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To be certified by ECFMG, international medical graduates must, among other requirements, pass a medical science examination.

Step 1 and Step 2

1. Clinical Knowledge (Step 2 CK) of the United States Medical Licensing Examination™ (USMLE™) are the exams currently administered that meet the medical science examination requirement for ECFMG Certification. To meet the medical science examination requirement for ECFMG Certification, you must pass both Step 1 and Step 2 CK within a specified period of time. You can take Step 1 or Step 2 CK in either order, provided you meet the eligibility requirements for these exams. The definitive source of information on Step 1 and Step 2 CK is the USMLE Bulletin of Information. For additional information on the USMLE, refer to the USMLE website. For detailed information on taking Step 1 and Step 2 CK for ECFMG Certification, refer to the ECFMG Information Booklet.

2. Criteria For Foreign Medical Graduates a. The University Health Center of Pittsburgh (UHCP) sponsors international medical graduates (IMG's) on J-1 clinical visas through the Educational Commission for Foreign Medical Graduates(ECFMG). In order for the GME office to sponsor an IMG the individual must be able to provide the following:

  • A valid copy of their ECFMG certificate.
  • A letter from the Ministry of Health in their home country.
  • A check for $140.00 made payable to ECFMG. If you have any additional questions, you can contact the University Health Center of Pittsburgh Graduate Medical Education Office at (412) 647-5819.

USMLE Step 3 Passage and Progression from PGY-2 to PGY-3


The Pennsylvania State Board of Medicine requires that a resident or graduate medical trainee has passed Step 3 of the United States Medical Licensing Exam (USMLE) before progressing from PGY-2 to PGY-3. It is required that the resident forward to their Program Director, in a timely fashion consistent with this policy, written notification of a passing score on USMLE

Step 3 to be promoted to the PGY-3 level


All residents must pass Step 3 of the USMLE exam (or equivalent D.O. exam) on or before their third attempt to pass the test. Any resident who fails to meet these requirements cannot, and will not, progress to the PGY-3 year, and, at the discretion of the Department Chair and the Program Director, may have his/her residency contract terminated. At the discretion of the Program Director and with the consent of the Department Chair, the resident may remain in the program and be placed on an unpaid leave of absence at the end of the PGY-2 year to successfully complete passage of USMLE Step 3. This leave may not exceed ninety (90) days. The successful completion of Step 3 will not be considered as having been achieved until the documentation of passage has been provided in writing in a timely fashion to the Program Director (i.e. before the ninety-day leave period has expired). The completion of a full year of training, in the event of an approved leave, will require approval of this additional residency position as appropriate to the number of ACGME-approved positions available in that program. This must be coordinated with the GME office and through the GMEC.

It is the responsibility of the resident to schedule the Step 3 examination. It is the responsibility of the resident to provide in a timely fashion the written documentation of successful passage to the Program Director. The resident should inform the Program Director of unsuccessful attempts at the Step 3 examination in order to allow for appropriate assistance if required.


Residents should schedule to take the USMLE Step 3 exam (or equivalent D.O. exam) by the end of their PGY-1 year. The resident is responsible for scheduling the examination

The Program Director should provide written notice of this policy to all entering residents in the program and keep up-to-date records of the status of the trainees in their program with respect to USMLE.

If an individual has not passed Step 3 by June 30 of the PGY-2 year, the resident may be placed on unpaid leave of absence no later than July 1, and will not be permitted to participate in the training program. This leave is not to exceed ninety (90) days. Resumption of training will require both written notification of passage of Step 3 not later than September 30, and determination by the Program Director and Department Chair, with the advice of the Departmental Residency Committee, that training progress to date had been satisfactory.

The Pennsylvania State Board of Medicine currently allows three attempts to pass USMLE Step 3. If a resident desires to train in Pennsylvania, and is unsuccessful passing USMLE Step 3 after three attempts, that trainee must retrain at Level 1 or Level 2 for one year before attempting to take the exam again. Trainees may take the USMLE Step 3 examination in another state, and Pennsylvania will accept results from another state without having to retrain. However, to apply for a License without Restriction to practice medicine in Pennsylvania, proof needs to be shown of a year of graduate training being completed after the third failure of the Step 3 examination.

Rita M. Patel, MD
Assistant Dean for Medical Education
University of Pittsburgh, School of Medicine
Designated Institutional Official
UPMC Medical Education

Anna Roman, PhD, MPA
Vice President
UPMC Medical Education

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