The route, step by step
Register with ECFMG
Your medical school must be listed in the World Directory of Medical Schools with an ECFMG note. You get a USMLE/ECFMG identification number and your credentials are verified.
USMLE Step 1
A one-day exam on the basic sciences as they apply to medicine. It has been reported as pass/fail since 2022.
USMLE Step 2 CK
Clinical knowledge — a one-day exam with a three-digit score that residency programmes weigh heavily. (The old Step 2 CS was discontinued in 2021.)
English communication requirement
ECFMG certification also requires proof of clinical communication skills in English — currently through the OET Medicine test.
ECFMG certification & the Match
Apply to residency programmes through ERAS, interview, and rank programmes in the NRMP Match. US clinical experience and strong letters make a real difference.
USMLE Step 3
A two-day exam, usually taken during or before the first year of residency — the last step towards an unrestricted licence.
Rules change — check before you book
ECFMG and the USMLE programme update their requirements from time to time. We walk you through the current rules on ecfmg.org and usmle.org before you register or book an exam.
How Padhai Likhai helps
- A realistic timeline from your current year of study to the Match
- Guidance on registration, documents and exam scheduling
- Planning for US clinical experience, letters of recommendation and your ERAS application
- Advice on specialties and programmes that are open to international graduates