Roadmap to Residency: - AAMC

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Roadmap to Residency: FromApplication to the Match and Beyond• Study at a medical school outsideof the United States and Canadalisted in the International MedicalEducation Directory published bythe ECFMG’s Foundation forAdvancement of InternationalMedical Education and Research(IMED, http://imed.ecfmg.org/)• Completion of all formal requirementsof the foreign medical schoolexcept for internship and/or socialservice• Attainment of a score satisfactoryto the sponsoring medical schoolon a screening examination, and• Attainment of passing scores onSteps 1 and 2 of the United StatesMedical Licensing Examination(USMLE).Three U.S. schools currently offer thefinal year of supervised clinicaleducation required of Fifth Pathwaystudents: New York Medical College(www.nymc.edu/depthome/fifth.asp),Mt. Sinai School of Medicine of NewYork University (www.mssm.edu/medschool/fifth_pathway/), and PonceSchool of Medicine (www.psm.edu,[click on “Academic Affairs,” then“Programs”]). Additional informationabout the Fifth Pathway programcan be found on the AmericanMedical Association’s Web site (AMA,www.ama-assn.org/ama/pub/category/9306.html).Note: Fifth Pathway applicants whowish to use the Electronic ResidencyApplication Service (ERAS,www.aamc.org/eras.htm) to apply toresidency training programs mustobtain their electronic token (aunique access code) from theECFMG to access the MyERAS Website (www.aamc.org/eras).Note: To participate in the NationalResident Matching Program (NRMP,www.nrmp.org), Fifth Pathway applicantsmust have satisfied the medicalscience examination requirements forECFMG Certification (USMLE Step 1and Step 2 Clinical Knowledge [CK]and Clinical Skills [CS]), and theresults must be available by theNRMP rank order list (ROL)deadline. Applicants who have previouslypassed the former ECFMGClinical Skills Assessment (CSA) andachieved a score acceptable to theECFMG on an English languageproficiency test (e.g., the Test ofEnglish as a Foreign Language[TOEFL, www.ets.org/toefl/] or theformer ECFMG English test) can usethose passing performances to fulfillthe Step 2 CS requirement.4. “Students” vs. “graduates”ACGME regulations require thatphysicians beginning residencyprograms be graduates of the medicaleducation programs listed above.Individuals may apply for residencyprograms in their final year ofmedical school, with the expectationthat they will complete all programrequirements before beginningresidency training. If all of thoserequirements have not beencompleted, residency training mustbe deferred.For international medical graduates,the ECFMG notes that both medicalschool students and graduates maybegin the ECFMG Certificationprocess. However, since ECFMGrequires primary source, independentverification of the medical diplomaand receipt of a full transcript fromthe medical school, an applicant forECFMG Certification cannotcomplete the ECFMG Certificationprocess until he or she has graduatedfrom the medical school and actuallyreceived his or her diploma.For senior medical students enrolledin U.S. medical schools, the NRMPrequires that medical schoolsimmediately revoke the school’ssponsorship of any applicant who isdetermined by the school official tobe ineligible to enter a residencytraining program on July 1 in theyear of the Match and that schoolsnotify the NRMP of that action priorto the rank order list certificationdeadline.5. USMLEU.S. medical schools’ requirements ofstudents differ with regard to takingand achieving a passing score on theUSMLE Step 1 and USMLE Step 2Clinical Knowlegde (CK) and ClinicalSkills (CS) examinations prior tograduation. Students enrolled at U.S.medical schools will not be able tobegin their residency training untilthey have completed all degreerequirements and graduated fromtheir medical school. For more informationon each medical school’sgraduation requirements, see theAAMC’s Curriculum Directory(http://services.aamc.org/currdir/).3Association of American Medical Colleges, 2005
Roadmap to Residency: FromApplication to the Match and BeyondSince many allopathic residencytraining programs recognize osteopathicmedical school education,senior students enrolled in andgraduates of colleges of osteopathicmedicine may not be required tocomplete USMLE examinations inorder to enter an ACGME-accreditedresidency program. However, sinceindividual programs can set theirown entrance requirements, somemay require documentation ofpassing scores on USMLE examinations.Other programs may require,instead, documentation of passingscores on the ComprehensiveOsteopathic Medical LicensingExaminations (COMLEX-USA),which are sponsored by the NationalBoard of Osteopathic MedicalExaminers (www.nbome.org).Interested individuals should checkwith each program regarding itsprogram requirements.Before entering a residency trainingprogram, international medicalgraduates must have achievedECFMG Certification, which includespassing scores on USMLE Step 1 andStep 2 CK and CS examinations, aswell as any other examinations thatthe ECFMG might require.6. ECFMGTypically, it takes some time to achieveECFMG Certification. To participatein the NRMP, international medicalgraduates and students enrolled ininternational medical schools musthave passed all examinations requiredfor ECFMG Certification, and theresults must be available by the NRMPrank order list deadline. The NRMPwill withdraw applicants who have notmet that deadline. For those reasons,appropriate and timely planning isessential.4Association of American Medical Colleges, 2005
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