US IMG - with Pathways, when to take USMLE for fellowship?

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Hi all,

I am a US IMG - medical student intending to pursue a residency outside of the US - in my country of residence.

Initially, I was planning to take the USMLE steps during medical school, while material is fresh, in order to receive an ECFMG certification allowing me to pursue a fellowship in the US (after completing residency outside of the US) and then return to my country with a US fellowship (it is a common practice where I live).

Now that the Pathways are in place, and permanent ECFMG certificates are no longer provided, I am wondering if it makes sense to take the USMLE exam during medical school. My residency program is at least 4.5 years long + ~2 years until I will begin the program (I will not start residency immediately) = almost 7 years, with no guarantee from the ECFMG that my USMLE steps will not expire after 7 years…

Therefore, I am thinking it may be better to postpone the USMLE steps until completion of residency, and only if a fellowship position is relevant - return to the med school material and complete the steps.

Trying to figure out if this makes sense.

Any input would be appreciated 🙏🏼

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