Introduction

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Important Notices

This Information Booklet reflects information available and requirements in place at the time of publication (August 18, 2025). International medical graduates (IMGs) pursuing ECFMG Certification must monitor the ECFMG and USMLE websites for the most current information.

Introducing MyIntealth™

MyIntealth is the new online environment for accessing services offered by Intealth and its ECFMG division. MyIntealth replaced dozens of older applications (including Interactive Web Applications (IWA), On-line Application Status and Information System (OASIS), and ECFMG Credentials Upload tool), centralizing access to services and offering a consistent user experience across services. With MyIntealth, applicants for ECFMG Certification enjoy fewer logins and passwords, less data entry, and more transactions that can be completed online.

MyIntealth consists of:

• Portal for Applicants (such as IMGs pursuing ECFMG Certification),
• Portal for Entities (organizations, such as medical schools and U.S. graduate medical education [GME] programs) and
• Related Web-based Applications (for certain services, such as the Pathways application).

For more information on MyIntealth, how to access the MyIntealth Applicant Portal, and additional resources, please visit the Online Services Overview on the ECFMG website.

The launch of MyIntealth resulted in significant changes to procedural requirements described in this booklet. All international medical students and graduates pursuing ECFMG Certification, especially those familiar with procedural requirements in previous versions of the booklet, must read the 2026 Information Booklet carefully to ensure they understand current procedural requirements.

USMLE Service Transition

The co-sponsors of the USMLE^®, the Federation of State Medical Boards (FSMB) and NBME, 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.

This change will consolidate all USMLE examinee services, including exam registration, score report delivery, and USMLE customer service, with the USMLE co-sponsors. The goal of this change is to streamline the examinee journey and to create a more consistent and efficient examinee experience.

Until the transition occurs, ECFMG will continue to provide USMLE services to IMGs. For additional information, including details on the timing of this transition, applicants should monitor the USMLE Service Transition Information Hub on the USMLE website.

Important Note: This change does not affect the requirements for ECFMG Certification. After the transition of services takes effect, ECFMG will continue to determine whether IMGs are eligible for ECFMG Certification, and eligibility for certification will continue to be a core requirement for IMGs to take USMLE. ECFMG will share information on certification eligibility with the USMLE co-sponsors for the purposes of registration for examination. Step 1 and Step 2 Clinical Knowledge (CK) will continue to be required by ECFMG to meet the medical science examination requirement for certification.

Update for Students and Graduates of Medical Schools Located in Canada

Medical education programs in Canada leading to the MD degree used to be accredited by both the Liaison Committee on Medical Education (LCME) and the Committee on Accreditation of Canadian Medical Schools (CACMS). Effective July 1, 2025, CACMS assumed sole responsibility for accrediting medical education programs in Canada.

LCME accreditation establishes eligibility to take the USMLE and to enter U.S. residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). With the transition away from LCME accreditation for Canadian medical education programs, Canadian medical school graduates establish their eligibility for USMLE and ACGME-accredited residency programs through ECFMG Certification.

As a result, individuals who graduate from Canadian medical schools on or after July 1, 2025, are considered international medical graduates for the purpose of entry into GME programs in the United States. Detailed information and instructions for students and graduates of Canadian schools who plan to apply for ECFMG Certification and pursue U.S. GME are available in the Certification section of the ECFMG website.

Important Note: If you graduated from a medical school located in Canada prior to July 1, 2025, you are not considered an IMG, and you are not eligible for ECFMG Certification.

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