Eligibility for Examination

---

Important Notes: The USMLE co-sponsors are developing plans to centralize all USMLE service functions. As part of these plans, USMLE services currently provided to IMGs by ECFMG will transition to the USMLE co-sponsors for them to provide to IMGs. All applicants should refer to the Important Notices section of this booklet for more information.

Students and graduates of medical schools located in Canada should refer to the Important Notices section of this booklet for information on their eligibility for ECFMG Certification and registration entity for USMLE.

The eligibility requirements for examination differ depending on whether you are an international medical school student or an international medical school graduate.

International Medical School Graduates

To be eligible for Step 1 and Step 2 CK, you must be a graduate of a medical school that is listed in the World Directory with an ECFMG note stating it meets ECFMG eligibility requirements. Your graduation year must be included in the "Graduation Years" listed in the ECFMG note in your medical school’s World Directory listing. See Medical School Requirements. You must have been awarded credit for at least four credit years (academic years for which credit has been given toward completion of the medical curriculum) by a medical school that is listed in the World Directory with an ECFMG note stating it meets ECFMG eligibility requirements.

Graduates must provide the final medical diploma and, if applicable, transcript(s) to document transfer credits as part of an Application for ECFMG Certification, and the graduate’s medical education credentials must be verified and accepted by ECFMG before the Application for ECFMG Certification is accepted. See Application for ECFMG Certification. Once the Application for ECFMG Certification is accepted, graduates can apply for examination.

Important Notes: Verification of graduate status by the medical school is no longer required at the time of exam application because a graduate’s medical education credentials are verified and accepted by ECFMG before the graduate can apply for examination. Verification of graduate status will not take the place of verification of medical education credentials for the purpose of exam eligibility.

If your eligibility for an exam changes after you apply but before you take the exam, you are required to inform ECFMG’s Applicant Information Services immediately in writing of this change in your status. Use the contact information for General Inquiries on the Contact Us page of the ECFMG website. Failure to inform ECFMG that you may no longer be eligible to take the examination may result in a finding of irregular behavior and permanent annotation of your record. See Policies and Procedures Regarding Irregular Behavior.

If you take a Step for which you are not eligible, results for that exam may not be reported or, if previously reported, may be canceled.

If you have already been granted a physician license by a U.S. medical licensing authority based on other licensure examinations, including but not limited to, the Federation Licensing Examination (FLEX), the Medical Council of Canada Qualifying Examination, NBME certifying examinations, or the National Board of Osteopathic Medical Examiners COMLEX-USA, or by exception, you may not be eligible to take the USMLE. Please contact ECFMG if you have questions about your eligibility.

Back to top