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ECFMG Certification study materials
ECFMG Certification study resources

ECFMG Certification: Examination Requirements: Step 1, Step 2 CK, and the ECFMG Pathway

ECFMG Certification · Work through your exam, one topic at a time.

All guide sections

Examination Requirements: Step 1, Step 2 CK, and the ECFMG Pathway

What this domain tests

Examination Requirements tests the exam and clinical-skills components of ECFMG Certification: USMLE Step 1, USMLE Step 2 CK, and the clinical skills route. The former Step 2 CS is discontinued; the current route is an ECFMG Pathway using OET Medicine, unless the applicant already passed Step 2 CS.

Core rules

  • Pass USMLE Step 1. It is reported pass/fail.
  • Pass USMLE Step 2 CK. It is scored and has a passing standard.
  • Meet the clinical skills requirement by either (a) a passing performance on the former Step 2 CS, or (b) completing an ECFMG Pathway, which requires OET Medicine and the pathway's additional eligibility criterion.
  • OET Medicine is not a replacement for Step 2 CK; it is the communication component used in the Pathway. Meet ECFMG's minimum OET scores in each subtest, and check validity dates.
  • Choose a Pathway for which you actually qualify; pathways differ in their additional criteria, such as prior clinical skills exam, licensure, postgraduate training, or school accreditation. Submit the Pathway application through MyIntealth and pay the fee.
  • Exam order can vary in practice, but certification requires all components. Scores are reported to ECFMG; unofficial copies are not a substitute.

Worked example

A candidate has passed Step 1 and Step 2 CK but never took Step 2 CS. They cannot claim the clinical skills requirement is met. They take OET Medicine and meet the minimum in all four sub-tests, then select an ECFMG Pathway whose additional criterion they satisfy, such as prior postgraduate training in an approved system. They submit the Pathway application. Passing OET alone is not enough; the pathway criterion must also be met.

Traps

  • Planning to take Step 2 CS, which is no longer offered.
  • Treating the Pathway as an exam rather than an application route with OET plus criteria.
  • Assuming OET replaces Step 2 CK.
  • Missing one OET subtest minimum or letting results expire.
  • Choosing a pathway without checking the additional criterion.