ECFMG application – for IMGs

ECFMG Certification — A Complete Guide for International Medical Graduates

Everything you need to know about one of the most important steps in your path to US residency.

If you attended medical school outside of the United States or Canada, ECFMG certification is not optional — it is a prerequisite for entering any ACGME-accredited residency program in the United States. Without it, you cannot match.

The process takes longer than most applicants expect. Start early, stay organized, and don’t assume anything is moving forward without confirming it yourself.

What is ECFMG?

The Educational Commission for Foreign Medical Graduates (ECFMG) is the organization that verifies the credentials of international medical graduates and confirms that they meet the educational requirements for entry into US graduate medical education. An ECFMG certificate signals to residency programs that your medical degree, your training, and your USMLE performance have been verified and meet US standards.

Official website: www.ecfmg.org

Step 1 — Create Your ECFMG Account

Go to the ECFMG IWA (Interactive Web Applications) portal and create your account. This is where you will manage your entire application — submitting documents, checking status, and registering for USMLE exams.

Once registered, you will receive a permanent ECFMG ID number. Keep this number. You will use it for the rest of your medical career.

Also download the MyECFMG mobile app — available for Android and iOS — which allows you to upload documents and track your certification status from your phone.

Step 2 — Pass the Required USMLE Steps

ECFMG certification requires passing both of the following:

USMLE Step 1 — Tests basic science knowledge as it applies to medicine. Now reported as pass/fail. Required for ECFMG certification.

USMLE Step 2 CK (Clinical Knowledge) — Tests clinical knowledge and medical decision-making. A strong Step 2 CK score is particularly important for IMGs and can significantly strengthen a residency application.

Important update: Step 2 CS (Clinical Skills) was permanently discontinued in January 2021 and is no longer required for ECFMG certification. Any older resources referencing Step 2 CS as a requirement are outdated. Always verify current requirements directly at ecfmg.org.

Step 3 is not required for ECFMG certification — it is typically taken during or after residency.

Step 3 — Submit Your Medical Education Credentials

This is the step that catches many applicants off guard because it is the most time-consuming and the most out of your control.

ECFMG must verify your medical degree directly with your medical school. Here is how the process works:

Upload your MD diploma through the Credentials tab in your MyECFMG app or the IWA portal. Your diploma must be in its original language; if it is not in English, a certified translation is required.

ECFMG contacts your medical school directly. They will request primary-source verification of your diploma and official transcripts. Your medical school must respond — and response times vary enormously by country and institution. Some schools respond within weeks; others take months.

You cannot rush this step — but you can monitor it. Check your OASIS portal regularly under Medical Education Credentials and Standard ECFMG Certificate to see the status of your verification request.

Follow up proactively. If your medical school has not responded after several weeks, contact them directly. Do not wait for ECFMG to prompt you. This is your timeline to protect.

Step 4 — Monitor Your Certification Status

Once all requirements are met — USMLE Steps 1 and 2 CK passed, and medical education credentials verified — ECFMG will issue your certificate. You will receive an email notification, and your status will update in OASIS.

Check OASIS regularly throughout the process, not just at the end. You want to catch any outstanding items or documentation requests before they become delays.

Typical timeline: The credential verification process alone can take anywhere from a few weeks to several months, depending on your medical school. Factor this into your overall application timeline — your ECFMG certification should ideally be complete or very close to complete when you submit your ERAS application in September.

Step 5 — Maintain Your Certification

ECFMG certification does not expire, but it is tied to your original medical degree. If anything changes — a name change, an update to your credentials — notify ECFMG promptly.

Additionally, ECFMG now administers the ECFMG Physician Credentials Verification Service (ECFMG PCVS), which is used throughout your career when hospitals, licensing boards, and other institutions need to verify your credentials. Your ECFMG record follows you.

Common Mistakes to Avoid

Starting too late. The credential verification process takes time that is entirely outside your control. Begin your ECFMG application as early as possible — ideally 12–18 months before you plan to apply for residency.

Assuming your medical school is moving forward. They may not be. Follow up directly and regularly.

Using outdated information. ECFMG requirements have changed over the years — most significantly with the discontinuation of Step 2 CS in 2021. Always verify current requirements at the official ECFMG website, not through secondhand sources.

Letting your USMLE attempt limits catch you off guard. USMLE has limits on the number of times you can attempt each Step. Know those limits and plan accordingly.

Not downloading MyECFMG. The mobile app makes it significantly easier to upload documents and track your status. Use it.

Helpful Resources

• ECFMG Official Website — always your primary source for current requirements

• ECFMG IWA Portal — where you manage your application

• ECFMG OASIS — credential status and token purchase

• MyECFMG App — Android

• MyECFMG App — iOS

• USMLE Official Website — exam registration and score reporting

• NRMP Data on IMGs — match statistics by applicant type