Which exams does ECFMG Certification need?

USMLE Step 1 and Step 2 Clinical Knowledge, applied for through the FSMB, plus OET Medicine and an accepted Pathway.

How long do my passes count?

Every examination requirement must be met within 7 years, counted from the first one you pass.

What does ECFMG verify?

At least four credit years from a Sponsor-Noted school; the final medical diploma and transcript are verified by ECFMG with the issuing school, and certification cannot complete before that verification.

When must I apply for a Pathway?

By 31 Jan 2027. An accepted Pathway is also needed to enter the 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.

How many international graduates match?

56.4 percent of non-US citizen international medical graduates who ranked programmes matched in 2026.

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How much do USMLE Step 1, Step 2 CK and ECFMG Certification cost?

USMLE Step 1 and Step 2 CK cost US$695 each, plus a region fee of US$210 for Step 1 and US$235 for Step 2 CK at a test centre outside the United States and Canada, and ECFMG charges US$110 to open your MyIntealth account, US$580 to apply for Certification, US$220 to verify your diploma and transcript and US$945 for a Pathway application.

Checked 31 Oct 2026 · ECFMG ↗

USMLE, at a test centre outside the United States and Canada

Step	Fee
Step 1You pay	US$695
Step 1 region fee	US$210
Step 2 CKYou pay	US$695
Step 2 CK region fee	US$235
Both Steps	US$1,835

ECFMG

Step	Fee
MyIntealth account, online notarisation includedYou pay	US$110
Application for ECFMG Certification	US$580
Verification of your medical diploma and transcript	US$220
Pathway applicationYou pay	US$945
ECFMG in all	US$1,855

Good to know

Which exams does ECFMG Certification need?: USMLE Step 1 and Step 2 Clinical Knowledge, applied for through the FSMB, plus OET Medicine and an accepted Pathway.
How long do my passes count?: Every examination requirement must be met within 7 years, counted from the first one you pass.
What does ECFMG verify?: At least four credit years from a Sponsor-Noted school; the final medical diploma and transcript are verified by ECFMG with the issuing school, and certification cannot complete before that verification.
When must I apply for a Pathway?: By 31 Jan 2027. An accepted Pathway is also needed to enter the 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.
How many international graduates match?: 56.4 percent of non-US citizen international medical graduates who ranked programmes matched in 2026.

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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