2027 Match cycle · Intealth terminology · checked
ECFMG Certification for the 2027 Match
Certification is four requirements that people routinely discuss as one. Missing any single component leaves you uncertified regardless of how strong the others are, and the component most often underestimated is the one you control least.
The four requirements
01 · Medical science
Pass USMLE Step 1 and USMLE Step 2 CK.
02 · Clinical and communication skills
Complete an applicable 2027 Pathway. Which Pathway applies depends on your licensure status, your clinical-skills examination history, your graduation recency, whether your school can provide an attestation, and any prior Pathway or certificate.
03 · English — OET Medicine
Listening 350, Reading 350, Speaking 350, Writing 300 — all within one administration. For 2027 Pathways, qualifying scores must be from 1 January 2025 onward. Meeting three subtests and missing one means a full retake, which is why the December recommendation exists.
04 · Credential verification
Primary-source verification of your medical diploma and, where applicable, transcripts. This is the component you control least — it depends on your school responding — and the one most likely to end a cycle. Start it early.
The Pathway is not an English exam. OET, Pathway approval, the examination requirements and the credential requirements are four separate things that happen to arrive at one certificate. Conflating them is the most common structural misunderstanding in IMG planning.
Which Pathway applies to you
The inputs that determine it: the country of your medical school; whether you are licensed to practise and the status of that licence; whether you have taken a clinical-skills examination; how recently you graduated; whether your medical school can provide the required attestation; any prior Pathway; and any prior ECFMG certificate with its expiration status.
No quiz on this site will give you a definitive eligibility determination, and any resource that offers one is overstating what it can know. The honest output of a decision tool is a likely Pathway plus the list of things that must still be verified — and the verification is with ECFMG, not with a website.
Does your ECFMG certificate expire?
This surprises people badly. Some ECFMG certificates issued on the basis of Pathways carry an expiration date. That is different from the older Step 2 CS-based certification, and different again from certificates that are valid indefinitely. The states that matter: valid; valid but Pathway-based with an expiration date; requiring revalidation; or valid indefinitely.
If you hold a certificate and are not certain which state applies to you, that is a question for ECFMG with your own record in front of them — not a question any general resource can answer, because the answer depends on the basis on which your certificate was issued.
Cycle deadlines · USMLE for IMGs · The full pathway · ECFMG/Intealth remains authoritative on every point on this page.