2001 information booklet - thaiclinic · you must use the appropriate edition of the information...

2001INFORMATIONBOOKLET E C F M G® C E R T I

Applications for

Step 1 and Step 2of the

United States MedicalLicensing ExaminationTM

(USMLETM)and for the ECFMG

Clinical Skills Assessment (CSA®)

Educational Commission for Foreign Medical Graduates3624 Market Street, Philadelphia, PA 19104-2685 USAwww.ecfmg.org

The USMLE Bulletin of Information contains information about USMLE, the single, three-step examinationprogram for medical licensure in the United States. The Bulletin of Information is available on the USMLEcompact disc and on the USMLE web site at www.usmle.org. Applicants for examination are required toread both the Information Booklet and the Bulletin of Information.

E C F M G® C E R T I F I C A T I O N

FORM 100S, JULY 2000

Usethis booklet and

the accompanyingapplication materials toregister for Step 1 and

Step 2 eligibilityperiods that end

in 2001.

ABOUT THIS PUBLICATION

The ECFMG® Information Booklet contains detailed information on ECFMG�s program of certification. TheInformation Booklet also provides information on ECFMG�s other programs and services for students and graduatesof foreign medical schools. Applicants for ECFMG certification are required to read the ECFMG InformationBooklet.

You can download the ECFMG Information Booklet and application materials for USMLE� Step 1 /Step 2 and the ECFMG Clinical Skills Assessment (CSA®) from the ECFMG web site at http://www.ecfmg.org. The Information Booklet and application materials are also available in printed format fromECFMG (see How To Obtain This Publication on page ii).

In addition to reading the Information Booklet, applicants for ECFMG certification are required to read theUSMLE Bulletin of Information. The Bulletin of Information provides information about the United States MedicalLicensing Examination�, the single, three-step examination program for medical licensure in the United States.You can download the Bulletin of Information from the USMLE web site at http://www.usmle.org. The Bulletinof Information also accompanies the printed edition of the Information Booklet / application materials.

You must use the appropriate edition of the Information Booklet and application materials. The 2001 InformationBooklet and application materials pertain to USMLE Step 1 / Step 2 eligibility periods that end in 2001 and to theECFMG Clinical Skills Assessment for the calendar year 2001.

If you plan to apply for a Step 1 / Step 2 eligibility period that ends in 2000, you must use the 2000 InformationBooklet / application materials. If you plan to apply for a Step 1 / Step 2 eligibility period that ends in 2002, youmust use the 2002 Information Booklet / application materials. The 2002 Information Booklet / applicationmaterials are expected to be available in July 2001. See Eligibility Period on page 26 for more information.

Although current at the time of publication, the informationcontained in this booklet is subject to change. Any changes tothe ECFMG Information Booklet will be posted on the ECFMGweb site at http://www.ecfmg.org.

Copyright© 2000 by the Educational Commission for Foreign Medical Graduates (ECFMG®). All rights reserved. Portions reprinted, with permis-sion, from the USMLE 2001 Bulletin of Information. Copyright© 2000 by the Federation of State Medical Boards of the United States, Inc., and theNational Board of Medical Examiners® (NBME®).

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® Registered in the U.S. Patent and Trademark Office

HOW TO OBTAIN THIS PUBLICATION

Individual Requests

You can download the ECFMG Information Booklet and application materials for USMLE Step 1 / Step 2and the ECFMG Clinical Skills Assessment (CSA) from the ECFMG web site at http://www.ecfmg.org.

You can also request a single copy of the Information Booklet / application materials from ECFMG at no cost.The materials that ECFMG sends in response to such requests are the same materials that are available on theECFMG web site.

To request a single copy of this publication:

� Visit the ECFMG web site at http://www.ecfmg.org, and send your request by e-mail.� Call (215) 375-1913 from any location worldwide. If you are calling from North America, you can call

(800) 500-8249 toll-free. You can call both numbers 24 hours a day / 7 days a week.� Fax your request to (215) 387-9963.� Write to ECFMG at the address for General Inquiries on page iv.

Copies of the ECFMG Information Booklet / USMLE Bulletin of Information and application forms may beobtained overseas from:� Public Affairs Offices of United States Embassies and Consulates;� Overseas Educational Advising Centers; and� Selected Test Centers of Prometric, Inc.®, a subsidiary of Thomson Learning�. (Prometric, Inc.® was formerly

Sylvan Prometric®.)

Both the ECFMG Information Booklet and the USMLE Bulletin of Information are available on the USMLEcompact disc (CD). Application materials are not available on the CD.

OrOrOrOrOrggggganizaanizaanizaanizaanizational Rtional Rtional Rtional Rtional Requestsequestsequestsequestsequests

Organizations such as foreign medical schools, overseas educational advising centers and U.S. embassies /consulates may request multiple copies of this publication. Requests for multiple copies of the InformationBooklet must be made in writing, on organizational letterhead, and sent to the address or fax number listed underGeneral Inquiries on page iv. Requests must include the:

� Mailing address for the shipment and the� Organization’s telephone number, fax number and e-mail address, if available.

For organizations that provide e-mail addresses with their requests, ECFMG will send e-mail confirmation whentheir orders are shipped.

Please Note: ECFMG reserves the right not to honor requests for multiple copies ofthis publication or to supply fewer copies than requested. ECFMG cannotaccommodate requests for special packaging and is not responsible for duties or value-added taxes applied to bulk shipments when they enter the country of destination.

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COMMUNICATING WITH ECFMG

The ECFMG web site at http://www.ecfmg.org provides:

� Access to ECFMG’s most frequently-requested publications and forms,� Answers to commonly-asked questions,� Important updates and announcements, and� Detailed information on ECFMG’s programs and services for students and graduates of foreign medical schools.

Many of these items are also available on the USMLE CD.

If you do not have access to the Internet or have questions that are not answered on the ECFMG web site, pleasecontact ECFMG using the appropriate telephone number, fax number, e-mail address or mailing address from thefollowing list.

Always include your USMLE / ECFMG Identification Number, if one has been assigned, when communicating withECFMG.

To Request the ECFMG Information Booklet and Application Materials:

� Visit the ECFMG web site at http://www.ecfmg.org. You can download the ECFMG Information Bookletand application materials for Step 1, Step 2 and CSA from the ECFMG web site. Step 1 / Step 2 applicants candownload the USMLE Bulletin of Information from the USMLE web site at http://www.usmle.org.

If you do not have access to the Internet, you can request a single copy of the Information Booklet / applicationmaterials from ECFMG by one of the following methods.

� Call (215) 375-1913 from any location worldwide. If you are calling from North America, call toll-free at(800) 500-8249. You may call both numbers 24 hours a day / 7 days a week.

� Fax your request to (215) 387-9963.

� Write to the address for General Inquiries below.

To Submit Applications and Payments for all Exams, TOEFL Acceptance, USMLETranscripts and USMLE Score Rechecks, send application / payment

By mail to:

Educational Commission for Foreign Medical GraduatesPO Box 820992Philadelphia, PA 19182-0992USA

By courier service to:

Educational Commission for Foreign Medical Graduates3624 Market StreetPhiladelphia, PA 19104-2685USA

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For General Inquiries and Correspondence, Contact ECFMG at:

Educational Commission for Foreign Medical Graduates3624 Market StreetPhiladelphia, PA 19104-2685USATEL: (215) 386-5900(Telephone assistance is available between 9:00 a.m. and 5:00 p.m., Eastern Time, Monday through Friday.)FAX: (215) 387-9963, orVisit the ECFMG web site at http://www.ecfmg.org.

For Information on the Certification Verification Service (CVS), Contact:

ECFMG / CVS DepartmentPO Box 13679Philadelphia, PA 19101-3679USATEL: (215) 386-5900, orVisit the CVS home page on the ECFMG web site at http://www.ecfmg.org.

For Information on the Electronic Residency Application Service (ERAS®), Contact:

ECFMG / ERAS ProgramPO Box 11746Philadelphia, PA 19101-1746USATEL: (215) 386-5900FAX: (215) 222-5641E-MAIL: [email protected], orVisit the ERAS home page on the ECFMG web site at http://www.ecfmg.org.

For Information on the Exchange Visitor Sponsorship Program (EVSP), Contact:

ECFMG / Exchange Visitor Sponsorship ProgramPO Box 41673Philadelphia, PA 19101-1673USATEL: (215) 823-2121FAX: (215) 386-9766, orVisit the EVSP home page on the ECFMG web site at http://www.ecfmg.org.

For information on the International Credentials Service, Contact:

ECFMG / International Credentials ServicePO Box 13795Philadelphia, PA 19101-3795USATEL: (215) 386-5900FAX: (215) 386-9767E-MAIL: [email protected]

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TABLE OF CONTENTS

ABOUT THIS PUBLICATION ....................................................................................................................................................... i

HOW TO OBTAIN THIS PUBLICATION................................................................................................................................... iiIndividual Requests ............................................................................................................................................................ iiOrganizational Requests ..................................................................................................................................................... ii

COMMUNICATING WITH ECFMG .......................................................................................................................................... iii

QUICK REFERENCE GUIDE FOR EXAMS ............................................................................................................................ vii

FREQUENTLY-ASKED QUESTIONS ......................................................................................................................................... 1

ECFMG CERTIFICATION............................................................................................................................................................ 7Requirements for ECFMG Certification ............................................................................................................................ 7

Examination Requirements ................................................................................................................................ 7Medical Education Credential Requirements ..................................................................................................... 8

Summary of Certification Requirements ............................................................................................................................ 8Standard ECFMG Certificate ............................................................................................................................................. 9

Revalidation of the Certificate ........................................................................................................................... 9Permanent Validation of the Certificate ............................................................................................................. 9Confirmation of ECFMG Certification Status ................................................................................................. 10

MEDICAL SCIENCE EXAMINATION ..................................................................................................................................... 11United States Medical Licensing Examination (USMLE) ............................................................................................... 11

Eligibility for Step 1 / Step 2 ............................................................................................................................ 11Requirements for Students ............................................................................................................... 11Requirements for Graduates ............................................................................................................. 12

Description of USMLE Step 1 and Step 2 ....................................................................................................... 12Minimum Passing Scores ................................................................................................................................. 13Reporting of Scores .......................................................................................................................................... 13Score Rechecks ................................................................................................................................................. 13Reexamination .................................................................................................................................................. 14Examinees with Documented Disabilities ........................................................................................................ 14Testing Conditions, Validity of Scores and Irregular Behavior ....................................................................... 14

Formerly-Administered Medical Science Examinations Acceptable for Certification .................................................... 15

ENGLISH LANGUAGE PROFICIENCY TEST ....................................................................................................................... 16English Language Proficiency Requirement for ECFMG Certification .......................................................................... 16Revalidation of the English Test Date .............................................................................................................................. 16Test of English as a Foreign Language (TOEFL) ............................................................................................................ 16

CLINICAL SKILLS ASSESSMENT ........................................................................................................................................... 18Description of CSA .......................................................................................................................................................... 18Test Development Committee .......................................................................................................................................... 18Ownership and Copyright of Test Items and Materials ................................................................................................... 18Eligibility for CSA ........................................................................................................................................................... 19

Requirements for Students ............................................................................................................................... 19Requirements for Graduates ............................................................................................................................. 19Requirements for Students and Graduates ....................................................................................................... 19

Preparation for CSA ......................................................................................................................................................... 19Taking the Exam .............................................................................................................................................................. 20Scoring Components of CSA ........................................................................................................................................... 20Minimum Passing Score ................................................................................................................................................... 20Reporting of Results ......................................................................................................................................................... 20Score Rechecks ................................................................................................................................................................. 20Revalidation of the CSA Date .......................................................................................................................................... 21Reexamination .................................................................................................................................................................. 21Examinees with Documented Disabilities ........................................................................................................................ 21Testing Conditions, Validity of Scores and Irregular Behavior ....................................................................................... 21Additional Information ..................................................................................................................................................... 21

MEDICAL EDUCATION CREDENTIALS ............................................................................................................................... 22Provision of Credentials and Translations ....................................................................................................................... 22Verification of Credentials ............................................................................................................................................... 23

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GENERAL REGISTRATION INFORMATION ....................................................................................................................... 24USMLE / ECFMG Identification Number ....................................................................................................................... 24Name of Applicant ........................................................................................................................................................... 24Address of Applicant ........................................................................................................................................................ 25Payment .......................................................................................................................................................................... 25

REGISTRATION AND SCHEDULING FOR USMLE STEP 1 AND STEP 2 ....................................................................... 26Overview .......................................................................................................................................................................... 26What You Need To Do ..................................................................................................................................................... 26Decide When and Where You Want to Take the Exam ................................................................................................... 26

Eligibility Period .............................................................................................................................................. 26Testing Region ................................................................................................................................................. 27

Check That You Are Using the Appropriate Application Materials ................................................................................ 27Complete the Application Form ....................................................................................................................................... 28

When to Send Your Application and Payment ................................................................................................ 28Include Full Payment ....................................................................................................................................................... 29

Fees for Step 1 and Step 2 ................................................................................................................................ 29Submit Your Application and Payment ........................................................................................................................... 29Receive Your Scheduling Permit ..................................................................................................................................... 29

Scheduling Permit ............................................................................................................................................ 29Contact Information Included on Scheduling Permit ....................................................................................... 30Replacement Scheduling Permits ..................................................................................................................... 31

Schedule Your Testing Appointment With Prometric ..................................................................................................... 31Rescheduling Your Testing Appointment ........................................................................................................ 32

Take the Exam .................................................................................................................................................................. 32How To Prepare ................................................................................................................................................................ 33

Format of the Exams ........................................................................................................................................ 33Sample Test Materials ...................................................................................................................................... 33Practice Session at a Prometric Test Center ..................................................................................................... 34

Examinees with Documented Disabilities ........................................................................................................................ 34

REGISTRATION FOR CLINICAL SKILLS ASSESSMENT ................................................................................................. 35Application Process .......................................................................................................................................................... 35CSA Fee .......................................................................................................................................................................... 35Scheduling CSA ............................................................................................................................................................... 35Admission Permit ............................................................................................................................................................. 36Clinical Skills Assessment Center .................................................................................................................................... 36Travel Status for CSA ...................................................................................................................................................... 36

ENTRY INTO GRADUATE MEDICAL EDUCATION IN THE UNITED STATES ........................................................... 37Residency Training Programs .......................................................................................................................................... 37

ACGME Accreditation ..................................................................................................................................... 37Graduate Medical Education Directory .......................................................................................................... 37Number and Availability of Residency Positions ............................................................................................ 38Selecting Residency Programs ......................................................................................................................... 38ECFMG Certification ....................................................................................................................................... 38

Applying to Graduate Medical Education Programs ....................................................................................................... 39Electronic Residency Application Service (ERAS) ......................................................................................... 39National Resident Matching Program (NRMP) ............................................................................................... 40

Obtaining a Visa ............................................................................................................................................................... 42Examination Requirements Under the Health Professions Educational Assistance Act of 1976 (PL94-484) ........................................................................................................... 42Exchange Visitor Sponsorship Program (J-1 Visa) ......................................................................................... 42

AIMS AND MISSIONS ................................................................................................................................................................. 43

SPONSORING ORGANIZATIONS ............................................................................................................................................ 43

ACRONYM KEY .......................................................................................................................................................................... 44

APPENDIX 1: Reference Guide for Medical Education Credentials ............................................................................................. 45

APPENDIX 2: Testing Regions and International Test DeliverySurcharges for USMLE Step 1 and Step 2 ....................................................................................................................... 49

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QUICK REFERENCE GUIDE FOR EXAMS

Medical Science Examination: Step 1 and Step 2 of the United States Medical Licensing Examination (USMLE)

ECFMG registers eligible students / graduates of foreign medical schools to take USMLE Step 1 and Step 2. These exams aredelivered throughout the world by Prometric in its network of test centers.

For Information On See

Medical Science Examination Medical Science Examination on page 11

Description of the Exams Description of USMLE Step 1 and Step 2 on page 12Format of the Exams on page 33Examination Content on page 6, Preparing for the Test on page 9 and Testing on page 16 of the USMLE Bulletin of Information

Registration and Scheduling Registration and Scheduling for USMLE Step 1 and Step 2 on page 26Scheduling Test Dates on page 13 of the USMLE Bulletin of Information

ECFMG�s Payment Policies Payment on page 25

Fees Fees for Step 1 and Step 2 on page 29List of Testing Regions and Test Centers on page 49USMLE application materials

Prometric Test Centers List of Testing Regions and Test Centers on page 49Prometric web site at http://www.prometric.comECFMG web site at http://www.ecfmg.org

Current Information & ECFMG web site at http://www.ecfmg.orgAnnouncements USMLE web site at http://www.usmle.org

Eng Eng Eng Eng English Langualish Langualish Langualish Langualish Languaggggge Pre Pre Pre Pre Profofofofoficiencicienciciencicienciciency y y y y TTTTTestestestestest

ECFMG requires applicants to demonstrate a performance acceptable to ECFMG on the Test of English as a Foreign Language(TOEFL) to meet the English language proficiency requirement for ECFMG certification. The TOEFL is offered throughout theworld by the Educational Testing Service (ETS). Applicants who passed the former ECFMG English Test may also use theirpassing performance on this test to satisfy this requirement.


English Language Proficiency English Language Proficiency Test on page 16Requirement for ECFMGCertification


ECFMG�s Policies Regarding Test of English as a Foreign Language (TOEFL) on page 16TOEFL and How to ContactETS

Clinical Skills Assessment Clinical Skills Assessment Clinical Skills Assessment Clinical Skills Assessment Clinical Skills Assessment

The Clinical Skills Assessment (CSA) is administered throughout the year at the ECFMG Clinical Skills Assessment Center inPhiladelphia.


Form and Content of the Clinical Skills Assessment on page 18Assessment Candidate Orientation Manual (available on the ECFMG web site at http://www.ecfmg.org)

and Candidate Orientation Video

Registration and Scheduling Registration for Clinical Skills Assessment on page 35


Fee CSA Fee on page 35

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FREQUENTLY-ASKED QUESTIONS

The questions that ECFMG receives most frequently from applicants are listed below by topic. A brief answerand instructions for finding more information are given for each question. All of these questions are answeredmore completely elsewhere in this publication. You should read this entire publication for detailed informationon ECFMG certification and its requirements. If you have questions that are not answered in this booklet, pleaserefer to the instructions for contacting ECFMG on pages iii-iv.

