{
 "standard": "data/img-pathway.json — the sixteen-stage IMG pathway. Each stage states what is required, what is optional, what is strategy, its lead time, its cost driver, the authority that governs it, the most common failure, and the next stage. Strategy is labelled strategy and never rendered as requirement.",
 "asOf": "2026-09-01T21:00:00-07:00",
 "studentGraduateRule": "Several stages differ for a current student and a graduate. Every stage carries appliesTo so the portal can ask STUDENT or GRADUATE once and filter thereafter.",
 "stages": [
  {
   "n": 1,
   "id": "school-eligibility",
   "name": "Medical-school eligibility",
   "appliesTo": "both",
   "required": "The school must be listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements.",
   "leadTime": "Fixed before you start",
   "costDriver": "None",
   "authority": "ECFMG / Intealth · World Directory",
   "commonFailure": "Assuming any recognised school qualifies. Listing and ECFMG-eligibility notation are different facts.",
   "next": "myintealth"
  },
  {
   "n": 2,
   "id": "myintealth",
   "name": "MyIntealth account and identity",
   "appliesTo": "both",
   "required": "Account creation and identity verification.",
   "leadTime": "Days",
   "costDriver": "Low",
   "authority": "Intealth",
   "commonFailure": "Name mismatches between passport, diploma and account, which surface later as credential-verification delays.",
   "next": "step1"
  },
  {
   "n": 3,
   "id": "step1",
   "name": "USMLE Step 1",
   "appliesTo": "both",
   "required": "Pass. Reported pass/fail.",
   "leadTime": "Months of preparation; scheduling by testing region",
   "costDriver": "Exam fee plus international testing surcharge where applicable",
   "authority": "USMLE / NBME / ECFMG",
   "commonFailure": "Eligibility-period expiry before sitting, forcing reapplication.",
   "next": "step2ck"
  },
  {
   "n": 4,
   "id": "step2ck",
   "name": "USMLE Step 2 CK",
   "appliesTo": "both",
   "required": "Pass. Scored, and the score is the one programmes see.",
   "leadTime": "Months",
   "costDriver": "Exam fee plus surcharge",
   "authority": "USMLE / NBME / ECFMG",
   "commonFailure": "Sitting before ready because a cycle deadline is close. A weak score is permanent and visible; a later application is not.",
   "next": "oet"
  },
  {
   "n": 5,
   "id": "oet",
   "name": "OET Medicine",
   "appliesTo": "both",
   "required": "Listening 350, Reading 350, Speaking 350, Writing 300 — all within a single administration.",
   "strategy": "Sit early enough that a retake fits before the Pathway deadline.",
   "leadTime": "Weeks to schedule; result turnaround",
   "costDriver": "Test fee, repeated if any single subtest misses",
   "authority": "ECFMG / Intealth · OET",
   "commonFailure": "Meeting three subtests and missing one. The requirement is all four in one sitting, so a partial pass is a full retake.",
   "next": "pathway"
  },
  {
   "n": 6,
   "id": "pathway",
   "name": "2027 ECFMG Pathway",
   "appliesTo": "both",
   "required": "Complete an applicable Pathway and file the Pathway application by 31 January 2027.",
   "leadTime": "Document gathering can take months; school attestations are the usual bottleneck",
   "costDriver": "Pathway application fee",
   "authority": "ECFMG / Intealth",
   "commonFailure": "Treating the Pathway as an English test. OET, Pathway approval, examination requirements and credential requirements are four separate requirements.",
   "next": "credential-verification"
  },
  {
   "n": 7,
   "id": "credential-verification",
   "name": "Credential verification",
   "appliesTo": "graduate",
   "required": "Primary-source verification of the medical diploma and, where applicable, transcripts.",
   "leadTime": "Highly variable — weeks to many months, entirely dependent on the issuing school’s responsiveness",
   "costDriver": "Included in certification fees; the cost is time",
   "authority": "ECFMG / Intealth",
   "commonFailure": "Starting late. This is the stage least under the applicant’s control and the one most likely to end a cycle.",
   "next": "certification"
  },
  {
   "n": 8,
   "id": "certification",
   "name": "ECFMG Certification",
   "appliesTo": "graduate",
   "required": "Step 1 pass, Step 2 CK pass, applicable Pathway complete, OET, credentials verified.",
   "leadTime": "Follows the slowest component",
   "costDriver": "Certification fees",
   "authority": "ECFMG / Intealth",
   "commonFailure": "Assuming certification is automatic once exams are passed. It is not; and some Pathway-based certificates carry an expiration.",
