Pathway 1 for ECFMG Certification
In 2021, the Education Commission for Foreign Medical Graduates (ECFMG) created a new system for international medical graduates to enter the United States as a practicing doctor.
This was in response to the end of the United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills exam.
This system is known as the Pathways.
In total, there are 6 Pathways available for IMGs to use when applying for ECFMG certification and therefore for US residency match.
Pathway 1
The first Pathway is Pathway 1.
This is for doctors who are licensed to practice medicine without supervision.
By this, it refers to a doctor who:
- has her/his own practice
- is not in a training program
- is not considered a junior doctor in her/his country
Furthermore, the doctor must not have any restrictions on her/his license. This means there is no disciplinary issues, no negative marks on record. If there are such restrictions or disciplinary action(s), a doctor will not be able to apply.
Another important note is that the license to practice must be after January 1, 2018.
If you have your license to practice before January 1, 2018, you will not be able to apply for this Pathway.
Your license does not need to be current. You could be working in another field, or perhaps doing research. Many doctors decide to get Masters in Public Health or try PhD tracks at this time.
The main point is your license must be applicable after January 1, 2018.
If you were licensed before, you will probably need to get a renewed license in your home country. Or you can try the other Pathway options.
Registration Process
When you register for the ECFMG for the first time, you will need to have your information ready.
After you check on the website and answer some questions to determine eligibility, you will then need to upload your license document.
You will need to upload the original and an official English translation of the license.
The ECFMG recommends Straker Translations as a translation service.
Certificate or Letter of Good Standing (CGS/LGS)
In addition to your license, you will need to provide a certificate or letter of good standing.
This is a certificate that must be issued by a regulatory agency in your country. The document must clearly state that the applicant has no limitations, no issues and no problems with practicing medicine.
It must be dated within 90 (ninety) days of the application.
Other Requirements
You will need to have completed the USMLE Step 1 and Step 2 Clinical Knowledge exams.
- USMLE Step 1: Passing
- USMLE Step 2 CK: 209 or higher. Each program might have its own criteria for scoring as well.
You will also need to take the Occupational English Test (OET) Medicine. This is required for anyone outside of the United States and Canada, regardless of country. For example, applicants from Australia and the United Kingdom must fulfill this requirement. For further information, please check the OET website.
- Speaking + Writing + Listening + Reading: 300 or higher in each area
Costs
It costs $925 for the application process. The fee is non-refundable.
Conclusions
The Pathways are the substitute for the USMLE Step 2 CS. They are opening different paths to IMGs to apply for work in the US in medicine.
Pathway 1 is useful for any doctor who is practicing unsupervised already. The license must be after January 1, 2018.
For anyone that has USMLE Step 2 CS scores, you can bypass the Pathways system and apply directly.
