ECFMG: U.S. has a rigorous system to assess physicians seeking licensure

LETTER — Posted Feb. 27, 2006

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Regarding "Quality concerns spur scrutiny of Caribbean medical schools" (Article, Jan. 16): Your article highlights important considerations in physician assessment. We agree that developing international standards and assessment for medical schools would complement our existing system of assessing physicians.

Toward this end, the Educational Commission for Foreign Medical Graduates is working actively with the Federation of State Medical Boards, Foundation for Advancement of International Medical Education and Research, and others, to gather and disseminate data on international accreditation processes and indicators of educational quality. However, development of an international accreditation system is a long-term endeavor.

It is important to emphasize that we have in place a rigorous system to assess physicians applying for licensure in the United States. This system is admired worldwide. This comprehensive process evaluates the qualifications of graduates of U.S. medical schools and international medical graduates.

For IMGs, this system of assessment begins with ECFMG certification, which evaluates their readiness to enter U.S. residency programs. To obtain ECFMG certification, IMGs must pass Step 1 and Step 2, which are also required of USMGs. Their medical school must be recognized by the government of the country in which it is located and must verify the physicians' medical diploma and transcript directly with ECFMG.

For nearly 50 years, ECFMG certification has been an effective means of assessment. Of all IMGs who registered with ECFMG for their first exam during the period 1980-2000, only 52% received ECFMG certification. IMGs who achieve ECFMG certification must meet a number of subsequent requirements before obtaining an unrestricted license. They must compete for and obtain a residency, complete a minimum two to three years of training, and pass Step 3.

Thus, IMGs are assessed by multiple parties, by a variety of means and at multiple points, as they seek entry into the U.S. health care system.

Only those who meet all requirements are eligible for entry into GME and ultimate licensure.

James A. Hallock, MD, president and chief executive officer, Educational Commission for Foreign Medical Graduates, Philadelphia

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/02/27/edlt0227.htm.

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