The Main Residency Match can test even the most confident graduating medical students, but the good news is most applicants match. This also goes for international medical graduates (IMG), although it is true that they match at a lower rate than graduating U.S. medical students, and this alone can create anxiety for IMGs during interviews with residency programs.
An education session at the first annual AMA Distinguish Yourself IMG Summit held in August featured advice on interviewing from an IMG physician with experience not only as a residency applicant interviewee but also as an interviewer.
“I go into a hospital, and I start new residency programs,” said Sabesan “Saby” Karuppiah, MD, a family physician and an IMG from India. “So ... I've seen some things.”
Dr. Karuppiah is a former residency program director and designated institutional official. As the vice president of graduate medical education (GME) at the largest GME provider in the country, he has created programs across multiple specialties.
He revealed the attribute that has stood out to him most over his years of interviewing applicants pre-Match, as well as in helping unmatched and partially matched applicants find positions through the Supplemental Offer and Acceptance Program (SOAP).
Oct. 20–24 is IMG Physicians Recognition Week, when the AMA honors and celebrates IMG doctors, who are a vital component of the physician workforce and the AMA.
It’s what everyone wants
“The residents who we find are really good are the ones who are wanted by all the programs,” Dr. Karuppiah said, noting that it has little to do with their United States Medical Licensing Examination (USMLE) Step 1 or Step 2 CK scores.
What sets such applicants apart is that “they carry themselves with a certain conviction, a certain confidence, a certain message that just attracts people,” said Dr. Karuppiah, who serves as a delegate for the American Academy of Family Physicians in the AMA House of Delegates.
In fact, he said, the interviewees who always stood out to him were the ones he most enjoyed talking with.
“You want to leave the impression that: Oh, I wish I could be talking to this person a little bit more. It doesn't always come across in your scores or your personal statement. All that is great, but you must want to make a connection,” he said, a point echoed by another IMG who helps run a residency program. “At the end of the day, faculty and program directors, they are looking for a colleague.”
Navigate the process of practicing medicine in the U.S. with the AMA IMG Toolkit (members only).
Colleagues show up for each other
While most residency-program interviews are done online, some programs offer what is known as a second look—an optional in-person visit to get a better sense of the program and its people.
“Take it,” Dr. Karuppiah said, recalling a time when an internal medicine residency program he was working for had offered second looks but got few takers.
“But there was one physician who came all the way from Canada to Kansas City, and the program director wouldn't stop talking about this. He kept talking about it for three months,” he said, noting that the applicant ended up matching with the program, partly because the program director was so honored by the applicant’s interest. “So it just goes to tell you a second look can be important."
The AMA Road to Residency Guide will help you successfully plan your path to residency, from researching programs and excelling at interviews to navigating Match Day and more.
Note: Your odds are already good
Roughly 16,000 IMGs participated in the 2025 Main Residency Match, Dr. Karuppiah pointed out.
“Out of the 16,000, how many matched? 9,000,” he said, noting that this came to about 60% of IMG applicants. The rates are somewhat higher for U.S. citizen IMGs, 67.8%, than non-U.S. citizen IMGs, 58%.
“So if I tell you 60% of you are going to match, how would you feel? Good odds, right? Great odds,” he said, adding that the match percentage for IMGs was only about 40% when he went through the process back in 2006.
Add to that: The 43,247 positions offered in 2025 were the most in the Main Residency Match’s history and up 4.2% from 2024, although the number of applicants rose by a similar number, 4.1%.
“I want you to see the glass half full, not half empty,” Dr. Karuppiah said. “This is the best time to match as an IMG.”
Learn more about the AMA IMG Section, which gives voice to and advocates on issues that affect IMG physicians. Check out the AMA IMG Recognition Week social media kit, which has downloadable images and sample posts to promote the great work and important roles IMGs play in this U.S. health care system.
