Which Pathway can I apply through?

Pathway 1: already licensed to practise medicine without supervision in another country; Pathway 2: passed a licensure OSCE at an acceptable medical school; Pathways 3, 4 and 5: school accredited by a WFME-recognised agency, by an agency with an NCFMEA comparability determination, or issuing a joint degree with an LCME school; Pathway 6: evaluation of clinical patient encounters by licensed physicians (Mini-CEX).

Can I skip the OET if I studied in English?

No. ECFMG makes no exception for native speakers or for English-medium schools.

What must I show for clinical and communication skills?

Satisfy an ECFMG Pathway, including a satisfactory OET Medicine score, or hold a valid pass of the former USMLE Step 2 CS; an accepted, unexpired Pathway is also required to enter the NRMP Match.

What is ECFMG Certification for?

The ACGME requires IMGs entering accredited residency or fellowship programs to be certified by ECFMG; ECFMG Certification is an eligibility requirement for USMLE Step 3; state licensing authorities require it for an unrestricted licence.

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What OET score does ECFMG accept, and which Pathway can you apply through?

ECFMG accepts OET Medicine with 350 in listening, reading and speaking and 300 in writing, all in one sitting, and you must also be accepted on a Pathway, applied for by 31 Jan 2027.

Checked 31 Oct 2026 · ECFMG ↗

Minimum OET Medicine score

	OET Medicine
Listening	350
Reading	350
Writing	300
Speaking	350

Dates and fee

Apply to a Pathway by	31 Jan 2027
OET taken on or after	1 Jan 2025
Pathway application fee	US$945
How long it lasts	Expires when the Pathway expires unless revalidated or made valid indefinitely

Good to know

Which Pathway can I apply through?: Pathway 1: already licensed to practise medicine without supervision in another country; Pathway 2: passed a licensure OSCE at an acceptable medical school; Pathways 3, 4 and 5: school accredited by a WFME-recognised agency, by an agency with an NCFMEA comparability determination, or issuing a joint degree with an LCME school; Pathway 6: evaluation of clinical patient encounters by licensed physicians (Mini-CEX).
Can I skip the OET if I studied in English?: No. ECFMG makes no exception for native speakers or for English-medium schools.
What must I show for clinical and communication skills?: Satisfy an ECFMG Pathway, including a satisfactory OET Medicine score, or hold a valid pass of the former USMLE Step 2 CS; an accepted, unexpired Pathway is also required to enter the NRMP Match.
What is ECFMG Certification for?: The ACGME requires IMGs entering accredited residency or fellowship programs to be certified by ECFMG; ECFMG Certification is an eligibility requirement for USMLE Step 3; state licensing authorities require it for an unrestricted licence.

What to do next

Tell us about your medical school, your USMLE steps and your OET, and we show what is left before ECFMG Certification and the Match, with each fee and how long it takes.

Sources

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