To become eligible for the match through the National Resident Matching Program (NRMP), which pairs candidates with residency programs in U.S., International Medical Graduates must receive certification from the Education Commission for Foreign Medical Graduates (ECFMG) to be eligible to apply for residency training in America. Below is a summary of the licensing and educational requirements of ECFMG certification.
1. USMLE Step 1: The United States Medical Licensing Examination (USMLE) Step 1 measures knowledge of fundamental concepts of science. The examination includes all subjects covered during the formational years of medical school, including microbiology, molecular biology, biochemistry, epidemiology, psychiatry, genetics, pharmacology, medical ethics, immunology, statistics, and neuroscience. It also covers the physiology and pathology of the organ systems. It is commonly viewed whether the candidate has mastered the basic science knowledge necessary to proceed to the next level of training. The test is an 8 hour multiple choice computer-based examination that is considered to be the most difficult of the USMLE exams.
2. USMLE Step 2 (CK): The second step of the United States Medical Licensing Examination, USMLE Step 2 (CK), focuses on medical knowledge as it applies to the clinical setting. Most continental U.S. medical students take the test in their fourth year of medical school, while the timing for IMGs varies. Topics covered on the USMLE Step 2 (CK) include typical 3rd year rotations subjects: internal medicine, family medicine, psychiatry, surgery, pediatrics, and obstetrics and gynecology. Broadly, questions on the USMLE Step 2 (CK) ask test takers to analyze a clinical situation and recommended next steps.
3. USMLE Step 2 (CS): The USMLE Step 2 Clinical Skills exam is an oral examination that tests the ability of students to interact with patients, follow clinical procedure, and communicate effectively. With a series of standardized patients, test takers perform a physical examination, generate a patient history, develop differential diagnoses, and write a patient note based on their findings with each. Patient simulators may also be used for certain disease presentations. The exam is graded using a pass/fail system in three categories: Integrated Clinical Encounter, Spoken English Proficiency, and Communication and Interpersonal Skills.
4. Graduation from an International Medical Education Directory (IMED) Approved Medical School: IMED is a product of the partnership of the ECFMG and the Foundation for Advancement of International Medical Education and Research (FAIMER). IMED provides information on international medical school’s accreditation status, certification, and curriculum. U.S. residency programs use IMED to make determinations as to whether residency applicants have graduated from an accredited institution.