US Residency & Licensure



Residency programs begin July 1 of every year. In order to be eligible, students must have the following before May 31: passing scores on USMLE Step 1 and USMLE Step 2 CK and Step 2 CS; diploma from American University of St Vincent; and an ECFMG Certificate. The application process is complex, and deadlines are critical. Most residency programs accept applications from July to December for entry the following July. Therefore, students must call or write to all the programs that they have an interest in, and obtain applications as early as possible. Interviews are generally conducted from September to January; if invited, students should definitely attend. The best way to become familiar with programs and their addresses is to obtain a copy of the American Medical Association (AMA) Graduate Medical Education Directory (also called the “green book”) from any medical library or bookstore. This book lists the programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). It can also be purchased directly from the American Medical Association.


The National Residency Match Program (NRMP) is a universal placement service in which most programs and applicants participate. It greatly optimizes the chances of getting a residency position. Applications are available from July to September for entry the following July, and the deadline for receipt of the application is October. Applications can be obtained from NRMP’s website. In order to be eligible to participate in the NRMP, students must have passed USMLE Step 1 and Step 2 CK and CS, by December of the year prior to which they wish to enter residency training. Additionally, they must be scheduled to graduate medical school on or before May 31.After applying to the NRMP, students must apply to each residency program in which they are interested, and go on interviews. In February, students must submit a “rank order list” to the NRMP. This is basically a list of the programs interviewed at in the order of most desirable to least desirable. Simultaneously, all the residency programs submit their rank order lists of the candidates they interviewed from their most desirable to least desirable. Subsequently, a computerized matching process begins, with results released in March. If a student matches at a specific program, it is a legally binding contract and he/she must begin the residency that July. If a student fails to match, or is not eligible to enter the NRMP, he/she can still apply to residency programs and hope to obtain a position “outside the match.” Simultaneously with the NRMP results released in March, a publication listing all unfilled residency positions is sent to all those who participated the NRMP, but did not match.


All residency programs require a medical school transcript, an MSPE or Medical Student Performance Evaluation (formerly known as the Dean’s Letter), and three letters of recommendation, as part of the application process. Most programs indicate that the transcript and MSPE must be official (sent directly from the school) and that the letters of recommendation must be confidential (sent directly from the persons writing them). For some programs, however, it may be possible to send unofficial copies of the transcript and letters directly with the application, and then have official/confidential originals sent only if the student is invited for an interview. Students should verify this issue with each program, before sending the application. An MSPE is a letter written by the Director of the Medical Program of American University of St. Vincent School of Medicine. It contains information about a student’s academic performance and excerpts from clinical evaluations in the student’s file. Students should be asking basic and clinical science faculty to write letters of recommendation on their behalf, and send them directly to the New York Office. Students will be required to make a request in writing to the Director of the Medical Program for their MSPE. The Director will require a curriculum vitae and a personal statement to be sent along with each written request.


The United States Medical Licensing Examination (USMLE) has three parts leading to licensure. The USMLE Step 1 is taken immediately after the completion of the Basic Sciences and the first nine weeks of clinical study (ICM); that is, at the end of Semester 5. Clerkship opportunities are available only to students who have passed Step 1 of the USMLE.A student who has successfully completed Semesters 1 through 4 and who has passed USMLE Step 1 is eligible to be certified to take the USMLE Step 2 CK and Step 2 CS (Clinical Knowledge and Clinical Skills) provided that the student has completed a minimum of 48 weeks of clinical training including Internal Medicine. The student must also be within 12 months of graduation. International medical graduates (IMGs) who are certified by ECFMG or pursuing ECFMG Certification should be familiar with these regulations. Detailed information is available on the USMLE website. Students must pass Step 2 CK & CS in a maximum of three trials, and within two calendar years of becoming eligible, in order to receive the Doctor of Medicine degree from American University of St. Vincent. USMLE Step 3, the final step for licensure, is taken after graduation or during (or at the conclusion) of residency training (except for non-residents of the U.S. who must pass Step 3 to be eligible for a certificate from the ECFMG).


To be eligible for graduation all students must: successfully complete all required coursework; pass USMLE Step 1 in three or fewer attempts; pass USMLE Step 2 CS and CK in three or fewer attempts; meet all financial obligations of the medical college; and have all required administrative documentation on file in the U.S. Office by the first week in April. The commencement exercises will be held each year in mid-April in Dallas, Texas.

ECFMG Certification

The Educational Commission for Foreign Medical Graduates (ECFMG) is an agency that validates the education of all foreign medical graduates and issues certification. The ECFMG certificate is required to enter residency and to obtain licensure. To obtain this certificate a student must have a valid medical school diploma and have passed USMLE Step 1 and USMLE Step 2 (CS and CK). More information can be obtained by visiting the ECFMG website and by reading their most recent bulletin.


Licensure to practice medicine is governed by each individual state, and each state has its own specific requirements. In order to better understand the requirements of the state(s) in which students intend to practice, they should call or write the state licensing board and request an application for medical licensure. A list of state licensing boards can be found by visiting the website of the Federation of State Medical Boards. Currently, all states require a diploma, an ECFMG certificate, and passing scores on USMLE Step 1, Step 2 CK and Step 2 CS, and Step 3. Additionally, all states require completion of some residency training, with the number of years varying from state to state. Students should be aware that many states have requirements beyond the evaluation of their medical school experience. They are therefore urged to make very specific inquiries of those states where they might have an interest in practicing