to the OET Exam and ECFMG Pathways

What in the world is happening!?

I did not want to write this blog post because I truly didn’t think the OET would continue to be relevant after this 2021 MATCH year, but SURPRISE!! The OET is here to stay, at least for 2022.

On January 26, USMLE made an announcement that the USMLE Step 2 Clinical Skills exam would be suspended indefinitely. (https://www.usmle.org/announcements/?ContentId=309). So you might think, OH YAY!!! We have one less exam and $1600 less dollars to shell out. And maybe if you are a US medical student this is true, but if you are an IMG, do not rejoice before you understand the full implications of this exam being cancelled.

After the coronavirus pandemic which caused USMLE to suspend the Step 2CS, some big changes were made that it seems will continue to impact IMGs:

  • IMG medical schools now have to submit a form to ECFMG called a clinical attestation. For the most part, the student isn’t in charge of anything for this to be completed, but at Ross we are required to take and to pass the Kaplan CSA (practice Step 2 CS) for this form to be completed. Then, the school takes it from there and completes and writes this on your behalf. HOWEVER, keep an eye on it and make sure it is turned in, because I have heard of students having to request theirs or have issues with theirs being submitted in a timely matter.
  • To receive ECFMG certification for ECFMG verification prior to submitting your rank order list (ROL), you must apply to 1 of 5 pathways. If you go to Ross, you apply for pathways 3-5 on the ECFMG website. Ross will send an email about this when you need to do this. The big change is that in order to receive this certification you must take and pass the OET and pay $900 USD (was previously around $150). The OET and ECFMG certification is not required for graduation, it is required for ECFMG certification.

To apply to the pathways, look here: https://pathways.ecfmg.org/

Info on the pathways: https://www.ecfmg.org/certification-requirements-2021-match/


You are not saving money!

In addition to the $900 USD you must pay to ECFMG, the OET itself costs $587 AUD ($451 USD). In the case that you need to cancel and reschedule your test, regardless of the circumstances (even family death or illness or it being their fault the test is cancelled, even if COVID related), you will only receive a PARTIAL refund and have to pay in full to schedule another exam.

So, you save $250. But you gain a whole lot of inconvenience and extra steps and what seems like a whole lot of unfairness. SO SAVE YOUR COINS! Do not spend this money thinking it won’t be needed later.

What is the OET and how do I study for it?

The OET is an Australian based occupational English exam made for healthcare workers who “wish to practice in an English speaking environment”. It is made up of four section: listening, reading, writing and speaking.


Listening (45 min)

During the listening section you listen to different types of extracts some short and some long and you fill in the blanks or answer multiple choice questions based on what you hear. The fill in the blanks and multiple choice go in order at which you hear them, so you answer them as you go along. This portion of the test is easy as long as you don’t drift off while listening to the prompt.

How to study for this portion:


Do all three listening sample tests and you will be good to go.


Reading (60 min total, but you can finish faster depending on how fast you read)

In the reading section you read excerpts from some short texts and some long, medically related. For the first part you full in matching, short answer questions and fill in the blanks. This is all about reading, if you can read you can find the answer. The text is placed next to the questions, so you do not have to memorize the text to fill this in. The second section you have to answer the question “what is the gist of this paragraph”.

How to study for this portion:


Do all three reading sample tests and you will be good to go.


Writing (45 min total, but you can finish faster depending on how fast you write)

This is the hard part. The way this is graded is entirely subjective. So, you could be world’s greatest writer and they do not like how you wrote the letter. Therefore, this will require the most practice and learning of all the sections. Your task is to write a letter of some sort, usually a referral letter, but it can also be a transfer letter or a discharge letter or a letter to advise a patient or care provider.

