ECFMG FORM 344 PDF

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Item 1. Select an Exam Select the exam you wish to take. After you complete Item 22 of this application, you will have the option to apply for other exams using the same application, provided you meet the eligibility requirements for the other exams. Item 2. Medical Education Status Indicate whether you are currently a medical school student or graduate. Item 3. Eligibility Period Step 1 and Step 2 CK only Select a three-month eligibility period during which you want to take the exam.

Your application does not need to be received in advance of an eligibility period to obtain that eligibility period. To select and obtain an eligibility period, ECFMG must receive both the on-line part of your application and the Certification of Identification Form Form by the 24th day of that eligibility period and your application must be processed by ECFMG by the 25th day of that eligibility period.

This means that, although you can select an eligibility period as late as the 24th day of that eligibility period, there is no guarantee that you will be assigned that eligibility period, since your application may not be processed by the 25th day of the eligibility period. If your application is not processed in time to assign the eligibility period you select, you will be assigned the next eligibility period.

Your assigned eligibility period will not be adjusted to compensate for days that have already passed. The eligibility period assigned to you will be listed on your scheduling permit. If you have a valid Certification of Identification Form on file with ECFMG, you must submit the on-line part of the application no later than the 24th day of the selected eligibility period. Your eligibility period typically begins on the date that you are registered for Step 2 CS.

Your eligibility period will be listed on your Step 2 CS scheduling permit. Applicants registered for Step 2 CS select their test center, subject to availability, when they schedule their testing appointment. These documents may include a visa to enter the United States. Upon request, ECFMG provides applicants with a letter that may assist during the the process of applying for a visa.

The letter also indicates that the applicant is required to travel to the United States to take the exam and provides the date by which the applicant must complete the exam. To request this letter, check the box in Item 3. The letter is sent via postal mail after completion of the registration process.

You should also review current requirements prior to applying for a visa by visiting the websites of the Department of Homeland Security DHS at www.

The scheduling permit includes instructions for scheduling your testing appointment. You should enter the e-mail address at which you would like to receive your scheduling permit in Item 9. Contact Information. Item 4. You should refer to the Prometric website for information on test centers in specific testing regions. Additionally, if you plan to test in Egypt, Hong Kong, India, or Israel, refer to the special information below.

After you submit the on-line part of your application, you cannot change the Testing Region you selected. If you would like to take the exam in Egypt, select Middle East.

If you would like to take the exam in Hong Kong, select Asia. If you would like to take the exam in India, select India. If you would like to take the exam in Israel, select Europe. Item 5. Examinees with Documented Disabilities Check "Yes" only if you have a documented disability, are covered under the Americans with Disabilities Act, and are requesting test accommodations for the exam you selected. Checking "Yes" does not constitute an official request.

Note: Evaluation of a request for test accommodations will delay the release of your scheduling permit up to six weeks. Step 1 and Step 2 CK: Following a review of a request for test accommodations, the eligibility period you selected in Item 3 will be adjusted, as required, to allow a full three-month eligibility period in which to schedule the exam.

Step 2 CS: You will be assigned a full twelve-month eligibility period that begins on the date your request for accommodations is approved. Item 6. You should enter this information even if you did not actually take the exam. If you have not submitted an application to either of these organizations, you may skip this item and proceed to Item 7. Item 7. Please note that ECFMG may share certain information contained in your application with other organizations under specific circumstances. Item 8.

If this name is no longer your correct and current legal name, you must change your name in your ECFMG record. Follow the instructions on-screen in Item 8 for instructions on how to have your ECFMG record changed to reflect your current, legal name.

When you arrive at the test center on the date of your exam, you must present an unexpired form of government-issued identification that includes your name in the latin alphabet, signature, and recent photograph no more than 10 years earlier see Acceptable Identification. If the name on the form of identification you present does not match exactly the name in your ECFMG record, you will not be allowed to take the exam. Graduates Only: Since the Certification of Identification Form Form is valid for five years once it is accepted, it must bear your correct and current legal name.

If your legal name changes in the future you will need to submit another Form bearing your correct and current legal name as part of the application process.

