Registration & Pathways
OET Passed. What’s Next? A Complete Guide to the ECFMG Pathway for IMGs
Oct
Congratulations to all IMGs who have passed USMLE Step 1, Step 2 CK, and OET Medicine.
Your next milestone is obtaining ECFMG Certification, which is essential before registering for the US Match and starting clinical training in the United States.
A key requirement for this certification is applying through the ECFMG Pathways.
This article explains how IMGs can complete the Pathway process smoothly.
What Is the ECFMG Pathway?
Previously, IMGs were required to pass Step 2 CS to demonstrate clinical and English communication skills.
After its permanent cancellation in 2021, the Pathways system was introduced as its alternative.
There are six Pathway options, applicable depending on:
- Whether you hold a valid medical license
- Academic background
- Step 2 CS exam history
Through the Pathway process, IMGs prove both clinical competency and English proficiency as part of ECFMG Certification requirements.
Most IMGs with Foreign Licenses Apply via Pathway 1
If you currently hold an active medical license outside the United States, you will most likely apply through:
Pathway 1 — Already Licensed to Practice Medicine in Another Country
Pathway 1 applies if:
- You have a valid medical license issued by your home country
- You have no failure record on Step 2 CS
- You have passed OET Medicine with:
- Each component ≥ 350, and
- Writing ≥ 300
If you previously attempted Step 2 CS and did not pass, you will be directed to:
Pathway 6 — Standardized Clinical Encounter
Step-by-Step Guide to Applying via Pathway 1
(1) Share Your OET Scores with ECFMG
Log into the MyOET Portal → My Results → Manage Verifier Access
Select ECFMG as the verifier.
✅ No emails or direct uploads needed — OET securely sends results for you.
(2) Request Official Licensing Documents from Your Authority
Pathway 1 requires official proof of medical license validity, sent directly to ECFMG by the licensing authority in your country.
Commonly required:
- Certificate of Good Standing
- Certificate of Medical License (Official English version)
📌 Important timelines
- Processing may take 4–6 weeks
- ECFMG accepts documents issued within the last 90 days only
Plan early to avoid delays.
(3) Submit the Application Online + Payment
Apply from the official ECFMG “Application for Pathways” page.
Fee: about 925 USD
⚠️ Warning
Once you begin the application, you must complete submission within 5 days, or the draft will be deleted.
Does Step 1 / Step 2 CK Failure Affect Pathway Eligibility?
No.
Pathway eligibility is influenced only by:
- Step 2 CS exam history
- Never attempted CS → Pathway 1–5
- Failed CS → Pathway 6
Step 1 and Step 2 CK results matter for overall ECFMG Certification, but not for Pathway selection.
Validity of the ECFMG Certificate
Certificates issued through Pathways have temporary validity.
| Pathway Year | Valid Through |
|---|---|
| 2025 Pathway | Dec 31, 2027 |
| 2024 Pathway | Dec 31, 2026 |
Once you complete one year of ACGME-accredited U.S. residency, the certification becomes permanently valid.
Many IMGs therefore time their application for the year before residency matching.
Important Notes on Official Translations
Any document not originally issued in English must be:
- Directly provided as an official English version by the medical school, or
- Translated using an ECFMG-authorized translation service
General translation firms are often not accepted, and incorrect submissions can delay processing for months.
📌 Best practice
Start confirming document issuance methods early with your university or licensing authority.
If you’re preparing for OET, consider exploring our practice resources at OET Bank.
We’re designed not just as mock tests, but as powerful review tools that make it easier to analyze weaknesses and focus on what’s needed to pass.
Explore professional learning materials and courses:
👉 https://oet-bank.com/shop