ECFMG Certification

1. What is ECFMG certification?

There are nearly 1,400 medical schools outside of the United States and Canada, each with varying educationalstandards and curricula. The purpose of ECFMG certification is to assess the readiness of graduates of foreignmedical schools to enter U.S. residency and fellowship programs that are accredited by the Accreditation Councilfor Graduate Medical Education (ACGME). To be certified by ECFMG, you must pass a series of exams; youmust also fulfill ECFMG�s medical education credential requirements. These requirements include providingECFMG with copies of your medical diploma, which ECFMG will verify directly with your medical school. SeeECFMG Certification on page 7.

2. Why would I want to be certified by ECFMG?

If you are a foreign medical graduate and wish to enter an ACGME-accredited residency or fellowship programin the U.S., you must be certified by ECFMG before you can enter the program. You must also be certified byECFMG if you wish to take Step 3 of the three-step United States Medical Licensing Examination (USMLE).Most states in the United States also require ECFMG certification as one of the prerequisites to obtain licensureto practice medicine. See ECFMG Certification on page 7.

3. How can I find out if students / graduates of my medical school are eligible for ECFMG certification?

To be eligible for examination, your medical school must be listed in the current edition of the World Directoryof Medical Schools, published by the World Health Organization (WHO), both at the time you apply for theexam and at the time that you sit for the exam. To be eligible for certification by ECFMG, your medical schoolmust be listed in the current edition of the Directory at the time that you graduate (among other requirements).See ECFMG Certification on page 7. The Directory may be available in your medical school�s library. Topurchase the current edition, visit the WHO web site at http://www.who.org.

4. How do I begin the certification process?

The certification process begins when you submit your first application for examination to ECFMG. At this time,ECFMG will assign you an identification number that you will use throughout the certification process. SeeUSMLE / ECFMG Identification Number on page 24.

5. How long does the certification process take?

The time required to complete the certification process is different for each applicant. You may apply for therequired exams as soon as you meet the eligibility requirements for the respective exams. All of the examsrequired for ECFMG certification are offered continuously throughout the year.

Both medical school students and graduates may begin the certification process. However, since one of therequirements for ECFMG certification is that your medical diploma be independently verified by ECFMG withyour medical school, you cannot complete the certification process until after you graduate and receive yourdiploma. The time required for some aspects of the certification process, such as the time required by yourmedical school to verify your medical diploma, are beyond the control of ECFMG. See ECFMG Certification onpage 7.

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6. In what order do I take the exams required for ECFMG certification?

To be eligible for ECFMG certification, you must, among other requirements, pass USMLE Step 1, USMLEStep 2, the Test of English as a Foreign Language (TOEFL) and the ECFMG Clinical Skills Assessment (CSA).See Requirements for ECFMG Certification on page 7.

You can take Step 1, Step 2 and the TOEFL in any order, provided you meet the respective eligibility requirementsfor these exams. You must have passed Step 1 and the TOEFL before you can take the CSA. You can takeStep 2 either before or after you take the CSA. See Eligibility for Step 1 / Step 2 on page 11 and Eligibility forCSA on page 19.

7. How can I have ECFMG confirm to a medical licensing authority or residency / fellowship program thatI am ECFMG-certified?

ECFMG will confirm your certification status when it receives a written request from a medical licensing authority,residency / fellowship program official, or other appropriate organization. Approximately two weeks are requiredfor the confirmation to be completed. Please note that there may be a fee for this service.

If you are applying to residency programs through ERAS, ECFMG will automatically send an electronic ECFMGstatus report to all of the programs to which you applied. See Confirmation of ECFMG Certification Status onpage 10.

Step 1 and Step 2

8. How can I learn more about the computer-based format for USMLE?

For information on computer-based testing, see Format of the Exams on page 33. The brochure entitled Computer-based USMLE�: An Introduction for Students and Graduates of Foreign Medical Schools provides an overviewof computer-based testing. This brochure is available on the ECFMG web site at http://www.ecfmg.org and fromECFMG upon request. The USMLE Bulletin of Information also provides detailed information on computer-based testing. See Preparing for the Test on page 9 and Testing on page 16. Additionally, sample test materialsfor both Step 1 and Step 2 are available on the USMLE web site at http://www.usmle.org and the USMLE CD.These materials employ the actual test delivery software that you will use to take the exams.

9. Are Step 1 and Step 2 still offered in paper and pencil format?

No. Only computer-based administrations of Step 1 and Step 2 are currently offered.

10. When and where can I take computer-based Step 1 and Step 2?

Step 1 and Step 2 are offered continuously throughout the year. You can apply for these exams as soon as youmeet the respective eligibility requirements. When completing the application form, you select the three-monthperiod, known as your eligibility period, during which you want to take the exam. Once you receive your schedulingpermit, you can schedule an appointment to take the exam on any day that it is offered during your assignedeligibility period. See Eligibility Period on page 26.

Step 1 and Step 2 are offered at more than 500 Prometric test centers worldwide. These test centers are distributedamong 14 testing regions. When completing your application form, you select the testing region where you wantto take the exam. You may take the exam at any test center in your assigned testing region, provided there isspace available at the center on the date that you choose. Although you must select a testing region when youregister, you do not need to choose a particular test center within that region until you schedule your testingappointment. See Testing Region on page 27.

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A list of Prometric test centers offering USMLE that was current at the time of publication is located on page 49.However, the list of test centers for Step 1 and Step 2 is subject to change. Before you complete your application,you should refer to the ECFMG web site at http://www.ecfmg.org or the Prometric web site athttp://www.prometric.com to obtain current information on test centers in your testing region. You can alsofollow instructions on your scheduling permit for contacting Prometric to obtain current information on testcenters in your testing region.

11. Do I need to graduate from medical school before taking Step 1 and Step 2?

Both students and graduates may take Step 1 and Step 2. To take Step 1, students must have completed at leasttwo years of medical school by the beginning of the eligibility period selected. To take Step 2, students must bewithin twelve months of completing the full didactic curriculum at their medical school by the beginning of theeligibility period selected. Other eligibility requirements apply to both students and graduates. Refer to Eligibilityfor Step 1 / Step 2 on page 11.

12. Can I choose to take Step 1 and Step 2 separately or together?

Step 1 and Step 2 are different exams. You must take these exams on different days. The testing day for Step 1lasts about eight hours. The testing day for Step 2 lasts about nine hours.

Although you must take these exams on different days, you can register for Step 1 and Step 2 at the same timeusing the same application (provided you meet the eligibility requirements for both exams) or you can registerseparately, submitting two different applications at different times. The eligibility periods you select for theseexams can be the same or different.

After taking one Step, you do not need to wait before taking the other Step. You can schedule your testingappointments for Step 1 and Step 2 as close together as you wish, as long as the dates you select fall within theeligibility periods assigned for each exam. However, there are certain restrictions on retaking the same Step. SeeReexamination on page 14.

13. Is there a deadline for scheduling a testing appointment for Step 1 and Step 2?

Once you receive your scheduling permit for Step 1 or Step 2, you may contact Prometric at any time to scheduleyour testing appointment. For international testing regions, you must contact Prometric before 12:00 noon (localtime at the Regional Registration Center for your testing region) at least five business days prior to the exam datethat you want. For the United States / Canada testing region, you must contact Prometric before 12:00 noon(Eastern Time in the United States) at least two business days prior to the exam date that you want. Testingappointments are scheduled on a first-come, first-served basis. To increase your chances of getting the testingdate and location that you want, you should contact Prometric as soon as possible after receiving your schedulingpermit. Refer to Schedule Your Testing Appointment with Prometric on page 31.

14. Is it possible to cancel my registration for an exam?

You cannot cancel your registration for USMLE Step 1 and Step 2. If you do not take the exam, ECFMG will notrefund your fee(s) or credit them to your account. See Please Note on page 25.

15. Is it possible to change my testing appointment or location once I have scheduled?

Under certain very limited circumstances you can change your scheduled testing appointment by contactingPrometric directly. Your new testing appointment must fall within the same eligibility period and testing regionlisted on your scheduling permit. If you contact Prometric before 12:00 noon (local time at the Regional RegistrationCenter for your testing region) at least five business days before your scheduled appointment, there is no chargeto reschedule. If you do not provide notice of at least five business days, Prometric will charge you a fee toreschedule your testing appointment. See Rescheduling Your Testing Appointment on page 32.

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16. Is there a limit to the number of times I can take Step 1 and Step 2?

For the purpose of ECFMG certification, there is no limit on the number of times you can take a Step until youhave passed that Step. Once you pass a Step, you may not repeat it, and you will have seven years to pass theother Step.

If you fail a Step, you may retake it, but you must submit a new application and fee(s). However, you may notretake a Step within sixty days of your last attempt on that same Step. As a result, if you reapply for Step 1 orStep 2, you must select an eligibility period that begins at least sixty days after your last attempt on the sameStep. Additionally, you cannot take the same Step more than three times in any twelve-month period. SeeReexamination on page 14.

Please Note: This policy applies only to ECFMG certification. The USMLE programhas made specific recommendations to state medical licensing authorities regardingthe time to complete all three Steps and the number of attempts allowed to pass eachStep. If you are taking the Steps for the purpose of licensure, refer to Time Limit andNumber of Attempts Allowed to Complete All Steps, Formerly Administered Examinations,and Retakes on pages 4-5 of the USMLE Bulletin of Information for more information.You should also contact the medical licensing authority of the jurisdiction where youplan to apply for licensure or the Federation of State Medical Boards, since licensurerequirements vary among jurisdictions.

17. Do I need to send my medical diploma with my application form?

If you are a medical school graduate, you must send two photocopies of your medical diploma with your examapplication if you have not submitted your diploma previously. You must also send two full-face photographswith the copies of your diploma. If you are a graduate but your medical diploma has not yet been issued, youmust send with your application two current photographs and a certificate signed by your Medical School Dean,Vice Dean or Registrar that confirms you graduated from medical school, have met all requirements to receiveyour medical diploma and states the date your medical diploma will be issued.

If you are a medical school student, both you and your Medical School Dean, Vice Dean or Registrar mustcertify on the application that you are officially enrolled when you apply and that you will be officially enrolledwhen you take the exam. As soon as you graduate and receive your medical diploma, you must send twophotocopies of your diploma and two full-face photographs to ECFMG.

If your credentials are complete, you are generally not required to resubmit these documents when you apply forsubsequent exams. See Provision of Credentials and Translations on page 22 and Verification of Credentials onpage 23.

English Language Proficiency Test

18. How do I fulfill the English language proficiency requirement for ECFMG certification?

You must take the TOEFL and achieve at least the minimum score acceptable to ECFMG. If you passed theformer ECFMG English Test, you have already satisfied this requirement. See English Language ProficiencyTest on page 16.

19. Do native speakers of English need to satisfy this requirement?

Yes. All applicants for ECFMG certification must demonstrate their proficiency in English by achieving a scoreacceptable to ECFMG on the TOEFL.

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20. How can I get the TOEFL application materials?

You must obtain application materials for the TOEFL directly from the Educational Testing Service (ETS). Youcan request these materials on the TOEFL web site at http://www.toefl.org. You can also contact ETS by telephone,fax and mail. See Test of English as a Foreign Language on page 16 for contact information.

21. What if my English test date expires?

Passing performance on the English language proficiency test is valid for two years from the date passed for thepurpose of entering an accredited program of graduate medical education in the United States. If your Englishtest date has expired, you may not enter such a program until you revalidate your English test date.

You can revalidate your English test date for an additional two-year period by achieving a score acceptable toECFMG on the TOEFL. You can revalidate your English test date before or after you are certified by ECFMG.If you do not enter a training program before your English test date expires, you may revalidate the English testdate at any time by taking the TOEFL and achieving a score acceptable to ECFMG. See Revalidation on page 9.

Clinical Skills Assessment (CSA)Clinical Skills Assessment (CSA)Clinical Skills Assessment (CSA)Clinical Skills Assessment (CSA)Clinical Skills Assessment (CSA)

22. Who must take the CSA?

All applicants who, as of June 30, 1998, had not met all requirements for ECFMG certification that were in effectthrough this date must pass the CSA as one of the requirements for ECFMG certification. Applicants who, as ofJune 30, 1998, had met all ECFMG certification requirements in effect through this date (regardless of whethertheir Standard ECFMG Certificates had been issued) are not required, but are permitted, to take the CSA. SeeRequirements for ECFMG Certification on page 7.

23. Can I cancel or postpone my CSA registration?

You cannot cancel or postpone your registration for the CSA. You must schedule your CSA within four monthsof the date indicated on your notification of registration. You must take the CSA within twelve months of thedate indicated on your notification of registration. If you do not meet these deadlines, ECFMG will not refundyour assessment fee or credit it to your account. See Please Note on page 25 and Scheduling CSA on page 35.

24. Can I change my CSA date once I have scheduled?

Once you have scheduled a date for your assessment, you cannot change it. If you do not appear for yourscheduled assessment session, you will lose your assessment fee. See Please Note on page 25 and SchedulingCSA on page 35.

25. What if my CSA date expires?

Passing performance on the CSA is valid for three years from the date passed for the purpose of entering anaccredited program of graduate medical education in the United States. If your CSA date has expired, you maynot enter such a program until you revalidate your CSA date.

You can revalidate your CSA date for an additional three-year period by passing a subsequent CSA. You canrevalidate your CSA date before or after you are certified by ECFMG. If you do not enter a training programbefore your CSA date expires, you may revalidate the CSA date at any time by passing a subsequent CSA. SeeRevalidation on page 9.

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Medical Education Credentials

26. How will I know if ECFMG has received verification of my medical diploma from my medical school?

ECFMG will send you a letter on the date that it sends the request for verification of your medical diploma toyour medical school. After ECFMG receives the verification from your medical school, ECFMG will send youanother letter to let you know that the verification was received. See Verification of Credentials on page 23.

ERAS

27. What medical specialties are participating in the Electronic Residency Application Service (ERAS) in2001?

Most residency programs in the following specialties are participating in ERAS 2001:

� Anesthesiology� Dermatology� Diagnostic Radiology� Emergency Medicine� Family Practice� Family Practice / Physical Medicine & Rehabilitation combined programs� Internal Medicine (preliminary and categorical)� Internal Medicine / Emergency Medicine combined programs� Internal Medicine / Family Practice combined programs� Internal Medicine / Pediatrics combined programs� Internal Medicine / Physical Medicine & Rehabilitation combined programs� Internal Medicine / Psychiatry combined programs� Obstetrics & Gynecology� Orthopedic Surgery� Pathology� Pediatrics� Pediatrics / Emergency Medicine combined programs� Pediatrics / Physical Medicine & Rehabilitation combined programs� Physical Medicine & Rehabilitation� Psychiatry� Surgery (General)� Transitional Year� All U.S. Army and Navy programs

These programs will, in principle, no longer accept paper applications. However, there may be exceptions byindividual program directors. You should contact the programs directly for their policies. See Electronic ResidencyApplication Service (ERAS) on page 39.

Payment

28. How do I pay for the exam(s)?

You must include full payment for Step 1, Step 2 and the CSA with the application form. If you do not includefull payment, your application will be returned to you. You can pay by credit card (Visa, MasterCard orDiscover) or with a personal check, bank draft or money order made payable to ECFMG in U.S. funds. Paymentsmay also be wire transferred. See Payment on page 25.

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ECFMG® CERTIFICATION

The Educational Commission for Foreign Medical Graduates (ECFMG), through its program of certification,assesses whether graduates of foreign medical schools are ready to enter residency or fellowship programs in theUnited States that are accredited by the Accreditation Council for Graduate Medical Education (ACGME).

ECFMG and its sponsoring organizations define a graduate of a foreign medical school as a physician whoreceived his/her basic medical degree or qualification from a medical school located outside the United States,Canada and Puerto Rico. To be eligible for ECFMG certification, the medical school must be listed in theWorld Directory of Medical Schools, published by the World Health Organization (WHO), at the time of thephysician�s graduation. The Directory may be available in your medical school�s library. To purchase a copy ofthis publication, visit the WHO web site at http://www.who.org.

Citizens of the United States who have completed their medical education in schools outside the United States,Canada and Puerto Rico are considered graduates of foreign medical schools; non-U.S. citizens who have graduatedfrom medical schools in the United States, Canada and Puerto Rico are not considered graduates of foreignmedical schools.

ECFMG certification assures directors of ACGME-accredited residency and fellowship programs, and the peopleof the United States, that graduates of foreign medical schools have met minimum standards of eligibility requiredto enter such programs. ECFMG certification does not, however, guarantee that these graduates will be acceptedinto programs since the number of applicants frequently exceeds the number of available positions.

ECFMG certification is one of the eligibility requirements to take Step 3 of the three-step United States MedicalLicensing Examination (USMLE). Most states in the United States also require ECFMG certification as aprerequisite to obtain licensure to practice medicine.

Requirements for ECFMG Certification

To be eligible for certification by ECFMG, graduates of foreign medical schools must meet the followingrequirements:

Examination Requirements

1. Pass the basic medical and clinical science components of the medical science examination within aseven-year period.

Step 1 (basic medical) and Step 2 (clinical) of the United States Medical Licensing Examination are the examscurrently administered that meet this requirement. (See Medical Science Examination on page 11 and Formerly-Administered Medical Science Examinations Acceptable for ECFMG Certification on page 15.)


2. Pass the English language proficiency test.

Applicants can satisfy this requirement by achieving a score acceptable to ECFMG on the Test of English as aForeign Language (TOEFL). A passing performance on the former ECFMG English Test is also accepted byECFMG to meet the English language proficiency requirement for ECFMG certification. Passing performance

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on either test is valid for two years from the date passed for the purpose of entry into graduate medical education.(See English Language Proficiency Test on page 16.)

3. Pass the Clinical Skills Assessment (CSA).

The CSA is a one-day exam that requires examinees to demonstrate clinical proficiency, spoken English languageproficiency and appropriate interpersonal skills. Applicants for the CSA must meet both examination and medicaleducation requirements. You can apply for the CSA at any time after meeting these requirements. Passingperformance on the CSA is valid for three years from the date passed for the purpose of entry into graduatemedical education. (See Clinical Skills Assessment on page 18.)

