February 27, 2024.
Educational Commission for Foreign Medical Graduates (ECFMG) is the U.S. organization charged with credentialing and approving foreign medical graduates for training and working in the United States.
Established in 1956, its primary goal is to ensure that foreign medical graduates who enter the U.S. healthcare system are qualified and ready for the rigorous demands of U.S. training. The Accreditation Council for Graduate Medical Education (ACGME), which certifies postgraduate training, requires foreign graduates who enter ACGME-accredited residency or fellowship programs to be certified by ECFMG.
ECFMG Certification remains the standard for evaluating the qualifications of international medical graduates (IMGs) entering the U.S. healthcare system for the past 68 years. No residency programs in the U.S. accept candidates without an ECFMG certification.
In September 2010, ECFMG announced (attached) a new medical school accreditation initiative and instituted recognized accreditation status as a future requirement for ECFMG Certification of IMGs. Therefore, every Medical School outside North America must undergo this new accreditation process.
For a medical school to achieve recognized accreditation status, the school's accrediting agency must be reviewed and recognized by an external quality assurance organization. This quality assurance organization, in turn, must be reviewed and approved by ECFMG. Only medical schools accredited by an agency or an organization approved by ECFMG will satisfy the requirements of the Recognized Accreditation Policy. Specifically, the medical school must be accredited by an agency recognized by the World Federation for Medical Education (WFME). Currently, 21 accrediting agencies have received WFME recognition, with many others in the process.
The new rule was to start in the fall of 2023, but because of COVID-19, ECFMG moved it to fall 2024. When the Policy is implemented in late 2024, if a medical school meets the requirements of the Policy, it will be on the list of ECFMG-approved Medical Schools, and a notation will be added to the school's listing in the World Directory of Medical Schools.
Importantly, new notations will also be added to the ECFMG Status Reports for students and graduates of that school who are applying to U.S. GME positions through the Electronic Residency Application Service®️ (ERAS®️) for the National Residency Matching Program (NRMP). Those with these ERAS and NRMP notations have significant implications because they will imply to the program directors as more credible candidates.
Although ECFMG stated that this initiative will not "impede" individual IMG certifications, it is doubtful that program directors will interview and take candidates from unapproved schools when there are many competitive candidates from approved medical schools.
"In 2024, we will begin to realize the benefits of more than a decade of intense activity and accomplishment," said William W. Pinsky, MD, CEO of Intealth and President of ECFMG. "The Recognized Accreditation Policy supports our steadfast commitments — to assure the U.S. public that IMGs, who provide supervised patient care while training, are ready to do so, and to ensure that directors of U.S. training programs have a properly qualified IMG applicant pool from which to choose their trainees."
To date, many countries, including the UK, Israel, and all the Caribbean countries, have completed the process. As of this writing, only Egypt and Sudan have completed the accreditation process among African countries. It takes an average of 8-12 months to complete this process. As of this writing, neither the Medical and Dental Council of Nigeria (MDCN) nor any Nigerian Medical Schools have started the process.
We hope that our healthcare leaders, starting from the Ministry of Health, the MDCN, the Provosts, and Deans of Nigerian Medical Schools, will consider this as a wake-up call to fix this problem and ensure the doors are open for future Nigerian doctors to have access to the U.S. market, the most extensive and most diverse training grounds in the world.
Abraham Ariyo, M.D.
Dr. Ariyo is a Cardiologist in Texas and the President of the Ibadan College of Medicine Alumni Association in the USA.
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