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ECFMG 2024 Update: What Does This Mean For IMG Doctors? – World Federation of Medical Education

The ECFMG 2024 Update for IMG Doctors will bring changes to the recognition of medical schools. However, these changes will not affect an individual’s eligibility for ECFMG certification. Instead of individual medical school recognition, the responsibility will shift to a national body in each country, which will then be recognized by the World Federation of Medical Education (WFME).

Currently, ECFMG approves the WFME and the National Committee on Foreign Medical Education and Accreditation (NCFMEA) of the U.S. Department of Education for recognizing medical school accrediting agencies.

In this article, I’ll explain what this update means for you as an IMG doctor, providing specific examples to help you understand the impact. Let’s explore this together.

What is the ECFMG 2024 Update for IMG Doctors?

If you are an International medical graduate specialist doctor who is exploring the alternate entry path program into the USA or who is someone planning to enter the USA to do a residency, here are the big changes from ECFMG you must know.

ECFMG has announced that effective in 2024, eligibility for USMLE and employment as a doctor in the United States will be restricted to graduates from medical schools/programs accredited by an agency that is recognized by the World Federation of Medical Education (WFME) Recognition Program. This is big. They go on to clarify that The World Federation of Medical Education or the WFME Recognition Programme is the only program accepted by ECFMG at the current time for the recognition of medical school accrediting agencies.

Can I give USMLE and be ECFMG Certified after 2024?

I will explain this in detail by giving you examples so this makes complete sense to you. In the new process starting 2024, individual medical school direct approval will be gone. Instead, there will be a national accrediting body in each country that must approve the medical schools and this national accrediting body must then be approved by the ECFMG. This will be a two-step process. The onus is moved from one medical school to the national body of each country.

I will give you a specific example of two doctors from the same medical college. Let’s call this ABC Medical College and the doctors Dr. A and Dr. B

Dr. A: Let’s say Dr. A graduated in the year 2020 and she investigates the list of WHO approved medical schools in this list at the World Directory of Medical Schools on the website https://www.wdoms.org/ she finds her medical school; she is all set. She registers with ECFMG, applies for USMLE, passes the exam, and becomes ECFMG certified.

Dr. B: In this case. Dr. B is from the same medical college as Dr. A and he is now graduating in 2024. Now Dr. B will look into the World Federation of Medical Education website which is wfme.org and not the world directory of medical schools. This is a major change. Whether Dr. B can apply for ECFMG will depend on whether his medical college or school is recognized by WFME. For some reason, Dr. B finds out that his school is not recognized by WFME and cannot be ECFMG certified even though Dr. A was ECFMG certified coming from the same medical college/school before 2024.

Can Indians write USMLE after 2024?

If you are an IMG from India like me, this can take two different situations.

Graduating before 2024: If you are from a WHO-recognized medical school and have already registered with the ECFMG, you can write USMLE after 2024 even though you will be graduating before 2024.

Graduating after 2024: If you are an IMG from India, the ECFMG 2024 update will require that the medical colleges in India be recognized by the National Medical Commission in India. The National national medical commission should then be recognized by WFME. At the time of my writing this, this recognition is still pending.

Can you be ECFMG certified without USMLE?

According to the U.S. Department of Education, National Committee on Foreign Medical Education and Accreditation (NCFMEA),Β Educational Commission for Foreign Medical Graduates (ECFMG) is the authorized credential evaluation and guidance agency for international medical graduates (IMGs) who seek to apply for residency in the U.S. or apply through the Alternate Entry Path program or practice directly in the United States.

There are many requirements for being ECFMG certified. One of the requirements is the requirement of an examination. This for IMGs is the USMLE. This is the same exam that US graduates take. The difference is that they can directly apply and IMGs have to go through the ECFMG for this. Upon successful completion of the USMLE Step 1, Step 2 CK, and other requirements the candidate will be issued the ECFMG certification. Following this, the candidate can take USMLE step 3 which is required for an independent license from the State Medical Boards. Out of the different visa types for an IMG like the H1B, J-1, and O visa, having an H1B visa will ease the transition to applying for permanent residency and potentially be successful.Β 

Is ECFMG the same as USMLE?

