Among the major milestones in the residency-selection process, one of the most influential is residency interview day.
Surveys of residency program directors have consistently shown that when residency programs decide which applicants to rank, several of the most important factors are either directly based on interview-day performance or are strongly shaped by it.
A presentation at the recent AMA IMG Distinguish Yourself Summit offered insight on how international medical graduates (IMGs) attempting to land a residency position in the U.S. can navigate the interview process. It often starts with confidence.
“If you have that passion, the grit to come here and do all the hard work, then first say it to yourself,” said AMA member Parag H. Mehta, MD. “If you believe in it, it will come out” during a residency interview.
With an understanding of the stakes, what does it take for IMGs to stand out during residency interviews? What does a successful interview look like? Two experts on the Match process for IMGs offered insight on these questions.
How IMGs should prepare for interviews
Understanding and having prepared responses for common residency-interview questions and being able to explain your training experiences are keys for IMGs to set the table in interviews. But to Dr. Mehta, it starts with mindset.
“Go into the interview with a plan to present yourself as a leader,” said Dr. Mehta, chief of the department of medicine at a hospital in New York. “Before you go, make sure you take a deep breath. Tell yourself that you are here to connect. You’re not here to prove anything.”
An IMG who spent five years as an internal medicine residency program director in New Jersey, AMA member Pramil Cheriyath, MD, highlighted the value of body language and a positive attitude in residency interviews.
“The one gesture everyone responds to is a smile,” he said. “People like likability. Every day you get up, if you plan to get matched into residency, you should look in the mirror and start laughing and smiling for a few minutes.”
As an IMG, another key part of interview prep should include knowing what’s on your CV and being able to explain differences in training and your previous work experiences to interviewers, Dr. Mehta added.
Clear communication is key
Interview questions related to communication may not come up overtly, but it is something interviewers may observe.
Dr. Mehta—who serves as chair-elect of the AMA IMG Section Governing Council—said IMGs are often concerned about their accents, but that’s almost never the source of communication problems.
After 15 years of conducting interviews and speaking with other interviewers, he has “never heard anyone say an accent was the reason they couldn’t understand someone.”
“The problem is speaking 100 miles per hour so nobody can understand you. When you are not a native speaker, please, please slow down.”
Beyond slowing down and not stressing about accents, both speakers urged IMGs to listen fully, pause before answering, avoid interrupting, and ask for clarification if needed.
Know how to contextualize your training
When explaining their training, research or clinical experience, the panelists urged IMGs to do more than recite duties, data points or credentials. The advice was to answer the question directly, then explain what the experience meant and how it changed them.
“When somebody asks you a question, don’t try to tell them every single thing you did. Answer the question in the first sentence,” Dr. Mehta said. “If you’re talking about research, just say, ‘I did research on pulmonary hypertension, and these were the findings.’ People go on about the statistics and all those things and spend all their time on the facts. What you should try to do is explain what you got out of it, how it changed you and what you learned.”
The AMA offers key Match guidance for IMGs, including best practices for residency interviews. Learn more about navigating the process of practicing medicine in the U.S. with the AMA IMG Toolkit (members only).
Address mistakes by showing growth
Tough questions are likely to come up. Some topics that IMGs should plan to have responses to, if applicable, include gaps in training, weak exam scores or previously unsuccessful Match attempts. It’s best to look at those questions as opportunities to show how adversity can be overcome.
“These are the best questions because they give you the chance to explain,” Dr. Mehta said. “You have to own it.
“You should be able to look them in the eye and say, ‘I screwed up. I was overconfident. I did not prepare well.’ But in the same breath, say ‘I will never fail again because I understand what is needed.’”
Remember: IMGs have unique strengths
Rather than treating international training as something to explain away, applicants should frame it as evidence of resilience and adaptability. IMGs often have navigated multiple health systems, cultures and languages, while overcoming financial, logistical and personal obstacles to pursue residency in the U.S.
“You should be proud of being an IMG,” Dr. Mehta said. “What you have done has not been done by your counterparts. You probably know more languages. You have seen more systems. You have adapted to many different environments. Don’t take it as a negative.”
AMA members who are IMGs can take part in the AMA-IMG Section. International medical graduates who are currently certified by Educational Commission for Foreign Medical Graduates (ECFMG, a member of Intealth) and have completed, are currently enrolled in, or are waiting to match into a U.S. residency program are eligible to become AMA members.
