International Medical Graduates

Who is an International Medical Graduate (IMG)?
A physician who received a medical degree from a medical school located outside the United States and Canada that is not accredited by a U.S. accreditation system. 

If you are interested in the details of each of these steps, we encourage you to download and read the AAFP guide to US residency for IMG. 

10 Steps Toward Residency as an IMG:
1 - Medical school Graduation

• You can start the process of testing while in school as described below.
• As soon as you graduate you will need to send copies of your diploma to ECFMG.​
• Check the World Directory of Medical Schools to confirm that your school is eligible for the ECFMG certification process. 
• Here is reference guide for medical education credentials.

2 - Applying for ECFMG Certification 

• The Educational Commission for Foreign Medical Graduates (ECFMG) assesses whether IMGs are eligible and ready for entering residency or fellowship programs within the United States. 
• You can find more information on the ECFMG website.

3 - Examination Requirements

• IMGs must submit an application for ECFMG certification before applying for exams.
• To meet examination requirements for ECFMG certification, applicants must complete USMLE Step 1, Step 2 CK, Step 2 CS examinations.
• You can read about starting the examination process here.
• There are three required USMLE exams for ECFMG certification: Step 1, Step 2 CK, Step 2 CS. 
• To be eligible for testing, you must be enrolled in an accredited medical school as described above and have completed at least two years. 
• It is very important to do well on these examinations. 
• You can read about the USMLE exams and updates on the USMLE website.

4 - Observerships

• Observerships allow IMGs to learn about the practice of medicine and healthcare in the United States. 
• You can learn about observerships at the AMA website where you can also research programs and apply. 
• You can also reach out to specific programs and ask if they allow IMGs to apply for their observerships. 
• An "audition rotation" at your top choices is always recommended. This allows the program to learn more about you and it will help you to show off your skills and interest. 

5 - Research

• Academic research has become more important over the recent years. It can be a positive asset to your application, especially for competitive specialty and programs.
• Find an area of interest that you are passionate about and reach out to appropriate faculty members for further assistance.
• Be realistic about your goals and timeline.
• Try to attend and present at a medical conference, help with data collection, write an abstract and learn about research skills and publishing. 

6 - Recommendation letters

• It is important to get to know your professors and have mentors. They will be able to write you strong letters.
• Letters from a US clinician that speaks to your medical abilities are very helpful.
• Applicants can submit up to four letters of recommendation to every program. It is highly recommended that the majority of letters are written by US clinicians.

7 - Personal statement

• This is the item where you can express yourself and interests. It is a chance for the committee to learn more about you.
• Make specific mention of your clinical abilities in your personal statement.
• Make sure it has no error.
• Have others proofread your statement and provide feedback.
• Applicants can use private agencies specialized in editing professional personal statements.

8 - Sign up for ERAS  (register here)

• The Electronic Residency Application Service (ERAS) usually opens in June and allows you to upload your documents (CV, Personal Statement, photo, etc), send your letter writers the appropriate directions to upload your letters of recommendation and apply to residency programs. 
• You can work on your application and submit it in September to the programs who have chosen.

9 - Interview 

• Once you have completed your ERAS application, you will be considered for interviews.
• Learn about the residency program and be ready to ask the questions that matter to you, as this is also the time for you to see if the residency program you are interviewing at will be a good fit.
• Here is a great resource on interview preparation. 
• Make sure you follow up with programs and send personal, handwritten preferred, thank you cards highlighting your visit.

10 - Match and Rank List

• Once you have completed your interviews, you will be asked to rank residency programs based on your interest. 
• It is important to discuss with your mentors about your choices and reasons for choosing programs. 
• Important factors are location, size of program, family, interview experience and future goals. 
• Remember, the Match is in your favor. Therefore, do not rank based on reputation but rather where you truly want to go and where you believe you will fit best. Remember, all programs have the same ACGME guidelines, what it comes down to is whether you will be happy at that location and will enjoy working with the residents you encountered during your interview day.  
• You will rank your programs on the NRMP website.
• The Match usually occurs in mid March and you will be notified on the Monday of Match week whether you have matched and be notified of the program you have matched at on that Friday, which is Match Day. 

Obtaining a Visa: 
The USA requires a visa for IMGs to participate in their residency programs. 
Here are some resources regarding the process:
- AMA
​- ECFMG
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Acceptance
We believe in your success. We look forward to hearing about your acceptance and future plans. Remember, it is a journey that might take a year or more, but you WILL get through it!