This is a start to finish guide for steps, residency and visa application process (J1 in

particular). This post is based on several posts from this forum which I thought were
invaluable for IMGs applying for the match.

1. USMLE/EFCMG ID - First step is to obtain a eight digit ID number via ECFMG website. Its
pretty straightforward and takes about 7-10 business days for ECFMG to send you the ID via
email. All future communications to ECFMG (including the photocopies of documents like
degree, passport, etc) should have your ID number written.

2. Application for ECFMG certification - once you have the ID/password, you can log in to
IWA and complete the application for ECFMG certification. You have to fill up
personal/medical school information and pay a fee of 65$.

3. Step application - You can now apply via IWA for step 1, 2CK or 2CS. Esentially you
begin the exam application online, fill up details including your medical school enrollement,
internship and graduation, clinical clerkships, choose your desired eligibility period and pay
the exam fee. Depending on whether you are a student or graduate, whether or not your
medical school participates ECFMG web portal for status verification you will be issued
either a form 183 or form 186 (students from school not participating in online status
verification get form 183 while graduates, students from schools in online status verification
get form 186). You have to get the form 183 or form 186 signed by the authorized ECFMG
representative from your school.

4. Send the documents to ECFMG - If you get a form 183 or if you are a student with form
186, you will only have to send the form. If you are a graduate, you will be usually sending
form 186, 2 copies of form 345 (medical school release request), photocopy of your degree.
(You may have to send a letter from your medical school signed by the authorized official
verifying your name if your name in your passport/ECFMG record does not match that on the
degree/diploma. Additionally, if you have graduated but have not yet recieved your degree
and wish to apply for the exam, you will have to send a letter from your school stating that
you have completed all the requirements for graduation including the date of graduation and
when the degree is expected to be issued. Once you get the degree, you need it to send it to
ECFMG). Note that you have to send a form 183 each time you apply for an exam if you are
a student while form 186 has to be sent only once and has a 5 year validity (for a
subsequent step exam you have to just complete the online application if you have a valid
form 186 on file)

5. Scheduling permit - Once ECFMG processes the form 183 or form 186 which takes about
3-4 weeks, your scheduling permit will be issued. If you send form 186, you need to careful
with the name issue described above as ECFMG will accept form 186 but reject the exam
application if your name on degree and ECFMG record do not match and you have not sent
a letter verifying the name. Another thing people usually get confused is between exam
application and credentials verification. When you send the degree to ECFMG, it starts the
process of verification of your degree from your medical school (credentials verification).
This has nothing to do with exam application and you will be issued the scheduling permit
once the online application is accepted when ECFMG recieves your documents. Once your
permit is issued you can book the slot via prometric for step 1 and 2 ck or step 2cs calender
for CS.

6. Issue with score withholding and status re-verification - This usually happens to medical
students when they apply to the exam and send form 183. When a form 183 is send, unlike
the form 186 which is valid for 5 years, ECFMG might send a request for status
re-verification from your medical school if more than six months have passed from the date
form 183 was accepted (who ECFMG decides to re-verify is completely random). This is
done either via the online portal if your school participates in status verification (note that
ECFMG web portal for status verification and credential verification are two different things.
Status verification is to verify the medical education details of students and graduates, i.e.
whether or not you are a student enrolled in or graduate from the particular medical school;
while credentials verification is esentially to verify your degree and your school to upload a
transcript). If your school is not in online status verification program, ECFMG sends the
request for re-verification via postal mail (neither you nor the college is informed when this
happens, so unless your college informs you when they get the form or you follow up about
this it can be a headache to deal with). Either way, your college has to complete the form,
sign it and send it back to ECMFG. ECFMG will release the score only after the
re-verification process is complete (if it was requested in the first place)

7. Credentials verification - When you send the degree and form 345 along the other
documents for exam application or independently, the credential verification process begins.
ECFMG will send your school the copy of your degree you submitted, form 327-A
(verification of credentials/education) and request to send/upload your final transcript. This
process is lengthy and takes 1.5 to 3 months (possibly more) depending on whether your
school participates in the online credentials verification or not. If it does not, the process has
to be done by postal mail and takes a while. It is required that your credentials are verified
for you to be issued the ECFMG certificate (even if you pass both step 1,2) when you apply
to residency in September. You can check the status of the process in OASIS and when it
says "Medical Education Credentials Recieved and Verified" you are done with the process
(unless ECFMG for some reason decides to re-verify your credentials which is very rare)

8. ECFMG certificate - Once you are done with step 1, CK and CS and your credentials have
been verified, you will be sent the physical ECFMG certificate via post to the address in your
record in 3-4 weeks.

