Step 1: Explore the Specialty
Before you pursue a career in Internal Medicine, it's important to be well informed about the specialty. We've put together a great collection of articles and resources which are essential reading for the aspiring internist.
These articles will give you a better idea of the pros and cons of a career in the field, trends in the specialty, and hot-topic issues for trainees.
Hot Topics, Concerns, and Future Directions in Internal Medicine
Step 2: Review Internal Medicine Match Data
Matching into internal medicine isn’t difficult for most US MD applicants. There are many more positions than interested applicants. In the 2024 NRMP Match, there were 10,261 total positions. Only 2% of US MDs failed to match.
Note that the number of US MD seniors entering categorical internal medicine (IM) residencies has risen every year for the past five years. According to the NRMP, 3,595 US MD seniors matched into the specialty in 2024. However, this number remains well below the peak reached in 1985 (3,884).
Although U.S. allopathic students have had great success matching into IM, it can be very difficult to match with a highly coveted program. For example, the internal medicine residency program at Massachusetts General Hospital receives nearly 4,000 applications each year for about 75 positions.
Osteopathic applicants also fare well in the Match, with only 4.8% failing to secure a position.
However, the specialty is much more competitive for international medical graduates, with failure to match rates of 40% and 33% for non-US IMGs and US IMGs, respectively.
Internal Medicine-Charting Outcomes in the Match for U.S. MD 2024
Charting Outcomes™: Characteristics of U.S. MD Seniors Who Matched to Their Preferred Specialty: 2024 Main Residency Match®
Internal Medicine-Charting Outcomes in the Match for U.S. DO 2024
Charting Outcomes™: Characteristics of U.S. DO Seniors Who Matched to Their Preferred Specialty: 2024 Main Residency Match®
Internal Medicine-Charting Outcomes in the Match for IMGs 2024
Charting Outcomes™: Characteristics of International Medical Graduates Who Matched to Their Preferred Specialty: 2024 Main Residency Match®
Step 3: Understand Residency Selection Criteria
"We receive approximately 2,000 applications per year for ten positions and therefore are able to personally interview only about four percent of applicants," writes the Indiana University Ball Memorial Hospital Internal Medicine Residency Program.
To maximize your chances of matching with your first-choice residency program in internal medicine, you must become well informed as early as possible. In particular, you need to know the criteria residency programs use to select residents.
We recommend beginning with the following resources:
Internal Medicine-2024 NRMP Program Director Survey
Charting Outcomes™: Program Director Survey Results, 2024 Main Residency Match®
Check out these other recommended resources
Step 4: Develop your Strategy for Success
The process of matching into the specialty and/or program of your choice begins well before it’s time to work on the residency application. Success is the culmination of many decisions and actions that take place over a period of several years.
Many medical students struggle to become strong residency applicants not because they are not talented or hardworking, but because they lack knowledge or guidance about the actions they should take to position themselves for future success.
Complicating matters even further is the rapidly changing landscape in residency admissions making it difficult for both residency applicants and mentors to stay well informed. A recent study showed that 75% of faculty advisors had advising concerns due to lack of knowledge of current practices or recent changes to the residency application.
As competition for positions in the internal medicine residency match intensifies, it's more important than ever to be an informed candidate who has the "right" strategy for success. To develop the optimal strategy, use our book, The Successful Match. It's been designated recommended or required reading by the Association of American Medical Colleges, American Medical Women's Association, and numerous allopathic and osteopathic medical schools.
AMSA wrote the book "provides the medical student reader with detailed preparation for the matching process." Fully updated in 2025 with over 1,000 pages of powerful information, the book is a must-have resource to help you stand out from the competition.
This book will empower you to become a stronger internal medicine residency applicant. Inside, you'll find answers to the following questions and much more:
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What type of content in the letter of recommendation appeals to internal medicine residency program directors?
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What is the Internal Medicine Structured Evaluative Letter (IM SEL) and how you earn a strong one for your residency application ?
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What should your signaling strategy be in internal medicine?
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Step 5: Make the Most of your Preclinical Years
Step 6: Apply for Scholarships and Awards
Winning medical school scholarships and awards can provide a major boost to your residency application, and set you apart from your peers. Awards can be placed in the application, MSPE (Dean's Letter), letters of recommendation, and CV. We have found that interviewers often ask about awards during residency interviews.
Step 7: Assess your USMLE Step 1 Score or COMLEX 1 Score
The USMLE or COMLEX is an important factor in the family medicine residency selection process. In 2018, the mean USMLE Step 1 score among matched U.S. seniors was 233 and the mean COMLEX 1 score among matched osteopathic students was 554. Among unmatched U.S. seniors and osteopathic students, the mean score was 207 and 465, respectively.
Step 8: Strive for Success During Clerkships, Observerships and Externships
Grades in required or core clerkships are very important to internal medicine residency programs. In a NRMP survey of internal medicine residency programs, 73% cited "grades in required clerkships" as a factor in selecting applicants to interview. Internal Medicine rotations are also of obvious importance to international medical graduates seeking positions in the field.
Step 9: Prepare a Powerful Residency Application
Step 10: Develop a Powerful Personal Statement
Step 11: Deliver an Impressive Interview Performance
What if I didn't match?
If you were unsuccessful during your initial match cycle, you'll need to sit down with your dean or advisor to review your match strategy. In planning your reapplication, each of the steps above becomes even more important.
For those who seek additional expert assistance, we can provide that. Dr. Desai has had significant experience in helping re-applicants match successfully.
This is provided via a Strategy for Success Session. Dr. Desai will perform a comprehensive review of your credentials, assess your strengths and weaknesses, and provide you with a specific plan to implement tailored to your unique situation.