ECFMG's 2026 Information Booklet lists its irregular behavior cases, and one of them is titled "Submitting a falsified translation of a medical school diploma to ECFMG." A physician had uploaded a fraudulent translation of a diploma through EPIC. The result was a permanent annotation of irregular behavior that, in ECFMG's words, "will appear on their CVS Report, ECFMG Status Report and in all EPIC Reports sent by ECFMG." Any program or licensing board that receives those reports will see it.
That case is extreme, but it shows how seriously ECFMG treats translations, and its rules are unusually specific. This guide covers each ECFMG translation requirement, which documents need translating, how name mismatches are handled, and how EPIC fits in.
What are ECFMG's translation requirements?
ECFMG's English Translations page sets the conditions below, and translations that miss any of them "will not be accepted."
| Requirement | What it means in practice |
|---|---|
| Word-for-word | No summaries or abstracts. Every printed word, stamp and handwritten note is rendered. |
| From the original or a photocopy | ECFMG will not accept a translation made from a transcription (a retyped version) of the document. |
| By an authorized translator | A government official (for example, a consular officer), a medical school official (for example, a dean or registrar) or a professional translation service. |
| Signed, with title and seal | The official or the service's representative signs, gives a title, and adds a seal if one exists. |
| On letterhead | If a private company translates, the letterhead must identify it as a translation service. |
| Certification statement in English | A statement from the translator or the service's representative that the translation is correct. |
| Not by the applicant | Applicants for ECFMG services may not translate their own documents. |
ECFMG also names what it rejects outright: translations by a notary who is not a government or medical school official, unsigned translations, and translations without the certification statement. An English-language certificate issued by your school that is not a word-for-word version of the original document "is not acceptable as a translation" either.
The 2026 Information Booklet adds the pairing rule. Documents must be submitted in the original language, original-language documents without an acceptable translation are not accepted, and "English translations that are not accompanied by the original language document will not be accepted."
ECFMG "strongly encourages" applicants to use its recommended service, Straker Translations, whose translations "will not be rejected for not meeting these requirements." Using it is optional. With any other provider, ECFMG says, it is your responsibility to make sure every requirement is met.
Can I translate my own medical diploma for ECFMG?
No. ECFMG states that "applicants for ECFMG services are not permitted to translate their own documents." Physicians are fluent in English and often assume their own careful translation will do; it will not.
The same list rules out most informal helpers. A bilingual colleague or relative qualifies only if he or she is a government official, a medical school official or part of a professional translation service, and ECFMG names translations "prepared by a notary who is not a government or medical school official" among those it rejects.
Which documents need a translation for ECFMG Certification?
ECFMG Certification is what ACGME-accredited residency programs require of international medical graduates, and US licensing authorities require it, among other things, for an unrestricted license. ECFMG is a division of Intealth, and since August 2025 applicants work in the MyIntealth portal. Certification rests on the USMLE Step 1 and Step 2 CK exams, a clinical and communication skills requirement (met through an ECFMG Pathway that includes a satisfactory OET Medicine score, or a valid pass on the former Step 2 CS), and verified medical education credentials. Translations live in that last part.
Final medical diploma
You upload a copy of the final diploma in the original language, showing the issue date and all signatures of school or university officials, with a translation if it is not in English. ECFMG says not to submit a professional evaluation of the diploma; it does not accept one in its place. If you have graduated but the diploma has not been issued, an authorized school official signs a letter with the school seal and a prescribed statement, and the diploma copy follows later.
Final medical school transcript
You do not upload this one. When ECFMG verifies your diploma, it asks the school to send the final transcript. If the transcript is not in English and the school does not provide an acceptable translation, ECFMG has it translated by an independent service, charges your financial account and notifies you afterward. ECFMG "will not notify you before sending the document for translation."
Transfer credit transcripts
If you transferred credits into the school that awarded your degree, you upload an official transcript from the institution where those courses were taken, in the original language with a translation. ECFMG verifies it with that institution. Our academic transcript translation guide explains how course lists, hours and grades should be rendered.
Name documentation
The name in your record must match your current, unexpired passport. If the name on your diploma or transcript differs, for example a maiden name on the diploma and a married name in your record, you must prove the credential's name is or was yours. ECFMG lists an expired passport, birth certificate, marriage certificate, court order or name change document, US immigration documents and a driver's license. Attestations are not accepted, and any of these not in English needs a translation meeting the same rules. ECFMG cannot finish verifying your credentials until acceptable name documentation arrives. See our name change guide and marriage certificate translation.