9. Start residency application - Usually OASIS will allow you to get a ERAS residency token
in last week of June when you would be able to access ERAS, send request for waived
LoRs to letter writers via letter of recommendation portal, submit supporting documents like
transcipt, MSPE, photograph and unwaived LoRs via OASIS.

Token - In the last week of June purchase ERAS token. Go to ECFMG website, go to your
OASIS and click ERAS support section at left hand bottom and choose to buy a Residency
Token. The token is valid for the match year.
AAMC - After purchasing the token you will get a special serial number. Go to AAMC
website and register it. This will give you access to MyERAS profile in order to begin
updating your profile with information and documents for the upcoming match.

Filling out your ERAS profile - You will be prompted to fill in some general information at first,
such as your school, date of graduation, whether you require visa or not and etc. Within that
same application you will also fill out your CV by adding experiences and writing how many
hours you have done and small descriptions of what you have done during that time. Work
experience is everything that was a rotation, observership, clinical teaching. Volunteer
experience is pretty much everything else (clubs, being part of societies, workshops, etc).
There will also be a separate section for research.

Document Upload - Letters of Recommendation (MyERAS). This is about generating PDFs

to send to those who will write them and upload on your behalf. If you are an IMG and have
non-waived letters, upload them via OASIS. You have two choices: waived or non-waived.
Non-waived letters are simply uploaded by you. “Waived” letter means that you don’t get to
see the letter and it is uploaded by the person who is recommending you. These letters are
considered much stronger. AAMC introduced the concept of waived letters being submitted
online via a secure network. The process works as such: you go on your MyERAS profile
and click on the documents section. There you carry out a request for a letter of
recommendation but filling out the name of the person who is recommending you and their
position. After you click below to authorize the generation of PDF file. This file contains
instructions for the letter write on how to upload the letter successfully on your behalf via
LoR portal. Send this PDF to your letter writer and have them follow the steps. As a
suggestion, these letters may take up to two weeks to process, so get them done early!

Other documents (upload via OASIS in the ERAS section) -They are unwaived LoRs,
medical school transcripts, passport photograph (professional/suited), MSPE.

Personal Statement - Start working on the personal statement early. Usually, a personal
statement alone will not get you an interview but it can certainly impact your application if
poorly written. Type the personal statement in word or google docs and paste/save it in
MyERAS once you are finished. Have it proofread by 2 or 3 people before you submit your
application to the programs in September.

Applying to the programs - Search and Select your programs by Clicking on “Programs” Tab.
You can search them by AAMC or NRMP ID or even by location. You should have a good
idea of where you want to apply to by now.
The best resource for research is FREIDA. Go to FREIDA, and set your own filters. After
selecting the programs, try visiting their website to find out any requirements which may cost
you an automatic disqualification from the game. Pay close attention to programs that don’t
sponsor visas.
Remember, It is always best to check their websites and request any addition information
first hand, then to trust lists people created years ago. Try to do this step before July, as it
will save you lots of time! Click on “Programs” tab and click on each program and check
boxes in order attach the necessary documents to them. These include LORs, Photo, and
your USMLE transcripts. NOTE! Your USMLE transcripts can only be checked when the
application season opens on September 1st, 2016. There is a one time fee of 65$ I believe
that will be included in your final invoice.

In September, go to your programs list and check the box next to each program. Scroll down
and complete the steps to make the payment. Once you have paid, wait to receive your
confirmation. To kill 2 birds with one stone: After you have completed the payment, go to
NRMP website and register for the match. It is a one time 65$ fee. This will come in handy in
February, when you will do your ranking. Once you have registered with NRMP, you will get
a NRMP ID which has to be updated in the personal information section in MyERAS (you do
not need this ID when you apply to the programs but it's preferred that you update the ID in
your profile once you register with NRMP).

"Personal" section is the only thing in ERAS which can modified once you certify and submit
your application. So make sure you double and triple check everything before you submit.

You can check the status of your ERAS application for each program in MyERAS, which is
located on the top right bar next to “Messages.”
Now the wait begins. You will get notifications to your e-mail and ERAS “Messages” section
for interviews and rejections!

10. Interviews - Not much to say here. If you have more interviews, it would obviously help to
relax and get a hang of things so you can do well in your preferred programs. Know what
you want to speak about. The most important things are to relax and be honest. You should
be prepared to a few questions which you will find online (Tell me about yourself, future
goals, etc). These should not be rehearsed but you should be prepared enough so that the
answers seem natural.

11. Once you have completed the IVs, you can start ranking programs in January (rank
order list deadline is in Feb). Rank programs based on where you want to go rather than
how you think you did in the interview.

12. Wait till the match week! Hopefully, all your efforts will come to fruition. If you don't
match, it sucks but it's not the end of the world. Assess your options, get USCE/research,
build your CV and try next year (if you can afford it).