How to study for this portion:


We personally did all 4 writing practice tests on the OET site. In addition, I would recommend doing the sample writing letters on the Ross Canvas site because Ms. Rachel Scott provides feedback to you there on your letters rather than you just trying to see if you did good enough based on the sample letter. Obviously, your letter will never be exactly the same as the OET sample but try to follow their style even if you like your style better. Also, spend some time watching OET YouTube videos and OET E2 YouTube videos on writing. Here are a few to get you started:




Speaking (20 min)

The speaking part is only testing your ability to communicate information given to you to a patient. You get a prompt card and have time to read all the information you need to provide the patient; you and the patient will ask each other questions that are directed at the information on your card. It’s a role play situation.

Here are some examples of how this looks like:



How to study for this portion:

Find a friend and do all 4 sample speaking tests together, one person as the doctor and one as the patient. Do these a few times and you will be prepared for this.

Other resources to study for OET:

OET E2 on YouTube


Official OET on YouTube


Ross Canvas OET Modules



What ways can I take the OET?

  • In person/on paper: you can take the OET at one of OETs sites. If you do this, you will do all 4 portions of your test in person and on paper.
  • San Diego, CA
  • Irvine, CA
  • Port Charlotte, Florida
  • Chicago, IL
  • Boston, MA
  • Manhattan, NY
  • Columbus, OH
  • Portland, OR
  • Philadelphia, PA
  • Pittsburgh, PA

Register in person/on paper here: https://registration.myoet.com/login.jsp

  • On computer: AKA at Prometrics. If you do this, you will do your speaking portion at home via Zoom on the days leading up to or following your Prometrics sit date. The remaining sections will be at Prometrics. Some people had technical difficulties at Prometrics like their screens not allowing a double screen to see the text and answers at the same time or their audio not working. If this happened, those participants had to stop their test and reschedule it, I think at no cost in this situation (do not quote me on that). We both took ours at Prometric’s and had no issues with this.

Register on computer here: https://booking.myoet.com.au/

  • OET@Home: in order to take the OET@home, you have to receive an invite from them. This option will most likely NOT be available to you. If it is, you have to take this on a Windows computer and NOT on a MacBook.


How is OET scored?

You must score above a 350 on every OET section to pass the exam. If you fail one section, you are required to retake the entire exam.

Read more about scoring here:

Results & Assessment

If you fail the writing or speaking section, it is recommended by fellow students to pay for a regrade as the grading is subjective for these categories. It costs $120 AUD or $91 USD PER SECTION that you need regraded.

Read more about requesting a regrade here:



After you take your test, the most important part.

After you take your exam, it takes about a month to get your OET results. If you took it at Prometric’s, the results are emailed to you. Once you get your results, you have to make sure they are released to the ECFMG.

DO NOT REGISTER FOR OET UNDER A DIFFERENT EMAIL THAN YOUR ECFMG PROFILE. USE THE SAME EMAIL ADDRESSES TO MAKE THIS A SMOOTHER PROCESS. This process could change for 2022 Match so just watch for an email from your school if so.

  • OET@home: scores automatically sent


Trouble Shooting

It is possible you get an email when you are supposed to receive your grades saying that:

  • Your scores are held up in customs
  • Your scores are held up in quality assurance
  • Unforeseen system issue
  • A variety of other issues

If this happens to you, it does not mean you failed. Many students had this issue and eventually got their scores.

When issues arise:

  • Contact the school immediately (for Ross this is Dr. Gnecco and Ms. Monica Garcia as of now)
  • Call OET and push as much as you can (you can be on hold for up to 2 hours or more): 1-855-585-0125

If your scores are reported and they are not sent to ECFMG in a timely manner (14 business days):

  • Call OET and let them know: 1-855-585-0125
  • Call ECFMG daily: 215-386-5900


  • Take this exam early, before interview season starts
  • You HAVE to have a passport, or your situation will get hard so get a passport ASAP
  • Do not take this test without studying for it, be prepared (you only need about 2 weeks of studying to pass this, unless you struggle more with writing/speaking/reading/listening then adjust accordingly)
  • Do not register for OET under a different email than your ECFMG profile. Use the same email addresses to make this a smoother process.

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1 Comment

  • Reply
    January 27, 2021 at 4:24 pm

    THANK U YASMINE!!!❤️❤️❤️🙏🏼🙏🏼🙏🏼

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