Dear Fellow IMG's, Supportive Friends, and Loving Families:

(For those who wish for a quicker read of what this petition hopes to accomplish, read below dotted line but we recommend reading it in its entirety: 3-4 min read)

The Education Council on Foreign Medical Graduates (ECFMG) has outlined FIVE alternate pathways to obtain ECFMG certification, a prerequisite for IMG's to obtain residency in the US. First and foremost, we would like to thank the Commission for the hard work they continue to do, and have been doing in their many years of service helping IMG's establish the American Dream. We also, however, need them to hear our cries.

Reference: Requirements for ECFMG Certification for 2021 Match

^THE OVERALL PROBLEM:  AN UNBELIEVABLE NUMBER OF HARDWORKING IMG's ARE NOT ELIGIBLE FOR ANY OF THESE ALTERNATIVE PATHWAYS, LENDING AN UNFAIR ADVANTAGE TO SOME APPLICANTS WHILE PENALIZING OTHERS.

COMMENTS ON EACH PATHWAY:

1. Already Licensed to Practice Medicine in Another Country:
   • Problem: This makes for a completely UNSTANDARDIZED alternative to certification as every country extreme degree of variation/quality control when it comes to becoming licensed. In this pathway, there is no way to ensure safeguards against corruption either.
2. Already Passed a Standardized Clinical Skills Exam for Medical Licensure (only through entities deemed acceptable by ECFMG)
   • Standardized and acceptable pathway because ECFMG approved sites/exams used.
   • Problem: Just like Step 2 CS, many of these exams are also suspended for the time being, disallowing anyone wishing to take one in lieu of the CS for this match. Also, because they are clinical, they often require some exam to be completed before them.
3. Pathway 3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME) and applicant must have graduated on or after January 1, 2018.
   • Standardized and acceptable through the use of an accreditation agency which has approved agencies under it to assess educational standards.
   • Problem: Denying students on the basis of their graduation date!
4. Pathway 4: Medical School Participates in U.S. Federal Student Loan Program (applicant must have graduated on or after January 01, 2018)
   • Standardized and acceptable through the vetting of schools to establish who can receive federal funding.
   • PROBLEM: Denying students on the basis of their graduation date!
5. Medical School Issues Degree Jointly with a U.S. Medical School Accredited by Liaison Committee on Medical Education (LCME)
   
   • Standardized and acceptable: These students must be commended and essentially equal US medical graduates.
   • PROBLEM: Denying students on the basis of their graduation date!

-------------------------------------------------------------------------------IN SUMMARY:

IDEALLY, we would ALL LOVE to be granted ECFMG certification on the basis of passing Step 1 and Step 2 CK. Even 90% of IMG's pass the English Proficiency portion of the CS exam. Unfortunately, this gift is looking unlikely, and thus, we are requesting some middle ground. One of the MOST DIFFICULT OBSTACLE FOR IMG'S to overcome when applying for residency is their GRADUATION DATE. Naturally, IMG's deal with many more issues than local graduates when trying to relocate to (or back to) the U.S. and complete USMLE examinations- a process that often begins AFTER graduating for most IMG's. Hurdles to exam completion/residency application can include, but are not limited to, individual school requirements (i.e mandatory NBME's or Shelf exams vs. not), relocation time/affordability, exam scheduling issues/affordability, visa issues, varying financial and familial obligations facilitating the need for full time employment for some, while not for others. ECFMG's proposed alternatives do not even account for the most basic spectrum of human health and how it may have affected some and not others! 

Overall, these alternative pathways treat IMG's in a discriminatory and differential fashion depending on where they are from, where they went to school, their socioeconomic status, their health, and much more. THESE DATE CUT-OFF's ALSO DO NOT ADDRESS LOOPHOLES SUCH AS DELAYED MATRICULATION (rewarding students with large gaps in the middle of medical school vs. those who graduated on time despite the same amount of time having elapsed). The system gives way to TOO MUCH SUBJECTIVITY in more than one area. These alternatives will reward some and punish others on a MERITLESS basis irrespective of their academic achievements and it will surely punish thousands of candidates who ARE qualified based on technicalities. 

PROPOSALS:

1. We STRONGLY request that graduation cut-offs be removed. These dates should not have any bearing on being able to apply for residency (AS IT NEVER HAS). It is a residency programs decision whether they want to take a candidate or not. Graduation cut-offs are the MOST COMMON denominator problem (included in FOUR OF FIVE of the alternatives) and we humbly ask they be removed for the sake of countless IMG's who have been struggling and working for years to achieve residency.

2. IF 2 is unacceptable, WE PROPOSE ADOPTING A FIVE YEAR WINDOW for cut-offs-  a somewhat recognized standard that many residency programs even include in writing as part of their eligibility requirements for applying. 

The current COVID/USMLE Step 2 CS crisis has left TOO MANY of us felt abandoned, confused, and terrified of whether we will certify in time for match despite the years of hard work we have put in to get here. Please make it easier for us to achieve our dreams, and not more difficult.

This is not the time for stringency, but rather leniency.

PLEASE GIVE US ALL A FAIR CHANCE TO APPLY AND LET RESIDENCY PROGRAMS DECIDE WHO THEY WANT, NOT HAVE IT LARGELY DECIDED FOR THEM. THANK YOU FOR YOUR TIME AND CONSIDERATION!