Information on Expiration of Pathways and ECFMG Certificate
The online Application for 2025 Pathways for ECFMG Certification and Pathways Revalidation is now closed. Information on the opening of the online Application for the 2026 Pathways and Pathways Revalidation, as well as requirements and associated deadlines, will be made available in the coming months. Please monitor the ECFMG News page for information.
As part of the 2026 Pathways, applicants will be required to have a satisfactory score on the Occupational English Test (OET) Medicine, among other requirements. If you are planning to apply to the 2026 Pathways for ECFMG Certification or for Pathways Revalidation, and you do not have a satisfactory score on OET Medicine that was attained on or after January 1, 2024, we encourage you to book OET Medicine now.
Pathways Expiration
If you meet the clinical and communication skills requirements for ECFMG Certification through the Pathways, your accepted Pathway is subject to expiration. The expiration date is based on the Pathways season for which your Pathways application was accepted as meeting the clinical and communication skills requirements for ECFMG Certification.
Current expiration dates are as follows:
| Pathways Season |
Pathway Expires |
| 2025 Pathways |
December 31, 2027 |
| 2024 Pathways |
December 31, 2026 |
| 2023 Pathways |
December 31, 2025 |
| 2021 or 2022 Pathways |
December 31, 2024 |
Important Notes:
- If you are certified by ECFMG based on a 2025 Pathway and your ECFMG Certificate lists an expiration date of December 31, 2024, this expiration date will be extended to December 31, 2027, as listed in the table above. You will receive notification from ECFMG that the expiration date has been updated in our records. You will not receive a new ECFMG Certificate reflecting the extended expiration date.
- If you were certified by ECFMG based on a 2024 Pathway and your ECFMG Certificate lists an expiration date of December 31, 2024, this expiration date will be extended to December 31, 2026, as listed in the table above. You will receive notification from ECFMG that the expiration date has been updated in our records. You will not receive a new ECFMG Certificate reflecting the extended expiration date.
- If you were certified by ECFMG based on a 2023 Pathway and your ECFMG Certificate lists an expiration date of December 31, 2024, this expiration date will be extended to December 31, 2025, as listed in the table above. You will receive notification from ECFMG that the expiration date has been updated in our records. You will not receive a new ECFMG Certificate reflecting the extended expiration date.
- If you were certified by ECFMG based on a 2021 or 2022 Pathway and your ECFMG Certificate lists an expiration date in 2021 or 2022, this expiration date has been extended through December 31, 2024. Please present this official letter with your ECFMG Certificate as confirmation of the extension. You will not receive a new ECFMG Certificate reflecting the extended expiration date.
Impacts of Pathways Expiration
If you meet the clinical and communication skills requirements for ECFMG Certification through a Pathway, an accepted, unexpired Pathway is required for the following:
- Participation in the National Resident Matching Program® (NRMP®) Main Residency Match® (The Match®). To participate in the NRMP Match, you must have an accepted, unexpired Pathway at the time of the NRMP Rank Order List (ROL) Certification deadline, among other requirements. If you do not have an accepted, unexpired Pathway at the time of the NRMP ROL Certification deadline, you will be ineligible to participate in the Match.
Note: For applicants with an accepted 2021 or 2022 Pathways application, your Pathway will expire on December 31, 2024. This means that you will be required to revalidate a Pathway by the NRMP ROL Certification deadline in March 2025 in order to participate in the 2025 Match.
If you need to revalidate an expired or expiring Pathway in order to meet requirements to participate in The Match, see Pathways Revalidation below for more information.
For additional Match eligibility requirements, see the NRMP® (The Match®) Eligibility section on the Eligibility page in the ERAS section of the website.
- ECFMG Certification. To become ECFMG certified, you must have an accepted, unexpired Pathway, among other requirements. ECFMG will not issue an ECFMG Certificate based on an expired Pathway.
If you need to revalidate an expired or expiring Pathway in order to meet the requirements for ECFMG Certification, see Pathways Revalidation below for more information.
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Expiration of ECFMG Certificate
If you are certified by ECFMG based on a Pathway, your ECFMG Certificate will expire when your Pathway expires, unless you revalidate a Pathway or meet the requirements to have your ECFMG Certificate become valid indefinitely (i.e., no longer subject to expiration).
If you were certified by ECFMG based on a formerly administered exam, such as United States Medical Licensing Examination® (USMLE®) Step 2 Clinical Skills (CS), your ECFMG Certificate is not subject to expiration and is, therefore, valid indefinitely.
A valid, unexpired ECFMG Certificate is required for the following:
- Graduate Medical Education. You must have a valid, unexpired ECFMG Certificate to enter a U.S. graduate medical education (GME) training program accredited by the Accreditation Council for Graduate Medical Education (ACGME).
- USMLE Step 3. To be eligible for Step 3 of the USMLE, you must have a valid, unexpired ECFMG Certificate, both at the time you apply for examination and on your test days.
Note: For applicants with an ECFMG Certificate based on an accepted 2021 or 2022 Pathways application, your accepted Pathway will expire on December 31, 2024. As a result, your ECFMG Certificate also will expire on that date. This means that, unless you have already met the requirements to have your ECFMG Certificate made valid indefinitely, you will be required to revalidate a Pathway in order to have a valid ECFMG Certificate to enter an ACGME-accredited training program or apply for and take USMLE Step 3.
