To become a licensed physician in the US, all doctors, no matter their experience, must first gain ECFMG Certification (Educational Commission for Foreign Medical Graduates), including taking the USMLE® Step 1, Step 2CK & Step 2CS exams, and then complete a Residency Training Program. It is important to get high scores on the first time that you take the exams, as once you pass an exam, you are then stuck with that score! So it is imperative that you go into every USMLE exam prepared!
This is the case for any doctor, no matter your experience or qualifications, if you want to work as a Board Certified Doctor. If you have ECFMG Certification but do not complete Residency, you can still work in the US - however, you won’t be Board Certified. This limits the positions available to you and caps your potential salary. Therefore, it makes sense for the majority of International Medical Graduates take some kind of Residency Training Program.
International Medical Graduates
If you have qualified as a doctor in any other country, you will be known in the US as an International Medical Graduate, or IMG. The ECFMG works for International Medical Graduates to tell Residency Training Program Directors that an applicant has the relevant qualifications to work or train as a doctor in the USA. As there are so many medical schools internationally, with different standards, this body makes sure that every applicant has a minimum level of knowledge to work and train in the US.
To gain ECFMG Certification you must have a medical degree from a recognized school, submit an application and take the USMLE Step 1, 2CK and 2CS exams.
Once you are ECFMG Certified you can start a Residency Training Program. Residency Training Programs are taken in a particular medical specialty and last between 3 and 6 years. After the first year of Residency, US Medical Graduates take the USMLE Step 3 and become Board Certified. As an International Medical Graduate, you may choose to take the USMLE Step 3 before Residency in order to gain an H1B Visa.