ECFMG determines whether IMGs are eligible for ECFMG Certification, and eligibility for ECFMG Certification continues to be a core requirement for IMGs to take USMLE. This means that, as part of the USMLE registration process for each Step, FSMB will confirm with ECFMG that you are eligible for ECFMG Certification.
The eligibility requirements for examination differ depending on whether you are an international medical school student or an international medical school graduate.
ECFMG will share information on your eligibility for ECFMG Certification with FSMB at the time you apply for examination. To be confirmed to FSMB as eligible for ECFMG Certification as a student, you must currently meet ECFMG’s identity verification requirements and must have an accepted Application for ECFMG Certification that indicates you are a student currently enrolled in medical school. For detailed information on eligibility requirements for ECFMG Certification, see Application for ECFMG Certification.
Once your application for examination is submitted to FSMB, FSMB will request ECFMG to confirm your current enrollment status and that you will have completed the basic medical science component of your medical school’s curriculum by the beginning of your exam eligibility period. An authorized official of your medical school must certify this information to ECFMG; instructions will be provided at the time of application for examination.
Important Notes: If your eligibility for ECFMG Certification changes, you are required to inform ECFMG immediately in writing of this change in your status by updating your Application for ECFMG Certification and sending an email to [email protected]. Such changes in your eligibility status include, but are not limited to, the following:
- Medical school students who transfer to another medical school after submitting a USMLE application to FSMB must inform ECFMG immediately of this transfer in writing. Applicants must also update their Application for ECFMG Certification. Any changes made to the Application for ECFMG Certification must be reviewed and accepted before submitting applications/service requests.
- Medical school students who have been dismissed or withdraw(n) from medical school are not eligible for USMLE, even if they are appealing the school’s decision to dismiss them or are otherwise contesting their status. Medical school students who have been dismissed or withdraw(n) from medical school must inform ECFMG immediately in writing of their dismissal or withdrawal.
- Medical school students who take a leave of absence should consult with their medical schools about whether they will be considered officially enrolled in medical school during leave. Your medical school may consider a student on leave of absence to be withdrawn from medical school. Medical school students who are not officially enrolled in medical school are not eligible to apply for or take USMLE. Applicants who take a leave of absence after submitting a USMLE application to FSMB must inform ECFMG immediately in writing of this leave.
Failure to inform ECFMG of these changes may result in a finding of irregular behavior and permanent annotation of your record. See Policies and Procedures Regarding Irregular Behavior.
ECFMG will share information on your eligibility for ECFMG Certification with FSMB at the time you apply for examination. To be confirmed to FSMB as eligible for ECFMG Certification as a graduate, you must currently meet ECFMG’s identity verification requirements and must have an accepted Application for ECFMG Certification that indicates you are a medical school graduate. Primary-source verification of your medical education credentials is required for your Application for ECFMG Certification to be accepted. For detailed information on eligibility requirements for ECFMG Certification, see Application for ECFMG Certification.
Important Note: If your eligibility for ECFMG Certification changes, you are required to inform ECFMG immediately in writing of this change in your status by updating your Application for ECFMG Certification and sending an email to [email protected]. Failure to inform ECFMG of these changes may result in a finding of irregular behavior and permanent annotation of your record. See Policies and Procedures Regarding Irregular Behavior.
ECFMG reserves the right to reverify your eligibility for certification at any time. This may include reverification of your current enrollment in medical school or of your medical education credentials. If ECFMG determines that you are no longer eligible for certification, your records will be updated accordingly, including updating the status of your Application for ECFMG Certification and medical education credentials, and sharing this information with FSMB. If you have failed to inform ECFMG of this change in your status, it may result in a finding of irregular behavior and permanent annotation of your record. See Policies and Procedures Regarding Irregular Behavior.
Back to top
[Last update: January 9, 2026]