   "next": "usce"
  },
  {
   "n": 9,
   "id": "usce",
   "name": "U.S. clinical and research experience",
   "appliesTo": "both",
   "optional": "Not a universal requirement.",
   "strategy": "Programmes vary enormously in what they require and in what they count. Verify per programme rather than assuming an observership satisfies a stated USCE requirement.",
   "leadTime": "Months to arrange; visa lead time on top",
   "costDriver": "Often the largest single cost in the whole pathway",
   "authority": "Individual institutions",
   "commonFailure": "Paying a third-party agency for a placement that no programme recognises.",
   "next": "eras"
  },
  {
   "n": 10,
   "id": "eras",
   "name": "ERAS application",
   "appliesTo": "both",
   "required": "Token, application, documents, MSPE and transcript where applicable, letters, ECFMG status report.",
   "leadTime": "Weeks of drafting; letter writers need longer notice than applicants expect",
   "costDriver": "Fees scale steeply with programme count",
   "authority": "AAMC",
   "commonFailure": "Mass application without regard to programme visa policy or graduation-year screens — money spent on applications that were never eligible.",
   "next": "signals"
  },
  {
   "n": 11,
   "id": "signals",
   "name": "Program signalling",
   "appliesTo": "both",
   "strategy": "Signal programmes you are genuinely most interested in. Signal counts and tiers vary by specialty; a signal is not a guaranteed interview.",
   "leadTime": "Decide before 23 September",
   "costDriver": "None directly",
   "authority": "AAMC · specialty participation lists",
   "commonFailure": "Spending signals on the most competitive programmes in the country rather than on programmes where the signal changes a real decision.",
   "next": "interviews"
  },
  {
   "n": 12,
   "id": "interviews",
   "name": "Interviews",
   "appliesTo": "both",
   "required": "Attend and prepare.",
   "leadTime": "October to January",
   "costDriver": "Travel where in-person",
   "authority": "Individual programmes",
   "commonFailure": "Rehearsed answers that make every applicant sound the same, and inability to discuss one’s own research.",
   "next": "rol"
  },
  {
   "n": 13,
   "id": "rol",
   "name": "NRMP rank order list",
   "appliesTo": "both",
   "required": "Register, certify a list by the deadline.",
   "strategy": "Rank in genuine preference order. The algorithm is applicant-proposing; strategic misordering is self-defeating as well as against NRMP principles.",
   "leadTime": "February",
   "costDriver": "NRMP fees",
   "authority": "NRMP",
   "commonFailure": "Missing the certification deadline, or omitting programmes an applicant would genuinely accept.",
   "next": "match"
  },
  {
   "n": 14,
   "id": "match",
   "name": "Match, and SOAP if needed",
   "appliesTo": "both",
   "required": "Match results are binding.",
   "leadTime": "Match Week, 15–19 March 2027",
   "costDriver": "None",
   "authority": "NRMP",
   "commonFailure": "Entering Match Week with no SOAP preparation, then making irreversible decisions in hours.",
   "next": "visa"
  },
  {
   "n": 15,
   "id": "visa",
   "name": "Visa sponsorship",
   "appliesTo": "both",
   "required": "For J-1: ECFMG Certification, contract or official offer, and a Statement of Need from the appropriate Ministry of Health, initiated by the institution’s Training Program Liaison. For H-1B: employer sponsorship plus the physician-specific requirements.",
   "leadTime": "Months; the binding constraint after a successful Match",
   "costDriver": "Varies; who pays varies by institution and by law",
   "authority": "ECFMG / Intealth (sole J-1 sponsor for foreign-national physicians in clinical GME) · USCIS · Department of State",
   "commonFailure": "Discovering after ranking that the programme sponsors only one category. The verification belongs before the application, not after the Match.",
   "next": "onboarding"
  },
  {
   "n": 16,
   "id": "onboarding",
   "name": "Residency onboarding and state training authorisation",
   "appliesTo": "both",
   "required": "State licensure or training permit as the state requires, institutional credentialing, immigration documents in order.",
   "leadTime": "Weeks to months before July",
   "costDriver": "Licensing fees",
   "authority": "State medical board · institution",
   "commonFailure": "Treating state training-authorisation rules as uniform. They are not, and some interact with Step 3 and with H-1B eligibility.",
   "next": null
  }
 ]
}