How To Apply For USA Residency: Tips For IMGs

1. Apply Early. The early bird catches the worm. Most medical residency programs have limited interview slots. According to FREIDA, on an average a Family Practice Residency Program interviews 50 applicants and an Internal Medicine Residency Program interviews 189 applicants. Normally a program receives applications, reviews them and sends out invitations for interviews. Usually all residency interview slots would be filled up quickly. If you apply after this happens, chances are even if you meet or even exceed the requirements, your application will not be reviewed. So, before 1st September, you should already have finalized the programs you plan to apply. And, you should apply as early as possible in the first week of September itself.

2. (Again) Apply Early. In case you missed the above point or underestimated the importance of applying early, read on. Programs are likely to be flexible in the beginning of the application season. This is the time when they don’t know how the applicant pool is going to be. In fact, most programs in InfoIMG database recommend applying early. If you are already ECFMG certified, not applying early is inexcusable. If you have passing USMLE scores, it becomes even more important that you apply early. As the interview season winds down, the program personnel are sometimes worn out and not that much enthusiastic.
3. Call it evidence-based-application. There is a program that claims to consider all applications including those from IMGs. But, except one, not a single resident in the program’s 30 years history was an IMG. One should rather read it as “IMGs need not apply”. In general, if a program has not had any IMG in last 5 years, chances are IMGs won’t be taken this year too. Whenever available, InfoIMG has collected the “Number to total IMGs” and “Number of PGY-1 IMGs” or “%IMGs” in a program.

4. Programs take IMGs, but most of them are US-IMGs. US citizens and permanent residents (aka, green card holders) who went to medical schools outside the US are called US-IMGs. They do not need H1 or J1 visa to pursue medical residency training in the USA. Most of the US-IMGs go to the Caribbean Medical Schools. In some cases, if you go through program’s website, you might find most of the IMGs are US-IMGs. These programs prefer undergraduate degree from a US university or feel comfortable with Caribbean Medical Schools graduates. If you are a US-IMG, your chances will be better at such programs. On the other side, if you are not a US-IMG, it is best not to have high degree of optimism about those programs. Whenever available, InfoIMG has collected this data too and can use it for your query.

5. Use your green card wisely. Consider this scenario: Program A requires minimum 80 on both the USMLE steps and sponsors H1 and J1 visa. And, Program B also requires minimum 80, but does NOT sponsor H1 and J1 visa. If you have a green card and an exact USMLE scores of 80, where will you apply? Probably both. But, what happens if there are 10 programs like Program A and Program B each? Program A will definitely have a lot many IMGs with 85 or more scores. Why would it take a green card holder then? So, if you have a green card, it makes more sense to apply for programs like B. For a couple of programs it might not matter, but if you have already applied to a lot many places and costs are becoming prohibitive, this will be a nice strategy. We have a list of medical residency programs that say they DO NOT sponsor any visas. InfoIMG can also run a query that gives out programs that do not sponsor visas, with other criteria that you might supply.

6. Persist: In one case, an IMG met all the requirements of a Residency Program. But, did not get an interview invitation or a rejection letter. She kept on calling the program. Eventually, the polite and friendly residency coordinator invited her for interview. So, InfoIMG’s advice is PERSIST till you get rejection letter or hear otherwise. Do not get on the nerves of the Residency Program, but do call sufficiently to let them know you continue to be interested. You can show your goodies (personality, motivation, determination, educational skills, US experience) to the program only if you are interviewed.

7. Make sure your application is complete. If your application is not complete, you are hurting your chances of being offered an interview and perhaps a medical residency position. More so if you are barely meeting the criteria. The average numbers of applications in PGY1 are 314 and 1388 for Family Practice and Internal Medicine respectively. DO NOT EXPECT THE PROGRAM TO CONTACT YOU FOR ANY MISSING DOCUMENTS. They will simply not consider your application. It has happened to quite a few IMGs.

8. H1 visa. It is getting harder to obtain H1 visa. Yet, 2 types of programs are likely to sponsor H1 visas – (a) programs that are unable to attract American Medical Graduates (AMGs) and are seeing a decline in number of applications, and (b) programs that want the best residents, no matter what. Currently Internal Medicine and Family Medicine are out of favor among AMGs and many medical residency programs depend on IMGs. In any case, if you need an H1 visa, most programs require that you pass USMLE Step 3, latest by 31st January. That is just before they submit their rank order list (ROL). However, the earlier you pass USMLE Step 3 and let the program know about it, the better. If you take Step 3 early and unfortunately fail, at least you can take it again. If you wait till the end, you might not be able to take and pass USMLE Step 3 by the time the program submits the ROL.

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Pubblicato da drsilenzi

Medico specialista in Igiene e Medicina Preventiva, PhD in Sanità Pubblica presso l’Università Cattolica del Sacro Cuore – Roma. Attualmente opera presso la Direzione Strategica dell'Agenzia di Tutela della Salute di Brescia ed è membro del Comitato Direttivo del Centro di Ricerca e Studi sulla Leadership in Medicina dell'Università Cattolica del Sacro Cuore. Dal 2014 riveste la carica di Vice Presidente Vicario della Società Italiana di leadership e Management in Medicina – SIMM (

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