The Educational Commission for Foreign Medical Graduates (ECFMG), a branch of Intealth, has published the updates on the 2026 certification cycle, which specify the modifications to Pathways, application processes, and fees of international medical graduates (IMGs). These updates are essential for IMGs planning to meet the certification standards so that they are eligible to attend the 2026 National Resident Matching Program (NRMP).
The ECFMG Certification and Revalidation Pathways for 2026 are designed for IMGs who are supposed to meet the requirements of clinical skills and communication or revalidate an expired Pathway. The fulfilment of those requirements is critical for eligibility in the residency match, alongside other criteria.
To support this process, Intealth and its units will introduce MyIntealth, a new online platform launching in August 2026, which will act as a major portal to all related services. Applicants can also process the entire certification process through MyIntealth and encompass the application, submission of credentials to be verified by the primary source, and tracking application progress. Detailed information regarding requirements, application procedures, and deadlines will also be made available upon launch.
The Step 1 and Step 2 CK materials of the 2026 USMLE can be used by the candidates to apply for the eligibility period through January 2026, including periods those ending in November 2025. Applicants who must meet the requirements of clinical and communication skills should apply via the available pathways.
These operational changes align with the launch of Phase 1 of the USMLE Service Transition. All step examination services, such as registration, score reporting, and customer support, have been transferred to the Federation of State Medical Boards (FSMB) USMLE portal.
Certification and eligibility determination remain under ECFMG. All IMGs must complete Step 1 and Step 2 CK to fulfill the medical science examination requirement. FSMB continues to coordinate with ECFMG to ensure applicant eligibility at the time of registration and to transmit exam results. ECFMG suggests that all applicants refer to the 2026 Information Booklet and adhere strictly to its policies when submitting applications.
ECFMG Certification remains a prerequisite to complete the USMLE tests by IMGs and residency training. As part of the Step examination registration process, FSMB verifies ECFMG certification status. USMLE performance data are transmitted directly to ECFMG once scores are released. The USMLE Service Transition is being implemented in two phases to streamline processes: in Phase 1, FSMB manages Step exam services for IMGs, while in Phase 2, the National Board of Medical Examiners (NBME) will assume responsibility for Step exam services for students and graduates of U.S. medical schools.
Updated fees include: MyIntealth Applicant Portal Account Establishment (110$), Application to ECFMG Certification (580$), Credential Verification Request (220$), Certification Verification Service (CVS) Report (70$), EPIC Portfolio Establishment (35$), Credential Verification Request to EPIC (110$), and EPIC Report (60$). The fees that are applicable in applications made in the 2027 application season are the 2027 Pathways to ECFMG Certification and Revalidation, 2027 ERAS Token, and 2027 Residency CAS Application Support at prices of 945$ and 185$ respectively. All the fees are in U.S dollars.
These updates indicate the ongoing efforts of ECFMG and USMLE to create a more streamlined, consistent, and transparent licensing process for international medical graduates seeking to practice in the United States.
Reference: ECFMG. Fee Increases Beginning April 1, 2026. Published March 19, 2026. Accessed March 27, 2026. Fee Increases Beginning April 1, 2026
