ECFMG certification is what allows graduates of Caribbean and other international medical schools to enter US residency, and it involves more than passing exams. You need USMLE Step 1 and Step 2 CK, an OET Medicine result for English proficiency, and verification of your medical credentials before you can start training.
Some of these steps take months to process, so planning semester by semester helps. Many students set up their USMLE/ECFMG ID during basic sciences, take Step 1 before rotations, sit Step 2 CK during clinical years, and finish OET early enough to have results ready before ERAS opens.
Do you have a semester-by-semester checklist that worked for you, from year 1 through residency applications? Share what you did and when, what you would do earlier next time, and which school you attended.