You can find all the 5PW info you need by going to (1) the AMA website and searching for "Fifth Pathway" -- it's under the ECFMG section ( <a href="http://www.ama-assn.org" target="_blank">http://www.ama-assn.org</a> ) and (2) the NY Med College 5PW site ( <a href="http://www.nymc.edu/depthome/fifth.asp" target="_blank">http://www.nymc.edu/depthome/fifth.asp</a> ).
But briefly, the 5PW program was created for American citizens and permanent residents who go to medical school in a country (usually Mexico) that requires 4 years of med school, a year of internship and one of social service before they grant the MD degree. Successful completion of 5PW allows one to enter an ACGME residency in the US, without technically having obtained the MD degree. It also allows you to bypass ECFMG certification (and you don't have to take the CSA or the TOEFL).
One can participate in 5PW if they have completed the 4 yrs of school, but not if they have done the internship/social service or if they have already been granted a degree. Also, you must pass Step 1 and 2 of the USMLE.
You might also want to check out <a href="http://www.fifthpathway.com," target="_blank">http://www.fifthpathway.com</a> -- a site created by the 5PW committee here at UAG.
I hope this helps. Let me know if you have any other questions.