The Bottom Line
- In January 2026, USMLE Step exam services for IMGs transitioned to FSMB’s USMLE portal (registration, score report delivery, customer service).
- ECFMG still determines certification eligibility and manages certification processes, but “exam services” moved for IMGs.
- The failure mode: doing the right step in the wrong system. Your fix: a single workflow map and a stable identity profile across portals.
What this transition means operationally
You now need to understand which actions are “ECFMG certification actions” versus “USMLE exam services actions.” The underlying requirements (Step 1/Step 2 CK + Pathways) remain, but the operational path for exam services changed.
The clean workflow for 2026 onwards
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1) Keep one “master identity” record
Your name spelling, DOB, and email must match across portals. Even small inconsistencies can create support tickets and delays.
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2) Separate tasks: certification vs exam services
Certification: ECFMG rules/status. Exam services: FSMB USMLE portal processes (registration and related services for IMGs).
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3) Build a two-column checklist
Column A: ECFMG certification tasks (credential verification, Pathways status). Column B: exam services tasks (registration, eligibility period changes, etc.).
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4) Use official transition FAQs and news posts as your truth source
If you encounter conflicting advice, default to the official transition announcements and FAQs.
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5) Plan support escalation early
If something fails, log: screenshots, timestamps, and which system you used. Support resolves issues faster when your report is specific.
Transition readiness checklist
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Practice
Test your knowledge
Apply this concept immediately with a high-yield question block from the iatroX Q-Bank.