Ethan Rhodes
International medical graduates (IMGs) face a challenging and competitive process when applying for residencies in the United States and Canada. IMGs must be certified and pass medical licensing exams in the country they plan to practice in, and while there are IMG-friendly hospitals, eligibility and application requirements vary. The application process is lengthy and costly, and applicants should be strategic about where they apply. IMG applicants averaged 144 applications in 2024, and it is recommended they apply to a minimum of 100 programs, with some applying to 50-100 more in additional specialties.
| Characteristics | Values |
|---|---|
| Average number of applications submitted by IMG applicants in 2024 | 144 |
| IMG applicants' top specialty in 2024 | Internal Medicine (107 applications) |
| IMG friendly residency programs in the US | Mass General Brigham/Brigham and Women's Hospital Massachusetts, Lincoln Medical and Mental Health Center New York, One Brooklyn Health System/Kingsbrook Jewish Medical Center New York, Montefiore Medical Center/Albert Einstein College of Medicine New York |
| IMG eligibility and application requirements | Can vary depending on the country, state or province and even the hospital or program |
| IMG friendly specialties | Internal medicine, family medicine, pediatrics, pathology, psychiatry |
| Recommended minimum number of programs to apply to | 100 |
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What You'll Learn
IMG-friendly hospitals in the US
International medical graduates (IMGs) looking to apply for residency programs in the United States should consider several factors. Firstly, IMG-friendly residency programs in the US vary in their eligibility and application requirements, which depend on factors such as the hospital, state, and applicant student status. Some hospitals may only accept US IMGs, while others may accommodate both US and non-US IMGs. Additionally, certain hospitals may have specific visa requirements, such as accepting applicants with an H-1B or J-1 visa.
When considering how many hospitals to apply to, it is recommended that IMG applicants create a personalized list of IMG-friendly residency programs that align with their qualifications and preferences. While there are a fair number of IMG-friendly hospitals in the US, the application process is lengthy and complex, so thorough research and preparation are crucial.
To increase the chances of a successful match, applicants should aim for a balance between the total number of applications and the selection criteria of the programs they are applying to. It is worth noting that IMG-friendly residency programs often receive thousands of applications and employ various filtering algorithms to narrow down their choices.
There are several well-known IMG-friendly hospitals and residency programs in the US. Here are some examples:
- Mass General Brigham/Brigham and Women's Hospital, Massachusetts: Offers a residency program in thoracic surgery.
- Lincoln Medical and Mental Health Center, New York: Provides a residency program in pediatrics.
- One Brooklyn Health System/Kingsbrook Jewish Medical Center, New York: Offers a residency program in physical medicine and rehabilitation.
- Montefiore Medical Center/Albert Einstein College of Medicine, New York: Another option for physical medicine and rehabilitation residency.
- HCA Florida Healthcare/USF Morsani College of Medicine GME Brandon Hospital, Florida: Features an emergency medicine residency program.
- Wyckoff Heights Medical Center, New York: Also offers an emergency medicine residency program.
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Eligibility and application requirements
International Medical Graduates (IMGs) looking to apply for residency programs in the United States face a different set of requirements compared to their American counterparts. These requirements can vary depending on the state, the hospital, and the applicant's student status.
Firstly, IMGs need to gain clinical experience. Residency programs are unlikely to consider applicants without relevant clinical experience, and some require US clinical experience. IMGs can gain clinical experience in the US by applying for a pre-residency fellowship, which can increase their chances of securing a US residency.
Secondly, IMGs must obtain certification from the Educational Commission for Foreign Medical Graduates (ECFMG) and take the USMLE Step 1 and USMLE Step 2 exams. Most residency programs in the US use the Electronic Residency Application System (ERAS) to screen applicants, and ECFMG certification is required to apply through this system.
Thirdly, IMGs should ensure they meet the eligibility requirements for the specific state and hospital they are applying to. For example, some states and hospitals may only accept US citizens or require specific medical licensing examinations. IMGs should research and create a personalized list of IMG-friendly residency programs that match their qualifications.
Finally, IMGs should aim to apply to IMG-friendly specialties such as internal medicine, family medicine, pediatrics, and psychiatry, which have higher rates of accepting international applicants. It is important to note that the application process for residency programs in the US is highly competitive, and IMGs should be prepared to invest significant time, energy, and money.
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Gaining clinical experience
Understanding the Types of USCE
US Clinical Experience (USCE) is a crucial component of the residency application process for IMGs. There are three main types of USCE: Observerships, Electives, and Externships. Observerships are shadowing experiences where you follow a physician in their daily activities but do not have hands-on patient contact. Electives and Externships involve direct patient care and hands-on clinical rotations, respectively. Sub-internships are also mentioned as a valuable option, providing an opportunity for hands-on experience and patient care.
Choosing the Right USCE for You
The choice of USCE depends on various factors, including your budget, level of experience, eligibility, and end goals. If you are new to the US medical system, starting with an observership can be a good way to gain insight and build connections. If you have some prior experience or rotations, you may consider an externship or fellowship, which can provide more hands-on patient care opportunities.
