The New Bill – New Opportunity For International Doctors

The applicant’s medical school must meet requirements established by ECFMG. A school that meets all requirements is listed in the World Directory of Medical Schools (World Directory) with an ECFMG note stating that the school meets eligibility requirements for their students and graduates to apply to ECFMG for ECFMG Certification and examination. For more information on the ECFMG Sponsor Note see Information on Sponsor Notes in the World Directory of Medical Schools. The ECFMG note also will include the graduation years for which the school meets ECFMG’s requirements. The applicant’s graduation year must be included.

Application for ECFMG Certification

The Application for ECFMG Certification consists of two parts: an on-line application and the Certification of Identification Form (Form 186). Applicants must confirm their identity, contact information, and graduation from or enrollment in a medical school that meets ECFMG’s requirements.

Examination Requirements

Medical Science Examination Requirement Applicants must pass USMLE Step 1 and Step 2 Clinical Knowledge (CK).

Clinical Skills Requirement and Communication Skills Requirement Applicants must: Complete an ECFMG Pathway, OR Have a passing performance on the former Step 2 Clinical Skills (CS) component of USMLE that is valid for ECFMG Certification.

Medical Education Credential Requirements

Applicants must have been awarded credit for at least four credit years (academic years for which credit has been given toward completion of the medical curriculum) by a medical school that meets ECFMG’s requirements. There are restrictions on credits transferred to the medical school that awards an applicant’s medical degree that can be used to meet this requirement.

Applicants must document the completion of all requirements for, and receipt of, the final medical diploma. See the Reference Guide for Medical Education Credentials for the exact title of the final medical diploma the applicant must have earned (and must provide).

ECFMG verifies every applicant’s medical school diploma with the appropriate officials of the medical school that issued the diploma and requests that the medical school provide the final medical school transcript. Verification by ECFMG with the issuing school may also be required for transcripts that are submitted to document transferred credits.

International Medical Graduates (IMGs) significantly contribute to the U.S. healthcare system, constituting 1 in 4 physicians. Despite their crucial role, IMGs face obstacles in obtaining licenses compared to domestic graduates. A groundbreaking law in Tennessee, enacted in April 2023 (SB 1451), aims to reduce these barriers and enhance opportunities for IMGs in the U.S. The law introduces a provisional licensing pathway, allowing IMGs licensed in another country to practice in the U.S. without the requirement of completing a U.S.-based residency.

Key Changes Introduced by Tennessee’s New Law:

1. Eligibility: IMGs who have completed a three-year postgraduate training program outside the U.S. or have practiced as a physician for at least three of the past five years.
2. Tests and Certification: Completion of USMLE Step 1 and Step 2, along with ECFMG certification.
3. Residency Training: Not required.
4. Visa Requirements: H1B sponsored by individual hospitals, eliminating previous restrictions.
5. Available Positions: No restriction on the number of positions.
6. Time to Achieve Full U.S. License: Two years of provisional license.
7. Licensure Type: Provisionally licensed before obtaining a full license.
8. Scope of Practice: Provisional and supervised, with clinical quality standards at the discretion of individual hospitals.
9. Salary and Specialty: Varies by hospital, providing flexibility for IMGs.
10. Practice Location: No restriction on practice location.

Tennessee’s new law differs significantly from existing IMG policies in the U.S., eliminating the requirement for U.S. residency training, offering flexibility in practice location, and streamlining the licensing pathway. The law addresses challenges faced by IMGs, but potential modifications are suggested to strengthen it, including addressing practice location requirements, ensuring quality of care, and setting standard salaries for provisional licensed IMGs. The law serves as a model to attract IMGs to practice in the U.S., with ongoing research needed to assess its impact on global medical ‘brain drain,’ compensation, and visa sponsorships.