Pathways for ECFMG Certification for 2023 Match

Published Date : 02 February, 2022

Author : Team IFMGE

Alternative Step 2CS Pathways

As in 2022, the 2023 Pathways will offer six Pathways.

Pathway 1: Already Licensed to Practice Medicine in Another Country

First, this is for applicants who currently hold or have recently held a license/registration to practice medicine without supervision. The license/registration must have been valid on or after January 1, 2018.

Pathway 2: Already Passed an Objective Structured Clinical Examination (OSCE) for Medical Licensure Administered by an Acceptable Medical School

Next, applicants who have not yet obtained a license/registration to practice medicine without supervision (Pathway 1), but who attend or have graduated from a medical school that administers an OSCE specifically required for medical licensure by the medical regulatory authority (MRA) in that country can apply to Pathway 2. Additionally, the medical school must meet certain ECFMG requirements and the applicant must successfully complete the OSCE.

Note, ECFMG does not accept passing results on OSCEs not administered by an acceptable medical school. 

Also, applicants to Pathway 2 must have a medical school graduation date on or after January 1, 2021.

Pathway 3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME)

See ECFMG.org for more information.

Pathway 4: Medical School Accredited by Agency that Has Received a Determination of Comparability by National Committee on Foreign Medical Education and Accreditation (NCFMEA)

See ECFMG.org for more information.

Pathway 5: Medical School Issues Degree Jointly with a U.S. Medical School Accredited by Liaison Committee on Medical Education (LCME)

In summary, students or recent graduates of medical schools that meet eligibility requirements established by ECFMG and who have not yet obtained a license/registration to practice medicine without supervision (Pathway 1) qualify for Pathways 3, 4, and 5. An authorized official of the medical school must attest to the applicant’s clinical skills.

Applicants to Pathways 3, 4, and 5 must have a medical school graduation date on or after January 1, 2021.

Pathway 6: Evaluation of Clinical Patient Encounters by Licensed Physicians

Finally, this last pathway is for applicants who don’t meet the requirements for the other Pathways and/or have failed the former USMLE Step 2 CS exam. For this, licensed physicians in six real, in-person clinical encounters must observe and evaluate the applicant’s clinical skills using the ECFMG Mini-Clinical Evaluation Exercise (Mini-CEX) for Pathway 6.

For 2023, each physician evaluator will be able to submit evaluations for no more than 10  applicants.

Note, there will be some changes to the processes that physician evaluators must follow to complete Mini-CEX evaluations for Pathway 6 applicants. See details on these changes as they become available.

ECFMG Pathways Application Fee

Please note, the fee to apply to the 2023 Pathways will be $925.

Expiration of the ECFMG Certificate

Remember, ECFMG Certificates issued to applicants through a Pathway can expire. However, once you complete the first year of U.S. GME training in an accredited program, the Certificate will no longer be subject to expire. 

So, that means that if you don’t complete the first year of training before the expiration date, the ECFMG Certificate will expire. If so, you’ll need to re-validate the Certificate by meeting requirements in place at that time in order to enter another GME program in the future.

In addition, ECFMG Certificates issued through the 2021 or 2022 Pathways will be valid through December 31, 2024.

Finally, Certificates issued based on the 2023 Pathways will be valid through December 31, 2024.