Medical Education Credential Requirements

Applicants for ECFMG certification must document the completion of all requirements for, and receipt of, thefinal medical diploma. All graduates of foreign medical schools must have had at least four credit years (academicyears for which credit has been given toward completion of the medical curriculum) in attendance at a medicalschool that is listed in the World Directory of Medical Schools at the time of graduation. (The Directory ispublished by the World Health Organization, which is not an accrediting agency. It contains information suppliedby countries about their medical schools. If a country or medical school that was listed in the World Directory ofMedical Schools is removed from the Directory, the ECFMG Board of Trustees will give consideration on acase-by-case basis. The Directory may be available in your medical school�s library. You can order a copy of theDirectory by visiting the WHO web site at http://www.who.org.) All documents provided to ECFMG are sentfor verification to appropriate officials of the foreign medical schools. You will not fulfill the medical educationcredential requirements for ECFMG certification until ECFMG receives verification of your medical diplomadirectly from the medical school. (See Medical Education Credentials on page 22.)

Please Note: Submitting altered or falsified documents to ECFMG may be sufficientcause for ECFMG to bar you from the exam, to terminate your participation in theexam, to withhold and / or invalidate the results of your exam, to withhold a certificate,revoke a certificate or to take other appropriate action. ECFMG may also reportinstances of altered or falsified documents to the USMLE Committee on IrregularBehavior, state medical licensing authorities and directors of graduate medicaleducation programs.

Summary of ECFMG Certification Requirements

Examination Requirements

Pass:

� Medical Science Examination

� English Language Proficiency Test

� Clinical Skills Assessment

Medical Education Credential Requirements

� Document: Completion Of All Requirements For, And Receipt Of, The Final Medical Diploma

� ECFMG Verification Of Final Medical Diploma With Medical School

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Standard ECFMG Certificate

ECFMG issues the Standard ECFMG Certificate to applicants who meet all of the examination and medicaleducation credential requirements. Applicants must also pay any outstanding charges on their ECFMG financialaccounts before their certificates are issued. Standard ECFMG Certificates are sent approximately two weeksafter all of these requirements have been met.

The Standard ECFMG Certificate includes:

� the name of the applicant;� the applicant�s USMLE / ECFMG Identification Number;� the dates that the examination requirements were met;� the date that the certificate was issued; and� the dates through which the passing performances on the English test and, if required for ECFMG certification,

the Clinical Skills Assessment (CSA) remain valid for the purpose of entry into graduate medical education.

Applicants may use the Standard ECFMG Certificate to enter an accredited program of graduate medical educationas long as the program�s start date is not later than both of the valid through dates (English test and, if requiredfor ECFMG certification, the Clinical Skills Assessment) on the Standard ECFMG Certificate.

Revalidation of the Certificate for Entering Graduate Medical Education

Two of the exam dates on the Standard ECFMG Certificate are subject to expiration for the purpose of enteringgraduate medical education programs. The English test date is valid for two years from the most recent date ofpassing performance. The Clinical Skills Assessment date is valid for three years from the most recent date ofpassing performance.

If the English test date on your Standard ECFMG Certificate has expired, you must take the TOEFL and achievea score acceptable to ECFMG before you can enter a program of graduate medical education. If the CSA date onyour Standard ECFMG Certificate has expired, you must pass another CSA before you can enter a program ofgraduate medical education. Once you meet these exam requirements, ECFMG will mail your revalidationsticker for the appropriate exam. You must attach the revalidation sticker to your Standard ECFMG Certificate,following the instructions that accompany the sticker. Each revalidation sticker is unique and includes the sameIdentification Number that is on your Standard ECFMG Certificate. If you do not enter a training program beforeyour English test / CSA dates expire, you may revalidate these dates at any time.

If your English test and / or CSA dates expire before your Standard ECFMG Certificate is issued, you mayrevalidate these dates, as described above, prior to becoming certified by ECFMG. In this event, the Englishtest / CSA valid through dates on your Standard ECFMG Certificate will reflect your most recent passingperformances on these exams.

Permanent Validation of the Certificate Following Entry into Graduate MedicalEducation

After you enter an ACGME-accredited program of graduate medical education in the United States, you canrequest permanent validation of your Standard ECFMG Certificate. This means that the English test and CSAdates are no longer subject to expiration. To receive the appropriate valid indefinitely sticker for the certificate,you and an authorized official of your training institution must complete the Request for Permanent Validationof Standard ECFMG Certificate (Form 246) and send it to ECFMG. Form 246 is available on the ECFMG website at http://www.ecfmg.org. ECFMG also sends Form 246 to all applicants with their Standard ECFMGCertificates and to officials at institutions offering accredited graduate medical education programs.

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After ECFMG receives and verifies the information contained on the form, a sticker indicating valid indefinitelystatus will be mailed to you. You should attach the sticker to your Standard ECFMG Certificate, following theinstructions that accompany the sticker. Each sticker is unique and includes the same Identification Number thatis on your Standard ECFMG Certificate.

Confirmation of ECFMG Certification Status � ECFMG�s Certification VerificationService (CVS)

ECFMG�s Certification Verification Service provides primary source confirmation of the ECFMG certificationstatus of graduates of foreign medical schools. The Joint Commission on Accreditation of Healthcare Organizations(JCAHO) has determined that an accredited health organization will satisfy the Joint Commission requirementfor primary source verification of medical school completion for graduates of foreign medical schools if itconfirms directly with ECFMG that an applicant possesses a valid Standard ECFMG Certificate.

ECFMG will confirm your certification status when a request is received in writing from a medical licensingauthority, residency program director, hospital or other organization that, in the judgment of ECFMG, has alegitimate interest in such information. Requesting organizations must normally secure and retain your signedauthorization to obtain certification information. Please note that there may be a fee for this service.

Requests for confirmation must contain your name, date of birth, USMLE / ECFMG Identification Number, andname and address of the organization to which the confirmation should be sent. You may obtain a copy of theappropriate request form from the ECFMG web site at http://www.ecfmg.org. Confirmations are mailed to therequesting organization within approximately two weeks. Confirmations are not sent to applicants directly.

If you are applying to residency programs through ERAS, ECFMG will automatically send an electronic ECFMGstatus report at the time that your application is processed to all of the programs to which you applied. If yourECFMG certification status changes during the ERAS application process, ECFMG will automatically send anupdated status report to all programs to which you applied.

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MEDICAL SCIENCE EXAMINATION

ECFMG requires a passing score on both a basic medical science test and a clinical science test to meet themedical science examination requirement for ECFMG certification. Step 1 (basic medical) and Step 2 (clinical)of the United States Medical Licensing ExaminationTM (USMLETM) are the exams currently administered thatmeet this requirement. If you apply for examination, you are required to read the USMLE Bulletin of Informationfor complete information on USMLE. The Bulletin of Information is available on the USMLE web site athttp://www.usmle.org and the USMLE CD.

The United States Medical Licensing Examination

The United States Medical Licensing Examination is a single, three-step exam for medical licensure in theUnited States. USMLE provides a common system to evaluate applicants for medical licensure. The UnitedStates Medical Licensing Examination is sponsored by the Federation of State Medical Boards of the UnitedStates (FSMB) and the National Board of Medical Examiners® (NBME®). USMLE is governed by a committeeconsisting of representatives of FSMB, NBME, ECFMG and the American public.

You can take Step 1 and Step 2 in either order, provided that you meet the respective eligibility requirements forthese exams. However, before applying for Step 3, you must have received official notification that you havepassed both Step 1 and Step 2. Graduates of foreign medical schools must also be certified by ECFMG beforeapplying to take Step 3. If you have not met these requirements, as well as the other Step 3 eligibility requirements(refer to Eligibility on page 3 of the USMLE Bulletin of Information), your application for Step 3 will not beaccepted. For detailed information about Step 3, contact the individual medical licensing authorities (seeCommunicating About USMLE on page 26 of the USMLE Bulletin of Information) or the Federation of StateMedical Boards, 400 Fuller Wiser Road, Suite 300, Euless, TX 76039 USA; Telephone: (817) 868-4041; Internet:http://www.fsmb.org.

ECFMG determines whether students / graduates of foreign medical schools are eligible to take USMLE Step 1and Step 2 and registers eligible applicants to take these exams for the purpose of ECFMG certification. NBMEregisters eligible students / graduates of medical schools in the United States and Canada that are accredited bythe Liaison Committee on Medical Education or the American Osteopathic Association to take USMLE Step 1and Step 2. Step 1 and Step 2 are delivered worldwide by Prometric, Inc.®, a subsidiary of Thomson LearningTM,in its network of test centers. Prometric, Inc.® was formerly Sylvan Prometric®. ECFMG is not responsible forerrors or any associated computer problems that may occur in generating the scheduling permits or deliveringthe exams. These functions are the responsibility of NBME and / or Prometric.

Eligibility for Step 1 / Step 2Eligibility for Step 1 / Step 2Eligibility for Step 1 / Step 2Eligibility for Step 1 / Step 2Eligibility for Step 1 / Step 2

The eligibility requirements for Step 1 and Step 2 differ depending on whether you are a medical school studentor a medical school graduate.

Please Note: If your eligibility for an exam changes after you submit the applicationbut before you take the exam, you are required to immediately inform ECFMG of thischange in your status.

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To be eligible for Step 1 and Step 2, you must be officially enrolled in a foreign medical school that is listed inthe current edition of the World Directory of Medical Schools (published by the World Health Organization)both at the time that you apply and at the time that you take the exam. Your Medical School Dean, Vice Dean orRegistrar must certify your current enrollment status on the application form. This certification must be current;

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the official must have signed the application form within four months of its receipt by ECFMG. As soon as yougraduate and receive your medical diploma, you must send two photocopies of your medical diploma and twofull-face photographs to ECFMG. The photographs that you send must be current; they must have been takenwithin six months of the date that you send them. A photocopy of a photograph is not acceptable.

In addition to being currently enrolled as described above, to be eligible for Step 1, the basic medicalscience component, you must also have completed at least two years of medical school. This eligibility requirementmeans that you must have completed the basic medical science component of the medical school curriculum bythe beginning of your eligibility period for Step 1.

In addition to being currently enrolled as described above, to be eligible for Step 2, the clinical sciencecomponent, you must be within twelve months of completion of the full didactic curriculum by the beginning ofyour eligibility period for Step 2.

ECFMG reserves the right to re-verify with the medical school the eligibility of medical school students who areregistered for Step 1 and Step 2.

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To be eligible for Step 1 and Step 2, you must be a graduate of a foreign medical school that was listed in theWorld Directory of Medical Schools at the time that you graduated. You must have had at least four credit years(academic years for which credit has been given toward completion of the medical curriculum) in attendance ata medical school that was listed in the World Directory of Medical Schools at the time that you graduated. Thesignature of the official who certifies your status as a graduate on the application form must be current; theofficial must have signed the application form within four months of its receipt by ECFMG.

You must also submit two photocopies of your medical diploma with your application for examination if youhave not sent the diploma to ECFMG previously. The name on your medical diploma must match exactly thename you entered on your application. (See Name of Applicant on page 24.) Two full-face photographs mustaccompany the copies of your diploma. The photographs that you send must be current; they must have beentaken within six months of the date that you send your application. A photocopy of a photograph is not acceptable.If your medical diploma has not yet been issued, you must submit with the application form two current photographsand a certificate signed by your Medical School Dean, Vice Dean or Registrar that confirms you graduated frommedical school, have met all requirements to receive your medical diploma and states the date your medicaldiploma will be issued. You must then send the photocopies of your medical diploma to ECFMG as soon as yourdiploma is issued. (See Provision of Credentials and Translations on page 22.)

Description of USMLE Step 1 and Step 2

Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice ofmedicine, with special emphasis on principles and mechanisms underlying health, disease and modes of therapy.

Step 2 assesses whether you can apply the medical knowledge and understanding of clinical science essential forthe provision of patient care under supervision, including emphasis on health promotion and disease prevention.

For more descriptive information about the content and format of computer-based Step 1 and Step 2, refer toExamination Content on page 6 of the USMLE Bulletin of Information and to the Step 1 / Step 2 sample testmaterials available on the USMLE web site at http://www.usmle.org and the USMLE CD.

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Minimum Passing Scores on the Medical Science Examination

A minimum score is required to pass USMLE Step 1 and Step 2 for ECFMG certification. These minimumpassing scores are based on achieving a specified level of proficiency. The minimum passing level is reviewedperiodically and may be adjusted at any time. Notice of such adjustments will be posted on the USMLE web siteat http://www.usmle.org. (See Minimum Passing Scores on page 21 of the USMLE Bulletin of Information.)

Reporting of Scores

It is expected that scores for Step 1 and Step 2 will typically be available for mailing three to four weeks after theexam date. Once your score is available, ECFMG will mail it to your ECFMG address of record. To avoidmisinterpretation and to protect the privacy of examinees, ECFMG will not provide scores by telephone, fax ore-mail to anyone, including examinees. Please note that the reporting of scores may be delayed if additional dataand / or analyses are required to assure the validity of the test scores.

Except as otherwise specified below, to receive a score, you must complete the entire test. This means that youmust begin and either exit from or run out of time for each block of the test. (See Format of the Exams onpage 33 for more information on test blocks.) If you begin but do not complete a Step, no scores are reported, andthe �incomplete examination� attempt appears on your USMLE transcript. If you register for but do not take aStep, no record of the test will appear on your transcript.

If your examination is incomplete, you may request that a score be calculated and reported, with all missed testitems scored as incorrect. This score is likely to be lower than the score you would have achieved had youcompleted all sections of the examination. If you decide to request calculation and reporting of your score, thescore will appear on your USMLE transcript as though it were complete. It may not be retracted subsequently. Ifyou receive notification that your examination resulted in an incomplete attempt, contact ECFMG in writing nolater than 45 days after the date the notification is mailed to you if you would like further information on havingthe score calculated and reported.

Score reports for Step 1 and Step 2 include a pass / fail designation, numerical scores, and graphical performanceprofiles, which summarize areas of strength and weakness to aid in self-assessment. These profiles are developedas assessment tools for the benefit of examinees only.

If you do not receive your Step 1 or Step 2 score report, you must send a written request for a duplicate scorereport to ECFMG. ECFMG will honor requests for duplicate scores received up to ninety days after the examdate. If more than ninety days have passed since your exam date, scores will be reported to you only in the formof a USMLE transcript. The Request for Official USMLE� Transcript form, which includes the current fee, isavailable on the ECFMG web site at http://www.ecfmg.org and from ECFMG upon request. (See Scoring andScore Reporting on page 20 of the USMLE Bulletin of Information.)

Score Rechecks

Standard procedures ensure that the scores reported for you are an accurate reflection of the responses recordedby the computer on the exam date. A change in score based on a recheck is an extremely remote possibility.However, a request for a recheck will be honored if you submit the Request for Recheck of Score on USMLE�Step 1 and Step 2 form and the fee for this service to ECFMG. This form, which includes the current fee, isavailable on the ECFMG web site at http://www.ecfmg.org and from ECFMG upon request. Your request mustbe received at ECFMG no later than ninety days after the date your score report is mailed.

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Reexamination

For the purpose of ECFMG certification, there is no limit on the number of times you can take a Step until youhave passed that Step. Once you pass a Step, you may not repeat it, and you will have seven years to pass theother Step. If you do not pass the other Step within a maximum of seven years, your previous passing score willno longer be valid for the purpose of ECFMG certification, and you must repeat the entire process.

If you fail a Step, you may retake it, but you must submit a new application and fee(s). However, you may notretake a Step within sixty days of your last attempt on that same Step. As a result, if you reapply for Step 1 orStep 2, you must select an eligibility period that begins at least sixty days after your last attempt on the sameStep. Additionally, you cannot take the same Step more than three times in any twelve-month period.


Examinees with Documented Disabilities

Appropriate accommodations will be made for USMLE examinees with documented disabilities covered underthe Americans with Disabilities Act (ADA). Students / graduates of foreign medical schools must submit theirofficial requests and documentation to ECFMG. ECFMG forwards these requests to NBME for processing.NBME processes requests for test accommodations in accordance with USMLE policies and procedures andrenders a decision. Once your request has been processed, NBME will inform you of the outcome of yourrequest. If you take USMLE Steps with test accommodations, your score reports and transcripts will indicate thatsuch accommodations were provided.

For application materials and instructions on how to apply for test accommodations, refer to the Request for TestAccommodations for Examinees with Disabilities booklet and follow its instructions before you send yourapplication for the exam. This booklet is available on the USMLE web site at http://www.usmle.org, on theUSMLE CD and from ECFMG upon request.

Testing Conditions, Validity of Scores and Irregular Behavior

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Policies and procedures to govern the administration of the exams have been established to ensure that noexaminee or group of examinees receives unfair advantage on the exam, inadvertently or otherwise. If theintegrity of the examination process is jeopardized, the USMLE parent organizations reserve the right to invalidateall or any part of an exam. If information indicates that continued testing would jeopardize the security of theexamination materials or the integrity of scores derived from the exam, the USMLE parent organizations reservethe right to suspend or cancel test administration. (Refer to Testing on page 16 of the USMLE Bulletin ofInformation.)

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Validity of Scores

To ensure the integrity of the examination system, the validity of scores reported for USMLE Steps is assured byevery means available to the USMLE program. The performance of all examinees is monitored and may beanalyzed statistically to detect aberrancies that may result in a classification of scores as indeterminate.

To ensure the meaningfulness of ECFMG certification, a score that has been classified as indeterminate will notbe reported. To designate a score as indeterminate means that the score achieved may not represent a validmeasure of the examinee�s knowledge or competence as sampled by the exam, based upon statistical analyses orotherwise. (Refer to Validity of Scores on page 24 of the USMLE Bulletin of Information.)

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Irregular behavior includes all actions on the part of applicants, examinees, potential applicants or others whensolicited by an applicant and / or examinee, that subvert or attempt to subvert the examination process. AllUSMLE exams at Prometric test centers are monitored through use of audio and video monitors and recordingequipment and by test center staff. Failure to adhere to the instructions of test center staff during the exam mayresult in a determination of irregular behavior and annotation of your USMLE record and transcripts, as describedin Irregular Behavior on page 24 of the USMLE Bulletin of Information. If you are observed engaging in apossible violation of test administration rules or other forms of irregular behavior during an exam, you will notnecessarily be told of the observation by a proctor at the time of the exam. ECFMG will deny or revoke theECFMG certification of any individual who it has determined has subverted or attempted to subvert the assessmentor ECFMG certification process. (Refer to Irregular Behavior on page 24 of the USMLE Bulletin of Information.)

