ECFMG has reported that they are creating five pathways for doctors given the lack of availability of the required USMLE Step 2 Clinical Skills assessment. According to ECFMG, the 5 pathways are the following:
Pathway 1: Already Licensed to Practice Medicine in Another Country
- Applicant has held a license/registration to practice medicine without supervision in any country at any time on or after January 1, 2015. A provisional license will meet the requirements for this pathway if it permits unsupervised practice. Individuals who hold only a license that requires supervised practice, such as a training license, are not eligible for this pathway. The license/registration does not need to be currently valid.
 - The license/registration has not been subject to disciplinary action.
 
Pathway 2: Already Passed a Standardized Clinical Skills Exam for Medical Licensure
- Applicant has successfully completed a secure, standardized clinical skills exam in English as a requirement for medical licensure or registration in another country, which is deemed acceptable by ECFMG. This includes such exams as:
- – General Medical Council: Professional and Linguistic Assessment Board (PLAB) Part 2
 - – Australian Medical Council: Clinical Examination Part 2 or Workplace Based Assessment
 - – Medical Council of Canada: Qualifying Examination Part 2 or National Assessment Collaboration Examination
 - – Medical Council of New Zealand: NZREX Clinical
 - – Medical Council of Ireland: Pre-Registration Examination System (PRES), Level 3
 
 - Date of examination must be on or after July 1, 2018.
 
In addition to the acceptable exams listed above, ECFMG will consider:
- Objective Structured Clinical Examinations (OSCEs) administered as part of the medical licensure or registration process, in any language
 - Medical school-administered OSCEs that meet the requirements for clinical skills assessment mandated by the appropriate medical regulator for licensure, only if the medical school:
- (1) is located in a region/country that is not served by a WFME-recognized accrediting agency; and
 - (2) is accredited by an agency that is recognized by the appropriate government agency in that region/country and that is responsible for licensure.
 
 
Pathway 3: Medical School Accredited by Agency Recognized by World Federation for Medical Education (WFME)
- Applicant’s medical school must meet one of the following requirements (in addition to meeting all other ECFMG requirements):
- currently accredited by an agency recognized by WFME. See the list of eligible schools; or
 - was accredited by an agency recognized by WFME at the time the applicant matriculated.
 
 - Date of graduation must be on or after January 1, 2018.
 - An authorized school official must attest to applicant’s clinical skills.
 
Pathway 4: Medical School Participates in U.S. Federal Student Loan Program
- Applicant’s medical school must meet one of the following requirements (in addition to meeting all other ECFMG requirements):
- currently participates in the U.S. Federal Student Loan Program. See the list of eligible schools; or
 - was approved for participation in the U.S. Federal Student Loan Program at the time the applicant matriculated; or
 - has a petition for reconsideration in process with the U.S. Federal Student Loan Program.
 
 - Date of graduation must be on or after January 1, 2018.
 - An authorized school official must attest to applicant’s clinical skills.
 
Pathway 5: Medical School Issues Degree Jointly with a U.S. Medical School Accredited by Liaison Committee on Medical Education (LCME)
- Applicant is a student or graduate of a medical school that grants an MD degree issued jointly with a U.S. medical school accredited by LCME (and meets other ECFMG requirements). Currently, these include:
- – Weill-Cornell Medicine – Qatar
 - – Duke University – National University of Singapore Medical School
 
 - Date of graduation must be on or after January 1, 2018.
 - An authorized school official must attest to applicant’s clinical skills.