Examination Requirements
To meet the examination requirements for ECFMG Certification, you must satisfy the medical science examination requirement, the clinical skills requirement, and the communication skills requirement. ECFMG has established time limits for completing these examination requirements for ECFMG Certification. See Time Limit for Completing Examination Requirements in Examination Requirements for ECFMG Certification.
To satisfy the medical science examination requirement for ECFMG Certification, you must pass Step 1 and Step 2 Clinical Knowledge (CK) of the United States Medical Licensing Examination (USMLE).
Effective with the USMLE Service Transition in January 2026, FSMB provides all USMLE Step exam services for IMGs, including exam registration, score report delivery, eligibility period extensions, testing region changes, and USMLE customer service.
The USMLE Bulletin of Information includes information on all aspects of USMLE, including preparation, eligibility requirements, scheduling test dates, requesting test accommodations, testing, and score reporting. You must review and become familiar with the bulletin before applying for USMLE. Before applying, see also Eligibility for the United States Medical Licensing Examination (USMLE) in the Examination Requirements for ECFMG Certification section of this booklet.
Information on the fees associated with USMLE and how to apply are available on the USMLE website .
If you apply for and take USMLE Step 1 and Step 2 CK, the USMLE program will share the outcome of your examinations with ECFMG directly as your scores become available.
Important Note: When planning the timing of your exam application, you should consider deadlines imposed by the National Resident Matching Program (NRMP) and graduate medical education (GME) programs. It is solely the responsibility of the applicant to complete the exam requirements in time to meet deadlines imposed by the NRMP and/or GME programs. Since the number of applicants seeking to complete exams may exceed the spaces available in time to meet those deadlines, there is no guarantee that sufficient spaces will be available for all applicants to meet deadlines imposed by the NRMP and/or GME programs. ECFMG assumes no liability of any kind if an applicant does not complete the exam requirements in time to have results available to meet NRMP and/or GME program deadlines. See Scoring and Score Reporting in the USMLE Bulletin of Information for information on scoring turnaround times.
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[Last update: January 9, 2026]
