ECFMG 2024 Update: Impact on Medical Students and US Residency Programmes

Updated on 21/05/2024 in ,
Woman doctor working on ECFMG updates for 2024

The world of medical education is constantly evolving in order to ensure that students get the most out of their academic journey. New policies and updates have been added over the years to enhance the quality of higher education and university recognition.

A key update will happen in 2024. This article will explain this change and how to stay qualified for US medical training and practice. Let's dive in.

What is the ECFMG, and what is ECFMG certification?

The Educational Commission for Foreign Medical Graduates (ECFMG) is an organisation that assesses whether an International Medical Graduate (IMG) is qualified to pursue further medical education and residency training in the United States. Basically, the ECFMG serves as a certification body that ensures that medical students coming from outside the US have met the necessary standards to practise medicine safely. 

IMGs are an integral part of the US healthcare system and make up about 25% of all

physicians in graduate medical education, so it is absolutely crucial to have a comprehensive way to assess each graduate’s knowledge and skill level. That’s where the United States Medical Licensing Exam (USMLE) comes in, which every IMG and native student needs to pass in order to become eligible for a residency programme.

However, before tackling the USMLE, graduates need to obtain ECFMG certification, which serves as proof that the student has graduated from a respectable, accredited, and internationally recognised medical university. This certificate serves as a testament to an IMG’s capability and readiness to work with real patients and affirms their preparedness to take on the USMLE.

What is the ECFMG 2024 Update

Up until recently, in order to qualify for a US residency programme, all you needed was to:
1. Graduate from a medical university that was listed in the World Directory of Medical Schools (WDOMS)
2. The university had also to be sponsored by the ECFMG on WDOMS sponsor notes 
3. Take the USMLE.

However, from 2024 onward, being listed in WDOMS won’t be enough for a medical university to be recognised. Instead, medical schools will need to be accredited by a National or Regional Agency that has been recognised by the World Federation for Medical Education (WFME).

For example, if you’re graduating from Georgia, your university/medical college has to be accredited by the National Centre for Educational Quality Enhancement (NCEQE), which in turn has to be recognised by the WFME. Only then would you be eligible to sit the USMLE and enrol in a residency programme in the US.

This change introduces a more rigorous and globally standardised accreditation process, ensuring that graduates throughout the world have received a high-quality medical education before signing up for residency.

What does this mean for current medical students?

The effect from ECFMG update on medical students - the infographic.

Some National or Regional Agencies are already recognised by the WFME. You can check their official Recognition of Accreditation map here.

However, it is also important to confirm if your university is accredited and recognised by the corresponding agencies. To see them, you can check WFME website.

If you can’t find your country on the map, don’t worry; there’s an easy solution.

If the medical university you’re attending is currently listed in WDOMS, you can register for an ECFMG/USMLE identification number via their online portal here. It is a simple process that only requires an e-mail address and your passport to verify your identity. If you intend to go to the United States after you graduate, we recommend registering as soon as possible.

Once you get your identification number, even if the university you’re studying in doesn’t apply for recognition, you will be “grandfathered” and will be eligible to take the USMLE and go on to enrol in a US medical residency programme.

If you have any questions at all, you can contact the ECFMG directly via e-mail or by phone, and they will be more than happy to help you. 
For general inquiries, you can e-mail

Implications for residency programmes

The residency programmes in the United States will likely change for the better, resulting in an overall increased quality of practical training. The new standards will play a crucial role in shaping the eligibility of international students, ensuring that only those who have undergone a robust and globally standardised medical education are granted entry into these programmes. 

If you haven’t started your academic journey and want to be absolutely certain that the medical school you will be attending is accredited and recognised, you’ve landed in the right place. Medlink Students specialises in finding the best university that aligns with your goals and ambitions, making sure that you receive high-quality medical education.

Our expert advisors possess an in-depth understanding of the latest international standards and requirements in higher education, with which they can guide you toward a successful career path. You can sign up for a free consultation here, and we will make sure that you start your medical education with confidence and peace of mind.


Overall, the path to practising health care in the US stays the same:

  1. Get an internationally recognised medical degree
  2. Pass the United States medical licensing examination
  3. Go through a US national residency program.

However, the ECFMG 2024 update is a great step towards fostering a global standard of excellence in medical education. It is a call for medical schools, local accrediting bodies, students, and the broader medical community to align with these improved standards, ensuring that the future of medical practice is marked by competence, excellence, and global recognition.

Article written by Dr Sam El Mais
Dr Sam El Mais, MD, MSc, BSc, graduated from a renowned medical school in Romania in 2019. He uses his professional knowledge and personal experience to guide students on crucial aspects such as university selection, admissions processes, and cultural adjustments.
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