Stop the Discrimination against International Medical Graduates

We the IMGs recognize that proven language capabilities are essential to patient management. We are therefore willing to take on the additional burden of another test - be it TOEFL, IELTS, or PTE. We believe this should be sufficient to render our qualifications equal to our American Medical Graduate Peers, who are now exempt from the USMLE Step 2 CS requirement for entering medical residencies. Should this alternative method of appraising our capabilities be deemed unsatisfactory for a justifiable reason, we would like to propose the following changes to the alternative pathways currently offered by the ECFMG.

1. Remove the newly imposed limit of 2 Step attempts. The current general ECFMG requirements, and those of the USMLE, have a limit of 6 attempts. This has been the standard students have been working with, and a sudden pivot 3 months before the Match Cycle discriminates against students who have some barrier to passing, but who have since fulfilled the wider ECFMG requirements except for step 2CS

2. Remove the graduation/licensure year requirements imposed on students. This particular provision would bar many physicians practiced prior to 2015, and would therefore deprive the US of countless capable, skilled, and experienced physicians

3. Remove the provision that applicants must have taken a Step since 2018. The USMLE steps expire after 7 years, and this should continue to be the standard to which we are held

4. Modify Pathway 1 to acknowledge post medical school graduation experience or a provisional license(current or expired), in lieu of full licensure. A full license has never been a requirement of the ECFMG, and so many incredible physicians have focused instead on preparing for US residencies. Many candidates from other medical systems do not receive their full license to practice until after completing their medical residencies. They are, however, allowed to practice in the capacity of an intern in the role of a house officer or junior medical officers. Countless candidates, determined to best serve the US, have worked or earned their provisional licenses while focusing on attaining a US medical residency instead of first completing one in their home countries. Other students began preparing for their USMLE steps immediately after graduating, but may have a provisional license. Still others may have chosen to come to the US to gain clinical experience. Many countries do not have a general licensure system, and have not thus far been barred from joining the US medical force. The applicants from all these countries are qualified medical professionals and should not be discriminated against because of their aspirations for US medical training

5. Modify Pathway 3 to be more globally inclusive by expanding the inclusion criteria from the WFME to the World Directory of Medical Schools. The World Directory has been the ECFMG’s traditional standard, and an abrupt deviation from this accepted goal barrs countless students who would otherwise have been eligible for ECFMG certification

6. Modify Pathway 3 to be more inclusive of older applicants by eliminating the arbitrary 2018 cut-off date. Many applicants who would otherwise qualify for this pathway may be restricted by a few months, and there seems to be little justification for a 2018 limit to this path

7. Allow candidates to take Step 3 - a component which will be artificially delayed by 12-18 months as a result of the suspension of Step 2CS. This can at this time only be achieved once we have ECFMG certification, and is often key for IMGs in residency applications. We should be allowed this opportunity to illustrate our clinical skills to future residencies

8. Acknowledge that Pathway 1 may require that US-based IMGs leave their families and loved ones to fulfill an unprecedented requirement should it be possible. This is an unacceptable risk to take during the uncertain time of Covid-19. More, this may be entirely impossible for US Citizens and Green Card Holders as they would need to organize a visa and a position in time to apply, a feat which is essentially impossible

9. Acknowledge that Pathway 2 is similarly impossible to accomplish at this time. Like Step 2 CS, most internationally based medical exams have been canceled due to Covid-19.

We appreciate a response in the next week as we continue to evaluate our options. We can be reached at: step2csalternatives@gmail.com