Individuals who graduate from Canadian medical schools on or after July 1, 2025, will be designated as international medical graduates (IMGs) for the purpose of entry into residency programs in the U.S. As part of this change, graduates from Canadian medical schools will need to obtain ECFMG Certification to be eligible for Step 3 of the United States Medical Licensing Examination® (USMLE®). Students with graduation dates on or after July 1, 2025, can begin applying for ECFMG Certification immediately. 

For graduates of Canadian medical schools to enter residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME), they must obtain ECFMG Certification or hold a full and unrestricted license to practice medicine in the U.S. state or territory in which the residency program is located. For more detailed information on ECFMG Certification, please visit the ECFMG website. 

Interim USMLE Registration Process 

Until the USMLE Service Transition, takes place, graduates from Canadian medical schools will continue to register for Step 1 and Step 2 CK with USMLE co-sponsor NBME, and all examinees will continue to register for Step 3 with USMLE co-sponsor the Federation of State Medical Boards (FSMB). The USMLE program will release more information on the timing of this transition as it becomes available.