International Medical Education

Residency program requirements for international medical graduates


After ECFMG certification, physicians who wish to practice medicine in the United States must complete an accredited residency training program in the United States or Canada. This process will take at least 3 years. The physician will have to complete a residency program regardless of the training they have received overseas.

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International medical graduates who have received a visa are eligible to apply for a residency program in the United States. It is strongly encouraged that international medical graduates participate in an observership rotation in a clinical setting before applying to a residency program. This allows international medical graduates to become familiar with clinical practice settings and meet physicians who can be used as references during the residency application process.

There are 4 tracks within an internal medicine residency program: transitional, preliminary, categorical and primary care.

It is best to choose the program that best suits one’s individual needs and goals.

  • Transitional programs rotate 1st-year residents through hospitals every 2–3 months. A transitional program counts as 1 year of training, but it may not provide enough credits to move to the 2nd year of training.
  • Preliminary programs are 1-year programs for those wishing to specialize and who need a year of internal medicine training.
  • Categorical programs are considered more traditional and hospital-based. These are 3-year programs that may allow residents to train up to board eligibility if performance is satisfactory.
  • Primary care programs provide increased emphasis on ambulatory care experience in the community and are becoming more prevalent. Those who are sure that they will be working as a generalist are advised to apply to a primary care program.

International medical graduates should submit applications to a minimum of 25 programs to have the best chance of being matched to a residency program.

Applicants must register with the National Resident Matching Program (NRMP), which matches applicants and hospital residency programs according to individual preferences.

Certain residency programs require applicants to apply through the Electronic Residency Application Service (ERAS), administered by the ECFMG for IMGs.

Find more information on how to apply for residency programs in the AMA Career Planning Resource.

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The process of finding a residency has become increasingly more competitive, therefore international medical graduate applicants should pay more attention to the application itself to stand out. Interviews are granted solely on the basis of the application.

Application tips:

  1. Present the application neatly and free of grammar and spelling errors. All applications should be original.
  2. Highlight any unique qualifications, academic experiences and volunteer work and test scores on the curriculum vitae.
  3. Gain experience in a U.S. health care facility before applying to a residency to assist in getting a strong letter of recommendation. While letters of recommendation from overseas schools are important, they are not comparable to U.S. schools.
  4. Ensure the application is filled out correctly, including your NRMP applicant number if you are registered for The Match.
  5. Write a personal statement that addresses your unique abilities as an applicant, even if a personal statement is required for your application.
  6. Be prepared to answer questions pertaining to your immigration status and visa status if you are a non-U.S. citizen.