How to become a Doctor in USA: All about USMLE, ECFMG and Residency


It’s a program of Certification for Foreign Students in Medicine Universities and Schools.

There are 1,400 world Medschool and Universities included in the World Directory of Medical Schools List, which is published here:

If you were graduated in one of the mentioned institutes, you need to verify your knowledge and pass several tests to become a doctor in USA. ECFMG Certificate is only the first part of this long way.

You need to apply for this certificate and provide copies of various documents like Diploma (with translation), School Transcript and Personal Documents.


It’s a General Medicine Test Compulsory for all doctors. More information here:

Why should I pass USMLE?
Anyone who wants to work in the medicine sphere should pass this test. Anybody is welcome to try it, not regarding the age or year of university graduation.

Structure of the test
USMLE consists of 3 steps.

How to pass it?
First two steps all US Doctors pass while studying in a Medschool. Third step should be passed during residency training which takes 4 to 6 years depending on speciality.

Step 1
Step 1 checks on how well a person can apply science concepts into practice. It includes questions in basic science:
Biochemistry and Molecular Biology
Biology of Cells
Human Development and Genetics
Biology of Tissue Response to a Disease
Gender, Ethnic, and Behavioral Considerations affecting disease treatment and Prevention, including Psychosocial, Cultural, Occupational, and Environmental
Multisystem Processes
Pharmacodynamic and Pharmacokinetic Processes
Microbial Biology and Infection
Immune Responses
Quantitative Methods
And all the rest like Normal Processes, Abnormal Processes, Principles of Therapeutics, Gender, Ethnic and Behavioral Considerations affecting Disease Treatment and Prevention, including Psychosocial, Cultural, Occupational, and Environmental. The whole list over here:

Step 2
It checks whether a student or a graduate is able to apply his/her knowledge and skills to provide a necessary care to patient. Nowadays this step consists of two parts: Clinical Knowledge and Clinical Skills. In the second part you need to deal with people trained to act as real patients and provide you daily situations.

Step 3
It checks whether a doctor can apply his/her knowledge and skills to provide care without supervision.

All questions have multiple-choice answers. Test is computer-based, with 7 blocks of 50 questions each, 1 hour for each. 45 minutes is for breaks and 15 minutes for computer instruction. Alltogether is 8 hours!

Test points
Different questions give you different points, depending on difficulty. You need to answer right 55-65% of all questions. Some of them give you no points. It’s better not to leave questions without answers, try to guess at least.

You need to get a higher score if you plan to enter residency training in prestige university or for specialty like ENT, Neurosurgery and Dermatology. If you get low points you can enter General Therapy, Family Medicine or Psychiatry, with no problems.

You will get your result within 6 weeks after the test. You will also get a performance profile that will state your strong and week points.

However, you can check your result quicker but only if your score was reported in score report part.
Step 1: Go to this website:
Step 2: Click on the OASIS button at the right
Step 3: Fill out your USMLE ID and password
Step 4: Click on USMLE/CSA Score Reporting Information at the left
Step 5: Check if your score has been reported.
If your score has been reported, go back to
Step 6: Click on the ECFMG Home button on the left
Step 7: Click on Interactive Web Application (IWA)
Step 8: Scroll down
Step 9: At the bottom left you will see "Begin new application"
Step 10: Click on "Step 1,2, or CSA"
Step 11: Scroll down and click on "Proceed with IWA application"
Step 12: You will see this
ECFMG Examination History
Have you ever submitted an application to ECFMG for any examination, even if you did not take the examination?
Yes, and I know my USMLE/ECFMG Identification Number.
Yes, but I do not know my USMLE/ECFMG Identification Number.
No, I have never submitted an application to ECFMG.
Step 13: Choose the first option and click next
Step 14: You may have to log in again on the next page with your USMLE ID and password
Step 15: The screen will ask which exam you are interested in. Select the exam you took and click next
The next screen will be in red print saying that you have successfully taken this step and can't re-apply for it if you passed. If you failed, it will let you go on.


You need to prepare to study 3 to 6 years depending on specialty. After finishing residency study, you can:
- Start working
- Enter a Fellowship
- Stay and work in a University