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For International Medical Graduates, the procedure of ECFMG-USMLE registration may seem complex. However, in reality, it follows a simple sequence. This article provides a step-by-step procedure for the easy registration of ECFMG-USMLE.

Confirm ECFMG eligibility

Before applying, verify that your medical school is listed in the World Directory of Medical Schools (WDOMS) and meets ECFMG eligibility requirements. From 2024 onward, your school must also be accredited by a WFME-recognized accrediting agency. In addition, you must have completed, or be currently enrolled in—at least four academic years of medical education, with your status officially verified by your institution to ECFMG. Confirming eligibility early helps avoid delays or application rejection later in the USMLE process.

Create an ECFMG account and obtain your ID

Go to the ECFMG website and login to Interactive Web Applications (IWA) for your ECFMG/USMLE Identification Number. Fill in information on the application exactly as it appears in your passport, because this will be the name that will appear on all your USMLE accounts.

Submit the ECFMG Certification application

Log in to IWA and submit the one-time Application for ECFMG Certification. This application includes demographic information and educational information. There is a certification application fee, which must be paid separately from exam fees. Once certified, this application does not expire.

Complete identity verification (Form 186 or 183)

After submitting the application for certification, ECFMG will prepare an identity verification form (usually Form 186). You must fill out this form through online notarization or from your medical school, depending on ECFMG’s instructions. Your status is updated after ECFMG verifies its receipt.

Register for USMLE Step 1 and Step 2 CK

As an IMG, you register for USMLE Step 1 and Step 2 CK through ECFMG, not USMLE directly. You pick your exam, pick your three-month eligibility period, and then pay for your exam fee. They will check your status as a medical school student or graduate through your medical school by ECFMG.

Receive the scheduling permit and book your exam

After approval, ECFMG will issue a Scheduling Permit with your Candidate Identification Number. This permit will be used to schedule a date, time, and location for taking the exam from Prometric within the eligibility period.

Complete exams and fulfill certification requirements

To be eligible for certification by ECFMG, you must successfully pass USMLE Step 1 and Step 2CK. However, Step 2CS is no longer offered and is now replaced by the ECFMG Pathways, which include English proficiency tests like OET Medicine. Your diploma and transcripts must now be primary source verified too.

Use ECFMG Certification for Step 3 and residency

ECFMG certification is required for ACGME-approved residency training, sponsorship of a J-1 visa, and USMLE Step 3 qualification. Although the certification doesn’t expire, a 7-year USMLE completion requirement still applies.

Bottom Line

So, if an IMG checks eligibility early, then the process of registration for the USMLE ECFMG becomes well-organized.

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Authored By: Varun Mohandas