Congratulations You've matched! Now what? Well, now the tedious process of visa and
license application begins.

13. Within a week of match result, your program will contact you and might send you a
welcome letter. Soon, they will be sending several forms including license application,
criminal background check, and health screening forms, etc. Make sure to fill them correctly
and send them as promptly as you can. Depending on which state you matched, you could
also be sent medical school verification form which has to be submitted to the state board
after it's signed by your Dean in a sealed envelope. These documents usually will be sent to
the program, which will then forward it to the board after filling out the program's details in
the application. Also, depending on the state, you will asked to send your ECFMG status
report to the license board. This is done via CVS online where you can request the ECFMG
status report to be sent after paying a fee of 40$.

14. J1 visa process - Personally, for me this has been the most stressful part of the whole
process.

The process starts with the program's TPL (training program liaison - the person who deals
with your visa/license paperwork in the program) sets up J1 sponsorship application in
OASIS. Once this has been done, you will be notified by ECFMG via email. You can then
access the J1 sponsorship page in OASIS, accept the position and pay the fee of 325$ (try
to do this early as ECFMG processes applications in the order the fee is paid). Once you fill
in your details and pay the fee, you can start submitting documents in the "Submissions"
section for J1 approval. You will be uploading a CV (including explanations for any gaps
during medical school and after graduation), contract/offer letter (which the program will
send you soon after the welcome letter), passport first and last pages. You also need to get
statement of need (SoN) from your health ministry. SoN has to be sent directly by the
ministry of health in a sealed envelope or you can send the sealed envelope to ECFMG
once you receive it (this is new as previously you would just upload the SoN directly. But
now, ECMFG has to get it in a sealed envelope and they will upload it to your application)

SoN process in India - Being direct here, this is a real pain in the arse. Download the SoN
application pdf from Ministry of Health and Family Welfare website (MOHFW). You have to
fill in the application and submit the necessary documents (passport pages excluding blank
pages, surety bond, offer/contract letter). Note that, it is preferred to get an offer letter
mentioning the duration of course as 3 years (though your initial contract is only for 1 year,
which will be renewed every year). You will also need a surety bond which has to be signed
by two people - a family member (usually this is a parent) and a gazetted officer who has 7
years service left who cannot be a family member. They are basically agreeing that if you do
not return to India after you complete the course, they will pay an amount of 5 lacs to the
Indian govt. The 1st surety (parent) is responsible for paying the amount, but if the 1st surety
does not the 2nd surety (gazetted officer) has to pay. If you are not able to find a gazetted
officer who is willing to sign the surety, you can take a bank guarantee in place of 2nd surety
(confirm this from MOHFW during the year you apply). This year, we were asked to get a
bank guarantee from any nationalized bank for an amount of 5 lacs for a 4-year duration (for
those applying to IM). You can extend the guarantee in the future if you plan to do a
fellowship after residency. A minor point here, remember to write your USMLE ID number on
the application you submit to MOHFW.

Once you get the above documents, send to MOHFW via courier service (rather than speed
post) or if you are in Delhi, you can personally drop off your application. Try to send it early
as it can take about 15-20 days for the SoN to be issued and sent to your address via post.
You can track your application status once it's delivered by calling MOHFW and finding out
you're application number. Once you get the SoN, send in to ECFMG in the sealed
envelope.
DS 2019 - Once ECFMG gets the SoN and other documents (CV, contract letter, passport
pages), ECFMG will issue the DS-2019 which will be sent to your TPL who will send the
form to you. ECFMG will also send you a welcome letter approving your J1 sponsorship and
will create your electronic record in SEVIS (maintained by DHS). You can now pay the
SEVIS fee of 180$ and submit form I-901 (you will need SEVIS ID and Exchange visitor
program no which will be in the welcome letter). To speed up the process of ECFMG
sending the DS-2019 to your TPL, you can upload a FedEx airbill (you will need to created
an account at fedex, then create a shipment, from address has to be ECFMG and to address
has to be the program, pay the amount for 2 day or overnight delivery and upload the
shipping label in the submissions page in OASIS). This is not mandatory though. ECFMG
will simply send the DS-2019 via postal service (USPS) if you have not uploaded the airbill.
Once your TPL get the form, ask them to send it to you via FedEx.

DS-160 - Fill in the DS-160 form and using the confirmation book your visa interview. You
will need the DS-2019 when you attend your interview though you can pay the interview fee
early and book your date.

After you get your J1 visa stamped, notify your TPL and upload the page in OASIS. Also
once you visit the US, you will be required to notify TPL to validate your J1 status.

15. Residency begins in June/July!

Good luck!