The Educational Commission for Foreign Medical Graduates (ECFMG) has clarified a component of the requirements that must be satisfied in order for it to sponsor J-1 physicians for participation in certain "non-standard" training programs. Following discussions with the academic medicine community and the U.S. Department of State, the ECFMG announced recently that it will continue to sponsor J-1 physicians in non-standard programs as long as the appropriate specialty board of the American Board of Medical Specialties (ABMS) recognizes the program, as evidenced by a letter of support, and additional requirements are met, including that all accreditable programs within the sponsoring institution are in "good standing" with the Accreditation Council for Graduate Medical Education (ACGME). A question had been raised recently as to whether an institution having a residency program on probation can satisfy this requirement. The ECFMG has clarified that having one or more programs on probationary accreditation does not preclude the institution from attesting that the programs are in good standing. According to the ECFMG, "good standing" assumes all ACGME-accreditable programs are authorized to accept residents for training, that residents are able to continue to progress appropriately through their educational sequence, and that residents in the program receive credit toward Board certification as a result of the training. According to the ECFMG, the spirit of the joint discussions that resulted in this policy assumes that the institution's graduate medical education committee is involved in oversight of all educational training activities including remediation efforts being taken by a probationary program to ensure the success of a corrective action plan.

Clinical Skills Assessment Transition
A Clinical Skills Examination (CSE) will become part of the U.S. Medical Licensing Exam (USMLE) in mid-2004. The CSE will complement the current USMLE Steps. Currently, international medical school graduates (IMGs) must pass a separate clinical skills assessment (CSA) in order to be certified to train in U.S. residency programs. Upon implementation of the CSE, the ECFMG will no longer administer the CSA, and IMGs will be required to pass the CSE in order to receive ECFMG certification.