ECFMG Pathway 6
*** Note that all Pathway applicants must complete OET Exam (Occupational English Test).
Who Should Apply:
Applicants who do not qualify for Pathways 1-5.
Applicants that have failed the STEP 2 CS exam.
Must have clinical skills evaluated via ECFMG’s Mini-Clinical Evaluation Exercise (Mini-CEX).
Eligibility Requirements:
Must not meet eligibility for Pathways 1-5.
Six real, in-person clinical encounters evaluated by licensed physicians using the Mini-CEX.
Obtain acceptable scores in four clinical skills components: Medical Interviewing, Physical Examination, Professionalism/Communication, and Clinical Reasoning & Judgment.
Criteria for Acceptable Physician Evaluators:
Hold an unrestricted medical license for at least five years.
Can evaluate up to two encounters per applicant, and no more than 10 applicants per season.
Not relatives and must not receive compensation from the applicant.
Their approval is required to share their contact details with ECFMG.
Criteria for Acceptable Clinical Encounters:
Real, in-person in primary care settings (e.g., outpatient office, urgent care, ER, hospital).
Focus on diagnosis and treatment of illnesses.
Conducted post-application and evaluator acceptance.
May be in any language, but the evaluation must be submitted in English.
Mini-CEX Details:
Four components scored on a scale of 1 to 9:
Medical Interviewing Skills
Physical Examination Skills
Professionalism/Communication Skills
Clinical Reasoning & Judgment
Evaluators provide reasons for scores.
Scoring and Review:
ECFMG calculates average scores from all six evaluations.
Failed scoring leads to review by the Pathway 6 Review Committee.
Possible to request a score recheck if not approved by the Committee.
Application Timing:
Apply online by January 31, 2025, ET.
All six Mini-CEX evaluations must be received by ECFMG by February 15, 2025.
Managing and Tracking Encounters:
Use the Clinical Encounters Dashboard to track and manage evaluations.
Only one physician evaluator per encounter.
Confirm and correct information before submission.
Remove or reassign evaluators as needed, but within specific allowed conditions.
Completing Mini-CEX Evaluations:
Evaluators must accept requests before conducting evaluations.
Evaluators submit assessments through the Clinical Skills Evaluation and Attestation Portal.
Monitor the status of all requests to ensure acceptance and completion.
Fees and Payment:
Application fee: $925 (non-refundable).
Pay with Visa, MasterCard, Discover, or American Express.
Complete and submit with payment within five days.
Application Processing Time:
Status updates available through the online application system.
Allow five business days after submission for initial review, and additional time for final review.
Evaluations reviewed by the Pathway 6 Review Committee if needed.
Step-by-Step Application Instructions:
Confirm Evaluators and Eligibility:
Identify 3-6 physicians who meet the Criteria for Acceptable Physician Evaluators.
Obtain their agreement to observe and evaluate your clinical skills using the Mini-CEX process.
Confirm each physician's full name and email address for accurate submission to ECFMG.
Access the Application:
Go to the ECFMG website and access the Application for 2025 Pathways for ECFMG Certification.
Log in using your USMLE/ECFMG ID and ECFMG On-line Services password.
Start the Application:
Begin your application. You have five days to complete and submit it.
If not submitted within five days, the application will be deleted, and you will need to start a new application.
Determine General Eligibility:
Respond to questions to determine if you meet the general eligibility requirements.
If you do not meet the eligibility for Pathways 1-5, the system will direct you to complete the Pathway 6 application.
Confirm Understanding of Pathway 6 Requirements:
Before submitting, confirm you have read and understood all the requirements for Pathway 6, including Criteria for Acceptable Physician Evaluators, Criteria for Acceptable Clinical Encounters, Application Instructions, and deadlines.
Complete and Submit the Application:
Provide all required information, certify the application, and pay the application fee ($925).
Submit your application once all information is correctly completed.
Enter Physician Evaluator Information:
After submission, enter the names and email addresses of the physician evaluators on the Clinical Encounters Dashboard in the application portal.
Ensure accurate information is provided and that each physician has agreed to be an evaluator.
Manage Evaluator Requests:
The Application system will notify each physician evaluator via email with instructions to accept or reject the request.
Track the status of requests in the Clinical Encounter Dashboard to ensure proper handling.
Replace or reassign evaluators if necessary (follow the system prompts for rejected or unaccepted requests).
Complete Mini-CEX Encounters:
Arrange and conduct the six in-person clinical encounters with your evaluators.
Encounters must align with Criteria for Acceptable Clinical Encounters.
Evaluators must observe and evaluate your Medical Interviewing Skills, Physical Examination Skills, Professionalism/Communication Skills, and Clinical Reasoning & Judgment.
Submit Mini-CEX Evaluations:
After the clinical encounter, ensure the evaluator submits the Mini-CEX evaluation through the ECFMG Clinical Skills Evaluation and Attestation Portal.
Monitor the status to confirm all evaluations are submitted and received by ECFMG.
The final deadline for submission by evaluators is February 15, 2025.
Check Application Status:
Use the online Application for 2025 Pathways for ECFMG Certification to monitor the status of your application and evaluator submissions.
Allow five business days after submission for initial review and an additional time for the final review.