By Sarah Wesley

Congrats, you have matched! At this point, the euphoria of matching might be wearing off as you begin to receive zillions of emails and packets from your respective programs. You have probably already discovered that you are going to need to gather a ton of paperwork before you head across the pond to your U.S. residency. I would like to discuss one of the documents you will need – the ECFMG (Educational Commission for Foreign Medical Graduates) certificate.

You must obtain an ECFMG certificate before you can begin work in the U.S. This document confirms that you have met the specified minimum standards of education and prerequisite licensing criteria in order to start residency. There are rules for who qualifies for one, and it is necessary that your residency program have a copy of yours in their office before you start to work, otherwise your start date may be delayed. For those who are planning for next year and for those currently applying for the certificate, you can visit the ECFMG website to read up on everything you’ll need for your ECFMG certification.

As a rule, most of the prerequisites for the certificate are met even before you apply for the match, such as USMLE Step 1, 2CS, 2CK; however, the most worrisome requirement for most people is the actual medical school diploma, as many people graduate only a few weeks before their residency start date. The ECFMG requires verification of your final medical diploma, final medical school transcript, and, if required, transfer credit transcript(s). Verifying these materials can take time, but if your ECFMG certificate is not issued in time (takes at least three weeks; much longer in some countries), your start date will be delayed. This can be frustrating as you attempt to make a good first impression at your new post.

The good news is that programs are generally aware of the diploma delay issue and may be more understanding that you think. Additionally, in 2012, the ECFMG launched an electronic Credentials Verification system that significantly speeds up the process. As the ECFMG works to expand this system, paper/mail verifications may eventually become a thing of the past.

Regardless, to avoid any delays altogether (especially if your institution does not yet participate in the electronic verification process), I recommend contacting your school’s administration EARLY (now!) and inquiring as to 1) their knowledge of the process from their end and 2) whether or not they can issue your diploma slightly early – i.e., after you have passed your final exams but before the ceremony date – in order for you to have the application off to ECFMG as soon as possible.

Schools will vary in their cooperation with issuing credentials before the graduation ceremony depending on how familiar they are with the process of applying for training in the U.S. For example, my school prepared everything for me with regard to my diploma and I sent them the materials I had completed for my ECFMG application. We worked together to get my application materials off “early,” although I was sweating it out when, 10 days before my start date, my ECFMG certificate had still not arrived. Had I not coordinated with my school, I doubt my ECFMG certificate would have arrived in time, so I would encourage everyone who has matched to contact your school’s administration as soon as you can to begin the ECFMG process. Congrats!

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