Understanding the Components
Following are brief descriptions of the components that all IMGs must complete before being eligible to apply for a license to practice medicine in California. This section will give IMG scholars an overview of the components in the process. You will find much more detailed information about each of the components by clicking on the accompanying links.
The USMLE is a three-part examination (Step 1 Basic Sciences/Step 2 Clinical Knowledge (CK) and Clinical Skills (CS)/Step 3) that all medical graduates must pass to qualify for a full license to practice medicine in the United States. The examinations assess a physician’s ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills that constitute the basis for safe and effective patient care.
- USMLE Step 1 Basic Sciences
- Successful completion of the USMLE Step 1 ensures that the medical graduate has mastered the sciences basic to the practice of medicine, with special emphasis on principals and mechanisms underlying health, disease, and modes of therapy.
- Step 1 is a one-day, computer-based examination divided into seven 60-minute blocks, and administered in one 8-hour testing session.
- USMLE Step 2 Clinical Knowledge and Clinical Skills
- Step 2 of the USMLE is divided into two distinct sections, Clinical Knowledge (USMLE Step 2 CK) and Clinical Skills (USMLE Step 2 CS).
- Clinical Knowledge (Step 2 CK) is a full-day computer-based examination. This test assesses the medical graduate’s ability to apply the medical knowledge skills and understanding of clinical science that are essential in the provision of patient care under supervision, including emphasis on health promotion and disease prevention.
- Clinical Skills (Step 2 CS) is a full-day examination consisting of 12 25-minute simulated patient encounters. The exam uses standardized patients to test medical graduates on their ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues.
- USMLE Step 3 Foundations of Independent Practice (FIP) and Advanced Clinical Medicine (ACM)
- Step 3 is the final examination of the USMLE sequence, and is the penultimate step before applying for full medical licensure. Passage demonstrates that the applicant can apply medical knowledge and understanding of biomedical and clinical science, with an emphasis on patient management in different settings.
- Step 3 is comprised of two one-day exams: the Step 3 FIP, a computer-based multiple choice exam; and the Step 3 ACM, with both computer-based multiple choice questions and case simulations. Although many medical graduates take the Step 3 exams after completing their first year of residency training. UCLA IMG Program participants prepare to take the Step 3 exams during Part D of the curriculum.
- The ECFMG, through its program of certification, assesses both the qualifications of IMGs and international medical schools, and certifies that IMGs have met the standards that allow them to enter medical residency in the United States.
- ECFMG certification is a lengthy process. Certification is awarded after an applicant has met all of the medical education credentialing requirements, and successfully passed both USMLE Step 1 and Step 2 (CK and CS). ECFMG certification is required for admission to a medical residency program, is one of the requirements to take Step 3 of the USMLE, and is necessary to obtain an unrestricted license to practice medicine in the United States.
- IMPORTANT: All international medical graduates MUST submit an application for ECFMG certification before they can apply to take any USMLE exam. Thus, all UCLA IMG Program participants are urged to register for the ECFMG certification process as early as possible to avoid potential delays. A brief guide to completing the ECFMG application form and subsequent filings can be found here.
- The Medical Board of California, the medical licensing authority for the state of California, conducts its own certification for international medical graduates— the PTAL, or more informally, the “California Letter.” A PTAL is required for admission to accredited medical residency training programs in California (and is therefore required of all participants in the UCLA IMG Program).
- The PTAL also tracks the IMGs progress through the USMLE, as well as requires full documentation of all medical education and training, including transcripts, medical school diploma, certified English transcripts (if applicable), and certificates of all prior clinical and clinical clerkship training.
- IMGs can apply for a PTAL as soon as they receive ECFMG certification. As with ECFMG certification, the issuing of a PTAL is also a lengthy process, and all IMG Program participants are urged to begin the process of obtaining a PTAL as early as possible. A PTAL remains valid for only one year after it is issued.
- A summary of the PTAL application process and brief guide to completing the required forms can be found here.
- The National Resident Matching Program, or “The Match”, is the process that matches all qualified medical graduates, including UCLA’s IMG Program graduates, to medical residency programs. Although registering for the Match is a straightforward process, the program operates on a strict calendar for registering and ranking choices. Hence, how quickly and when an IMG successfully navigates the USMLE, ECFMG, and PTAL procedures will dictate when one can enter the Match, which is only conducted once a year.
- An overview of the Match process timeline and its interactions with the UCLA IMG program calendar can be found here.
- The application for a California medical license is the final step to full licensure. This step is undertaken after the IMG has graduated from the IMG Program, and during their Family Medicine residency. An overview of the documentation required for the application for medical licensure can be found here.