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ECFMG accepts a passing performance on former medical science examinations for the purpose of ECFMGcertification. Those formerly administered by ECFMG are:

� ECFMG Examination� Visa Qualifying Examination (VQE)� Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS)� Part I and Part II Examinations of the National Board of Medical Examiners (NBME)

Combinations of exams are also acceptable. Specifically, if you have passed only part of the former VQE,FMGEMS, or the NBME Part I or Part II, you may combine a passing performance on the basic medical sciencecomponent of one of these exams or USMLE Step 1 with a passing performance on the clinical science componentof one of the other exams or USMLE Step 2, provided that the components are passed within the period specifiedfor the exam program.

Additionally, ECFMG accepts for the purpose of its certification a score of 75 or higher on each of the three daysof a single administration of the former Federation Licensing Examination (FLEX), if taken prior to June 1985.

Please note, however, that after December 31, 1999, use of the former FederationLicensing Examination (FLEX) components or the former NBME certifying exams tofulfill eligibility requirements for Step 3 is no longer accepted. You should contact theFSMB or the licensing authority of the jurisdiction where you plan to apply for licensurefor information on licensure requirements.

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ENGLISH LANGUAGE PROFICIENCY TEST

Physicians who assume patient care responsibilities in graduate medical education programs in the United Statesmust be proficient in the English language. Proficiency in English is also one of the requirements for obtaining avisa to enter the United States. As a result, applicants for ECFMG certification are required to demonstratecompetence in the English language.

English Language Proficiency Requirement for ECFMG Certification

There are two ways to satisfy the English language proficiency requirement for ECFMG certification: a passingperformance on the former ECFMG English Test or a score acceptable to ECFMG on the Test of English as aForeign Language (TOEFL). The option you will use depends on whether you have previously taken the ECFMGEnglish Test, which was administered for the last time on March 3, 1999:

� If you passed the ECFMG English Test on or before March 3, 1999, you have already satisfied thisrequirement.

� If you have taken the ECFMG English Test but did not pass, you must take the TOEFL. To satisfy theEnglish language proficiency requirement for ECFMG certification, you must achieve at least the minimumscore acceptable to ECFMG.

� If you have never taken the ECFMG English Test, you must take the TOEFL and achieve at least theminimum score acceptable to ECFMG. However, you must take the TOEFL and achieve this minimumscore on or after March 4, 1999. If you have never taken the ECFMG English Test, you cannot use a TOEFLtaken before March 4, 1999 to satisfy the English language proficiency requirement for ECFMG certification.

If you take the TOEFL to fulfill the English language proficiency requirement, refer to Test of English as aForeign Language (TOEFL) below for information on the minimum score that ECFMG will accept and instructionson how to have ECFMG evaluate your TOEFL score.

Revalidation of the English Test Date

Passing performance on the English language proficiency test is valid for two years from the date passed for thepurpose of entering a program of graduate medical education. If you wish to revalidate your English Test date foran additional two-year period, you must take the TOEFL and achieve at least the minimum score accepted byECFMG. You may revalidate your English test date before or after you are certified by ECFMG. Refer toRevalidation on page 9 and Test of English as a Foreign Language (TOEFL) below for additional information.

Test of English as a Foreign Language (TOEFL)

The TOEFL is offered throughout the world by the Educational Testing Service (ETS). You should contact ETSdirectly for information and application materials for the TOEFL:

Educational Testing ServicePrinceton, NJ 08541 USATelephone: (609) 771-7100E-mail: [email protected]: http://www.toefl.org

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The TOEFL is administered in either computer-based format or paper-based format. The format of the TOEFLthat you take will depend on where you take the test. ECFMG accepts both the computer-based and paper-basedTOEFL to fulfill the English language proficiency requirement for ECFMG certification and to revalidate theEnglish Test date.

If you take the paper-based TOEFL, you must take a Friday or Saturday (formerly special or international)administration and must achieve a minimum overall score of 550. If you take a computer-based administrationof TOEFL, you must achieve a minimum overall score of 213. However, achieving these minimum scores doesnot guarantee that ECFMG will accept the scores. Your performance on the TOEFL may be compared to yourmost recent performance on the English language proficiency test. If your TOEFL score varies greatly fromyour prior performance on the English language proficiency test, your score may be reevaluated by the EducationalTesting Service.

If you want ECFMG to evaluate your TOEFL score to fulfill the English language proficiency requirement or torevalidate your English test date, you must do the following:

1. Request that ETS send your official TOEFL score report to ECFMG.

You should make this request at the test center when you take the TOEFL by entering the ECFMG institutioncode number 9108 when you are asked for official score report recipients. The TOEFL score report must comedirectly from ETS. If you send a copy of your TOEFL score report to ECFMG, it will not be accepted.

2. Send a TOEFL Acceptance Request Form (Form 163) and payment of the $40 fee for acceptance ofyour TOEFL score to ECFMG.

Form 163 is available on the ECFMG web site at http://www.ecfmg.org, on the USMLE CD and fromECFMG upon request. You must provide the following information on Form 163: your full name, both as itappears in your ECFMG file and as you reported it on the TOEFL application; your USMLE / ECFMGIdentification Number; date of the TOEFL that you took; and your ETS Registration / AppointmentConfirmation Number. (ETS assigns a Registration Number to a paper-based TOEFL, and an AppointmentConfirmation Number to a computer-based TOEFL.) Form 163 also includes space for you to indicate achange of address, if any. If you do not provide all of the information requested or do not include fullpayment, your request will not be processed.

Mail your TOEFL Acceptance Request Form and payment to:

Educational Commission for Foreign Medical GraduatesPO Box 820992Philadelphia, PA 19182-0992USA

If you send your TOEFL Acceptance Request Form and payment by courier, you should use the followingaddress:

Educational Commission for Foreign Medical Graduates3624 Market StreetPhiladelphia, PA 19104-2685USA

ECFMG typically receives TOEFL scores within five weeks of the test date. ECFMG will require several additionalweeks to process your request. This time may be extended if your score requires reevaluation by ETS. If yourTOEFL score is accepted, ECFMG will notify you in writing.

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CLINICAL SKILLS ASSESSMENT

The Clinical Skills Assessment (CSA®) evaluates your ability to gather and interpret clinical patient data andcommunicate effectively in the English language. The CSA consists of eleven stations, ten of which are scored;in each station you will encounter a Standardized Patient (SP), a lay person trained to realistically and consistentlyportray a patient. SPs respond to questions from examinees with answers appropriate to the patient being portrayedand will react appropriately to physical examination maneuvers. You will be expected to proceed through eachencounter with an SP as you would with a real patient.

The CSA assesses whether you can obtain a relevant medical history, perform a focused physical exam andcompose a written record of the patient encounter. The CSA also requires that you demonstrate proficiency inspoken English and appropriate interpersonal skills as evaluated by the Standardized Patients you encounter inthe test stations.

The CSA is administered only in English.

Description of CSA

The CSA includes test cases representing the major clinical education programs encountered at medical schoolsin the United States and Canada accredited by the Liaison Committee on Medical Education (LCME). Thesedisciplines include:

� Internal Medicine� Surgery� OB / GYN� Pediatrics� Psychiatry� Family Medicine

The cases constituting any CSA reflect a balance of these disciplines, although not every discipline will necessarilybe represented on every assessment. There is also a balance of genders, ages and ethnicities among the SPs onany assessment.

The CSA consists of eleven encounters with SPs; ten of these encounters will be scored. In each encounter youwill be allowed fifteen minutes to interact with the SP and ten minutes to compose the written record of theencounter. Breaks will be provided at various points in the exam. The total administration time is approximatelyeight hours.

Test Development Committee

The cases for CSA are developed by a Test Development Committee composed of practicing physicians andmedical educators who are experienced in working with Standardized Patients. Committee members who author,review and validate all cases used in the CSA represent a diverse spectrum of generalists and specialty physiciansin the United States.

Ownership and Copyright of Test Items and Materials

All cases and materials used in the CSA are owned by ECFMG and are copyrighted. Distribution or reproductionby any means of CSA test cases and materials without the express written authorization of ECFMG is prohibitedand infringes on the rights of ECFMG. Appropriate legal action will be taken when any such infringementoccurs.

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Eligibility for CSA

The eligibility requirements for the CSA differ depending on whether you are a medical school student or amedical school graduate.

Requirements for Medical School Students

To be eligible for the CSA, you must be officially enrolled in a foreign medical school that is listed in thecurrent edition of the World Directory of Medical Schools (published by the World Health Organization) both atthe time that you apply and at the time you take the assessment. You must also be within twelve months ofcompleting the full didactic curriculum at the time that you take the assessment. Your Medical School Dean,Vice Dean or Registrar must certify your current enrollment status on the application form. This certificationmust be current; the official must have signed the application form within four months of its receipt by ECFMG.As soon as you graduate and receive your medical diploma, you must send two photocopies of your medicaldiploma and two full-face photographs to ECFMG. The photographs that you send must be current; they musthave been taken within six months of the date that you send them. A photocopy of a photograph is not acceptable.

Requirements for Medical School Graduates

To be eligible for the CSA, you must be a graduate of a medical school that was listed in the World Directory ofMedical Schools at the time of your graduation. You must have had at least four credit years (academic years forwhich credit has been given toward completion of the medical curriculum) in attendance at a medical school thatwas listed in the World Directory of Medical Schools at the time of your graduation. The signature of the officialwho certifies your status as a graduate on the application form must be current; the official must have signed theapplication form within four months of its receipt by ECFMG.

You must send two photocopies of your medical diploma with your application for the CSA if you have not sentthe diploma to ECFMG previously (for example, with an application for a previous exam, such as Step 1 orStep 2). The name on your medical diploma must match exactly the name you entered on your application. (SeeName of Applicant on page 24.) You must send two full-face photographs with the copies of your diploma. Thephotographs that you send must be current; they must have been taken within six months of the date that yousend your application. A photocopy of a photograph is not acceptable. If your medical diploma has not yet beenissued, you must send with your application form two current photographs and a certificate signed by yourMedical School Dean, Vice Dean or Registrar that confirms you graduated from medical school, have met allrequirements to receive your medical diploma and states the date your medical diploma will be issued. You mustthen send the photocopies of your medical diploma to ECFMG as soon as your diploma is issued. (See Provisionof Credentials and Translations on page 22.)

Both Medical Students and Graduates must have passed USMLE Step 1 or its equivalent (see page 11) andthe English Language Proficiency Test (see page 16) before taking the CSA.

Applicants who, as of June 30, 1998, had met all ECFMG certification requirements in effect through this date(regardless of whether their Standard ECFMG Certificates had been issued) are not required, but are permitted,to take the CSA.

Preparation for CSA

Since the CSA evaluates general clinical proficiency in cases commonly encountered and / or representingimportant medical conditions, knowledge gained from clinical experiences should be adequate to manage thetest cases. When you are registered to take the CSA, ECFMG will send you the CSA Candidate OrientationManual and Candidate Orientation Video, which describe the content and form of the assessment. The CandidateOrientation Manual is available on the ECFMG web site at http://www.ecfmg.org and the USMLE CD. Inaddition, each assessment begins with an on-site orientation to the CSA.

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Taking the Exam

The CSA is administered in morning and / or afternoon sessions as scheduled throughout the year. The durationof the CSA, including orientation, testing and breaks is approximately eight hours.

The Clinical Skills Assessment Center is a secured facility. Once you enter the secured area of the AssessmentCenter for orientation, you may not leave that area until the CSA has been completed. You may not use cellulartelephones or beepers at any time during the CSA.

You are responsible for making the necessary travel and accommodation arrangements. This includes obtainingvalid travel documents (passport, visa, exit permits, etc.), as required. If you are traveling from a distant location,you should consider arriving in Philadelphia a day or two before your CSA in order to be rested for this assessment.

Scoring Components of CSA

Within each case, the specific skills being documented and assessed are:

� the ability to elicit an appropriate history;� the ability to perform an appropriate, focused physical exam;� demonstration of interpersonal skills appropriate to a physician-patient interaction;� generation of a legible, organized, complete and accurate written record of the encounter; and� proficiency in spoken English.

Minimum Passing Score on CSA

A minimum score is required to pass the CSA for ECFMG certification. This minimum passing score is based onachieving a specified level of proficiency. The minimum passing level is reviewed periodically and may beadjusted at any time.

Reporting of Results

A report of performance on the CSA consists of a pass / fail designation. ECFMG will mail this report to yourECFMG address of record approximately six to eight weeks after your assessment date. ECFMG reserves theright to delay the reporting of scores if additional data and / or analyses are required to assure the validity of thetest scores. To avoid misinterpretation and to protect the privacy of examinees, ECFMG will not provide resultsby telephone, fax or e-mail to anyone, including examinees. If you do not receive your report of performance onthe CSA, you must send a written request for a duplicate report of performance to ECFMG.

Score Rechecks

CSA scores are based on checklists and score sheets completed by the Standardized Patients at the time of theassessment, as well as subsequent scoring of the written records by medically-qualified raters. Standard proceduresensure that the score reported for each examinee is an accurate reflection of the answers marked on the checklistsand score sheets. A change in score based on a recheck is an extremely remote possibility.

However, a request for a recheck of the checklists and score sheets will be honored if the examinee submits aCSA Examinee Request for Score Recheck form and payment for this service to ECFMG. This form, whichincludes the current fee, is available on the ECFMG web site at http://www.ecfmg.org or from ECFMG uponrequest.

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Revalidation of the CSA Date

Passing performance on the CSA is valid for three years from the date passed for the purpose of entering aprogram of graduate medical education. If you wish to revalidate your CSA date for an additional three-yearperiod, you must pass a subsequent CSA. You may revalidate your CSA date before or after you are certified byECFMG. Refer to Revalidation on page 9.

Reexamination

For the purpose of ECFMG certification, there is no limit on the number of attempts to pass the CSA. Once youpass the CSA, you may only repeat it to revalidate your CSA date. If you fail the CSA and wish to retake it, youmust submit a new application and assessment fee. You may not take the CSA within three months of your lastattempt on the CSA.


Reasonable accommodations will be made for the administration of the Clinical Skills Assessment to examineeswith documented disabilities. To apply for test accommodations, you must obtain a copy of the packet entitledGuidelines and Questionnaire: Requests for Test Accommodations for Examinees with Disabilities Taking theClinical Skills Assessment. This packet is available on the ECFMG web site at http://www.ecfmg.org, on theUSMLE CD and from ECFMG upon request. Your request for accommodations, including the completedQuestionnaire and supporting documentation, must be received at ECFMG no later than your application for theCSA.

Testing Conditions, Validity of Scores and Irregular Behavior

ECFMG administers the CSA in conformity with the policies and procedures of the CSA program. If a situationarises in which, in ECFMG�s judgment, the integrity of the process is jeopardized, ECFMG reserves the right toinvalidate all or part of an exam, to withhold scores, or to take any other appropriate action for the purpose ofECFMG certification.

In order to ensure the validity of scores that are reported and the meaningfulness of ECFMG certification, it isECFMG�s policy that it will not report a score which it has determined to be indeterminate. To designate a scoreas indeterminate means that the score achieved may not represent a reasonable assessment of the examinee�sknowledge or competence as sampled by the exam, based upon statistical analyses or otherwise. ECFMG willdeny or revoke the ECFMG certification of any individual who it has determined has subverted or attempted tosubvert the assessment or ECFMG certification process by engaging in irregular behavior.

Additional Information

For detailed information on the CSA, including information on test regulations and test accommodations, referto the CSA Candidate Orientation Manual. ECFMG sends this publication to applicants when they are registeredfor the CSA. The current edition of this publication is available on the ECFMG web site at http://www.ecfmg.organd on the USMLE CD.

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MEDICAL EDUCATION CREDENTIALS

Applicants for ECFMG certification must document the completion of all requirements for, and receipt of, thefinal medical diploma.

A graduate of a foreign medical school must have had at least four credit years (academic years for which credithas been given toward completion of the medical curriculum) in attendance at a medical school that was listed inthe World Directory of Medical Schools at the time of graduation. The Directory contains information suppliedby countries about their medical schools. It is published by the World Health Organization, which is not anaccrediting agency. If a country or medical school that was listed in the World Directory of Medical Schools isremoved from the Directory, the ECFMG Board of Trustees will give consideration on a case-by-case basis.

ECFMG verifies every applicant�s medical school diploma with the appropriate officials of the foreign medicalschool that issued the diploma. An applicant�s credentials are not considered complete until ECFMG receivessuch verification directly from the medical school.

Note Regarding Ineligible Practitioners: Graduates licensed only in stomatology,ayurvedic or homeopathic medicine, or those awarded only the diploma of Physician-Epidemiologist-Hygienist, Physician-Cyberneticist, Physician-Biophysicist, LicensedMedical Practitioner or Assistant Medical Practitioner are not eligible for admissionto the exams or for ECFMG certification.

Provision of Credentials and Translations

Credentials for ECFMG Certification

You must send two photocopies of your medical school diploma to ECFMG. The two photocopies of yourmedical diploma must each be 216 mm x 279 mm (8½ in x 11 in). You should not send these credentials by faxonly. If you fax your credentials to ECFMG, you must also send photocopies to ECFMG by mail or courierservice.

The exact name of the final medical diploma you must provide is listed in the Reference Guide for MedicalEducation Credentials on page 45. The Reference Guide lists these medical credential qualifications by country.Although this Reference Guide is based upon information that was current at the time of publication, thisinformation is subject to change.

If the name on your diploma is different from the name you entered on your application, you must submit a copyof a legal document verifying that both of these names belong to you. If the name on your diploma is differentthan the name you entered on the application, and you do not submit a copy of a legal document verifying thatboth of these names belong to you, your application will be rejected. Refer to Name of Applicant on page 24.

You must send two full-face photographs with the copies of your diploma. The photographs that you send mustbe current; they must have been taken within six months of the date that you send them. A photocopy of aphotograph is not acceptable.

Please Note: Submitting altered or falsified documents to ECFMG may be sufficientcause for ECFMG to bar you from the exam, to terminate your participation in theexam, to withhold and / or invalidate the results of your exam, to withhold a certificate,revoke a certificate or to take other appropriate action. ECFMG may also reportinstances of altered or falsified documents to the USMLE Committee on IrregularBehavior, state medical licensing authorities and directors of graduate medicaleducation programs.

