Foreign medical graduates educational commission for foreign medical graduates

Examinations for ECFMG Certification

Examination Requirements

 | Time Limit for Completing Examination Requirements

Time Limit for Completing Examination Requirements

ECFMG policy requires that international medical students/graduates pass the USMLE Steps and Step Components

required for ECFMG Certification within a seven-year period. This means that once you pass a Step or Step

Component, you will have seven years to pass all of the other Step(s) or Step Component(s) required for ECFMG

Certification. This seven-year period begins on the exam date of the first Step or Step Component passed and ends

exactly seven years from that exam date.

If you do not pass all required Steps and Step Components within a maximum of seven years, your earliest USMLE

passing performance will no longer be valid for ECFMG Certification. It is your responsibility to track your

progress toward meeting the exam requirements for ECFMG Certification. ECFMG will not notify you of

upcoming deadlines to meet the seven-year requirement and will not notify you if one (or more) of your

passing performances becomes invalid for ECFMG Certification because you failed to meet the seven-year

requirement.

Example: An international medical graduate took Step 1 on October 1, 2011 and passed. He has through

October 1, 2018 to take and pass Step 2 CK and Step 2 CS, satisfying the remaining exam requirements

for ECFMG Certification. If he does not take and pass Step 2 CK and Step 2 CS on or before October 1,

2018, his passing performance on Step 1 would no longer be valid for ECFMG Certification.

Under this policy, more than one USMLE passing performance can become invalid for ECFMG Certification.

Example: An international medical graduate passed Step 1 on April 1, 2010, and passed Step 2 CK on

May 1, 2011. She had through April 1, 2017 (seven years from her Step 1 passing performance) to pass

Step 2 CS, satisfying the remaining exam requirements for ECFMG Certification. She did not pass Step 2

CS by April 1, 2017, so her passing performance on Step 1 is no longer valid for ECFMG Certification. Her

earliest USMLE passing performance that is valid for ECFMG Certification is now the Step 2 CK passing

performance on May 1, 2011. She now has through May 1, 2018 (seven years from her Step 2 CK passing

performance) to pass Step 1 and Step 2 CS, satisfying the remaining exam requirements for ECFMG

Certification. If she does not pass Step 1 and Step 2 CS by May 1, 2018, her passing performance on Step

2 CK will no longer be valid for ECFMG Certification.

There are exceptions to this policy:

This seven-year limit does not apply to the former ECFMG CSA because the CSA was not a USMLE Step or

Step Component. International medical students/graduates who satisfied the clinical skills requirement for

ECFMG Certification by passing the CSA are required to pass only Step 1 and Step 2 CK within seven years of

each other for ECFMG Certification. For these individuals, the seven-year period begins on the exam date of

the first USMLE Step or Step Component passed, regardless of when the CSA was passed.

If your earliest USMLE passing performance that is valid for ECFMG Certification took place before June 14,

2004, you are required to pass only Step 1 and Step 2 CK within seven years of each other for ECFMG

Certification; if required for ECFMG Certification, Step 2 CS can be passed outside the seven-year period.

If you have passed a Step or Step Component but this passing performance is no longer valid for ECFMG

Certification, you may request an exception to retake the previously passed exam that is no longer valid. The USMLE

program limits to six the total number of times an examinee can take the same Step or Step Component. See

Reexamination and Reapplication

 in The United States Medical Licensing Examination (USMLE).

Important Notes: Time limits to complete the USMLE for the purpose of U.S. medical licensure are

established by state medical licensing authorities and may require completion of all Steps or Step

Components (including Step 3, which is not required for ECFMG Certification) within a certain number of

years. Information regarding specific state requirements can be obtained on the 

FSMB website

.

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Applicants who retake a previously passed Step or Step Component to comply with a time limit should

understand the implications of a failing retake performance on their Step 3 eligibility. See Retaking

Previously Passed Steps in the 

USMLE Bulletin of Information

.

Last updated: September 7, 2017

Copyright © 2017 by the Educational Commission for Foreign Medical Graduates. All rights reserved.

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Eligibility for Examination

Medical School Students | 

Medical School Graduates

 | 

Reverification of Eligibility

The eligibility requirements for examination differ depending on whether you are a medical school student or a

medical school graduate.

Medical School Students

To be eligible for Step 1, Step 2 CK, and Step 2 CS, you must be officially enrolled in a medical school located

outside the United States and Canada that is listed in the 

World Directory

 as meeting ECFMG eligibility requirements,

both at the time that you apply for examination and on your test day. In addition, the “Graduation Years” in the ECFMG

note in your medical school's World Directory listing must be “Current” at the time you apply and on your test day. See

Medical School Requirements

. An authorized official of your medical school must certify your current enrollment

status; instructions will be provided at the time of application for examination.

As soon as you graduate and receive your medical diploma, you must send two photocopies of your medical diploma

to ECFMG. See 

Final Medical Diploma and Transcript

 in Medical Education Credentials.

In addition to being currently enrolled as described above, to be eligible for Step 1, Step 2 CK, and Step 2 CS,

you must have completed at least two years of medical school. This eligibility requirement means that you must have

completed the basic medical science component of the medical school curriculum by the beginning of your eligibility

period. Although you may apply for and take the examinations after completing the basic medical science component

of your medical school curriculum, it is recommended that you complete your core clinical clerkships, including actual

patient contact, before taking Step 2 CK and Step 2 CS.

If you have passed the former ECFMG CSA, you are not eligible to take Step 2 CS, except under certain, well-defined

circumstances. Eligible circumstances include: taking Step 2 CS to permanently validate an expired CSA examination

date for the purpose of entering U.S. GME; taking Step 2 CS because your most recent performance on a clinical skills

exam (CSA or Step 2 CS) is a failing performance (See Retaking Previously Passed Steps in the 

USMLE Bulletin of

Information

); and retaking Step 2 CS to meet a time limit (See 

Reexamination and Reapplication

 in The United States

Medical Licensing Examination (USMLE)).

Important Notes: If your eligibility for an exam changes after you apply but before you take the exam, you

are required to inform ECFMG immediately in writing of this change in your status. Such notification must

be sent to ECFMG’s Applicant Information Services. Use the contact information for General Inquiries on

the 

Contact ECFMG

 page of the ECFMG website. Such changes in your eligibility status include, but are

not limited to, the following:

Medical school students who transfer to another medical school after submitting an application for

examination must inform ECFMG immediately in writing of this transfer.

Medical school students who have been dismissed or withdraw(n) from medical school are not eligible for

USMLE, even if they are appealing the school's decision or otherwise contesting their status. Medical

school students who have been dismissed or withdraw(n) from medical school must inform ECFMG

immediately in writing of their dismissal or withdrawal.

Medical school students who take a leave of absence should consult with their medical schools about

whether they will be considered officially enrolled in medical school during leave. Your medical school may

consider a student on leave of absence to be withdrawn from medical school. Medical school students who

are not officially enrolled in medical school are not eligible to apply for or take USMLE. Applicants who take

a leave of absence after submitting an application for examination to ECFMG must inform ECFMG

immediately in writing of this leave.

Failure to inform ECFMG that you may no longer be eligible to take the examination may result in a

finding of irregular behavior and permanent annotation of your ECFMG record. See 

Policies and

Procedures Regarding Irregular Behavior

.

If you take a Step or Step Component for which you are not eligible, results for that exam may not be

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