of the Medical Council of Canada (LMCC), which requires passing the MCCQE Part I and Part II Complete postgraduate training program in allopathic medicine and been evaluated by a recognized authority. For entering a residency program, the candidate must first pass the National Assessment Collaboration Examination Be certified by the College of Family Physicians of Canada, the Royal College of Physicians and Surgeons of Canada, or the Collège des médecins du Québec. However, some provinces may have alternate paths to licensure, e.g. British Columbia. IMGs in Canada have a harder time getting into residency programs compared to Canadian graduates—only ten percent of IMG applicants get a position. Several organizations have put pressure on the government such as the Association For Access to Health Care Services, and Association of International Physicians and Surgeons of Ontario. However, other organizations deny there is a physician shortage that requires Canada to import more physicians. United States In the United States, an international medical graduate (IMG) is a graduate from a medical school located outside the United States and Canada. Graduates of Canadian M.D. programs are not considered IMGs in the United States. IMGs may be either United States citizens or non-citizens who were educated in a school outside U.S. or Canada. Process The main process for IMGs who wish to be licensed as physicians in the United States requires them to complete a U.S. residency hospital program. The general method to apply for residency programs is through the National Resident Matching Program (abbreviated NRMP, also called "the Match"). To participate in the NRMP match, an IMG is required to be ECFMG verified. IMGs who have not met the examination requirements for ECFMG Certification by the Rank Order List deadline *usually in February" cannot participate in the Match. However, for most IMGs it is advisable to have an ECFMG certification prior to participating in the match as many program directors decide not to grant interviews. The purpose of ECFMG Certification is to assess whether graduates of these schools are ready to enter U.S. residency and fellowship programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME). To acquire an ECFMG certification, the main requirements are: Completion of USMLE Step 1, USMLE Step 2 Clinical Knowledge. Previous to 2021 the USMLE Step 2 Clinical Skills was also required but has now been discontinued. A medical diploma of medical education taken at an institution