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Credentials for Exam Registration

If you are a medical school graduate, you must send the copies of your medical diploma and the two currentphotographs with your application for examination (if you have not submitted your diploma and photographs toECFMG previously). If your medical diploma has not yet been issued, you must send with the application formtwo current photographs and a certificate signed by your Medical School Dean, Vice Dean or Registrar thatconfirms you graduated from medical school, have met all requirements to receive your medical diploma, andstates the date your medical diploma will be issued. You must then send the photocopies of your diploma toECFMG as soon as the diploma is issued.

If you graduated from medical school and do not submit your medical diploma or a certificate from your medicalschool as described above, and this documentation has not been previously received by ECFMG, your applicationwill be rejected.

If you are a medical school student, you should send the copies of your medical diploma and the currentphotographs to ECFMG as soon as you graduate and receive the diploma.

If your credentials are complete, you are generally not required to resend these documents when you apply forsubsequent exams. After receiving your medical diploma, ECFMG will write to you to acknowledge receipt andto advise if additional credentials are required.

English Translations

All documents that are not in English must be accompanied by English translations. The translation must beprepared by and certified to be correct by a government official, medical school official or recognized translationservice. The translation must appear on official stationery, must identify the translator, and must bear the signatureof the official or representative of the translation service. A copy of the document from which the translation wasmade must accompany the translation.

Verification of Credentials

ECFMG verifies every applicant�s medical school diploma with the appropriate officials of the foreign medicalschool that issued the diploma. You will not fulfill the ECFMG medical education credential requirements untilsuch verification is received directly from your medical school and accepted by ECFMG.

In some instances, the verification process for medical diplomas can be lengthy due to the processing timerequired by the institutions and prevailing postal conditions. ECFMG will write to you to advise when yourdiploma is sent to your medical school for verification. If ECFMG does not receive a response from yourmedical school within the anticipated time period, ECFMG will send subsequent verification requests to yourmedical school. ECFMG will notify you when it sends these subsequent requests. ECFMG will also notify youafter receiving the verification from your medical school.

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GENERAL REGISTRATION INFORMATION

Before you send your application to ECFMG, please review the following general information. The informationin this section pertains to all exams for which you may register with ECFMG (USMLE Step 1 and Step 2 and theECFMG Clinical Skills Assessment).

USMLE / ECFMG Identification Number

When you apply for the first time to ECFMG for an exam, you will be assigned an eight-digit USMLE / ECFMGIdentification Number. If you provide an e-mail address on your application, ECFMG will send notification ofyour USMLE / ECFMG Identification Number by e-mail. If you do not provide an e-mail address, ECFMG willnotify you of your number by mail.

Your USMLE / ECFMG Identification Number cannot be changed. It will become a part of your permanentECFMG record. Once ECFMG informs you of this number, you must include it on all communications, medicaleducation credentials, application forms and payments that you send to ECFMG.

Name of Applicant

Your ECFMG file contains your name as it appears on your most recent application form. This is the name thatwill appear on all communications that ECFMG sends to you. This name will also appear on your StandardECFMG Certificate once you have met all requirements for certification. Unless you legally change your name,you must use the name that appeared on your initial application consistently on all communications to ECFMG.

Please Note: The name you enter on your application will appear on your Step 1 /Step 2 scheduling permit. The spelling and order of the names on your schedulingpermit must match EXACTLY the spelling and order of the names on the form(s) ofidentification you present at the test center. If the name listed on your schedulingpermit is not correct, contact ECFMG immediately. See Take the Exam on page 32for more information.

The name on your medical school diploma must match exactly the name you entered on your application.If these two names do not match, you must submit a copy of one of the following legal documents verifying thatboth of these names belong to you:

� Passport (including the page with your photograph),� Birth certificate,� Marriage certificate, or� Official court order.

Attestations before a notary public are not acceptable as verification of a change of name.

This legal document must verify that the name on your medical diploma refers to you or is your previous ormaiden name. All documents submitted will become a part of your permanent ECFMG record. Please do notsubmit an original document; a copy of the document is sufficient.

If the legal document is not in English, you must include an official English translation of the legal document.The English translation must be prepared by and certified to be correct by a government official, medicalschool official or recognized translation service. The translation must appear on official stationery, must identifythe translator and must bear the signature of the official or representative of the translation service.

If the name on your diploma is different than the name as you entered it on your application, and you do notsubmit a copy of a legal document verifying that both of these names belong to you, your application will berejected.

If you request a change in the name in your ECFMG record, your request must be accompanied by one ofthe legal documents described above.

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Address of Applicant

All communications, including your admission permits / scheduling permits, score reports and your StandardECFMG Certificate, will be sent to the address that appears on your most recent application. If you reside withan individual whose name is different from yours, you should include that individual�s name in the address.Requests to have your address changed in your ECFMG record must be in writing. ECFMG will not processaddress changes received from any person other than the applicant.

Payment

You must include full payment of all fees with your completed application. Applications received withoutfull payment will not be processed. If you apply for both Step 1 and Step 2 on the same application form, youmust include full payment of all applicable fees for both exams or your application will be returned to you. Youcan pay by:

� Visa, MasterCard, or Discover. Complete the credit card portion of the application form.

Please Note: If you choose to pay by credit card, there will be an additional $20 creditcard processing fee for each application to cover the costs of processing your creditcard payment.

� Check, bank draft or money order. Your check, bank draft or money order must be made payable to theEDUCATIONAL COMMISSION FOR FOREIGN MEDICAL GRADUATES (or ECFMG). Paymentsfrom outside the United States must be made in United States funds through a United States bank. Youmust write your full name and USMLE / ECFMG Identification Number, if one has been assigned,on your payment.

� Wire Transfer. Funds may be wire transferred through most banks in the United States (Fedwire) to theECFMG ACCOUNT NUMBER 8611080982 at PNC BANK, N.A., ROUTING / TRANSIT NUMBER031000053. However, in order for a wire transfer to be credited to your ECFMG financial account,it must be identified with your full name and USMLE / ECFMG Identification Number, if one hasbeen assigned. If you pay by wire transfer, you must also include the following information in thepayment section of the application form: the date that the wire transfer was sent, its bank referencenumber, name of the originating bank, amount and the name of sender, if different from your name.

Do not send payments in cash.

If you owe money to ECFMG at the time that your application (or other request for service, such as TOEFLacceptance or USMLE transcripts) is processed, ECFMG will apply the payment included with yourapplication / service request to the amount that you owe. Any money that is left after this will be used to pay forthe exam(s) / service that you request. If there is not enough money remaining to pay for the exam(s) / serviceyou request, your application / request for service will not be processed.

If you have money in your ECFMG account at the time that your application (or other request for service) isprocessed, it will be used to pay for the next exam / service request processed by ECFMG. If you have money inyour ECFMG account and will not request additional exams / services, you may send a written request to ECFMGfor a refund.

Please Note: You cannot cancel or postpone your exam registration. Your fees will notbe credited toward a future exam or refunded. If you do not schedule and take theexam, you will lose your fee for the exam, and you will be required to send a newapplication and payment of all applicable fees to take the exam. If you are ineligible totake an exam, you are not entitled to a refund or credit of the exam fee(s).

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REGISTRATION AND SCHEDULING FORUSMLE STEP 1 AND STEP 2

Overview

When you apply for Step 1 or Step 2, ECFMG serves as your registration entity. This means that ECFMGprocesses your application and payment, determines your eligibility and notifies you of the outcome of yourapplication.

If ECFMG determines that you are eligible, ECFMG will forward your registration information to the NationalBoard of Medical Examiners (NBME). After receiving this information, NBME will mail your Step 1 or Step 2scheduling permit. Although your scheduling permit will be mailed by NBME, you should contact ECFMG ifyou have questions or concerns about this document.

The scheduling permit is your authorization to schedule your own testing appointment with Prometric. Prometricserves as your test delivery entity. The exam will be delivered to you in one of Prometric�s test centers. Step 1 andStep 2 are available at more than 500 Prometric test centers worldwide.

ECFMG is not responsible for errors or any associated computer problems that may occur in generating thescheduling permits or delivering the exams. These functions are the responsibility of NBME and / or Prometric.

What You Need to Do

To take Step 1 or Step 2, you must:

� Decide When and Where You Want to Take the Exam� Check That You Are Using the Appropriate Application Materials� Complete the Application Form� Include Full Payment� Submit Your Application and Payment� Receive your Scheduling Permit� Schedule your Testing Appointment with Prometric� Take the Exam

Each of these steps is discussed in detail below.

Decide When and Where You Want to Take the Exam: Your EligibilityPeriod and Testing Region

Eligibility Period

Before you apply for Step 1 or Step 2, you must choose a three-month period, such as January-February-March,February-March-April, etc., during which you would like to take the exam. This three-month period is referredto as your eligibility period. You must enter the eligibility period that you prefer on your application.

You must take the exam during the eligibility period assigned to you. You can take the exam on any day that itis offered during your assigned eligibility period, provided that there is space available at the test center that youchoose. If you apply for both Step 1 and Step 2 on the same application form, you can choose the same eligibilityperiod for both Step 1 and Step 2, or you can choose a different eligibility period for each Step.

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You should choose your eligibility period carefully. When choosing your eligibility period, remember that:

� Prometric test centers are closed on major local holidays;

� USMLE is not offered during the first two weeks in January; and

� The busiest testing times in the United States / Canada testing region are May through July and Novemberthrough December.

Your eligibility period will not be adjusted to compensate for dates when USMLE is not available.

ECFMG cannot assign you to the eligibility period you select if that eligibility period has already begun. If yourapplication is received at ECFMG after the beginning of the eligibility period you select, you will be assigned tothe next eligibility period. The eligibility period assigned to you will be listed on your scheduling permit. Youshould allow four weeks for processing of your application after it is received at ECFMG.

Testing Region

Prometric�s test centers are grouped into distinct geographical regions. Each region consists of one or morePrometric test centers. You must choose the region where you want to take the exam and enter it on the applicationform. The region that you select is referred to as your testing region. If you apply for both Step 1 and Step 2 onthe same application form, you can choose the same testing region for both Step 1 and Step 2, or you can choosea different testing region for each Step. Although you need to choose a testing region, you do not need to choosea particular test center until you contact Prometric to schedule your testing appointment.

You must take the exam in the testing region you select on the application form. You can take the exam at anytest center in your testing region that offers USMLE, provided there is space available on the date you choose.

Once your testing region has been assigned, it cannot be changed. If you cannot take the exam in the testingregion you selected on your application form, you will lose your payment for the exam, and you will needto submit a new application and full payment of all applicable fees to take the exam. In this event ECFMGcannot process a subsequent application for this exam until two weeks after the end of the eligibilityperiod for the missed exam.

A list of the Prometric testing regions and the test centers included in each region is located on page 49. Althoughthis list was current at the time of publication, the testing regions and test centers offering USMLE are subject tochange. You should visit the ECFMG web site at http://www.ecfmg.org or the Prometric web site athttp://www.prometric.com for a current list of test centers offering USMLE before you select your testing region.

Check That You Are Using the Appropriate Application Materials

Once you know when you want to take the exam, you should check that you are using the appropriate edition ofthe Information Booklet and application materials. The edition of the Information Booklet / application materialsthat you will use depends upon when you want to take the exam. You can use the 2001 application materials toapply for all eligibility periods that end in the year 2001. These eligibility periods are listed on the applicationform.

If the eligibility period that you want is not listed on the 2001 application form, you are not using the appropriateedition of this publication. If the eligibility period that you want ends in 2000, you must use the 2000 InformationBooklet. If the eligibility period that you want ends in 2002, you must use the 2002 Information Booklet. The2002 edition will be available beginning in July 2001. See How to Obtain This Publication on page ii.

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Complete the Application Form

ECFMG accepts only the official application (Form 104S). Form 104S is available on the ECFMG web site athttp://www.ecfmg.org and from ECFMG upon request. You may not register using a letter, postcard or e-mailmessage. To register for the exams, you must complete Form 104S and send it to ECFMG by mail (or courierservice). All photographs, signatures and seals / stamps must be original. You cannot register by faxing yourapplication or sending photocopies to ECFMG.

Detailed application instructions are included with the application form. Follow these application instructionscarefully and answer all questions completely. You should review these instructions before you begin workingon the application. Some of the necessary items require advance planning. These items include photographs,official signatures and additional documentation, such as copies of your medical diploma if you are a medicalschool graduate. If your application is not complete, it will be returned to you.

Please Note: The name you enter on your application will appear on your Step 1 /Step 2 scheduling permit. The spelling and order of the names on your schedulingpermit must match EXACTLY the spelling and order of the names on the form(s) ofidentification you present at the test center. If the name listed on your schedulingpermit is not correct, contact ECFMG immediately. See Take the Exam on page 32for more information.

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Step 1 and Step 2 are offered on a regular basis throughout the year. As a result, there is no deadline to submityour application and payment for these exams. However, you should consider the following factors whenplanning the timing of your application:

First, ECFMG cannot assign you to the eligibility period that you selected on your application if that eligibilityperiod has already begun. If your application is received after the beginning of the eligibility period you selected,you will be assigned to the next eligibility period.

Example: An applicant mails her Step 1 application in late July for the August-September-October eligibility period. ECFMG receives her application on August5th. Since the eligibility period selected by the applicant began on August 1st and herapplication was received on August 5th, the applicant cannot be assigned to the August-September-October eligibility period. In this case the applicant would be assigned tothe next eligibility period, September-October-November, and would not be eligibleto take the exam in August.

You should send your application well in advance of the beginning of the eligibility period that you select.Delays or interruptions in postal service may delay delivery of your application to ECFMG, especially if youmail your application from outside the United States. You should also allow four weeks for processing of yourapplication once it has been received at ECFMG.

Second, if any month in the applicant�s desired eligibility period falls within the next calendar year, the applicantmust use the next year�s application materials.

Example: An applicant decides in May 2001 that he wants to apply to take Step 2during the November-December-January eligibility period. Since the last month ofthe eligibility period desired by the applicant (January) falls within the year 2002, theapplicant must apply using the year 2002 application materials.

Application materials for the next calendar year are expected to be available in early July of the current year.The year 2002 application materials are expected to be available in July 2001.

Third, the USMLE application materials may specify a date after which you cannot use these application materialsand after which you must use the year 2002 application materials. You should check for this date before youcomplete the application form.

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Include Full Payment

You must include full payment of all fees with your application. If you do not include full payment of allapplicable fees, your application will be returned to you. If you apply for both Step 1 and Step 2 on the sameapplication form, you must send full payment of all applicable fees for both Steps with your application. SeePayment on page 25.

FFFFFees fees fees fees fees for Steor Steor Steor Steor Step 1 and Step 1 and Step 1 and Step 1 and Step 1 and Step 2p 2p 2p 2p 2

The total fee for Step 1 or Step 2 consists of the examination fee plus the appropriate international test deliverysurcharge, if applicable. All examinees must pay the examination fee. The 2001 examination fee is $615 foreach Step. If you choose a testing region other than the United States / Canada, you must also pay the internationaltest delivery surcharge for the international testing region that you choose. These surcharges represent theadditional cost of offering Step 1 and Step 2 by computer outside of the United States and Canada. If you chooseto take the exam in the United States or Canada, you do not need to pay a surcharge. Refer to pages 49-51 or tothe USMLE application materials for the international test delivery surcharges that apply to eligibility periodsending in 2001. If your application is incomplete and returned to you, any money received with that applicationwill be held as a credit on your ECFMG account and can be used toward any future exam application or service.

Submit Your Application and Payment

You should send your completed application, any attachments and full payment in the same envelope to ECFMG,following the mailing instructions on the application form. ECFMG will notify you when your application isreceived. If you provide an e-mail address on your application, ECFMG will send this notification by e-mail. Ifyou do not provide an e-mail address, ECFMG will send this notification by mail.

ECFMG will process your application and payment and determine your eligibility to take the exam(s) yourequested on the application. Once your application has been processed, ECFMG will notify you of the outcomeof your application by mail. For eligible applicants, ECFMG will also send important information about schedulingand taking the exams.

Receive Your Scheduling Permit

Once ECFMG determines that you are eligible, ECFMG will also notify NBME of your eligibility. NBME willmail your scheduling permit within two weeks of this notification. However, if the beginning of your assignedeligibility period is more than six months away, NBME will not mail your scheduling permit until approximatelysix months before the beginning of your assigned eligibility period. Although your scheduling permit will bemailed by NBME, you should contact ECFMG if you have questions or concerns about this document.

Scheduling Permit

The scheduling permit is your authorization to schedule your testing appointment with Prometric. Your schedulingpermit is a very important document, and you should be careful not to lose it. You cannot schedule yourtesting appointment or take the exam without it. The scheduling permit contains the following information:

� Your name and mailing address;� The exam for which you registered�either Step 1 or Step 2 (If you register for both Step 1 and Step 2 on the

same application form, you will receive two separate scheduling permits, one for Step 1 and one for Step 2.);� Your eligibility period�the three-month period during which you are eligible to take the exam; and� Your testing region�the geographical region in which you will take the exam.

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It also contains two important numbers:

� Your Scheduling Number�you must provide this number when you contact Prometric to schedule yourtesting appointment; and

� Your Candidate Identification Number (CIN)�you must enter your CIN into the computer at the Prometriccenter on the date of your test to unlock your exam. You must keep this number confidential. For your ownprotection, do not share your CIN with anyone.

Your scheduling permit tells you how to contact Prometric to schedule a testing appointment or get currentinformation on the test centers offering USMLE in your testing region. The contact information included onyour scheduling permit will vary, depending on whether you register for the United States / Canada testingregion or an international testing region. The information included for both cases is summarized below.

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United States / Canada Testing Region

If you are registered to take the exam in the UnitedStates or Canada, you must call Prometric to scheduleyour testing appointment. Your scheduling permitwill include the:

� telephone number

for Prometric�s Regional Registration Center for theUnited States / Canada testing region.

When you schedule your testing appointment, you will receive specific information from Prometric. Thisinformation will consist of your confirmed test date and time, the address and telephone number of the test centerand your Prometric Confirmation Number. The scheduling permit includes space for you to write down thisinformation. Be sure to record all of this information on your scheduling permit. If you need to reschedule yourtesting appointment with Prometric, you will need this Confirmation Number. Do not write anything else onyour scheduling permit.

