As of January 26, 2021, the USMLE Step 2CS examination was permanently canceled. In response, the Educational Commission for Foreign Medical Graduates, or ECFMG®, devised five pathways to allow qualified international medical graduates (IMG) to acquire ECFMG certification. These five pathways require applicants to attain a satisfactory score on the Occupational English Test (OET), an English-language proficiency assessment.
Let’s try and answer the most frequently asked questions to clear up some confusion!
What is the OET?
The OET is an international English proficiency test that assesses the language communication skills of healthcare professionals. OET Medicine is designed specifically for physicians: the ECFMG chose this test to determine if a candidate meets the minimum English skills required to practice medicine in the U.S.
OET assesses English proficiency in different types of communication. The test is divided into four parts: listening, writing, reading, and speaking.
OET: Listening component (50 minutes)
In this section, the exam assesses your ability to understand spoken language. It is divided into three parts: A, B, and C. You will listen to consultations between physicians and patients (part A), monologues (i.e., one person speaking), and/or dialogues (i.e., two people speaking) (parts B and C). With each encounter, you will have to fill in the answers based on information in the listening exercise.
→ Click here for a sample listening test.
OET: Writing component (45 minutes)
In this section, you will be provided with a case note and a task and given five minutes to read through them (during those five minutes you are not allowed to use a pen or a pencil). After that, you have forty (40) minutes to write a letter according to the task. In the writing session, you will be assessed for purpose, content, conciseness and clarity, genre and style, organization and layout, and language. The writing section is usually the most challenging, and it is advisable to practice before the actual exam.
→ Click here for a writing sample test.
OET: Reading component (60 minutes)
In this section, you will be provided with texts talking about different healthcare-related topics, and you will answer questions according to these texts. The reading is divided into three parts A, B, and C. Part A is done alone, and it is 15 minutes. While parts B and C are taken in tandem, you have 45 minutes to complete both (so make sure you monitor the time carefully). Part B consists of six short texts of about 100-150 words from a healthcare workplace, where you will get one multiple-choice question with three options about each text. Part C consists of two long texts of up to 800 words, in which each text covers a specific topic and is divided into paragraphs. In Part C, you will get eight multiple-choice questions with four options. The good thing about part C questions is that they guide you where to look in the text (i.e., specifying what paragraph in the text the question is about).
→ Click here for a reading sample test.
OET: Speaking component (20 minutes)
In the speaking section, you participate in two role-playing exercises where you take the role of the professional ( i.e., physician), and the interlocutor (the person facilitating this portion of the exam) plays the patient, a patient’s relative, or a caregiver.
You start by getting a card that states the setting, the patient’s information, and the task. Once you get the card, you have three minutes to prepare. Then, you have five minutes to perform the role-play. Once you finish the first role-play, you will get a card for the second role-play, repeating the same steps as the first but in a different setting, with a different patient and task.
→ Click here for a sample speaking test.
What materials do I need to study for the OET?
The most recommended resource to use for OET preparation is the OET official website, which contains a variety of useful services. These include master classes (videos that will help you understand the exam), books, sample tests, writing guides, etc. You can find these resources on the OET’s preparation portal.
Although the materials you use, as well as preparation time, are mainly dependent on your English proficiency, everyone—even native English speakers—is advised to take assessment tests to familiarize themselves with the format of the exam and make sure they know what to do on exam day. Such assessment exams are also found on the OET official website. In addition, E2 Language has an amazing mock test for medical students that will be helpful in preparing for the OET exam.
Do I take the OET exam in person or online?
The OET is available in 45 countries where you can take the exam in person. You can find the list of countries here.
Although the OET is currently administered in person, an at-home version of the test is on the horizon, OET@home, which is facilitated via remote proctoring. Please visit the OET website to learn more about the timeline, requirements, and regulations.
When are OET exam dates scheduled? How often can I take it?
OET is scheduled twice per month (please check the test dates here and the test dates in the U.S. region here). Remember, if you aim to participate in next year’s Match, you must take the OET on or before the last test date in December.
