There are a few basic requirements for the attainment of ECFMG certification. In order to be eligible, a student must have graduated from an institution listed in the International Medical Education Dictionary. One must also pass Step 1, Step 2 CS, and Step 2 CK of the USMLE. These exams are offered at locations around the United States throughout the year; assuming that one's graduation documentation has been approved, these exams may be taken in any order.

Once these exams are complete, a student will be eligible for ECFMG certification so long as Certification of Identification and a final medical school transcript have been provided. The ECFMG administration is unable to estimate the duration of the certification process, since it is dependent on many variables. Students may begin applying for certification while they are still in medical school but, as mentioned above, certification cannot be issued until a confirmation of graduation is provided. Students must be certified by the ECFMG before beginning any graduate-level medical education program in the United States, although they may apply to these programs before they receive certification.

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