ECFMG’s Pathways 3, 4 and 5
A pathway is an application process to work in the United States as a resident for IMGs.
The Educational Commission for Foreign Medical Graduates – the ECFMG – is the institution responsible for approving the medical educations and backgrounds of doctors trained outside of the United States.
With the cancellation of the United States Medical Licensing Exam Step 2 CS in 2021, there needed to be a new way to vet medical training requirements. The ECFMG decided to test out a new process in 2021, which was used in the certification process for residency.
The ECFMG has given no indication that they will stop using Pathways.
There are 6 pathways to apply for certification by the ECFMG and that you can apply for residency programs in US hospitals.
In previous posts, I have explained about Pathway 1 and Pathway 2.
Pathway 3
Pathway 3 is for international medical graduates who graduated from a medical school that is accredited by the World Federation for Medical Education – the WFME.
The WFME is responsible for evaluating medical education around the world. They work with agencies in each country on standards. The WFME lists schools that are accepted as well as agencies that are accepted. If your medical school is in an agency that is accepted, you can use this pathway.
This pathway is eligible for doctors who graduated on or after January 1, 2021.
If you graduated before January 1, 2021 this does not apply.
The thinking here is that before 2021, anyone interested in going to the United States would have taken the USMLE Step 2 CS. If you have taken the USMLE Step 2 CS, it is still valid for certification.
If your medical school is approved, then there should be no problems with applying through Pathway 3.
Pathway 4
Pathway 4 is for IMGs who graduated in a country that is determined to have comparable education with that of the United States.
Comparable means having the same education quality and values as education in the US. These programs provide the same and/or similar content with the same professionalism expected in medical education.
This is determined by the National Committee on Foreign Medical Education and Accreditation (NCFMEA). The NCFMEA was established in 2008 by an act of the US Congress (Higher Education Opportunity Act).
At this time, only 18 countries have been determined to have comparable education.
The United Kingdom, Australia and New Zealand are on the list. Canadian schools are evaluated with the Liaison Committee on Medical Education (LCME) along with US medical schools.
Pathway 5
Pathway 5 is for medical school programs that issue MD degrees jointly with a US medical school. The medical school in the US must be accredited by the Liaison Committee on Medical Education (LCME).
At this time, there are only 2 programs.
Duke University and the National University of Singapore in Singapore.
Weill Cornell Medical Qatar located in Doha, Qatar
Attestation
For these pathways, there is an additional catch.
Your school must attest – provide clear evidence – to your clinical skills as a doctor. In other words, they have to show that you have the clinical skills required to be a doctor and to practice medicine.
This is done through the Clinical Skills Evaluation Attestation Portal.
This is not something you can do on your own. Your medical school must provide this information.
Requirements
The requirements for the Pathways are the same to Pathways 1 and 2.
You will need both USMLE Step 1 and Step 2 CK.
USMLE Step 1 : Passing
USMLE Step 2 CK: 209 or higher
You will also need the Occupational English Test Medicine (OET Medicine).
The score requirement is 300 in each area of listening, reading, speaking and writing.
The fee is $925 for each pathway.
Which One Is Good For You
Are these pathways right for you? If you graduated after 2021, and you don’t match the requirements for Pathway 1 and 2, then these are the options for you.
If you have attended medical school in the United Kingdom or Australia, then Pathway 4 is a great fit for you.
Most new graduates can check if Pathway 3 works for them.
Pathway 5 is very specific, so basically students from Singapore and Qatar – or any student who attends the school regardless of nationality – can benefit.
There is Pathway 6 which will be explained in another post.
The ECFMG reserves the right to change pathways and add things or get rid of things.
I am not sure about what other countries are doing about getting certified for their medical schools. I know it is stressful for many current medical school students, and there is no easy answer or solution for this.
I will do my best to keep up to date with this information and any changes.