Finally, the scheduling permit includes basic information on how to schedule your testing appointment, whatyou need to bring with you to the test center and what you should expect when you arrive at the test center onyour test date.

International Testing Regions

If you are registered to take the exams in an internationaltesting region, you can contact Prometric by phone, faxor mail to schedule your testing appointment. Yourscheduling permit will include the:

� telephone number� fax number, and� mailing address

for Prometric�s Regional Registration Center for thetesting region that you selected.

Telephone scheduling is the most direct method.However, if you cannot schedule by phone, part of yourpermit is a form that you can use to schedule anappointment by fax or mail.

Contact Information Included on Scheduling Permit

RRRRReeeeeplacement Scplacement Scplacement Scplacement Scplacement Scheduling Pheduling Pheduling Pheduling Pheduling Pererererermitsmitsmitsmitsmits

If you lose your scheduling permit, you should contact ECFMG immediately to request a replacement schedulingpermit. There may be a fee for this service. ECFMG will notify NBME that you need a replacement schedulingpermit, and NBME will mail the replacement to you by first-class mail. If you would like your replacementscheduling permit sent by a courier service, you must pay for delivery by Visa or MasterCard. Although yourreplacement scheduling permit will be mailed by NBME, you should contact ECFMG if you have questions orconcerns about this document.

Schedule Your Testing Appointment With Prometric

You must have your scheduling permit before you can schedule your testing appointment.

Before you contact Prometric to schedule your appointment, you should choose several dates when you couldtake the exam. All of the dates that you choose must fall within the eligibility period indicated on your schedulingpermit. You should also choose the test center where you want to take the exam. If there is more than one testcenter where you could take the exam, you may choose alternate test centers. The test centers that you choosemust fall within the testing region indicated on your scheduling permit. A list of the test centers included in eachtesting region is located on pages 49-51. Although this list was current at the time of publication, the testingregions and test centers offering USMLE are subject to change. For current information on test centers offeringUSMLE in your testing region, you should follow the instructions on your scheduling permit for contactingPrometric. You can also visit the ECFMG web site at http://www.ecfmg.org or the Prometric web site at http://www.prometric.com for a current list of test centers offering USMLE.

Once you receive your scheduling permit for Step 1 or Step 2, you may contact Prometric at any time to scheduleyour testing appointment. You can schedule your testing appointment with Prometric up to six months in advanceof the beginning of your eligibility period. For international testing regions, you must contact Prometric before12:00 noon (local time at the Regional Registration Center for your testing region) at least five business daysprior to the exam date that you want. For the United States / Canada testing region, you must contact Prometricbefore 12:00 noon (Eastern Time in the United States) at least two business days prior to the exam date that youwant. Testing appointments are scheduled on a first-come, first-served basis. To increase your chances of gettingthe testing date and location that you want, you should contact Prometric as soon as possible after receiving yourscheduling permit.

Scheduling by telephone is the most direct method. The appropriate Prometric telephone number is listed onyour scheduling permit. If you are registered for an international testing region and do not have access to atelephone, you can contact Prometric by fax or mail. Prometric�s fax number and mailing address are listed onyour scheduling permit. Simply make a photocopy of the Form to Schedule an Appointment by Fax or Mail thatappears on your scheduling permit and send it to Prometric. When scheduling by fax or mail, be sure to copy theform that appears on your scheduling permit. Do not send your original scheduling permit to Prometric.When copying the form, be sure not to copy your confidential Candidate Identification Number thatappears below the form. You must send a clear copy; illegible copies or faxes may delay or preventscheduling.

When you contact Prometric to schedule, you will need to give the Scheduling Number listed on your schedulingpermit. Prometric will let you know what dates are available at the location(s) you have chosen. When you makeyour appointment, Prometric will confirm with you the date and time of your exam. Prometric will give you theaddress and telephone number of the Prometric test center you selected. You will also receive a ConfirmationNumber. Be sure to write all of this information in the spaces provided on your scheduling permit. Do not writeanything else on your scheduling permit. If you schedule by phone, you will not receive a written confirmation.

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Rescheduling Your Testing Appointment

If you already have a scheduled testing appointment and you need to reschedule within your three-montheligibility period, you must contact Prometric, not ECFMG. You will need to provide your Confirmation Number.For this reason, you should be sure to record your Confirmation Number on your scheduling permit when youschedule for the first time. If you contact Prometric before 12:00 noon (local time at the Regional RegistrationCenter for your testing region) at least five business days before your scheduled appointment, you can cancel orreschedule the appointment free of charge. If you give notice of less than five business days, you must payPrometric a rescheduling fee when you arrange your new appointment. If you give notice of less than fivebusiness days, Prometric may require additional time to process your request.

Take the Exam

On the date of your testing appointment, you should arrive at the Prometric test center thirty minutes before yourscheduled start time. If you need directions to the test center, you should call the test center prior to your examdate using the telephone number that Prometric provided when you scheduled your appointment.

You need to bring both your original scheduling permit and one of the following forms of unexpired,government-issued identification that contains both your signature and photograph:

� Passport;� Driver�s license;� National identity card; or� Other form of unexpired, government-issued identification that has both your signature and photograph.

If your government-issued form of identification contains your photograph but not your signature, you can useanother form of unexpired identification that contains your signature, such as a student / employee identificationcard or a credit card, to supplement your photo-bearing, government-issued identification.

Please Note: The spelling and order of the names on your scheduling permit mustmatch the spelling and order of your names on your form(s) of identificationEXACTLY. If the name listed on your scheduling permit is not correct, contactECFMG immediately.

If you arrive late, you may not be allowed to take the exam. If you arrive more than thirty minutes late ordo not have both the scheduling permit and proper identification, you will not be allowed to take theexam. If you are not allowed to take the exam for these reasons, you will need to reschedule your testingappointment and pay Prometric a rescheduling fee.

Before beginning the exam, you will be asked to:

� Present your scheduling permit and identification,� Sign in,� Have your photograph taken, and� Store all of your personal belongings in a locker.

A proctor will lead you to a computer in the testing area. To begin your exam, you must enter your CIN into thecomputer. The exam will begin with a brief tutorial. The tutorial will help you become familiar with how thecomputer and test software work. The answers that you choose during the tutorial do not contribute to your scoreon the exam.

When your testing appointment is over, you will sign out, and a proctor will give you a notice indicating that youappeared for the exam. This notice does not include your score. Before leaving the test center, you must turn inthe portion of your scheduling permit which contains your CIN.

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How To Prepare

Format of the Exams

Step 1 and Step 2 are each one-day, multiple-choice exams. Step 1 has approximately 350 multiple choicequestions, divided into seven sixty-minute blocks, administered in one eight-hour testing session. Step 2 hasapproximately 400 multiple choice questions, divided into eight sixty-minute blocks, administered in one nine-hour testing session. The computer will keep track of how much time you have left in each block and for theentire exam.

You will have sixty minutes to complete each block of questions. Once you begin a block of the test, no breaksare provided during the block. The questions in a block will appear on the computer screen one at a time. Youwill read the material available and select an answer to the question. You can select an answer by pointing to theanswer and �clicking� with the computer�s mouse or by typing the letter (A, B, C, etc.) on the computer�skeyboard that corresponds to the answer. When you are finished with a question, you choose to move on to thenext question. Once you exit the block or the time allotted for the block runs out, you cannot go back to thequestions in that block.

Please Note: Although current at the time of publication, these exam descriptions,including test length and number of test items, are subject to change. Notice of anychanges will be posted on the USMLE web site at http://www.usmle.org.

You can take breaks, including a lunch break, between blocks of questions. You will have at least 45 minutes ofbreak time for the entire testing day. This break time can be divided in any manner, according to your preference.If you finish one or more blocks early, you can take this extra time as break time. The brief tutorial at thebeginning of the exam is available on the USMLE web site at http://www.usmle.org and on the USMLE CD. Ifyou are already familiar with the tutorial and choose to exit from it early, you can use this extra time for breaks.See Test Lengths and Formats on page 9, Completing the Test on page 19, and How Break Time Works on page19 of the USMLE Bulletin of Information.

Sample Test Materials

ECFMG provides applicants with sample test materials when they are registered for Step 1 or Step 2. Thesematerials are available in two formats�as a printed booklet and in the form of a CD. Both the booklet and CDwill help you become familiar with the types of questions you will encounter on the exams. The CD will helpyou to become familiar with the exam software that you will encounter on the date of your exam. All of thesample test materials that ECFMG provides to registered applicants are available on the USMLE web siteat http://www.usmle.org.

If you do not have extensive experience with computers, you may be concerned about taking a computer-basedexam. NBME has conducted field trials to determine the effect of prior computer experience on examineeperformance on computer-based exams. These field trials show that experience with computers generally doesnot affect how examinees score on computer-based, multiple-choice exams.

It is recommended that you practice with the exam software before taking the exam. One way to do this is to usethe Step 1 / Step 2 sample test materials that are available on the USMLE web site and on the USMLE CD. Inaddition to sending the CD to registered applicants, ECFMG provides copies of the CD containing the sampletest materials to foreign medical schools, U.S. embassies and consulates, overseas educational advising centersand a variety of other international organizations. The sample test materials may be available to you through oneof these organizations.

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Practice Session at a Prometric Test Center

If you have already received your scheduling permit for a computer-based Step, you can register to take apractice session for this Step at a Prometric test center. You must pay a fee to Prometric for this service. Youshould know that the materials used for the practice sessions at Prometric test centers are the same sampletest materials available on the USMLE web site and on the USMLE CD. No new material will be presentedduring the Prometric practice sessions.

If you would like to take a practice session at a Prometric test center, you must register for the practice session toobtain a practice session scheduling permit. You can register for a practice session on the USMLE web site athttp://www.usmle.org. Information on the fee for the practice sessions is also available at this site. If you do nothave access to the Internet, you can call ECFMG at (215) 386-5900 for assistance.

When you register for a practice session, you will be asked for the Scheduling Number and Candidate IdentificationNumber from your Step 1 or Step 2 scheduling permit. You must have your Step 1 or Step 2 scheduling permitbefore you can register for a practice session. Once you are registered for a practice session, your practicesession scheduling permit will be mailed to you.


Appropriate accommodations will be made for USMLE examinees with documented disabilities covered underthe Americans with Disabilities Act (ADA). The procedures for requesting test accommodations vary, dependingon whether you have been granted test accommodations previously and the type of accommodations you request.

� If you have never received test accommodations for a USMLE Step, you must obtain the publicationentitled Request for Test Accommodations for Examinees with Disabilities and follow its instructions beforeyou apply for the exam. This publication outlines the procedures and requirements for initial requests fortest accommodations.

� If you have received test accommodations for a previous USMLE Step and would like the identicalaccommodations, you must obtain the Form for Requesting Subsequent Test Accommodations before youapply for the exam.

� If you have received test accommodations for a previous USMLE Step but are requesting a change inaccommodations, you must obtain the Request for Test Accommodations and follow the instructions forinitial requests before you apply for the exam.

The Request for Test Accommodations and Form for Requesting Subsequent Test Accommodations are availableon the USMLE web site at http://www.usmle.org, on the USMLE CD and from ECFMG upon request.

All requests and accompanying documentation must be in English. You must send your official request /documentation to the ECFMG Test Accommodations Coordinator at the address for General Inquiries on pageiv at the same time that you mail your application for the exam. To protect your privacy, do not send yourrequest for test accommodations to the same address or in the same envelope as your application.

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REGISTRATION FOR CLINICAL SKILLS ASSESSMENT

Application Process

ECFMG accepts applications for CSA on an ongoing basis. Since ECFMG offers the CSA throughout the year,there is no deadline for submitting your application to register for the CSA.

Before applying for the CSA, you must have passed USMLE Step 1 or its equivalent (see page 11) and theEnglish Language Proficiency Test (see page 16). If ECFMG does not have your Step 1 or English languageproficiency test score at the time your CSA application is received, the application will be returned toyou. Applicants for the CSA are required to read the appropriate edition of the ECFMG Information Booklet.

ECFMG accepts only the official application (Form 706). Form 706 is available on the ECFMG web site athttp://www.ecfmg.org and from ECFMG upon request. You may not register using a letter, postcard or e-mailmessage. To register for the CSA, you must complete Form 706 and send it to ECFMG by mail (or courierservice), following the mailing instructions on the application form. All photographs, signatures andseals / stamps must be original. You cannot register by faxing your application or sending photocopies toECFMG.

Detailed application instructions are included with the CSA application form. Follow these application instructionscarefully and answer all questions completely. You should review these instructions before you begin workingon the application. Some of the necessary items require advance planning. These items include photographs ofyourself, official signatures and additional documentation, such as copies of your medical diploma if you are amedical school graduate. If your application is not complete, it will be returned to you.

If you fail the CSA and wish to retake it, you must first submit a new CSA application and payment. OnceECFMG receives your application and payment and determines that you are still eligible, information onscheduling the CSA will once again be sent to you. The scheduling process will be the same as for the originalCSA, except that you may not take the CSA within three months of your last attempt on the CSA. SeeReexamination on page 21.

CSA Fee

The Clinical Skills Assessment fee is $1,200 (U.S. dollars / Fee subject to change).

You must send full payment of the assessment fee with your application. If you do not send full payment,your application will be returned to you. See Payment on page 25.

Scheduling CSA

Once ECFMG receives your completed application and payment and determines that you are eligible (seeEligibility for CSA on page 19), ECFMG will send your notification of registration, which includes informationon scheduling the CSA.

You must schedule your CSA within four months of the date indicated on your notification of registration. Youmust take the CSA within one year of the date indicated on your notification of registration. If you do not meetthese deadlines, you will lose your payment for the assessment, and you will need to send a new application andfull payment of the assessment fee to take the CSA. Once you have scheduled a date for the CSA, you maynot change it.

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Admission Permit

Once you schedule your CSA, ECFMG will mail your admission permit to your ECFMG address of record. Theadmission permit will confirm the date, time and location of your assessment. You must present this admissionpermit at the Clinical Skills Assessment Center on your scheduled assessment date.

Clinical Skills Assessment Center

The CSA is administered only at the following location:

ECFMG Clinical Skills Assessment Center3624 Market Street, Third FloorPhiladelphia, PA 19104-2685 USA

The Clinical Skills Assessment Center cannot accommodate relatives or guests during the assessment. Luggagecannot be stored in the Center. Therefore, you should make other arrangements.

Travel Status for CSA

Applicants coming to the ECFMG Clinical Skills Assessment Center in Philadelphia who are neither U.S. citizensnor U.S. residents are responsible for obtaining appropriate travel documents to allow them to enter the UnitedStates for the purpose of taking the CSA.

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ENTRY INTO GRADUATE MEDICAL EDUCATIONIN THE UNITED STATES:

An Overview for Graduates of Foreign Medical Schools

Graduates of foreign medical schools must have a valid Standard ECFMG Certificate to enter programs ofgraduate medical education (GME) in the United States that are accredited by the Accreditation Council forGraduate Medical Education (ACGME). However, for graduates of foreign medical schools, obtaining ECFMGcertification is just one of the steps required to enter an ACGME-accredited program of graduate medical education.The purpose of this section is to provide an introduction to the steps typically involved in entering graduatemedical education in the U.S.

Please Note: The information that follows is intended as a general introduction. It isnot intended to be a complete list of all requirements. Additionally, some informationmay not be relevant for all applicants. While this overview is believed to be accurateas of this writing, ECFMG assumes no responsibility or liability therefore. In eachcase, you should contact the particular institution, organization, program or statelicensing authority for specific requirements.

Residency Training Programs

Residency programs, usually referred to as �residencies,� are offered by training institutions, such as universities,medical schools, and hospitals. Residencies are offered in the twenty-four medical specialties recognized by theAmerican Board of Medical Specialties (ABMS). These specialties are:� Allergy & Immunology� Anesthesiology� Colon & Rectal Surgery� Dermatology� Emergency Medicine� Family Practice� Internal Medicine� Medical Genetics� Neurological Surgery� Nuclear Medicine� Obstetrics & Gynecology� Ophthalmology

� Orthopedic Surgery� Otolaryngology� Pathology� Pediatrics� Physical Medicine & Rehabilitation� Plastic Surgery� Preventive Medicine� Psychiatry & Neurology� Radiology� Surgery� Thoracic Surgery� Urology

AAAAACGME CGME CGME CGME CGME AccrAccrAccrAccrAccreditaeditaeditaeditaeditationtiontiontiontion

The Accreditation Council for Graduate Medical Education is the body that accredits U.S. graduate medicaleducation programs. The ACGME has established General Requirements for all residencies as well as SpecialRequirements for each medical specialty. The ACGME accredits individual programs, not institutions. Refer tothe current edition of the Graduate Medical Education Directory (see below) for a complete list of ACGME-accredited residency programs.

The Graduate Medical Education Directory

The Graduate Medical Education Directory, published by the American Medical Association (AMA), is recognizedas the official list of ACGME-accredited graduate medical education programs. In addition to describing theGeneral and Special Requirements for each medical specialty, the Directory lists all accredited residency programsby specialty. The entry for each program includes:

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� the name and location of the residency program,� the size of the program,� the official program number, and� contact information for the residency program director.

This publication may be available to you in your medical school�s library. You can purchase this publication byvisiting the AMA web site at http://www.ama-assn.org or by contacting the American Medical Association,Order Dept. OP416700, PO Box 7046, Dover, DE 19903-7046 USA; Telephone: (800) 621-8335; Fax: (312)464-5600.

Number and Availability of Residency Positions

There are no formal restrictions, overall or by program, limiting the number of graduates of foreign medicalschools that enter into ACGME-accredited residency training programs. However, certain specialties and programswithin those specialties vary in their competitiveness.

The number of positions available in any given year depends on a variety of factors, including the amount offunding available to the program and the program�s staffing needs. In the 2000 Match (for residency programsbeginning in July 2000), ACGME-accredited programs offered 20,598 Post Graduate Year 1 (PGY1) positions.Of the 8,456 foreign graduates who were active participants in the 2000 Match, 3,532 or 41.7% were matched toPGY1 positions.

ECFMG plays no role in determining the number or mix of residency positions that are offered by residencyprograms or in selecting applicants to fill these positions. All decisions regarding the selection of applicants,including whether an interview is granted, whether and where an applicant is ranked for purposes of the NationalResident Matching Program, and whether a contract is actually offered, are made by the Program Directors ofthe residency programs.

