ECFMG requires that IMGs satisfy the examination requirements for ECFMG Certification within a seven-year period. This means that once you pass an exam, you will have seven years to meet the other examination requirements for ECFMG Certification. This seven-year period begins on the date of the first exam passed and ends exactly seven years from that date.
Important Note: Accepted Pathways are subject to this seven-year requirement. This means that your Pathways application must be accepted within the seven-year period in order to meet the clinical skills requirement and communication skills requirement for ECFMG Certification.
Once you satisfy all exam requirements for ECFMG Certification within a seven-year period, you have met the time limit for completing examination requirements. However, accepted Pathways are subject to expiration for other purposes, including for becoming ECFMG Certified and for entering the NRMP Match. If you have satisfied all examination requirements within a seven-year period but need to revalidate a Pathway for other purposes, the revalidation can occur outside of the seven-year period. For detailed information on Pathways expiration and revalidation, refer to the ECFMG Certification section of the ECFMG website.
If you do not satisfy all examination requirements within a maximum of seven years, your earliest passing performance will no longer be valid for ECFMG Certification. It is your responsibility to track your progress toward meeting the exam requirements for ECFMG Certification. ECFMG will not notify you of upcoming deadlines to meet the seven-year requirement and will not notify you if one (or more) of your passing performances becomes invalid for ECFMG Certification because you failed to meet the seven-year requirement. You can track your progress toward meeting the exam requirements for ECFMG Certification, including the date on which you met the requirement, on the ECFMG Certificate tab in the ECFMG Certification section of MyIntealth.
Examples: An IMG passed Step 1 on January 20, 2019 and Step 2 CS on February 20, 2020. He has through January 20, 2026 to take and pass Step 2 CK to satisfy the remaining exam requirements for ECFMG Certification. If he does not take and pass Step 2 CK on or before January 20, 2026, his passing performance on Step 1 would no longer be valid for ECFMG Certification.
An IMG passed Step 1 on November 30, 2018 and Step 2 CK on February 1, 2022. She has through November 30, 2025 to satisfy the clinical skills and communication skills requirements for ECFMG Certification through a Pathway. If she does not have an accepted Pathways application on record by November 30, 2025, her passing performance on Step 1 will no longer be valid for ECFMG Certification.
An IMG passed Step 1 on January 15, 2019, and her 2023 Pathways application was accepted on February 1, 2023. Her Pathway will expire on December 31, 2025 (the expiration date for all 2023 Pathways). If she passes Step 2 CK on November 1, 2025, she will have met ECFMG's time limit for completing the exam requirements. However, her Pathway is still subject to expiration for other purposes, including for becoming ECFMG Certified and for entering the NRMP Match. Since the applicant met ECFMG’s time limit for completing the exam requirements, revalidation of a Pathway for these purposes can occur outside of the seven-year period.
Under this ECFMG requirement, more than one passing performance can become invalid for ECFMG Certification.
Examples: An IMG passed Step 1 on April 1, 2018, and passed Step 2 CK on May 1, 2019. She had through April 1, 2025 (seven years from her Step 1 passing performance) to complete a Pathway, satisfying the remaining exam requirements for ECFMG Certification. She did not have an accepted Pathways application by April 1, 2025, so her passing performance on Step 1 is no longer valid for ECFMG Certification. Her earliest USMLE passing performance that is valid for ECFMG Certification is now the Step 2 CK passing performance on May 1, 2019. She now has through May 1, 2026 (seven years from her Step 2 CK passing performance) to pass Step 1 and complete a Pathway, satisfying the remaining exam requirements for ECFMG Certification. If she does not pass Step 1 and complete a Pathway by May 1, 2026, her passing performance on Step 2 CK will no longer be valid for ECFMG Certification.
An IMG passed Step 1 on January 15, 2019 and her 2023 Pathways application was accepted on February 1, 2023. Her Pathway will expire on December 31, 2025 (the expiration date for all 2023 Pathways). The applicant has until December 31, 2025 to pass Step 2 CK before her Pathway expires. If the applicant does not pass Step 2 CK before this date, she will have until January 15, 2026, to pass Step 2 CK and complete Pathways revalidation. If she does not, her passing performance on Step 1 will no longer be valid for ECFMG Certification.
If you have passed a USMLE Step but this passing performance is no longer valid for ECFMG Certification, you may request an exception to retake the previously passed exam that is no longer valid. See Retaking Previously Passed Steps in the USMLE Bulletin of Information .
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[Last update: January 9, 2026]