If you need to revalidate an expired or expiring Pathway in order to have a valid ECFMG Certificate for participation in an ACGME-accredited training program or to apply for and take USMLE Step 3, see Pathways Revalidation below for more information.
Permanent Validation of ECFMG Certificate
For your ECFMG Certificate based on a Pathway to become valid indefinitely, you must meet one of the following requirements:
- successfully complete at least 12 months of clinical education in a U.S. GME training program accredited by ACGME;
- or
- successfully complete at least 12 months of clinical education in a U.S. non-standard training program associated with an ACGME-accredited program;
- or
- hold an unrestricted license to practice medicine in a U.S. state or the District of Columbia.
If you have met these requirements, see Obtaining Permanent Validation of ECFMG Certificate for detailed information on how to ensure that your ECFMG Certificate is made valid indefinitely.
If you have entered an eligible program, and your ECFMG Certificate will expire before you have met the requirements for your Certificate to become valid indefinitely, contact us regarding the process for extending the validity of your Certificate; do not use the Pathways Revalidation process below to extend the validity of your Certificate.
If your ECFMG Certificate will expire before you enter an eligible program and you need to revalidate your Pathway in order to have a valid Certificate for participation in an eligible program, see Pathways Revalidation below for more information.
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Pathways Revalidation
If you have an accepted Pathway from a previous Pathways season and wish to revalidate for any of the purposes described above, you will need to complete and submit a 2025 Pathways Revalidation Application. The Pathways Revalidation Application requires you to meet the requirements for either Pathway 1 or Pathway 6, depending on your eligibility.
Please note that you cannot revalidate through Pathways 2-5.
The Pathways Revalidation Application requirements include attaining a satisfactory score on the Occupational English Test (OET) Medicine, as described below, in addition to other Pathways requirements.
Application Process
To revalidate, you will need to meet the requirements for one of the following Pathways:
- Pathway 1: Already Licensed to Practice Medicine in Another Country
Pathway 1 is for applicants who currently hold or have recently held a license/registration to practice medicine without supervision. Applicants who meet the eligibility requirements for Pathway 1 must apply to Pathway 1. The requirements for Pathway 1 are the same for 2025 Pathways Revalidation as they are for the Application for 2025 Pathways for ECFMG Certification. For additional information, please see the Pathway 1 page.
- Pathway 6: Evaluation of Clinical Patient Encounters by Licensed Physicians
For the purpose of revalidation, Pathway 6 is for applicants who do not meet the eligibility requirements for Pathway 1. To meet the requirements for Pathway 6, the applicant’s clinical skills must be evaluated by licensed physicians using ECFMG’s Mini-Clinical Evaluation Exercise (Mini-CEX) for Pathway 6. The requirements for Pathway 6 are the same for 2025 Revalidation as they are for the Application for 2025 Pathways for ECFMG Certification. For additional information, please see the Pathway 6 page.
Assessment of Communication Skills, Including English Language Proficiency
As part of Pathways Revalidation, applicants are required to attain a satisfactory score on OET Medicine to satisfy the communication skills requirement for ECFMG Certification. All Pathways Revalidation applicants, regardless of native language, language of instruction at medical school, or citizenship, must satisfy this requirement in addition to meeting the requirements for Pathway 1 or Pathway 6. There will be no exceptions.
To meet ECFMG’s requirements for Pathways Revalidation:
- Applicants must attain a minimum score of 350 on the Listening, Reading, and Speaking sub-tests, and a minimum score of 300 on the Writing sub-test, in one test administration.
- Applicants must attain a satisfactory score, as described above, on or after January 1, 2023.
This means that applicants who attained a satisfactory score on OET Medicine prior to January 1, 2023 will need to retake OET Medicine and attain a satisfactory score as part of Pathways Revalidation. For additional information on the OET Medicine requirement, please see Assessment of Communication Skills, Including English Language Proficiency.
Accepted Revalidation
If you are not ECFMG Certified, and your 2025 Pathways Revalidation Application is accepted:
- You will continue to meet the clinical and communication skills requirements for ECFMG Certification through December 31, 2027.
- You will be eligible to participate in the NRMP Match through December 31, 2027, provided that you have met all other requirements for the Match.
If you are ECFMG Certified, and your 2025 Pathways Revalidation Application is accepted:
- The expiration date of your ECFMG Certificate will be updated through December 31, 2027. You will receive a letter via e-mail confirming the updated expiration date. You will not receive an updated copy of your ECFMG Certificate.
- You will be eligible to participate in the NRMP Match through December 31, 2027, provided that you have met all other requirements for the Match.
- You will be eligible to enter an ACGME-accredited training program through December 31, 2027.
- You will be eligible to apply for and take USMLE Step 3 through December 31, 2027, provided you meet all other eligibility requirements as set by USMLE.
The preceding information is current as of June 2, 2025 and is subject to change. Please visit the ECFMG website frequently for updates regarding these requirements.
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