinations have consistently posted higher pass rates. For the year 2000, in which all Step administrations were computer-based, 65.3% of all IMGs taking Step 1 for the first time passed this exam. IMGs who were not U.S. citizens passed at a rate of 66.5%, performing slightly better than their U.S.-citizen counterparts, who posted a 60.6% pass rate. Compared to IMG pass rates on the paper and pencil Step 1 exams administered in 1997, the pass rate for U.S.-citizen IMGs increased by 3.5 percentage points, while the pass rate for non-U.S. citizen IMGs increased by 9 percentage points.
Improved performance was also noted for IMGs taking USMLE Step 2 for the first time. The pass rate for first-taker IMGs was 73.2% on this exam. U.S.-citizen IMGs slightly outperformed examinees who were citizens of other countries, 72.8% to 73.3%. These pass rates represent a greater improvement in IMG scores than those described for Step 1 above, compared to 1997, with the pass rates for both groups being 15 to 20 percentage points higher.
The number of candidates presenting for the Clinical Skills Assessment (CSA) exceeded 6,000 again last year. For 2000, the overall CSA pass rate for all IMGs was 80.4%. U.S.-citizen IMGs passed at a rate of 87.1%, while 78.7% of IMGs who were not U.S. citizens received passing decisions.
Although not all graduate medical education positions are offered through the National Resident Matching Program ("the Match"), a large number, in excess of 20,000, have been offered annually for the past several years. As with USMLE Step registrations, there was a decrease in the number of IMGs participating in the Match this year, with the decrease being more marked for non U.S.-citizen IMGs than for U.S.-citizen IMGs. However, as with the Step examinations, the percentage of IMGs meeting with success has increased. 52.4% of U.S.-citizen IMGs who submitted final rank order lists (ROLs) to the Match were offered PGY-1 positions as were 44.8% of non U.S.-citizen IMGs. These figures represent the highest match rates for both groups in the last five years.
Notice to USMLE™ Step 1/Step 2 Applicants
Approximately 30 percent of all USMLE applications received by ECFMG are rejected and returned to applicants because they are missing essential information or payment.
When completing your application, you should follow the instructions that accompany the application form. Before sending your USMLE application to ECFMG, you should check that you have enclosed full payment for all required fees and that you have answered all questions accurately and completely.
The most common mistakes encountered on USMLE applications are listed below. Before sending your exam application to ECFMG, you should review each of these items carefully.
1. Failure to Select a Testing Region.
You must select a testing region in
item 11 for each exam for which you are applying. All applicants must select
a testing region, including applicants who plan to test in the United
States/Canada. If you select a testing region other than the United
States/Canada, you must also enter in item 12.2 the amount of the
International Test Delivery Surcharge for the region you selected. If you do
not select a testing region for each exam, ECFMG cannot register you for the
exam(s) you requested, and your application will be returned to you. Refer
to the application instructions for item 11.
2. Failure to Enclose Copies of Medical Diploma (Medical School Graduates
only).
If you have already graduated from medical school, ECFMG must have a
copy of your medical diploma at the time that your application is processed.
If you have not already sent a copy of your medical diploma to ECFMG, you
must send a copy with the application. You must indicate in item 15.3
whether: (a) you have already sent these documents to ECFMG, or (b) are
sending them with your exam application. If you are a medical school
graduate and ECFMG does not have a copy of your medical diploma when your
application is processed, you will not be registered, and your application
will be returned to you. Refer to the application instructions for item
15.3.
3. Failure to Include Full Payment.
You must include full payment of all
fees with your application. The examination fee for USMLE eligibility
periods ending in 2001 is US$615. For applicants testing outside of the
United States/Canada, there is an additional International Test Delivery
Surcharge. If you owe money to ECFMG for previous exams or services, you
must also include payment for this amount. If you do not include full
payment of these amounts, you will not be registered, and your application
will be returned to you. Refer to the application instructions for items 12
and 13.
If you have questions about completing the USMLE application that are not answered in the ECFMG Information Booklet or application instructions,you can contact ECFMG's Applicant Information Services for assistance by calling (215) 386-5900.