Educational Commission for Foreign Medical Graduates
Educational Commission for Foreign Medical Graduates
ECFMG supports applicants applying to residency programs through the Residency Centralized Application Service (ResidencyCAS). We will assist in collecting and uploading your Medical Student Performance Evaluation (MSPE), medical school transcript, and ECFMG Status Report. Please review the information on this page in its entirety.
To participate in ResidencyCAS, you must have a USMLE/ECFMG Identification Number. You may register for the residency application services and apply to programs before you complete the examinations required for ECFMG Certification.
IMPORTANT NOTE: Individual programs set their own eligibility criteria and application deadlines. It is up to applicants to research their programs of interest prior to applying.
For ECFMG to support your ResidencyCAS residency application, you will be required to complete the Residency Application Support Form and pay the fee. Once the form is received and processed, a member of ECFMG’s residency application support team will contact you with specific information and instructions for document submission. Your instructions might vary depending on several factors, such as whether or not you are participating in multiple residency application services.
ECFMG is unable to submit your residency application documents directly to programs that are not participating in ERAS or ResidencyCAS.
In the United States, a license to practice medicine is granted by individual state medical licensing authorities. Each state sets its own requirements for licensure. Depending on the state, a training or restricted license may be required to participate in graduate medical education (GME) programs. Participants in GME may also be required to obtain an unrestricted medical license by a certain point in their training in order to progress in the program.
Some states have established additional criteria with respect to international medical schools for the purpose of eligibility for licensure. When you plan to apply to residency programs, consult the state’s medical licensing board to determine if graduates of your medical school are eligible for licensure in that state.
Additionally, if you were certified by ECFMG based on former medical science exams (such as the Visa Qualifying Examination [VQE] or the Foreign Medical Graduate Examination in the Medical Sciences [FMGEMS]), you should be aware that these exams may not be acceptable for the purpose of eligibility for a training license. Of the states that require a training license for participants in GME, most do not accept these exams for this purpose.
ECFMG does not create or control the medical licensure requirements for any jurisdiction and does not create or control the eligibility requirements for any GME program. Additionally, ECFMG does not preclude any students/graduates from participating in residency application services, based on their eligibility for licensure. Before applying to residency programs in a given state, it is your responsibility to become familiar with that state’s licensure requirements and to ensure that you meet any licensure requirements to enter and complete residency training in that state.
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Specialties: Emergency Medicine, and Obstetrics and Gynecology
Application: https://www.residencycas.com/
Note: You must complete the Residency Application Support Form to gain access to ResidencyCAS. Once the form is processed, ECFMG will authorize you to use ResidencyCAS, and you will receive a link to register for ResidencyCAS at your e-mail address of record with ECFMG.
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Following are the documents that ECFMG will upload to the ResidencyCAS service.
Medical Student Performance Evaluation (MSPE)
The Medical Student Performance Evaluation (MSPE) evaluates a medical student’s performance during his or her academic career relative to his or her peers. The MSPE has replaced the term “Dean’s letter” to better describe the purpose of this document.
An MSPE should:
Once your Residency Application Support Form is received and processed, a member of ECFMG’s residency application support team will contact you with specific information and instructions for document submission. Your instructions might vary depending on several factors, such as whether or not you are participating in multiple residency application services.
If you are unable to secure the MSPE from your medical school, please advise ECFMG’s residency application support team when we contact you regarding your supporting documents. A neutral placeholder letter will be provided in place of the MSPE. This will ensure that your application will appear as complete for those programs that require an MSPE before considering your application. The neutral placeholder will state, “This document is provided in lieu of the applicant’s MSPE. Please contact the applicant with any questions you may have.”
If the MSPE is not in English, you must have an English translation prepared and certified to be correct by one of the following:
Medical School Transcript
Medical school transcripts come in a variety of formats, such as:
Medical school transcripts give program directors an overview of:
The transcript must include your full name and should not be on “security paper” with a busy background. Busy backgrounds make the scanned image illegible. Ask your school to copy your transcript onto plain paper.
Once your Residency Application Support Form is received and processed, a member of ECFMG’s residency application support team will contact you with specific information and instructions for document submission. Your instructions might vary depending on several factors, such as whether or not you are participating in multiple residency application services.
If you are unable to secure a medical school transcript, please advise ECFMG’s residency application support team when we contact you regarding your supporting documents. A neutral placeholder letter will be provided in place of the transcript and will state, “This document is provided in lieu of the applicant’s medical school transcript. Please contact the applicant with any questions you may have.” This will ensure that your application will appear as complete for those programs that require a medical school transcript before considering your application.
If the medical school transcript is not in English, you must have an English translation prepared and certified to be correct by one of the following:
Submit only the English translation to ECFMG.
If you are a transfer student and would like to submit more than one medical school transcript, please advise ECFMG’s residency application support team when we contact you regarding your supporting documents.
ECFMG Status Report
The ECFMG Status Report confirms your ECFMG Certification status. The ECFMG Status Report contains the month and year that you passed examinations for ECFMG Certification. It does not include your USMLE scores, which can be reported only as part of an official USMLE transcript.
ECFMG Status Reports contain the following information:
Important Note for Pathways Applicants:
If you meet the clinical and communication skills requirements for ECFMG Certification through an ECFMG Pathway, this will be reported on your ECFMG Status Report. If you are ECFMG Certified based on a Pathway, your ECFMG Status Report will list your certificate’s expiration date.
*If you received your Standard ECFMG Certificate based on any of the following exams, the scores will be listed on your ECFMG Status Report:
Your ECFMG Status Report will be generated and transmitted to ResidencyCAS in early September 2025. If your status changes after this date, an updated Status Report will be transmitted to ResidencyCAS within one week of the status change.
For processes regarding additional supporting documents, such as USMLE Transcripts, please refer to the ResidencyCAS website.
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The National Resident Matching Program® (NRMP®) Main Residency Match® (The Match®) matches applicants with available residency positions. If your specialty participates in the NRMP Match, you will need to register separately with the NRMP to participate. More information can be found at www.nrmp.org .
To participate in The Match, NRMP requires that you meet the examination requirements for ECFMG Certification and that your passing results/satisfactory completion of these requirements are available by the NRMP Rank Order List (ROL) Certification deadline. To maximize the chances that you meet these requirements in time for you to participate in The Match, you should become familiar with them, including applicable deadlines and turnaround times. Please consider the following:
Please note that the number of applicants seeking to complete the required medical science exams may exceed the spaces available in time for all applicants to meet deadlines imposed by NRMP and/or GME programs.
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Irregular behavior includes all actions or attempted actions on the part of applicants, examinees, potential applicants, others when solicited by an applicant and/or examinee, or any other person that would or could subvert the examination, certification or other processes, programs, or services of ECFMG.
Submission of a falsified document to ECFMG for submission to a residency application service is an example of irregular behavior. A determination by ECFMG that an individual engaged in irregular behavior may be sufficient cause to bar an individual from ECFMG Certification, revoke an ECFMG Certificate, or take other appropriate action. Applicants to residency programs using ECFMG’s residency application support services should read and become familiar with the Policies and Procedures Regarding Irregular Behavior.
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All times shown are Eastern Time in the United States.
[Last update: June 25, 2025]
