Physicians who received their basic medical degree from a school outside the United States and Canada (international medical graduates or IMGs) make up roughly 25% of physicians in training and practice in the United States. Certification by the Education Council for Foreign Medical Graduate (ECFMG) is the standard for evaluating the qualifications of these physicians before they enter U.S. graduate medical education (GME), where they provide supervised patient care and it is recognized by the Joint Commission as primary source verification of foreign education.
Evaluating the readiness of IMGs to enter graduate medical education (GME) programs in the United States has long been a concern of medical organizations, hospitals, state licensing agencies, and the public. During the 1950s, the need for a formal program of evaluation intensified due to explosive growth in the demand for health care services, an increase in economic opportunities for trained medical personnel, and a greater dependence on residents to provide medical care, which created a large number of available positions in U.S. GME programs.
In 1956, a private, nonprofit organization, the Education Council for Foreign Medical Graduate (ECFMG), was established to:
- Provide information and to answer inquiries of IMGs planning to come to the United States for GME
- Evaluate IMGs’ credentials, knowledge of medicine, and command of English
- Certify that IMGs have met certain medical education and examination requirements.
The ECFMG exam is three-step process in assessing 1) clinical skills. 2) verbal communication skills, and 3) United States Medical Licensing Examination (USMLE) to obtain an unrestricted license to practice medicine in the United States.
MPR uses electronic verification of the ECFMG as primary source verification for education attained on foreign soil by a physician. Written verification requests are sent to secure the training attained on foreign soil.
Although the electronic verification of foreign education has reduced the turn-around-time for primary source verification of foreign graduates, the verification of training remains a challenge. The majority of accredited and licensed health care facilities accept verification of training provided in the United States or verification of a 5th pathway to establish medical staff membership and clinical privileges. Regardless, each foreign graduate application is evaluated and verified according to education and training received to establish documentation of current clinical competency.