Discrimination in ECFMG and TOEFL

Hector Carbajal

New Member
I am seeking certification from the Educational Commission for Foreign

Medical Graduates. I have a question about the english language requirement. They tell me that I need to present the TOEFL to convince
them that I am competent in english no matter what other credentials
that I may have!

     I have a Bachelor of Arts. degree with a major in Biology from a
prestigious U.S. university. The B.A degree requires several core
classes in basic English. I also have most succesfully passed advanced
English classes technical writing, literature, and philosophy not to say
the least that I am extremely fluent in English. Should not a transcript
of my degree or a personal interview satisfy the language requirement.

    This policy stance seems quite absurd if not very restrictive; it
screams of discrimination against highly trained and competitive foreign
immigrants. What ECFMG or TOEFL are doing- I do not know who to blame or
if this is collusion- should, quite naturally, be illegal. How can they
require a person to pay for an exam that serves as an english language
credential when that person already has superior credentials?

    Another form of abuse that they are practicing is their time
restriction on validity of credentials. Once two years have passed, you
automatically lose your certification status and have to retake the
TOEFL for more than a hundred dollars every time that the exam is taken.
This policy would be fine if they gave a person at least 5 years before
expiring their credentials.

    I hope this letter has reached sympathetic eyes so that if it were
at all possible you could point me in the right direction to see who is
the best person or institution that I should contact in order to help
change this policy.

Hector Carbajal


Washington Post
Corporate Headquarters Educational Testing Service
Paul E. Barton - ETS director policy information center
Richard J. Coley- ETS education program and policy analyst policy
information center
Harold Wenglinsky- ETS research scientist policy information center
Carla Cooper- ETS staff associate policy information center
Washington, D.C. Educational Testing Service, Office of State and
Federal Relations director Patty McAllister
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Registered Users (C)
No Title

Welcome to the real world. ECFMG is a big scam to make loads of money off of people like you and me. Here\'s several points that you may not know:
1. Have you heard of a FMG getting more than 90 percentile on Step 1 or Step 2? Rarely, if ever. Reason? Are FMG\'s not smart enough? No, because ECFMG may be truncating scores for FMGs to make them less competitive. If not, why not have NBME report our scores to us?
2. Why have TOEFL? If I can take the board exams in English, does it not imply that I know enough English to pass a basic English exam like TOEFL?
3. Did you see the fees FMGs have to pay to take these exams? They tell their own story.
4. How about CSA? Is that a joke or what? Another money making scam by ECFMG to rip off people like us.
ECFMG is pathetic. Do we have a choice? No. Solution? Suffer, for you have no choice.

Crazy graduate

New Member
No Title

We are a \'majboor\' lot.Have to pay a price(lots of it) to get a better education in US.Take the TOEFL ,crack that exam. U will be happy. Dont search for logic.

bhola ram

New Member
No Title

I agree with your assumptions that ECFMG does charge lots of money. I was as mad as you guys when I was paying for my wife\'s fees. It is no easy writing checks for $500 for USMLE and $1200 for CSA.

But then I heard the story on the other side also. The local American Graduates from US Med school .. by the time they finish med school have a avg debt of $120,000 . Most of the IMG\'s come in with barely any debt from med school education. Now these AMG\'s need some protection. So the bar for IMG\'s is a bit higher, and as more and more IMG\'s clear the bar they are raising the bar more. This is a demand/supply game.

Anyway I know of many IMG\'s who have scores in the 90 plus area.


Registered Users (C)
No Title

While most of your accusations of score fruads and stuff is baseless...I agree that there is methodical descrimination. Well, I am sorry to say you have not seen it all..

The fees are somewhat justifiablw, for the reason that not just the test but the standardization is what takes most effort.

Toefl, beyond other things establishes ability to understand speech.

CSA is genuinely a AMA effort to curb immigrant doctors b addition of another layer..

It being 1200 dollars and needing everyone in the world to come to USA (Everyone knows, an able bodied indian doctor at the age 30 will not even get a visitor visa to USA)... is a method established to racially descriminate asian and high volume immigration countries...

Since most Europians have 6 month no visa visit rights,.. they are not affected. More over, it is impossible to establish that simulated patients are not affected in their judgement by the race of the person in front of them.

All said and done, they want to boost doctor salaries in USA, and curbing immigrant doctors is number 1 priority.


Registered Users (C)
No Title

Blatant Discrimination of FMG Graduate Educations.

This is what happened with my wife..

Passed Step 1,2 & 3, ECFMG certifications and CSA.
Qualifications: MBBS, MD (India), and MRCOG (UK)

Did get the residency in PA. but State Medical Board of PA refuse to
give Trainee Medical License required to start Residency.

Reason : Do not have enough Clinical Rotations Hrs In MBBS.
they need 2880 hrs. My college did provide info. of requisite
nos of hrs. the Board is so bureaucratic that they refuse to
consider the clinical rotations hrs. in any other format than
required by them.

 Actually Clinical rotations for MBBS do not make any sense after
 having done two Masters and ECFMG certifications.

  But that is what PA Medical Board need...?

Unfortunately the Babu\'s (clerk) in my college (India) are also
not very co-operative.

I will have to drop off from the residency program from PA and try
next year somewhere else, where they will accept ECFMG board certificate.

I had other offer in New York to do Residency but my fate is so bad
it brought me to PA.

I am posting this for the welfare of other FMG, so they do not get
in my situations. Please do proper re-search before selecting
the residency program.