Canadian graduates now count as IMGs
Graduates of Canadian medical schools on or after July 1, 2025 are treated as IMGs for US residency, and they establish eligibility through ECFMG Certification. Credentials from French-language faculties fall under the same translation rule as any other non-English document.
How does EPIC handle translations?
EPIC, the Electronic Portfolio of International Credentials, is ECFMG's primary-source verification service for physicians whose credentials must be confirmed for licensing boards, employers and other organizations. You can add a final diploma, medical school transcripts, internship certificates, postgraduate training credentials, specialist qualifications, certificates of good standing, medical registrations or licenses, and advanced degrees in the medical sciences.
Any document you upload to EPIC that is not in English must come with an English translation that meets ECFMG's requirements. EPIC notifications sent to organizations include a copy of the credential "including its English translation, if applicable," so the board reads your translation alongside the verified document. Credentials already verified for ECFMG Certification can often be added without a new upload or fee after ECFMG reviews the file.
Specialist and license documents are where IMGs underestimate the work. A residency completion certificate, a specialty board diploma and a medical council registration can each run several pages of stamps and endorsements, and all of it needs translating. For state licensure after residency, see our guide to professional licensing with foreign credentials.
Terms that trip up medical diploma translations
Word-for-word does not mean blind. Several degree titles carry traps:
- Spanish Médico Cirujano (Mexico, Colombia and elsewhere) is the general first medical degree. Translate it literally as "Physician and Surgeon"; it does not indicate a surgical specialty.
- Spanish Doctor en Medicina is a professional degree title, not a PhD. Translate the wording as written and do not add "PhD" or "MD."
- Russian Lechebnoe delo is the general medicine program, often rendered "General Medicine." Pediatriya is a separate first medical degree in Russia and several neighboring countries, not a pediatrics residency.
- Russian vrach is "physician." Qualification lines such as vrach-lechebnik are rendered literally rather than modernized.
- Grades and hours are reproduced as issued. A 5-point scale stays a 5-point scale.
The exact degree title ECFMG requires for your school and graduation year appears in its Reference Guide for Medical Education Credentials. A literal translation makes the match easy to see.
Why ECFMG rejects translations
Self-translation. Prohibited outright, however good your English.
No letterhead, or the wrong one. A freelance translator's signature on plain paper does not meet the letterhead rule.
Summary translations. A one-line "This is to certify that X graduated in Medicine" version of a dense diploma fails the word-for-word test.
Translation from a retyped copy. If the translator worked from a transcription instead of the document, ECFMG will not accept it.
Translation uploaded without the original. Both go in together.
Inconsistent names. A diploma translated as "Iurii" and a passport reading "Yuriy" create a name verification problem that holds up everything else.
Checklist for IMGs
Questions people ask
Can I translate my own medical diploma for ECFMG?
No. ECFMG states that applicants for its services are not permitted to translate their own documents. The translation must come from a government official, a medical school official or a professional translation service.
Do I have to use Straker Translations?
No. Straker is ECFMG's recommended service, and ECFMG says its translations will not be rejected for failing the requirements, but using it is optional. Any professional translation service can be used if the translation is word-for-word, signed, on letterhead identifying it as a translation service and accompanied by an English certification statement.
My school issued an English version of my diploma. Is that enough?
Only if it is a word-for-word version of the original. ECFMG says an English-language certificate from the school that is not a word-for-word version of the original document is not acceptable as a translation, and the original-language diploma must be submitted with it.
Can a notary translate my documents for ECFMG?
Not unless the notary is also a government or medical school official. ECFMG lists translations prepared by a notary who is not such an official among those it does not accept. Its requirements do not call for notarization of a translation at all.
Who translates my final medical school transcript?
ECFMG requests the final transcript directly from your school. If it arrives in another language without an acceptable translation from the school, ECFMG has it translated by an independent service, charges your financial account and tells you afterward, not before.
What happens if the name on my diploma differs from my passport?
You must submit documentation showing the name on the diploma is or was yours, such as a marriage certificate, birth certificate, court order or expired passport. Any of these not in English needs a translation that meets ECFMG's requirements, and ECFMG cannot complete verification of your credentials until it receives acceptable name documentation.
Does EPIC have different translation rules?
No. EPIC uses the same ECFMG translation requirements. The difference is the audience: EPIC notifications to organizations include your credential with its English translation, so licensing boards and employers read the translation you provided.
How much does a medical diploma translation cost, and how fast is it?
Official Translations charges $29.95 per page. A one or two page diploma is usually delivered within 24 hours as a signed PDF by email, and multi-page credentials, such as residency certificates with endorsements, typically take one to three business days.