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General Guidelines for International Medical Graduates (IMGs) Who Wish to Enter a Family Medicine Residency Training Program in the United States

The American Academy of Family Physicians provides this web page as general information to international medical graduates who wish to enter a U.S. family practice residency program. For more specific and up-to-date information, international medical graduates should contact directly the entities listed below.

Entering a U.S. Family Medicine Residency Program

1. Obtain the Standard Educational Commission for Foreign Medical Graduates (ECFMG) Certificate.

International medical graduates must have a valid Standard ECFMG Certificate to enter Accreditation Council for Graduate Medical Education (ACGME)-accredited GME programs in the United States. To become ECFMG certified, the applicant must:
  • Pass the basic medical and clinical science components of the medical science examination, currently Step 1 and Step 2 of the U.S. Medical Licensing Examination.
  • Pass the English language proficiency test.
  • Document medical education credentials.
  • Pass the Clinical Skills Assessment (CSA), which is administered in the ECFMG office in Philadelphia, Pennsylvania, after certain eligibility requirements are met.
Further information regarding examination and certification may be obtained by contacting the ECFMG at:

Educational Commission for Foreign Medical Graduates (ECFMG)
3624 Market Street, 4th Floor
Philadelphia, PA 19104-2685
Telephone: (215) 386-5900
Fax: (215) 386-9196
Web: www.ecfmg.org

2. Apply directly to family medicine residency programs.

Currently, there are 470+ ACGME-accredited family practice residency programs in the U.S. The Graduate Medical Education Directory, published by the American Medical Association, is the official list of ACGME-accredited GME program in the U.S. and is available for purchase online. The AAFP also offers a family medicine residency directory which can be accessed at www.aafp.org/residencies. Click on the U.S. map to view the listing of programs within each state.

3. Register with the National Resident Matching Program (NRMP) **

Many programs only select applicants who participate in the Main Residency Match. It is possible that an applicant may not match with any of his or her selected programs as the number of applicants may be larger than the number of available positions.

For more information on NRMP, contact:

National Resident Matching Program
2450 N Street, NW
Washington, DC 20037-1127
Telephone: (202) 828-0566
Fax: (202) 828-4797
E-mail: NRMP@aamc.org
Web: www.nrmp.org

**Some residency programs require applicants to apply through the Electronic Residency Application Service (ERAS). If the residency programs in which you are interested require you to apply through ERAS, write to the following or call for an application:

ECFMG ERAS Program
P.O. Box 11746
Philadelphia, PA 19101-11746
Telephone: (215) 386-5900
Fax: (215) 222-5641
E-mail: eras-support@ecfmg.org
Web: www.ecfmg.org/eras/index.html

4. If selected to a residency program, apply for the appropriate visa (according to your situation) to enter the United States as a student.

Questions on obtaining a visa should be directed to your residency program staff, the U.S. embassy or consulate in your country of residence (http://usembassy.state.gov), or the U.S. Citizenship and Immigration Services (http://www.uscis.gov/portal/site/uscis).

After One Year of Graduate Medical Education

1. USMLE Step 3 may be taken.

The Federation of State Medical Boards (FSMB) recommends that Steps 1, 2, and 3 be completed within a seven-year period. However this varies from state to state. State medical licensing authorities may require international medical graduates to have zero to three years of postgraduate education before being eligible for Step 3. Some states may also require that an application for a state license at the time of applying for Step 3. Currently, USMLE Step 3 must be taken at testing centers in the US or US territories.

2. Upon successful completion of USMLE Step 3, candidates may apply for medical licensure from most individual states.

It is important to note that each state has different licensing requirements for physicians. Individual medical licensing authorities may accept the recommended pass/fail score from the USMLE, or they may establish a different passing score for their own jurisdiction. Contact the individual state licensing board to find out more about a state’s licensing requirements. A directory of state licensing boards can be obtained by contacting:

Federation of State Licensing Boards (FSMB)
PO Box 619850
Dallas, TX 75261-9850
Telephone: (817) 868-4000
Fax: (817) 868-4099
Web: www.fsmb.org

(Some information in the above sections is adapted from “The International (Foreign) Medical Graduate” by Nancy E. Gary which can be found in the 1998 second edition of the Guide to Graduate Medical Education, published by the Association for Hospital Medical Education.)

Completion of a Family Medicine Residency Program

Board certification in family medicine generally requires completion of an accredited three-year family medicine residency program. The American Board of Family Medicine (ABFM) is the certifying agency responsible for the specialty of family practice. It is an autonomous body which certifies family practice residency graduates and requires re-certification every seven years to maintain “diplomate” status.

To obtain more information on the board certifying exam, eligibility requirements, and reciprocity agreements, contact the ABFM at:

American Board of Family Medicine (ABFM)
2228 Young Drive
Lexington, KY 40505-4294
Telephone: (859) 269-5626/ (888) 995-5700
Fax: (859) 335-7516 or (859) 335-7516
E-mail: help@theabfm.org
Web: www.theabfm.org