Finding USCE Opportunities
Finding USCE positions can be challenging, but there are several strategies you can employ:
- Check hospital websites, particularly larger US teaching hospitals, as they may have observership or externship options posted.
- Utilize state medical societies, as they sometimes help match IMGs to USCE opportunities in their region.
- Consider federal programs, such as the US Department of State's Exchange Visitor Program, which may facilitate J1 clinical programs.
- Look for international options that can help match IMGs to US electives and facilitate the necessary processes.
- Tap into your network by contacting friends and peers who have already completed rotations. They may be able to introduce you to universities or physicians open to providing clinical experience.
- Research and apply to multiple programs, as competition is high, and don't forget to have all your required documents ready.
The Benefits of USCE
USCE provides IMGs with valuable insights into the US healthcare system and helps determine if it is a good fit for your desired branch of medicine. It allows you to build a network and gain letters of recommendation, which are crucial for residency applications. IMGs who complete US electives and observerships have higher match rates than those without USCE. It also helps validate your credentials and readiness for residency, making it an essential bridge to residency in the US.
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Application costs
Firstly, it is important to note that IMG applicants face a range of potential difficulties when applying to US residency programs, including differences in background, language, and medical education, as well as stigmas surrounding the quality of their education and training. As a result, many residency programs have never accepted IMGs in the past, and some IMG-friendly programs only accept US citizens, despite their ability to sponsor or accept visas. This limits the number of programs that IMGs can apply to, and it is important to research and create a personalized list of IMG-friendly residency programs.
The application process for residency programs can be expensive, and costs can add up quickly, especially if you are applying to a large number of programs. According to one source, applying to 100 programs in two different specialties can cost over $4,500. IMG applicants should be prepared for these costs and consider their financial situation when deciding how many programs to apply to.
In addition, the time and energy required to complete the applications should not be underestimated. IMG applicants should carefully research the requirements and eligibility criteria for each program to ensure they are a good fit before applying. This includes considering factors such as clinical experience, as residency programs often require relevant clinical experience, and some may even require US clinical experience. Gaining clinical experience in the US can help IMG applicants make valuable connections and start growing their professional network, which can increase their chances of matching with a residency program.
While it is important to be strategic and consider the costs and time investment required, IMG applicants should also keep in mind that applying to a larger number of programs can increase their chances of matching. IMG applicants should carefully weigh these factors and decide how many hospitals to apply to based on their own financial situation, time availability, and the likelihood of acceptance at each program.
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Acceptance rates
The acceptance rates for International Medical Graduates (IMGs) vary depending on the hospital, state, and student status. In 2025, the National Resident Matching Program (NRMP) reported a 60.8% match rate among IMG applicants who submitted a certified rank order list. The match rate was slightly lower for non-US IMGs at 58% and higher for US IMGs at 67.8%.
The acceptance rates also depend on the specialty. IMG-friendly specialties such as internal medicine, family medicine, pediatrics, pathology, and psychiatry have higher rates of IMG acceptance. According to the American Medical Association (AMA), the average number of applications to all specialties for graduates of MD-granting public medical schools was 74 in 2023. However, IMG applicants averaged 144 applications, with some applying to as many as 250 programs.
To increase their chances of matching, many IMG applicants apply to a large number of programs, considering the varying acceptance rates and competitiveness of different programs. Some programs may not accept IMGs due to visa-related issues or other eligibility criteria. It is recommended that IMG applicants apply to a minimum of 100 programs in their top specialty, with some applying to additional specialties as well.
While applying to more programs can increase the probability of matching, it is important to apply strategically and consider personal values and preferences when creating a residency rank order list. Additionally, gaining clinical experience, especially in the US, can help IMG applicants make valuable connections, grow their professional network, and increase their chances of matching.
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Frequently asked questions
IMGs (International Medical Graduates) should apply to as many hospitals as they can reasonably afford, as the application process is competitive and costly. IMGs averaged 144 applications in 2024. It is recommended that IMG applicants apply to a minimum of 100 programs in their top specialty, and they may apply to 50-100 more programs in 1-3 additional specialties.
The number of applications you submit depends on your preferences and resources. Applying to more hospitals increases your chances of acceptance, but this process is expensive, so consider your budget. Also, keep in mind that some hospitals are more likely to accept IMGs than others, so apply strategically.
IMG-friendly hospitals are those with high IMG acceptance rates. Many of the top hospitals in the US are IMG-friendly, regularly accepting international students for postgraduate medical training. However, eligibility and application requirements vary depending on the hospital, state, and applicant student status.
Gain clinical experience, ideally in the US, to make valuable connections and grow your professional network. Also, get letters of recommendation from physicians at American or Canadian institutions, as these are considered more reliable.
IMG-friendly residency programs in the US include Mass General Brigham/Brigham and Women's Hospital Massachusetts for thoracic surgery and Lincoln Medical and Mental Health Center in New York for pediatrics.
