ECMFG Alternative Pathway Requirement – Passing the OET Exam

Posted July 21st, 2021 by .

Categories: ECFMG, Medical Licensing, NBME, NRMP, USMLE.

With the permanent discontinuance of the USMLE Step 2 CS examination, the Educational Commission for Foreign Medical Graduates (“ECFMG”) announced its plan to implement an additional pathway (that is, the Sixth Pathway) by which IMGs could qualify for temporary ECFMG Certification.  As previously reported on this blog, IMGs seeking certification by way of Pathway 6 must meet ECFMG’s criteria for its Mini-CEX exam.   IMGs seeking ECFMG Certification through any Pathway are required to pass the Occupational English Test (OET) Medicine.  This holds true for both foreign and American born IMGs, regardless of fluency.

The OET Medicine exam is challenging, even for native English speakers.  Designed specifically for physicians, the exam assesses the health care-specific English language competency and communication skills of physicians, emphasizing the type of language physicians will need to communicate effectively in a clinical setting with peers and patients.  It is not a multiple choice test. For more information on OET, ECFMG has directed applicants to the ECFMG|FAIMER page on the OET website, found here.

To meet ECFMG requirements, applicants must attain a minimum score of 350 on each of the four subset categories (Listening, Reading, Writing, and Speaking).  Applicants to the 2022 Pathways who took OET Medicine on or after July 1, 2018 and attained the minimum passing score on each of the four components do not need to retake OET Medicine.

Unlike the USMLE Step examinations, there is no limit to the number of attempts that applicants are permitted to take in order to pass the OET Medicine for purposes of ECFMG Certification.

For more information from ECFMG on registering, scoring, the release of test results, and deadlines for the 2022 Match, consult ECFMG’s “Certification Requirements” page, which can be found here.  The page is frequently updated.

If you find yourself in need legal assistance in navigating the new pathways, or with any ECFMG, USMLE, or NRMP related matter, our experienced attorneys stand ready to assist.

For more than 10 years, Dennis L. Abramson has dedicated a significant portion of his practice to counseling and representing medical students, IMGs, residents, fellows, and practicing physicians in compliance and disciplinary matters related to ECFMG, USMLE, NBME, and NRMP, including responding to and defending allegations of irregular behavior and violations of the Match® agreement. Should you need advice or counsel with a related issue, please contact Mr. Abramson at 610-664-5700 or

Mr. Abramson regularly updates this page with the latest developments related to ECFMG, USMLE, NRMP, ABIM, irregular behavior, and physician licensing and credentialing issues, so check back soon.

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