Overview
The Pathways service was introduced by the Educational Commission for Foreign Medical Graduates (ECFMG) as a response to the challenges that arose from the COVID-19 pandemic, particularly concerning the United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills (CS) component.
Since the Step 2 CS exam was suspended and subsequently discontinued due to the pandemic, many International Medical Graduates (IMGs) were left without a way to satisfy the clinical skills requirement to gain ECFMG Certification. ECFMG Certification is a key step for IMGs who wish to enter U.S. graduate medical education programs.
Learn more about ECFMG Certification
Pathways Overview
The Pathways are designed as alternative options for IMGs to demonstrate their clinical skills without the Step 2 CS exam.
Below is a general outline of each of the Pathways:
- Pathway 1 — Already licensed to practice medicine in another country
- Pathway 2 — Already passed a standardized clinical skills exam for medical licensure in another country
- Pathway 3 — Graduated from a medical school accredited by agencies with rigorous criteria (e.g., WFME-recognized)
- Pathway 4 — Completed a U.S. residency or fellowship
- Pathway 5 — Demonstrated significant clinical experience in the U.S.
- Pathway 6 — Completed a medical school clinical skills curriculum that meets ECFMG criteria
Applicants must also pass the Occupational English Test (OET) Medicine to satisfy the English language proficiency requirement.