The ECFMG is an agency while the USMLE is an exam. The ECFMG agency does the credential evaluation and provides final certification for IMGs to practice medicine in the USA. The completion of the USMLE exam is one of the many requirements to be ECFMG certified. In my experience, all other requirements are paperwork to make sure the IMGs training is recognized and legit. The USMLE exams are what most people find onerous in this pathway for ECFMG certification.

There are other pathways to practice in the USA, however, the ECFMG and the USMLE exam pathways are the most straightforward that almost all IMGs I know of have used.

What is the World Federation of Medical Education recognition program?

They are a not-for-profit, non-governmental organization. According to the website they have offices in London, France, and the Czech Republic. This makes me think they have nothing to do with the US in particular. It is the organization in official relation with the World Health Organization (WHO) and represents medical education and the education and training of medical doctors worldwide.

The World Federation of Medical Education is used by the following:

  • Australian Medical Council
  • Medical Council of Canada

How do I know if my medical school is accredited by WFME?

The World Federation of Medical Education provides a list of countries whose national accrediting agency is already approved, congratulations to you. For those countries who are still waiting for approval, I will join you in keeping my fingers crossed and hoping for the best for you.

Which are the WFME accredited medical schools list?

As of me writing this, here is the list of WFME accredited national organizations. This is publicly available information from the website

What countries are on the WFME Pending medical schools list?

The following countries are on the pending list for WFME recognition at the time of me writing this.

  • India
  • Germany
  • Austria
  • Colombia
  • Israel
  • Greece
  • Italy
  • Pakistan
  • Philippines
  • Sri Lanka
  • Switzerland

What is the status of IMGs from UK with the ECFMG 2024 Update?

I have come across a lot of IMGs from UK when I was in Canada and now in the USA. But I do not find UK on the list. If you are an IMG from the UK and if the UK national body is not recognized by the WFSE, UK IMGs will no longer be able to enter the USA starting from 2024.

What can I do if my medical college is not approved by WFME?

If you are from UK or from any other country and find out if your medical college or school is not under the list of approved countries, here is what you can do.

  1. You could work on getting your medical college recognized by your national organization.
  2. As a next step, you could discuss with your national organization to apply for recognition by WFME and follow up to make sure they are on track because the approval itself may take some time.
  3. Plan for the approval time. It may take up to a year or maybe even two.

If you are looking into coming to the USA in 2024 or after, there is no other way you can obtain ECFMG certification. This could be an entry through the alternate entry path program or residency. Get to work on it now.

This article was first published on anesthesiaguru.com. If you find this on any other sites, this is stolen content.Β 

Next, I recommend you watch this video below, where I explain step by step how you can enter the USA through the alternate entry path program without repeating residency all over again if you are already a specialist.

Can IMG Doctors Work in the USA Without Residency or Green Card?

Can IMGs Work in Canada as Licensed Doctors Without Residency or Citizenship?


Dr. Rajeev Iyer, MBBS, MD, FASA
Associate Professor of Anesthesiology
University of Pennsylvania, USA

The opinion in this article is author’s own and does not represent the opinion of University of Pennsylvania or any other organization.Β 

4 thoughts on “ECFMG 2024 Update: What Does This Mean For IMG Doctors? – World Federation of Medical Education”

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  4. Sebastian Lacau

    Hello, I am a Venezuelan student in Mexico who is currently preparing for the USMLE Step 2. When this came out I was really worried, since my school is not recognized internationally by Mexico’s governing body. However, i emailed WFME who clarified to me that the important thing to be evaluated until current guidelines is not graduating before 2024, it is applying before 2024, and they told me the application process begins with presenting the USMLE Step 1.

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