What IMG Residency Candidates Need to Know About Matching for Postgraduate Positions


You’ve never let naysayers get you down. Despite hearing that international medical schools can be a bit lacking, you’ve excelled at a program outside the US. You’ve done well in your clinical rotations and obtained strong exam scores. Now that residency is on the horizon, you’re ready to conquer the negative rumors once again.

One of the most pervasive myths about being an international medical graduate (IMG) is that you won’t be able to secure a residency and become a doctor. This simply isn’t true for a number of reasons. IMGs who attended a quality medical school in the Caribbean or elsewhere in the world should feel good about their odds.

Perhaps you’d like to see some specific information about how IMGs fare. There’s plenty of evidence showing international grads have a bright future when it comes residency placements. There’s more opportunity than you might realize.

6 things IMG residency applicants should keep in mind

These facts highlight what the overall residency matching landscape looks like for IMGs as well as how you can give yourself the best odds of securing a position.

1. More IMGs matched in 2019 than in 2018

Numbers can certainly fluctuate from year to year, but 2018 proved to be a successful one for international grads. In fact, the number of IMGs who secured residency positions through the National Resident Matching Program’s (NRMP’s) Main Residency Match went from 6,862 in 2018 to 7,025 in 2019. That’s a 2.4 percent increase.

It’s also worth pointing out the number of IMGs participating in the Match decreased, which means a greater percentage of those seeking postgraduate training positions obtained them. The idea that IMGs are fighting a losing battle just doesn’t hold up.

2. IMGs fill a considerable portion of US residencies

Residency positions are filled by a number of applicant groups, including US allopathic grads, international medical graduates, and US osteopathic grads. IMGs secured a significant portion of spots in 2019. They obtained 23 percent of the total number of US residency positions filled.

And there are hundreds of thousands of international grads already practicing medicine in the US. According to data from the Association of American Medical Colleges (AAMC), IMGs account for nearly 25 percent of the active physician workforce in the US. This goes to show that you can build a lasting career in the US as an international grad.

3. The number of residency positions is growing

One concern medical students seem to have is that there aren’t enough residency positions in general. A shrinking number of spots would definitely mean shrinking chances of success. But the number of spots isn’t decreasing—it’s actually growing. The number of available spots has increased every year since 2002.

4. Your step scores and interview matter more than your school

As an IMG, you might be worried that you could be at a disadvantage when interviewing for US residency programs. You’re vying for the same positions as applicants who attended US programs, after all. But where you attended medical school doesn’t seem to make much of a difference. According to results from the NRMP’s most recent program director survey, whether you attended a highly regarded US program is pretty far down on the list of factors considered.

Program directors are much more concerned about your scores on the United States Medical Licensing Examination (USMLE) Step 1, your letters of recommendation, and your Medical Student Performance Evaluation (MSPE). Even your personal statement matters more than which school you attended.

5. You stand the greatest chance of matching into primary care

One thing to keep in mind when you’re going through the residency application process is that you stand the best chance of matching into primary care. But that’s true for every medical student, not just IMGs.

It’s a simple matter of numbers. There are vastly more positions available for primary care fields than for specialties. For example, internal medicine accounted for about 25 percent of all the available spots in 2019.

6. Some locations are especially IMG-friendly

Some states have a tendency to accept more IMGs than others. This is definitely the case for locations in the Northeast. New York, New Jersey, and Pennsylvania are good examples. Hundreds of IMGs match into residency programs in these three states. If you’d like to look more specifically at other locations, you can see the breakdown in one of the NRMP’s data reports.

Aim for residency success

There are clearly fewer obstacles for IMGs than you may have originally thought. Many graduates who obtained their MD at an international school have secured residency positions in the past, and it’s likely that will continue into the future.

Just keep in mind that all Caribbean medical schools are not created equal. But if you attend a quality program and work hard, you could become another IMG residency success story.

It also helps to have a good strategy when applying to and ranking programs. The brightest student could find themselves unmatched if they aren’t thoughtful about the process. You’ll need to do your research and make sure you identify the right programs.

Learn more about how you can give yourself the best odds of matching by reading our article, “The International Medical Student’s Guide to Finding IMG-Friendly Residency Programs.”

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