Selecting Residency Programs

Before you can begin the application process, you must select one or more medical specialties. Selecting amedical specialty is best done with the help of advisors. It may be helpful to consult physicians practicing in thespecialties you are considering. You should also consider the degree to which a given specialty would beprofessionally satisfying. For each specialty, it may be useful to research the overall number of positions available,the degree of competition typically experienced in obtaining a position, and the experience of prior graduates offoreign medical schools, particularly graduates of your medical school, in obtaining residency positions.

After you have selected a specialty or specialties, you must decide to which programs within those specialtiesyou will apply. There is no limit on the number of programs to which you can apply. Additional factors that youmay wish to consider in selecting programs include location of individual programs, their hospital affiliations,accreditation, and the performance of their graduates.

ECFMG Certification

You must hold a valid Standard ECFMG Certificate before entering an ACGME-accredited residency program.See Requirements for ECFMG Certification on page 7. Two of the exam dates, the English test date and the CSAdate, on the Standard ECFMG Certificate are subject to expiration for the purpose of entering a graduate medicaleducation program. The dates through which passing performances on the English test and, if required forECFMG certification, the Clinical Skills Assessment remain valid for the purpose of entry into graduate medicaleducation are indicated on the Standard ECFMG Certificate. If your English test or CSA date expires, you mustrevalidate it prior to the program start date by passing a subsequent exam. See Revalidation on page 9.

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Although you must be ECFMG-certified by the program start date, you can apply to residency programs beforeyou are certified by ECFMG. When you make preliminary inquiries with hospitals, you may use a photocopyof your exam results, which contains your ECFMG certification status. Prior to entering into the program, youshould provide the hospital with a copy of your Standard ECFMG Certificate. Additionally, the hospital shouldcontact ECFMG to confirm your ECFMG certification status. See Confirmation of ECFMG Certification Statuson page 10.

You can also participate in the National Resident Matching Program prior to becoming ECFMG certified, providedyou have passed all exams required for ECFMG certification and the results of these exams are available by theNRMP Rank Order List deadline in February of the year that the training program begins. See National ResidentMatching Program on page 40.

Applying to Graduate Medical Education Programs

Electronic Residency Application Service (ERAS®)

There are currently two methods of applying to U.S. GME programs: submitting an electronic application usingthe Electronic Residency Application Service and submitting a paper application. Most programs requireapplicants to submit their residency applications using ERAS. ERAS transmits residency applications andsupporting documents, such as transcripts and letters of recommendation, to residency program directors overthe Internet. ERAS was developed by the Association of American Medical Colleges (AAMC).

As the designated Dean�s Office for all students and graduates of foreign medical schools, ECFMG coordinatesthe application process for these applicants. To participate in ERAS 2001, applicants must have access to theInternet. ECFMG provides each applicant with a unique identification number, known as a token, which allowsthe applicant to access the AAMC�s ERAS web site to complete his / her ERAS application via the Internet. Theapplicant also sends his / her supporting documents to ECFMG for scanning and transmission to the ERAS PostOffice.

Specialties utilizing ERAS 2001 (for residency positions beginning in July 2001) are:

� Anesthesiology� Dermatology� Diagnostic Radiology� Emergency Medicine� Family Practice� Family Practice / Physical Medicine & Rehabilitation combined programs� Internal Medicine (preliminary and categorical)� Internal Medicine / Emergency Medicine combined programs� Internal Medicine / Family Practice combined programs� Internal Medicine / Pediatrics combined programs� Internal Medicine / Physical Medicine & Rehabilitation combined programs� Internal Medicine / Psychiatry combined programs� Obstetrics & Gynecology� Orthopedic Surgery� Pathology� Pediatrics� Pediatrics / Emergency Medicine combined programs� Pediatrics / Physical Medicine & Rehabilitation combined programs

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� Physical Medicine & Rehabilitation� Psychiatry� Surgery (General)� Transitional Year� All U.S. Army and Navy programs

If you apply to programs in any of these specialties, you must submit your applications using ERAS. The formfor requesting ERAS application materials is available on the ECFMG web site at http://www.ecfmg.org or fromECFMG upon request. If you apply to programs in specialties that are not listed above, you must contact theProgram Directors for paper application materials and instructions.

Additional specialties are expected to utilize ERAS for residency programs beginning in July 2002. Informationon participating specialties for ERAS 2002 and other topics will be posted on the ERAS home page on theECFMG web site at http://www.ecfmg.org as it becomes available. All applicants for residency positions, regardlessof the method of application, should contact residency program directors for specific requirements and deadlines.

National Resident Matching Program (NRMP)

The National Resident Matching Program (NRMP), also known as �the Match,� matches applicants with availablepositions in programs of graduate medical education. Applicants submit to the NRMP a list of residency programsin order of preference. The programs listed are those programs to which they have applied (via ERAS ortraditional paper applications). Program directors also submit to the NRMP ranked lists of the applicants theyprefer for positions in their programs. These lists are referred to as rank order lists. Once the NRMP has collectedall of this information, applicants and available positions are matched by a computer algorithm. The matches areannounced in March for programs that begin in July. Both applicants and program directors that submit rankorder lists are obligated to accept the results of the Match.

You can include any or all of the programs to which you applied (via ERAS or traditional paper applications) onyour rank order list. When compiling your rank order list, you should consider any indications that ProgramDirectors have given you regarding the likelihood of being highly ranked. However, you should not interpretthese indications as commitments. Other factors, including the competitiveness of the programs, should also beconsidered. Recent data from the NRMP indicate that your chances of being matched may increase with thenumber of programs that you rank. However, since it is possible to match with any program you rank, even if theprogram ranks low on your list, you should not include programs that you definitely do not want to attend.

Most Program Directors consider the interview to be a critical part of the selection process. When compilingtheir rank order lists, program directors typically give preference to applicants they have interviewed. There isno guarantee that the programs to which you have applied will include you on their rank order lists. If you areranked by programs, there is no guarantee that you will be matched to any of these programs.

Please Note: The NRMP and ERAS are distinct, complementary programs. ERAS isa method of applying to residency programs. The NRMP is a method of matchingapplicants with positions in these programs.

Registering for the NRMP is a separate process from applying to residency programsthrough ERAS. If you wish to participate in both the NRMP and ERAS, you mustapply to both programs. Applying to residency programs through ERAS does notenroll you in the NRMP.

Participants who are not matched to a position and program directors with positions that were not filled by theMatch are notified of this fact simultaneously, one day prior to the day on which the general Match results areannounced. The NRMP posts the list of unfilled positions on its web site at http://www.nrmp.aamc.org.

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To participate in the Match, students / graduates of foreign medical schools must have passed all exams necessaryfor ECFMG certification and the results must be available by the NRMP Rank Order List deadline in February.(Students / graduates of Fifth Pathway Programs must have met the medical science examination requirementfor ECFMG certification and the results must be available by the NRMP Rank Order List deadline to participatein the Match.) The NRMP will contact ECFMG directly to confirm that you have passed the necessary exams.

Please Note: If you have passed exam(s) administered by other organizations, such asthe National Board of Medical Examiners, the Federation of State Medical Boardsand the Educational Testing Service, that may be used for ECFMG certification, youshould provide this information to ECFMG well in advance of the NRMP Rank OrderList deadline. ECFMG will not report such exam information to the NRMP for thepurpose of confirming your eligibility to participate in the Match until such examinformation has been verified by ECFMG with the organization that administeredthe exams and accepted by ECFMG.

To participate in the 2001 Match, you will need access to the Internet. Participants in the 2001 Match will usethe Internet to submit their rank order lists to the NRMP. They will also use the Internet to access informationresulting from the Match, such as whether they have matched, where they have matched and information onvacant positions.

Important dates for the 2001 Match:

June 2000 Registration Materials Available / Independent Applicant Agreement

December 1, 2000 Enrollment Deadline

February 22, 2001 Rank Order Lists / Withdrawals / Other Pertinent Information to the Match

March 19, 2001 Results of Match Announced

Tentative dates for the 2002 Match:

June 2001 Registration Materials Available / Independent Applicant Agreement

December 1, 2001 Enrollment Deadline

Mid-February 2002 Rank Order Lists / Withdrawals / Other Pertinent Information to the Match

Mid-March 2002 Results of Match Announced

For NRMP application materials and additional information, visit the NRMP web site at http://www.nrmp.aamc.orgor contact: NRMP, 2501 M. Street, NW, Suite 1, Washington, D.C. 20037-1307 USA; Telephone: (202) 828-0566; E-mail: [email protected]. Students / graduates of foreign medical schools (and Fifth Pathway Programs)must include their USMLE / ECFMG Identification Number on all enrollment materials.

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Obtaining a Visa

Foreign medical graduates who are not U.S. citizens or permanent residents must obtain an appropriate visa forthemselves and their dependents, if any, to participate in programs of graduate medical education or training inthe United States. The most common visa employed for this purpose is the J visa (see Exchange Visitor SponsorshipProgram on page 42).

Examination Requirements Under the Health Professions Educational Assistance Act of1976 (PL94-484)

To obtain a visa to enter the United States to perform services as members of the medical profession or to receivegraduate medical education, certain alien physicians are required under the provisions of Public Law 94-484 topass the National Board of Medical Examiners (NBME) Part I and Part II exams or an exam determined to beequivalent for this purpose. The Secretary of Health and Human Services has recognized Step 1 and Step 2 of theUnited States Medical Licensing Examination (USMLE), as well as the former Visa Qualifying Examination(VQE) and the Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS), as equivalent toNBME Part I and Part II exams for the purposes of PL94-484. For additional information on visa requirements,you should contact U.S. Embassies or Consulates abroad or the Immigration and Naturalization Service in theUnited States.

Exchange Visitor Sponsorship Program (J-1 Visa)

ECFMG is authorized by the U.S. Department of State to sponsor foreign national physicians as J-1 ExchangeVisitors in ACGME-accredited programs of graduate medical education and training. The objectives of thisprogram are to enhance international exchange in the field of medicine and to promote mutual understandingbetween the people of the United States and other countries through the interchange of persons, knowledge andskills.

The duration of stay for a J-1 Exchange Visitor physician is limited to the time typically required to complete theadvanced medical education program. This refers to the specialty and subspecialty certification requirementspublished by the American Board of Medical Specialties. Participation is further limited to seven years and isreserved for those progressing in accredited training programs.

Foreign national physicians seeking ECFMG sponsorship as J-1 Exchange Visitors must, among otherrequirements, meet the following general requirements:

� Have passed USMLE Step 1 and Step 2 or the former VQE, NBME Part I and Part II or FMGEMS (SeeExamination Requirements Under PL94-484 above.);

� Hold a valid Standard ECFMG Certificate (See Revalidation on page 9.);

� Hold a contract or an official letter of offer for a position in an ACGME-accredited program of graduatemedical education or training that is affiliated with a medical school;

� Provide a statement of need from the Ministry of Health of the country of nationality or last legal permanentresidence. This statement must provide written assurance that the country needs specialists in the area inwhich the Exchange Visitor will receive training. It also serves to confirm the physician�s commitment toreturn to that country upon completion of training in the United States (as required by §212(e) of theImmigration and Nationality Act as amended). (Note: If permanent residence is in a country other than thatof citizenship, the Ministry of Health letter must come from the country of last legal permanent residence.)

Application materials and additional information on the Exchange Visitor Sponsorship Program are available onthe ECFMG web site at http://www.ecfmg.org, on the USMLE CD and from ECFMG upon request.

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ECFMG AIMS AND MISSIONS

The Educational Commission for Foreign Medical Graduates (ECFMG) has the responsibility of evaluatingqualifications of graduates of foreign medical schools who seek entry into postgraduate medical education positionsin the United States, and has an organizational commitment to promote excellence in international medicaleducation.

In recognition and fulfillment of public responsibilities for the quality of health care, its delivery, and healthprofessions education, the sponsoring organizations established ECFMG to concern itself with internationalmedical education and graduates of foreign medical schools.

To meet its responsibilities, ECFMG identifies the following as its aims and missions:

� Provide information to graduates of foreign medical schools regarding entry into graduate medical educationand health care systems in the United States;

� Evaluate the qualifications of graduates of foreign medical schools for entry into graduate medical educationand health care systems in the United States;

� Identify the cultural and professional needs of graduates of foreign medical schools and assist in theestablishment of educational policies and programs to meet these needs;

� Provide international access to testing and evaluation programs;

� Gather, maintain, analyze, and disseminate data and conduct research studies on such data concerninggraduates of foreign medical schools;

� Assist foreign medical schools and other institutions and international agencies concerned with healthprofessions education through consultation and cooperation relative to program development, standard settingand evaluation.

ECFMG SPONSORING ORGANIZATIONS

The Educational Commission for Foreign Medical Graduates (ECFMG) is a private, non-profit organizationsponsored by the:

American Board of Medical Specialties

American Medical Association

Association of American Medical Colleges

Association for Hospital Medical Education

Federation of State Medical Boards of the United States, Inc.

National Medical Association

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ACRONYM KEY

AAMC Association of American Medical Colleges

ABMS American Board of Medical Specialties

ACGME Accreditation Council for Graduate Medical Education

AMA American Medical Association

CBT Computer-Based Testing

CD Compact Disc

CIN Candidate Identification Number

CSA Clinical Skills Assessment

ECFMG Educational Commission for Foreign Medical Graduates

ERAS Electronic Residency Application Service

ETS Educational Testing Service

EVSP Exchange Visitor Sponsorship Program

FLEX Federation Licensing Examination

FMGEMS Foreign Medical Graduate Examination in the Medical Sciences

FSMB Federation of State Medical Boards of the United States, Inc.

LCME Liaison Committee on Medical Education

NBME National Board of Medical Examiners

NRMP National Resident Matching Program

SP Standardized Patient

TOEFL Test of English as a Foreign Language

USMLE United States Medical Licensing Examination

VQE Visa Qualifying Examination

WHO World Health Organization

44

Please Note: The information in this reference guide, although based upon the mostcurrent information available at the time of publication, is subject to change.

ACountry of Medical School Required CredentialsAfghanistan ____________________________________ Doctor of Medicine diplomaAlbania ________________________________________ Mjek I Perggithshem (Physician) diplomaAlgeria ________________________________________ Docteur en Medecine diplomaAngola ________________________________________ Doctor em Medicina diplomaAntigua and Barbuda _____________________________ Doctor of Medicine DiplomaArgentina ______________________________________ Medico diplomaArmenia _______________________________________ Physician diplomaAustralia _______________________________________ MB, BS diplomaAustria ________________________________________ Doctor Medicinae Universae diplomaAzerbaijan______________________________________ Physician diploma

BCountry of Medical School Required CredentialsBahrain ________________________________________ MB, BS diplomaBangladesh _____________________________________ MB, BS diplomaBarbados _______________________________________ MB, BS diplomaBelarus ________________________________________ Physician diplomaBelgium _______________________________________ Doctor of Medicine, Surgery and Obstetrics diplomaBelize _________________________________________ Doctor of Medicine diplomaBenin _________________________________________ Doctorat d�Etat en Medecine diplomaBolivia ________________________________________ Titulo en Provision Nacional diplomaBosnia-Herzegovina ______________________________ Physician or Doctor of Medicine diplomaBrazil _________________________________________ Medico diplomaBulgaria _______________________________________ Master�s diploma (qualification �Physician�)Burkina Faso____________________________________ Doctorat d�Etat en Medecine diplomaBurundi ________________________________________ Doctorat en Medecine diploma

CCountry of Medical School Required CredentialsCambodia ______________________________________ Diplome de Docteur en MedecineCameroon ______________________________________ Docteur en Medecine diplomaCentral African Republic __________________________ Doctorat d�Etat en Medecine diplomaChile __________________________________________ Titulo de Medico Cirujano diplomaChina, People�s Republic of ________________________ Bachelor of Medicine in Medicine diplomaColombia ______________________________________ Doctor en Medicina y Cirugia diplomaCongo _________________________________________ Diplome d�Etat de Docteur en MedecineCook Islands ____________________________________ Doctor of Medicine diplomaCosta Rica ______________________________________ Titulo, Licenciado or Grado en Medicina y Cirugia diplomaCote d�Ivoire____________________________________ Doctorat d�Etat en Medecine diplomaCroatia ________________________________________ Physician or Doctor of Medicine diplomaCuba __________________________________________ Doctor en Medicina diplomaCzech Republic __________________________________ Medicinae Universae Doctor diploma

DCountry of Medical School Required CredentialsDenmark _______________________________________ Laegevidenskabelig Kandidatekamen (diploma)Dominica ______________________________________ Doctor of Medicine diplomaDominican Republic ______________________________ Doctor en Medicina diploma

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APPENDIX 1: REFERENCE GUIDE FOR MEDICAL EDUCATION CREDENTIALS

ECountry of Medical School Required CredentialsEcuador ________________________________________ Doctor en Medicina y Cirugia diplomaEgypt _________________________________________ MB, BS diplomaEl Salvador _____________________________________ Doctor en Medicina diplomaEstonia ________________________________________ Physician diplomaEthiopia _______________________________________ Doctor of Medicine diploma

FCountry of Medical School Required CredentialsFiji ___________________________________________ MB, BS diplomaFinland ________________________________________ Licentiate in Medicine diplomaFrance _________________________________________ Diplome d�Etat de Docteur en Medecine

GCountry of Medical School Required CredentialsGabon _________________________________________ Doctorat d�Etat en Medecine diplomaGeorgia ________________________________________ Physician diplomaGermany _______________________________________ Zeugnis uber die Arztliche Prufung (dritten Abschnitt)Ghana _________________________________________ MB, ChB diplomaGreece _________________________________________ Ptychion Iatrikes diplomaGrenada________________________________________ Doctor of Medicine diplomaGuatemala ______________________________________ Titulo de Medico y Cirujano diplomaGuinea ________________________________________ Docteur en Medecine diplomaGuyana ________________________________________ MB, BS diploma

HCountry of Medical School Required CredentialsHaiti __________________________________________ Docteur en Medecine diplomaHonduras ______________________________________ Doctor en Medicina y Cirugia diplomaHong Kong _____________________________________ MB, BS diplomaHungary _______________________________________ Orvosdoktori diploma

