After the USMLE announced a 12-18 month delay for Step 2CS on May 26th, 2020 – the ECFMG quickly responded by presenting 5 Alternative Pathways for IMG applicants to still become ECFMG Certification eligible for the 2021 Match Cycle. 

However, these Alternative Pathways were less inclusive and lenient than many applicants would have hoped. 

In some effort to keep the doors open for some candidates that would have otherwise been excluded, the ECFMG has recently released clarifications regarding 2 exceptions to the following eligibility requirements:

Alternative Pathway Eligibility Requirement 1 

“Applicant Has Taken or Been Registered for a United States Medical Licensing Examination® (USMLE®) Step or Step Component Since January 1, 2018 (a general eligibility requirement for all pathways)”

and/or…

Alternative Pathway Eligibility Requirement 2 

“Applicant’s Graduation Date is Before January 1, 2018 (an eligibility requirement for applicants who apply to Pathway 2 based on completion of a medical school Objective Structured Clinical Examination (OSCE) and for all applicants who apply to Pathways 3, 4, and 5)”

Exceptions to Alternative Pathway Eligibility Requirements

Exception 1 – Certain Employment or Academic Pursuits

This may qualify candidates for an exception on the grounds that such pursuits have substantively and significantly affected the applicant’s timeline of pursuing ECFMG Certification. However, such exceptions are limited to the following: 

• Enrollment in advanced degrees in healthcare or relevant degree programs (such as MPH, PhD, etc.), or
• Documented active participation in clinical science-related or basic research, or
• Currently employed in a clinical setting in the United States as an advanced clinical care provider (with no disciplinary action on license)

Exception 2 – Extraordinary Circumstances Beyond Applicant’s Control

This may qualify candidates for an exception on the grounds that such pursuits have substantively and significantly affected the applicant’s timeline of pursuing ECFMG Certification. Examples would include the following: 

• Serious medical condition 
• Illness or death in family (outside ‘typical’ life experiences)
• Military service
• Restrictions on visa required to travel to USA to take USMLE Step 2CS

Applying for an Exception

1. We recommend that you contact the ECFMG directly in order to discuss your Pathway options and potential exceptions at the end of August only AFTER online applications for Pathways have become available 
2. Be sure to apply for the exception at the same time you apply for the Pathway
3. Make sure all documentation is in English (translate according to ECFMG standards)
4. Be ready to pay the fee of applying for Alternative Pathways with an exception – which is $1,200 (USD) 

If you feel that you will qualify for an exception, be sure to visit the ECFMG to learn more about required documentation for exceptions as well as detailed instructions regarding the application, fees, and beyond.