There is no limit on how many times you can take the test, but this, of course, is subject to availability, as the seats are usually limited.
How do I get started booking an OET?
To begin the application for OET Medicine, you must pre-register at the ECFMG page on the OET website. In the pre-registration, you will enter your information, preferred test date(s), and the country and city where you wish to take the test. Once you have completed the pre-registration, the OET will send you emails about the available test locations and dates, materials you may need to help you prepare for the tests, and instructions on the next steps to book your exam venue and date.
You can also book your exam directly before filling out the pre-registration form from the OET website if you find a suitable venue and date. But you have to make sure that the exam you book is OET Medicine. Additionally, if you book it directly, you still have to complete the pre-registration form to let the ECFMG know that you are taking the OET Medicine to complete your certification.
Can I repeat only a specific part of the OET (e.g., the speaking component)?
No. According to the ECFMG, the minimum required score of 350 in all test measures (e.g., speaking, listening, reading, and writing) must be achieved in one test administration. Therefore, if you do not get the minimum score in one or more components of the test, you have to retake all of the OET components( speaking, listening, reading, and writing) and achieve the minimum score in each one, all in a single test administration.
How do OET exam scores work, and what do I need to pass?
For ECFMG certification, IMGs must score a minimum of 350 (Grade B) on each of the four components of the OET exam (i.e., listening, reading, writing, and speaking). If your scores are below the minimum requirement in any component, you will have to retake the entire test.
On what date can I expect my OET results?
Your OET exam results will be available to you 14 business days after the test date. It is important to give your consent to the OET for releasing the results to ECFMG to avoid any delays in the process of ECFMG certification.
After I’m done with the OET exam, how long does it take to get my ECFMG certification?
There is no exact answer to that, but it usually takes 10–14 business days to get ECFMG certified once the results of OET are out, given your other components of pathway applications are complete and validated.
Will program directors be able to see that I got certified via OET?
Yes, the program directors will be able to see that a candidate is ECFMG certified via one of the pathways. Therefore they will be aware that you took the OET exam.
If I passed the OET but did not match, will I have to take Step 2 C.S. if it is reinstated?
Currently, the OET exam is only validated for the applicants applying through one of the five pathways in the Match. If you do not match or fail to enter a U.S. GME program accredited by the ACGME for the Match, your ECFMG certificate will expire. Check the ECFMG website for updates and changes.
I failed my initial attempt at Step 2 Clinical Skills (C.S.). If I obtain Certification through one of the pathways, will ECFMG still report my failed attempt to programs?
Yes, if you request and pay for a USMLE® transcript to be sent to programs. The USMLE transcript is required by many ACGME-accredited residency programs as part of the ERAS application process. It contains your examination history for the Step 1 exam, Step 2 Clinical Knowledge (C.K.), Step 2 C.S., and if taken, Step 3. All attempts at USMLE® Steps and Step Components (passed, failed, incomplete, etc.) will be included, regardless of whether you meet the clinical skills requirement for ECFMG Certification through one of the pathways.
We hope this quick guide has helped give you a better understanding of the Occupational English Test. We wish you the best of luck with this exam!
About the Authors
Qirat Jawed is an ECFMG-certified international medical graduate who is a USMLE Question Writer at Osmosis. Qirat graduated from Dow Medical College, DUHS, Karachi, Pakistan, in 2019 and is applying for a residency in Internal Medicine this year. She hopes to stay near the East Coast (mainly New Jersey) with her husband. In her free time, Qirat enjoys cooking, spending time with family and friends, and sometimes playing badminton with her new friends in Elizabeth, New Jersey.
Hamzah Qandil is a Medical Doctor who graduated in 2019 from the Jordan University Of Science and Technology. He is currently a Medical Question Writer at Osmosis. Hamzah is passionate about surgery and is applying this year for a General Surgery residency in the United States. In his free time, Hamzah enjoys playing or watching soccer, reading, and traveling whenever possible.
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