Can you imagine having to apply and pay $900 for a certification of your medical degree every year if you don't match? and taking an English proficiency test (OET) every 2 years? Well that's exactly what is occurring right now under the latest update of the @ECFMG_IMG . 1/6 ECFMG certification is how international medical graduates validate their medical degrees in the USA, to apply for the match. In order to acquire it we need to take Step1, Step2 and Step2 CS. Since the latter was removed, the @ECFMG_IMG needs to find new ways to certify us. 2/6