Foreign-Trained Veterinarians in the US: ECFVG vs PAVE, Step by Step

Thousands of veterinarians trained outside North America want to practice in the United States, and many practices short of veterinarians would gladly hire them. Between the two sits a demanding process: proving that an education from a school the AVMA has not accredited is equivalent to one it has. There are two programs for that, the AVMA's ECFVG and the AAVSB's PAVE.

This guide explains both, what still follows them, and what practices should know when hiring an internationally trained veterinarian.

Who needs it

Graduates of a veterinary school accredited by the AVMA follow the same path as US graduates: the NAVLE and a state license. Several schools outside the US and Canada hold AVMA accreditation.

Graduates of a school that is not AVMA accredited must first complete an educational equivalency program. Maryland's application, for example, states that applicants from non accredited schools must submit a certificate from either the ECFVG or PAVE.

ECFVG: four steps

The AVMA's Educational Commission for Foreign Veterinary Graduates (ECFVG) has run its certification program for decades. According to the AVMA, the ECFVG certificate is accepted by all US state veterinary boards and the federal government as meeting, in part or in full, the educational requirement for licensure.

The four steps, completed in order:

1. Application. Register and provide supporting documents, including proof of graduation.
2. English language requirement. Show English proficiency.
3. BCSE. The Basic and Clinical Sciences Examination tests knowledge of basic and clinical veterinary science.
4. CPE. The Clinical Proficiency Examination tests hands on clinical skills.

PAVE: four steps

The AAVSB's Program for the Assessment of Veterinary Education Equivalence (PAVE) takes a different approach to the clinical part. Its steps:

1. Application, including English proficiency and documents.
2. QSE. The Qualifying Science Examination.
3. ECE. An Evaluated Clinical Experience: supervised clinical training at an AVMA accredited veterinary school, described as a 12 month experience.
4. The PAVE certificate.

PAVE has a caution on its own page. Because of high demand, applicants should expect a wait for a place in an Evaluated Clinical Experience, and paying fees and passing the QSE does not guarantee a place.

ECFVG or PAVE?

The key practical difference is the clinical step: a defined exam in ECFVG, or months of supervised training in PAVE. PAVE's training can be more thorough, but placement capacity is limited. Check that your target state accepts PAVE before choosing it; the AAVSB asks every applicant to confirm their jurisdiction first.

What still follows

The AVMA is explicit: an ECFVG certificate is not a license. The same is true for PAVE. Afterward, a candidate still needs:

• The NAVLE, the licensing exam every US veterinarian passes. See the NAVLE explained.
• A state license in each state where they will practice, with that state's laws exam, background check and verifications. See moving states with a veterinary license.
• Immigration status that allows the work. The AVMA publishes information for foreign graduates on visas and working in the US; immigration advice should come from an immigration attorney.
• DEA registration and any state controlled substance registration before handling controlled drugs.

A realistic timeline

Every case is different, but expect the process to take years rather than months. Each step has its own application windows and exam dates, PAVE's clinical placements have waiting lists, and the NAVLE runs in only three windows a year. Many internationally trained veterinarians work in other roles in the meantime, such as veterinary assistant or technician roles where state law allows.

For practices hiring international veterinarians

• Ask exactly where they are in the process. "ECFVG step 3 passed, CPE booked for spring" is a clear answer. "Working on licensure" is not.
• Do not let them practice as a veterinarian before they are licensed in your state, even under supervision. Check your state's rules on what a graduate in an equivalency program may do.
• Consider a supporting role. Some practices hire candidates as assistants or, where allowed, technicians while they finish, then promote them once licensed. Make sure their visa allows the role.
• Help with the expensive parts. Exam fees, travel to the CPE or study time are meaningful support, and a commitment period in return is reasonable.
• Verify the license once issued, like any other. See how to verify a veterinary license.

How Zuse helps

On Zuse Talent, veterinarians can claim their state license as soon as it is issued and browse veterinarian jobs with pay shown. Practices on Zuse Hire see each license checked against the state board.

Sources

• AVMA, Educational Commission for Foreign Veterinary Graduates
• AAVSB, International pathway for veterinarians (PAVE)
• Maryland Board of Veterinary Medical Examiners, Application for veterinary license
• Today's Veterinary Practice, Unlocking potential: the untapped power of immigrant veterinarians (January 2026)

This article explains the licensing programs and is not immigration or legal advice.

FAQ

What is the ECFVG?

The AVMA's Educational Commission for Foreign Veterinary Graduates certification. Graduates of non accredited schools complete four steps (application, English, the BCSE science exam and the CPE clinical exam) to show their education is equivalent.

What is PAVE?

The AAVSB's Program for the Assessment of Veterinary Education Equivalence. Its four steps are the application, the QSE science exam, an Evaluated Clinical Experience at an AVMA accredited school, and the certificate.

Is ECFVG or PAVE accepted in every state?

The AVMA states that ECFVG is accepted by all US state boards. PAVE is accepted by participating boards, so check your state before choosing it.

Does an ECFVG certificate mean I can practice?

No. It meets the education requirement. You still pass the NAVLE and get a license in each state where you will practice.

Do graduates of accredited schools abroad need ECFVG or PAVE?

No. Graduates of AVMA accredited schools, including some outside North America, take the NAVLE and apply for a state license directly.