ECFMG Certification for Foreign Medical School Graduates

ECFMG Certification is the key to securing a residency or fellowship in the United States if you are a graduate of one of the foreign medical schools

The Educational Commission for Foreign Medical Graduates (ECFMG) wants to ensure graduates of international medical schools have a solid foundation in medicine in-order to enter U.S. residency or fellowship programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME).

If you graduated from a medical school outside of the United States or Canada and want to complete your graduate medical education in the U.S. you will need ECFMG Certification.

By becoming certified you will be able to obtain an unrestricted license to practice medicine.

Requirements for Certification

To receive your ECFMG Certification as an international medical school graduate you will need to meet certain examination and medical education requirements outlined below.

The examination requirements for certification include:

  1. Pass USMLE Step 1
  2. Pass USMLE Step 2

Step 2 has two components which must be passed:

  1. Clinical Knowledge (CK)
  2. Clinical Skills (CS)

Medical Education Credentials

Medical education credential requirements must include at least four academic years of credit given for completing your medical school curriculum at a medical school that is listed in the International Medical Education Directory (IMED)

Please note you cannot submit you educational credentials until you apply for the exam. If they are submitted in advanced they will not be processed.

  • If you are a medical school graduate: when you submit your first exam application, your medical education credentials must be submitted with this initial exam application.
  • If you are a medical student: when you submit your first exam application, send your medical education credentials as soon as you graduate and receive them.

You are allowed to have transfer credit to meet this requirement but you must have your medical school and graduation year listed in the IMED. It will be your responsibility to document that you have met all the requirements, and have actually received your final medical diploma.

The Educational Commission for Foreign Medical Graduates will request that your international medical school provide your final medical school transcript because your medical school diploma must be verified with the appropriate officials of your medical school that issued your diploma.

You will be required to submit two photocopies of your final medical diploma in the original language, containing the issue date and all appropriate signatures. If your diploma is not in English it must be accompanied by an official English translation.

Receiving Your Certificate

If you meet all of the examination and medical educational credential requirements you will be issued Standard ECFMG Certificate but only after all outstanding balances have been paid.

Your certificate will include:

  • Your name
  • Your USMLE/ECFMG Identification Number
  • Date examination requirements were met
  • Date your certificate was entered


With your Standard ECFMG Certificate you are able to enter an accredited program of graduate medical education in the United States.


Before applying to the Educational Commission for Foreign Medical Graduates for the first time you will need to get a USMLE/ECFMG Identification Number. This can be found by accessing your Interactive Web Application (IWA).

Step 2 CS passing performance is not subject to expiration for the purpose of entering programs of graduate medical education.

English Requirement: passing performance on an English language proficiency test (such as TOEFL) is no longer a requirement for Certification.

Educational Commission for Foreign Medical Graduates Certification Verification Service: will provide confirmation of your status when a request is received from an entity such as a:

  • medical licensing authority
  • residency program director
  • hospital
  • or other appropriate organization

Residency Programs: if you apply to residency programs through ERAS, an electronic Status Report will automatically be sent to all the programs to which you apply.

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