Note: If the name on your medical diploma is not your current and correct legal name, you must submit documentation that verifies that this name is or was your name.

Do not request your name to be changed in your ECFMG record to the name on your diploma if the name on your diploma is not your correct and current legal name.

Item 9. You should use proper case when entering your address. This means you must capitalize the first letter only of each of the words in the address and use lower case for the remainder of the letters. Do not use all capitalization or all lower case. The 3 lines for street address and the line for city are case-sensitive. Take care. If any of your contact information including e-mail address has changed, you can make the necessary changes in this item.

You must provide an e-mail address in this section. If you do not have an e-mail address, you cannot apply on-line. Item Social Security Number, enter it in the space provided. If you have been issued a national identification number from a country other than the United States, enter it in the space provided and specify the country that issued it. Gender Indicate whether you are male or female. Native Language Indicate whether your native language is English or a language other than English.

If your native language is not English, enter the name of your native language. Other Languages Spoken If you speak a language or languages other than English at home, indicate the language s spoken.

Check all that apply. Although you are encouraged to complete this item, providing this information is voluntary. This information will be used for research purposes and will be kept confidential.

Choosing a particular answer or answers, or choosing not to answer this question, will not affect the outcome of your application. Citizenship Select the country of your citizenship at birth, upon entering medical school, and now. Ethnicity Select the option s that best describe s your ethnicity. Select all that apply. Medical School Information Enter the exact name and complete address of the medical school from which you graduated.

Also enter your dates of attendance and number of years attended at this school, your graduation date, the date your medical diploma was issued and the exact title of your medical degree. If you were required to complete an internship prior to receiving your medical diploma, enter the start and end dates of your internship. Other Medical School s Attended If you attended medical school s other than the medical school you entered in Item 17, enter the exact name s and complete address es of the other medical school s.

Also enter your dates of attendance and number of years attended for each medical school. To add a medical school, click "Add. Item 18 A. Add Other Medical School For all other medical schools, enter the official name of the medical school, the address, dates of attendance, and number of years attended.

Transfer Credits Indicate whether you transferred academic credits from any school to the medical school that conferred your medical degree. To add a course, click "Add. Item 19 A. Transfer Credits For all transferred credits, enter the name of the school from which the credits were transferred, course titles, and number of credits transferred and click the "Add" button. Clinical Clerkships The term clinical clerkships refers to that period in your medical education in the clinical disciplines during which, as a medical student, you gained practical experience in hospitals or clinics through rotations, pregraduate internships, etc.

To add a clinical clerkship, click "Add. Item 20 A. You must also provide the dates of the clinical clerkship. Present Employment Indicate whether you are currently employed. Medical Diploma Indicate which of the following statements applies to you. I have graduated from medical school and have previously submitted to ECFMG photocopies of my medical diploma.

I have graduated from medical school. I have graduated from medical school, but my medical diploma has not been issued. With my Certification of Identification Form Form , I am enclosing the ECFMG Medical Education Credentials Submission Form Form ; two copies of Medical School Release Request Form ; a letter from my medical school that confirms I graduated, have met the requirements to receive my medical diploma and states the date my medical diploma will be issued; an English translation of the letter if required , and a photograph.

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Form 344- Ecfmg

Providing the correct medical educ ation credentials to ECFMG will reduce the possibility that your application for exami nation will be rejected if you are applying for an examination and expedite the medical educ ation credential verification process. If your Certification of Identification Form is signed by an authorized official of your medical school, this envelope must be sent to ECFMG directly from the office of that official. Form I, Rev. SEP Page 1 of 2. If you are not currently applying for an examination , you may submit your medical education credentials and associated forms and documents, but you should not include an IWA Document Submission Form Form These forms and documents must be sent to:.

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Will be rejected if you are applying for an examination and expedite the medical education credential verification process. SignNow's web-based application is specially developed to simplify the arrangement of workflow and improve the whole process of qualified document management. Use this step-by-step guide to complete the form swiftly and with ideal accuracy. By utilizing SignNow's comprehensive service, you're able to execute any needed edits to form, make your customized electronic signature within a few fast steps, and streamline your workflow without leaving your browser.

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