Eligibility for the USMLE Steps
Impact of Change to Accreditation Body for Medical Schools in Canada Effective in July 2025
Currently, medical education programs in Canada leading to the MD degree are accredited by both the Liaison Committee on Medical Education (LCME) and the Committee on Accreditation of Canadian Medical Schools (CACMS). Effective July 1, 2025, CACMS will become the sole accrediting body for medical education programs in Canada.
Accreditation by LCME establishes eligibility to take the USMLE and to enter U.S. residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). In the absence of LCME accreditation for Canadian medical education programs, Canadian medical school graduates will establish their eligibility for USMLE and ACGME-accredited residency programs through ECFMG Certification.
This means that individuals who graduate from Canadian medical schools on or after July 1, 2025 will be considered international medical graduates (IMGs) for the purpose of entry into graduate medical education (GME) programs in the United States, and, in order for these graduates to enter ACGME-accredited residency programs, the ACGME will require that they either obtain ECFMG Certification or hold a full and unrestricted license to practice medicine in the U.S. licensing jurisdiction in which the ACGME-accredited program is located.
ECFMG Certification is the standard for evaluating the qualifications of IMGs entering the U.S. health care system and includes requirements for medical schools, examination requirements (which include USMLE Step 1 and Step 2 CK among other requirements), and verification of medical education credentials directly with the issuing institution. For more detailed information, please visit the ECFMG website.
Individuals who will graduate from Canadian medical schools on or after July 1, 2025, will be able to apply for ECFMG Certification beginning in late spring 2025, prior to the start of the 2026 residency application cycle in the United States. Additional details and a definitive date when these individuals can begin applying for ECFMG Certification will be provided in a future update. In the interim, these individuals should continue to apply for USMLE exams as planned and based on current policies and procedures.
Individuals who will graduate from medical schools in Canada on or after July 1, 2025, and who plan to pursue U.S. GME should monitor the ECFMG and USMLE websites for detailed information on applying for ECFMG Certification and USMLE.
