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Steps for Success for International Medical Graduates

Home  >  Steps for Success for International Medical Graduates

Step 1: Data

The NRMP [National Resident Matching Program] publishes data on matching outcomes every 2 years. This resource is known as "Charting Outcomes in the Match for
International Medical Graduates", and it's an extremely valuable data set. For each specialty, the NRMP includes remarkably specific data points, such as how many applicants with a USMLE score below 220 were able to match into internal medicine in the 2018 cycle. 

The NRMP also surveys program directors (PDs) in every specialty. The PDs report on the factors that are most important to them in deciding whom to interview and whom to rank.

Step 2: U.S Clinical Experience

As an IMG, you undoubtedly had significant clinical experience prior to your decision to seek training in the U.S. Although you may have had excellent clinical training in your native country, the reality of the matter is that your past experience will carry little weight in the residency selection process.


Far more important to programs is the depth and breadth of your clinical involvement here in the U.S. Lack of U.S. clinical experience is a major reason why applicants fail to match. 


Although programs require or recommend U.S. clinical experience, it can be difficult to secure such rotations. To help ease the process, we have created a list of observership and externship opportunities in different specialties. 

We also offer clinical rotation experiences for IMGs. These rotations have all been created by Dr. Samir Desai in partnership with dedicated physician mentors. We invite you to explore our opportunities below.

Once you've secured a rotation, your next order of business is to excel during the rotation. This requires that you have a strong understanding of the roles and responsibilities of healthcare professionals on the team, the differences between patients in the U.S. and elsewhere, and the non-cognitive skills and qualities that are highly valued in the U.S. healthcare system. Your ability to make a strong impression will be crucial to your chances of landing an outstanding letter of recommendation. 


Because of unfamiliarity with the system and the way in which care is delivered, talented IMGs often fall short of making a strong impression upon attendings and faculty members. To help you succeed in this crucial area, we have developed the resource "Success on the Wards." This book is a recommended or required resource at many U.S. medical schools, particularly when students transition from the basic science to clinical years. Feedback we have received from IMGs indicates that our resource has also helped IMGs perform at a high level sooner rather than later in the rotation. We invite you to learn more about "Success on the Wards."


One important goal of your rotation is to obtain a strong letter of recommendation from your faculty preceptor or attending physician. Increasingly, letter writers are asking applicants to submit a letter draft first. Letter writers will then use this draft as the basis for their letter. If you've been asked to submit a letter draft, feel free to contact us for assistance. Dr. Samir Desai has considerable experience writing powerful letters of recommendation. 

Step 3: Advance Planning

International medical students and graduates are making important contributions in patient care, research, teaching, advocacy, and leadership, and may be recognized for these efforts. Awards can provide a significant boost to the strengh of the residency application, and distinguish an applicant form this peers. 


We recently wrote the book "Medical School Scholarships, Grants, & Awards." Through this process, we've become familiar with grants and awards open to both U.S. medical students and IMGs. 


While it's true that many awards are only open to U.S. medical students, a surprising number are also available to international medical students and graduates. As competition for residency positions intensifies, applicants who've won awards will stand out from their peers. In 2015, we wrote an article describing 10 awards that can enhance the credentials of IMG applicants at (see link below).

Step 4: Take Action

Are you an IMG interested in exploring pathology as a career choice? Or an IMG working on strengthening your credentials because you've decided on anesthesiology as a career choice? 


Or are you an IMG getting ready to apply to the top internal medicine programs in the country? Perhaps you are an IMG who is concerned about matching successfully because of a low USMLE score?


If any of these apply, you need to take action. And that involves a series of steps to bolster your credentials and strengthen your application. 


Our specialty-specific action items walk you through the process. These recommendations are applicable to both pre-clinical and clinical students. 

Step 5: Residency Interview Resources

The Residency Interview: Overview from TSM 2017
Read More
Acing Healthcare Interview Questions
Hot Topics and Future Directions
Interview Coaching Service with Dr. Desai

Step 6: Future Directions

We're constantly reviewing the literature on future directions in medicine, and especially as these relate to particular specialties. What is the future jobs outlook for radiology? What are some of the changes in store for the field of anesthesiology? If you're planning to enter a particular field, these articles make for fascinating, thought-provoking reading. They can also serve as valuable preparation for residency interviews. 

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