NRMP Statement Regarding USMLE/ECFMG Action on Invalidated Exam Scores

The NRMP is publishing this position statement in response to recent actions taken by the United States Medical Licensing Exam (USMLE) and the Educational Commission for Foreign Medical Graduates (ECFMG), as well as inquiries from applicants potentially impacted.

On January 31, 2024, the USMLE issued a statement reporting detection of a pattern of anomalous exam performance and concerns of score validity among a select group of examinees associated with Nepal. The USMLE indicated that the Step scores for the select group of examinees had been invalidated and that subsequent verification exam(s) would be required. Also on January 31, the ECFMG announced its position with respect to actions taken by the USMLE, namely that examinees with invalidated USMLE Step scores were no longer considered to have met the medical science examination requirement for ECFMG certification.

Verification of Applicant Credentials: The actions of the USMLE and ECFMG directly impact applicant eligibility for participation in the 2024 Main Residency Match and may affect residents who previously matched to an Advanced Program. Specific to international medical graduates (i.e., independent applicants) who may be affected by these decisions, Section 3.2.1 of the NRMP Match Participation Agreement for Applicants reads as follows: 

3.2.1 Verification of Independent Applicant Credentials

The following credentials of independent applicants will be verified by NRMP:

  1. MD or DO graduate credentials will be verified with the applicant’s medical school.
  2. Fifth Pathway program enrollment will be verified with the respective LCME-accredited medical school and the ECFMG.
  3. If required, IMG credentials will be verified with the ECFMG.
    • Before the Rank Order List Certification Deadline, NRMP will verify with the ECFMG that IMG applicants have completed the medical science examination, clinical skills, and communication skills requirements for ECFMG certification.

An independent applicant must be eligible to participate in the Match and SOAP before the Rank Order List Certification Deadline.

The NRMP engages in routine data exchanges with the ECFMG to ensure accurate identification of those international medical graduates who have met the requirements for verification by ECFMG and are eligible to participate in the Main Residency Match. Applicants not identified by the ECFMG as verified ultimately are withdrawn from the Match prior to processing the matching algorithm. The NRMP will continue its practice of verifying the eligibility status of international medical graduates through the Rank Order List Certification Deadline and applicants who are not verified when ranking concludes on February 28 will be withdrawn from the Match in accordance with the Match Participation Agreement. No action with regard to an applicant’s Match participation eligibility will be taken until after the Rank Order List Certification Deadline on February 28 at 9:00 p.m. ET.

The NRMP will continue to monitor the situation. Questions about licensure exams or certification status should be directed to the USMLE or the ECFMG. Questions about NRMP Policy should be directed to