Fifth Pathway Certificates and USMLE Step 3

Step 3 assesses whether you can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care. A principal organizing dimension for Step 3 design is normal conditions and disease categories. Second and third organizing dimensions are the clinical encounter frame and physician tasks. Step 3 content reflects a data-based model of generalist medical practice in the United States.

Currently, the USMLE program accepts either a valid Standard ECFMG Certificate or a valid Fifth Pathway certificate (issued through December 31, 2009) from international medical graduates for purposes of meeting Step 3 eligibility requirements. The governing committee of the USMLE program and the USMLE parent organizations (the Federation of State Medical Boards and the National Board of Medical Examiners) have determined that the USMLE program will cease acceptance of Fifth Pathway certificates for the purpose of meeting Step 3 eligibility requirements, effective January 1, 2017. Individuals who hold valid Fifth Pathway certificates, and are otherwise eligible, may use their Fifth Pathway certificates to meet Step 3 eligibility requirements, and may apply for Step 3, through December 31, 2016.

Individuals holding Fifth Pathway certificates that are not accepted by the USMLE program for purposes of meeting Step 3 eligibility will be required to obtain ECFMG certification in order to be eligible for Step 3.

If you hold a valid Fifth Pathway certificate but have not completed the full USMLE sequence, you should remain mindful of the December 31, 2016 deadline, after which use of your Fifth Pathway certificate to meet Step 3 eligibility requirements will not be permitted.