ICountry of Medical School Required CredentialsIceland ________________________________________ Candidatus Medicinae et Chirugiae diplomaIndia __________________________________________ MB, BS diplomaIndonesia ______________________________________ Dokter diplomaIran ___________________________________________ Doctor of Medicine diplomaIraq ___________________________________________ MB, BCh diplomaIreland _________________________________________ MB, BCh, BAO diplomaIsrael __________________________________________ Doctor of Medicine diplomaItaly ___________________________________________ Laurea in Medicina e Chirurgia diploma

JCountry of Medical School Required CredentialsJamaica ________________________________________ MB, BS diplomaJapan __________________________________________ MB diplomaJordan _________________________________________ Bachelor of Medicine and Surgery diploma

KCountry of Medical School Required CredentialsKazakhstan _____________________________________ Physician diplomaKenya _________________________________________ MB, ChB diplomaKorea, Democratic People�s Republic ________________ Doctor diplomaKorea, Republic of _______________________________ Hak Sa diplomaKuwait ________________________________________ Bachelor of Medicine and Surgery diplomaKyrgyzstan _____________________________________ Physician diploma

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LCountry of Medical School Required CredentialsLaos __________________________________________ Docteur en Medecine diplomaLatvia _________________________________________ Physician diplomaLebanon _______________________________________ Doctor of Medicine diplomaLiberia_________________________________________ Doctor of Medicine diplomaLibyan Arab Jamahiriya ___________________________ MB, BCh diplomaLithuania _______________________________________ Physician diploma

MCountry of Medical School Required CredentialsMacedonia _____________________________________ Physician or Doctor of Medicine diplomaMadagascar _____________________________________ Docteur en Medecine Diplome d�EtatMalawi ________________________________________ Bachelor of Medicine diplomaMalaysia _______________________________________ Bachelor of Medicine and Bachelor of Surgery diplomaMali __________________________________________ Diplome d�Etat de Docteur en MedecineMalta __________________________________________ Doctor of Medicine and Surgery diplomaMexico ________________________________________ Titulo de Medico Cirujano or Medico Cirujano y Partero or Medico

Homeopatia, Cirujano y Partero diplomaMicronesia _____________________________________ Doctor of Medicine DiplomaMoldova _______________________________________ Physician diplomaMongolia ______________________________________ Physician diplomaMontserrat _____________________________________ Doctor of Medicine diplomaMorocco _______________________________________ Docteur en Medecine diplomaMozambique ____________________________________ Licenciatura em Medecina diplomaMyanmar ______________________________________ MB, BS diploma

NCountry of Medical School Required CredentialsNepal__________________________________________ MB, BS diplomaNetherlands _____________________________________ Arts diplomaNetherlands Antilles ______________________________ Doctor of Medicine DiplomaNew Zealand ____________________________________ MB, ChB diplomaNicaragua ______________________________________ Doctor en Medicina y Cirugia diplomaNiger __________________________________________ Docteur en Medecine diplomaNigeria ________________________________________ MB, BS diplomaNorway ________________________________________ Candidatus Medicinae diploma

OCountry of Medical School Required CredentialsOman _________________________________________ Doctor of Medicine diploma

PCountry of Medical School Required CredentialsPakistan _______________________________________ MB, BS diplomaPanama ________________________________________ Doctor en Medicina diplomaPapua New Guinea _______________________________ MB, BS diplomaParaguay _______________________________________ Doctor en Medicina y Cirugia diplomaPeru ___________________________________________ Titulo de Medico Cirujano diplomaPhilippines _____________________________________ Doctor of Medicine diplomaPoland _________________________________________ Lekarz diplomaPortugal _______________________________________ Licenciatura em Medicina diploma

Q/RCountry of Medical School Required CredentialsRomania _______________________________________ Medic diplomaRussia _________________________________________ Physician diplomaRwanda ________________________________________ Docteur en Medecine diploma

47

SCountry of Medical School Required CredentialsSt. Christopher and Nevis__________________________ Doctor of Medicine diplomaSt. Lucia _______________________________________ Doctor of Medicine diplomaSaudi Arabia ____________________________________ MB, BS diplomaSenegal ________________________________________ Doctorat d�Etat en Medecine diplomaSierra Leone ____________________________________ MB, BS diplomaSingapore ______________________________________ MB, BS diplomaSlovak Republic _________________________________ Medicinae Universae Doctor diplomaSlovenia _______________________________________ Physician or Doctor of Medicine diplomaSomalia ________________________________________ Laurea en Medicina e Chirugia diplomaSouth Africa ____________________________________ MB, BS diplomaSpain __________________________________________ Licenciado en Medicina y Cirugia diplomaSri Lanka ______________________________________ MB, BS diplomaSudan _________________________________________ MB, BS diplomaSuriname _______________________________________ Arts diplomaSweden ________________________________________ Lakarexamen with Course MeritsSwitzerland _____________________________________ Federal DiplomaSyria __________________________________________ Doctor of Medicine diploma

TCountry of Medical School Required CredentialsTaiwan ________________________________________ MB diplomaTajikistan ______________________________________ Physician diplomaTanzania _______________________________________ Doctor of Medicine diplomaThailand _______________________________________ Doctor of Medicine diplomaTogo __________________________________________ Doctor of Medicine diplomaTrinidad and Tobago _____________________________ MB, BS diplomaTunisia ________________________________________ Doctorat d�Etat en Medecine diplomaTurkey ________________________________________ Doctor of Medicine diplomaTurkmenistan ___________________________________ Physician diploma

UCountry of Medical School Required CredentialsUganda ________________________________________ MB, ChB diplomaUkraine ________________________________________ Physician diplomaUnited Arab Emirates _____________________________ MB, BS diplomaUnited Kingdom _________________________________ MB, ChB, BAO diploma or MB, ChB diplomaUruguay _______________________________________ Doctor en Medicina diplomaUzbekistan _____________________________________ Physician diploma

V/WCountry of Medical School Required CredentialsVenezuela ______________________________________ Titulo de Medico Cirujano diplomaVietnam _______________________________________ National Doctor of Medicine (Bang Tot Nghiep) diploma

X/Y/ZCountry of Medical School Required CredentialsYemen, Republic of ______________________________ MB, BS diploma or Doctor of Medicine diplomaYugoslavia, Federal Republic of ____________________ Physician or Doctor of Medicine diplomaZaire __________________________________________ Doctor of Medicine diplomaZambia ________________________________________ MB, ChB diplomaZimbabwe ______________________________________ MB, ChB diploma

Note Regarding Ineligible Practitioners: Graduates licensed only in stomatology,ayurvedic or homeopathic medicine, or those awarded only the diploma of Physician-Epidemiologist-Hygienist, Physician-Cyberneticist, Physician-Biophysicist, LicensedMedical Practitioner or Assistant Medical Practitioner are not eligible for admissionto the exams or for ECFMG certification.

48

APPENDIX 2: TESTING REGIONS AND INTERNATIONAL TEST DELIVERY SURCHARGES FOR

USMLE STEP 1 AND STEP 2

USMLE Step 1 and Step 2 are expected to be available at the Prometric test centers listed below in 2001. You must enter on theapplication form one of the TESTING REGIONS (AFRICA, ASIA, etc.) from the list below. The countries and cities listed foreach testing region are provided for reference only in selecting a testing region. Do not write countries or cities on the application.Although this list was current at the time of publication, the test centers available for USMLE are subject to change. You arestrongly encouraged to visit the ECFMG web site at http://www.ecfmg.org or the Prometric web site athttp://www.prometric.com to obtain current information on test centers in specific testing regions.

You must also enter the appropriate INTERNATIONAL TEST DELIVERY SURCHARGE from the list below for each examfor which you register. These surcharges are in addition to the examination fee of $615. (See Fees for Step 1 and Step 2 onpage 29.) Please note that the surcharges differ depending on which testing region and exam (Step 1 or Step 2) you select.

AFRICA International Test Delivery Surcharges: STEP 1 - $100 / STEP 2 - $110CAMEROON: YaoundeGHANA: AccraKENYA: NairobiMAURITIUS: Port Louis

SENEGAL: DakarSOUTH AFRICA: Cape Town, Durban, JohannesburgUGANDA: KampalaZIMBABWE: Harare

ASIA International Test Delivery Surcharges: STEP 1 - $100 / STEP 2 - $110BANGLADESH: DhakaMALAYSIA: Kota Kinabalu, Kuala Lumpur, Kuching, PenangNEPAL: KathmanduPAKISTAN: Islamabad, Karachi

PEOPLE�S REPUBLIC OF CHINA: Hong Kong (For other PRC centers, see CHINA testing region.)PHILIPPINES: Cebu City, ManilaSINGAPORE: SingaporeSRI LANKA: Colombo

AUSTRALIA International Test Delivery Surcharges: STEP 1 - $100 / STEP 2 - $110AUSTRALIA: Brisbane, Perth, Sydney NEW ZEALAND: Auckland, Christchurch, Wellington

EUROPE International Test Delivery Surcharges: STEP 1 - $125 / STEP 2 - $140ARMENIA: YerevanAUSTRIA: ViennaBELGIUM: BrusselsCROATIA: ZagrebCYPRUS: Nicosia-Homer Avenue, Nicosia-Gurner TurkmenCZECH REPUBLIC: PragueFINLAND: HelsinkiFRANCE: Bordeaux, Lyon, Marseille, Paris, Rennes, ToulouseGEORGIA: TiblisiGERMANY: Berlin, Frankfurt, Hamburg, MunichGREECE: Athens, ThessalonikiHUNGARY: BudapestICELAND: ReykjavikIRELAND: Dublin

ISRAEL: Tel Aviv (For other Israel centers, see MIDDLE EAST testing region.)ITALY: Milan, RomeLITHUANIA: VilniusNETHERLANDS: Arnhem, WoerdenNORWAY: OsloPORTUGAL: LisbonROMANIA: BucharestRUSSIAN FEDERATION: MoscowSPAIN: Barcelona, Madrid, PamplonaSWEDEN: Goteborg, Lund, StockholmSWITZERLAND: GenevaTURKEY: AnkaraUKRAINE: KievUNITED KINGDOM: Belfast, Glasgow, London, Manchester, Twickenham

INDIA International Test Delivery Surcharges: STEP 1 - $100 / STEP 2 - $110INDIA: Ahmadabad, Allahabad, Bangalore, Hyderabad, Madras, Mumbai, Mumbai Usefi, New Delhi, Trivandrum

INDONESIA International Test Delivery Surcharges: STEP 1 - $100 / STEP 2 - $110INDONESIA: Jakarta, Medan, Surabaya

49

CHINA International Test Delivery Surcharges: STEP 1 - $100 / STEP 2 - $110PEOPLE�S REPUBLIC OF CHINA: Beijing, Guangzhou, Shanghai (For Hong Kong, see ASIA testing region.)

JAPAN International Test Delivery Surcharges: STEP 1 - $245 / STEP 2 - $270JAPAN: Fukuoka, Hiroshima, Osaka, Sapporo, Sendai, Tokyo

KOREA: Seoul

LATIN AMERICA International Test Delivery Surcharges: STEP 1 - $100 / STEP 2 - $110EL SALVADOR: San SalvadorGUATEMALA: Guatemala CityJAMAICA: KingstonMEXICO: Guadalajara, Mexico City, MonterreyNICARAGUA: ManaguaPANAMA: Panama CityPERU: LimaVENEZUELA: Caracas

KOREA International Test Delivery Surcharges: STEP 1 - $125 / STEP 2 - $140

ARGENTINA: Buenos AiresBOLIVIA: La PazBRAZIL: Belo Horizonte, Brasilia, Curitiba, Fortaleza, Porto Alegre, Recife, Rio De Janeiro, Salvador, Sao PauloCHILE: SantiagoCOLOMBIA: BogotaCOSTA RICA: San JoseDOMINICAN REPUBLIC: Santo DomingoECUADOR: Quito

MIDDLE EAST International Test Delivery Surcharges: STEP 1 - $100 / STEP 2 - $110BAHRAIN: ManamaEGYPT: CairoISRAEL: East Jerusalem (For other Israel centers, See EUROPE testing region.)JORDAN: AmmanKUWAIT: Kuwait CityLEBANON: Antelias, BeirutMOROCCO: Rabat

OMAN: MuscatQATAR: DohaSAUDI ARABIA:

DAMMAM-Men, JEDDAH-Men, RIYADH-MenDAMMAM-Women, JEDDAH-Women, RIYADH-Women

SYRIA: DamascusTUNISIA: TunisUNITED ARAB EMIRATES: Abu Dhabi, Dubai

THAILAND International Test Delivery Surcharges: STEP 1 - $100 / STEP 2 - $110THAILAND: Bangkok, Chiang Mai

TAIWAN International Test Delivery Surcharges: STEP 1 - $125 / STEP 2 - $140TAIWAN: Taipei

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UNITED STATES & CANADA International Test Delivery Surcharges: STEP 1 - $ 0 / STEP 2 - $ 0

UNITED STATESALABAMA: Birmingham, Decatur, Dothan, Mobile,

MontgomeryALASKA: AnchorageAMERICAN SAMOA: Pago PagoARIZONA: Phoenix, Phoenix/Goodyear, TucsonARKANSAS: Arkadelphia, Fort Smith, Little RockCALIFORNIA: Anaheim, Atascadero, Brea/Fullerton,

Diamond Bar, Fremont, Gardena, Glendale, Irvine, LosAngeles/Culver City, Palm Desert, Piedmont, RanchoCucamonga, Redlands, Riverside, Sacramento/Fair Oaks,San Diego/Del Mar, San Diego/La Mesa, San Francisco,San Francisco/West Portal, San Jose, Santa Rosa, WalnutCreek, Westlake Village

COLORADO: Colorado Springs, Denver, Glendale,Longmont, Pueblo

CONNECTICUT: Glastonbury, Hamden, NorwalkDELAWARE: Dover, WilmingtonDISTRICT OF COLUMBIA: WashingtonFLORIDA: Fort Myers, Gainesville, Jacksonville, Miami

Lakes, Miami/Davie, Miami/Hollywood, Orlando/Maitland, Orlando/Castleberry, Sarasota, Tallahassee,Tampa, Temple Terrace

GEORGIA: Albany, Atlanta, Atlanta/Jonesboro, Atlanta/Marietta, Augusta, Macon, Savannah, Valdosta

GUAM: Hagatna, Dedeo/SaipanHAWAII: KailuaIDAHO: BoiseILLINOIS: Carbondale, Chicago, Chicago/Lombard,

Homewood, Northbrook, Peoria, Springfield, Sycamore,Westchester

INDIANA: Evansville, Fort Wayne, Indianapolis, Lafayette,Merrillville, Mishawaka, Terre Haute

IOWA: Ames, Bettendorf, Sioux City, West Des MoinesKANSAS: Topeka, WichitaKENTUCKY: Lexington, LouisvilleLOUISIANA: Baton Rouge, Bossier City, New OrleansMAINE: Orono, South PortlandMARYLAND: Baltimore, Bethesda, Columbia, Lanham,

Pikesville, SalisburyMASSACHUSETTS: Boston, Boston/Braintree, Boston/

Brookline, Boston/Lexington, Boston/Waltham, EastLongmeadow, Worcester

MICHIGAN: Detroit/Livonia, Detroit/Southfield, Detroit/Troy, Detroit/Utica, Grand Rapids, Lansing, Portage

MINNESOTA: Bloomington, Duluth, Rochester, St. Cloud,Woodbury

MISSISSIPPI: Jackson, TupeloMISSOURI: Ballwin, Cape Girardeau, Hazelwood, Jefferson

City, Lee�s Summit, St. Joseph, SpringfieldMONTANA: Billings, HelenaNEBRASKA: Columbus, Lincoln, OmahaNEVADA: Las Vegas, RenoNEW HAMPSHIRE: PortsmouthNEW JERSEY: Deptford, East Brunswick, Fair Lawn,

Hamilton, Toms River, Union, VeronaNEW MEXICO: Albuquerque

NEW YORK: Albany, Brooklyn Heights, Buffalo/Amherst,East Syracuse, Garden City, Ithaca, Manhasset, Melville,New York/Midtown, New York/Penn Plaza, New York/Wall Street, Queens/Rego Park, Rochester, Staten Island,Vestal, Wappingers Falls, Watertown, White Plains

NORTH CAROLINA: Asheville, Charlotte, Gastonia,Greensboro, Greenville, Raleigh, Salisbury, Wilmington

NORTH DAKOTA: Bismarck, FargoOHIO: Akron/Stow, Centerville, Cincinnati, Columbus, Hilliard,

Lima, Mentor, Niles, Reynoldsburg, Strongsville, ToledoOKLAHOMA: Oklahoma City, TulsaOREGON: Eugene, Milwaukie, PortlandPENNSYLVANIA: Allentown, Clarks Summit, Erie,

Harrisburg, Lancaster, Philadelphia, Philadelphia/Montgomeryville, Pittsburgh, State College, York

PUERTO RICO: Hato ReyRHODE ISLAND: CranstonSOUTH CAROLINA: Charleston, Columbia/Irmo, Greenville,

Myrtle BeachSOUTH DAKOTA: Sioux FallsTENNESSEE: Chattanooga, Clarksville, Franklin, Johnson

City, Knoxville, Madison, MemphisTEXAS: Abilene, Amarillo, Austin, Beaumont, Corpus Christi,

Dallas, Dallas/Mesquite, El Paso, Ft. Worth/Arlington, Ft.Worth/Bedford, Houston/Clear Lake, Houston/Kingwood,Houston/Sugar Land, Lubbock, Midland, New Braunfels,San Antonio, Tyler, Waco

UTAH: Ogden, Orem, Salt Lake CityVIRGINIA: Fairfax, Lynchburg, Mechanicsville, Newport

News, RoanokeVIRGIN ISLANDS: St. CroixVERMONT: WillistonWASHINGTON: Mountlake Terrace, Seattle/Puyallup,

SpokaneWEST VIRGINIA: Morgantown, South CharlestonWISCONSIN: Madison, Milwaukee/Fox Point, Milwaukee/

New Berlin, Milwaukee/RacineWYOMING: Casper

CANADAALBERTA: Calgary, EdmontonBRITISH COLUMBIA: Coquitlam, RichmondMANITOBA: WinnipegNEWFOUNDLAND: St. John�sNOVA SCOTIA: HalifaxONTARIO: Cambridge, Detroit/Windsor, Etobicoke, London,

Ottawa, WhitbyQUEBEC: MontrealSASKATCHEWAN: Saskatoon

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2001 information booklet - thaiclinic · you must use the appropriate edition of the information...

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