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Hoping to Transfer your International Medical Degree to Practice Medicine in the U.S.?

Hoping to Transfer your International Medical Degree to Practice Medicine in the U.S.?

Are you hoping to transfer your international medical degree to be able to practice medicine in the United States? While this can be a lengthy and tedious process, the payoff is worth it. Doctors working in the United States are in the top ten highest paid doctors in the world. In order to achieve this, there are several steps one must take prior to being able to transfer another country’s medical training to the United States.

Where to Start - A Basic Overview:

All individuals who are educated outside the U.S.A. are termed Foreign Medical Graduates (FMGs). In order to be recognized as eligible to practice medicine in the United States, a FMG must first check with the organization that regulates all non-U.S. educated doctors, The Educational Commission for Foreign Medical Graduates (ECFMG). There are three broad steps to take in order to reach this goal:

  1. First, one must search the medical school they attended in this directory to see if it is listed in the World Directory of Medical Schools. If it is, this means it meets the ECFMG eligibility requirements. One can then submits their initial application for ECFMG certification.
  2. Then, one is now eligible to take the United States Medical Licensing Examination (USMLE). This is a three-part exam that tests readiness for medical residency in the U.S. It is important to note that U.S. medical students often take courses to enhance their USMLE scores, because the higher the score, the better the program that one can secure.
  3. Lastly, once one has taken all three parts of the USMLE, then a temporary non-immigrant visa is required for those seeking entry into the United States as a future physician.

How to Prepare for This Exam- What to Study:

In general, the USMLE consists of three steps. The first test is simply named the USMLE step 1. This is a joint program of the Federation of State Medical Boards of the United States and the National Board of Medical Examiners.

It covers the broad principles of basic science and the functioning of human organs and organ systems. Because this exam is designed to test the compatibility with American standards, the material is based on the first two years of medical school requirements in the United States and Canada. The broad subject areas covered include:

  • Anatomy
  • Behavioral Sciences
  • Biochemistry
  • Biostatistics and Epidemiology
  • Microbiology
  • Pathology
  • Pharmacology
  • Physiology

In addition, certain interdisciplinary topics discussed on this examination include the following:

  • Aging
  • Genetics
  • Immunology
  • Molecular and Cellular Biology
  • Nutritional Sciences

Preparation for this exam should focus on these study areas, rather than what your particular medical school taught. The main focus is on subject areas included above.

Step 2 is centered around Clinical Knowledge (CK) and Clinical Skills (CS). In this part of the exam, one is required to be able to display knowledge and efficiency in clinical problem-solving questions. As well as other technical skills such as interpreting graphs and tables and identifying microscopic and pathologic specimens for normality.

Step 3 is the final part and consists of patient management and other unsupervised practices of medicine. Step 3 is a two-day examination and is formatted mostly in multiple choice format. There are study tools and books for each part of the USMLE.

Next Step- Take the Exam:

One must pass USMLE Step 1 Step 2, AND Ck and CS before the ECFMG certification becomes official. Finally, once this is completed, one is then considered an International Medical Graduate (IMG). This certification is also required for visa sponsorship and for one to be eligible to take Step 3 of the USMLE. These two steps are needed first as well before one can apply for visa sponsorship to the US, usually on a J-1 visa.

As an FMG, you do not need to pass the USMLE Step 1 before taking the USMLE Step 2, however, you must achieve a passing score on both exams before you become eligible to take the USMLE Step 3.

It is important to note that the fee to take the USMLE ranges between $895-$1500 USD, and all examinations have to be booked via the ECFMG website. Also, it is important to consider that certain testing for the USMLE is only held in the U.S., so one must factor in flights and accommodation in order to complete this step.

After the Exam- Applying for a J1 Visa:

The United States requires a temporary nonimmigrant visa in order to reside in the United States as a prospective physician. One visa commonly used by foreign national physicians is the J-1, a temporary nonimmigrant visa reserved for participants in the U.S. Department of State’s Exchange Visitor Program. According to the ECFMG J-1 Visa Sponsorship Fact Sheet, in order to receive this visa, there are eligibility requirements that one must meet, including the following:

• Hold a Standard ECFMG Certificate without expired examination dates, if applicable.

• Have passed United States Medical Licensing Examination® (USMLE®) Step 1 and Step 2 Clinical Knowledge (CK); or the former Visa Qualifying Examination (VQE), National Board of Medical Examiners® (NBME®) Part I and Part II, or Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS); or an acceptable combination thereof.

• Hold a contract or an official letter of offer for a position in an approved GME or training program.

• Provide a “Statement of Need” from the Ministry of Health in the country of most recent legal permanent residence.

The U.S. Department of State Exchange Visitor Program (DOS-EVP) provides goals for international exchange, FMG physicians that possess a J-1 visa are required to return home for at least two years after their training before being eligible for other U.S. visas.

FMGs seeking sponsorship through an employer in the United States for J-1 visas need to fulfill another application with another set of general requirements. These are detailed in ECFMG’s Exchange Visitor Sponsorship Program (EVSP).


Please note, it is important that when applying for something so unfamiliar, we recommend looking for a mentor in the United States, that can aid with the process and provide recommendations for each distinct situation. Preferably someone who has gone through this application process themselves. An immigration attorney can also provide connections and recommendations for prospective foreign medical students. One can also visit the USMLE courses website to sign up and learn more, as well as contact the FMG offices directly today for more information.

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