4 Tips for Applying for Residency as an International Med Student

4 Tips for Applying for Residency as an International Med Student

May 13, 2020 Published by Kathrin O'Neill

Table of Contents

Although more difficult, it is not impossible for foreign medical graduates to pursue residency in the US.

According to Daviratanasilpa et al. (2003), it is more difficult than ever for international medical students to obtain postgraduate medical training in America. In recent years, high educational standards and a rigid system of testing for both scientific and clinical skills, along with communication abilities, have served as barriers to entry for the foreign student. However, not all is lost. We’ve rounded up some steps for you to take to give you the edge as an international medical student. Check it out below:

Apply for ECFMG Certification

All international medical graduates wishing to enter the US healthcare system must be certified by the Educational Commission for Foreign Medical Graduates (ECFMG). This ensures that the qualifications of the graduate are up-to-par with the healthcare standards in America. This certification is required for those wishing to participate in residency programs that are accredited by the Accreditation Council for Graduate Medical Education. Here’s a rundown of the requirements for ECFMG Certification:

  • Application. Submit an application for ECFMG certification before applying to the ECFMG for examination. Be sure to first consult the World Directory of Medical Schools to confirm that graduates and students from your medical school are eligible.
  • Examination Requirements. Pass Step 1 and Step 2 of the United States Medical Licensing Examination. These are the same exams taken by medical school graduates in the US and Canada. For more on the USMLE, read on below.
  • Medical Education Credential Requirements. Make sure that the following requirements are met. You must have been awarded credit for at least 4 years of med school, have documentation for completion of credit, and have your final medical school transcripts.

Pass the USMLE Exams

The United States Medical Licensing Examination is a mandatory three-step exam for those wishing to obtain a medical license in the United States. Each step covers the following topics:

  • Medical Science. Step 1 measures your understanding of basic sciences and how well you apply these concepts to the practice of medicine.
  • Clinical Knowledge & Skills. Step 2 is divided into 2 parts. The first part evaluates how well you can apply your medical foundation and understanding of clinical science for the provision of health care. The second step is more practical. It evaluates how well you can employ your acquired knowledge and skills in a patient-oriented setting.
  • Patient Management. The third and final step focuses on providing patient care in an ambulatory setting. It devotes attention to the importance of assessing the knowledge and skills of physicians who are assuming independent responsibility for providing general medical care to patients.

Consider Visa Options

If you are already a US citizen or a permanent resident (with a Green Card), then you will not need to worry about a visa. Otherwise, a visa is required to participate in a medical residency program in the United States. Although you do not need to apply for a visa until after you have matched into a residency program, it is best to start thinking about your visa options early.

Most international medical graduates commonly avail of the following visas: the H1-B (Temporary Worker) or the J-1 (Exchange Visitor). Depending on your residency program, your institution may sponsor a visa for you.

It is also worth noting that the ECFMG is authorized by the United States Department of State to sponsor foreign nationals for the J-1 visa.

Preparing the Residency Application

As mentioned earlier, it has become more difficult for international medical graduates to enter a residency program. Top residency programs have competitively raised their standards over the years and are known for only accepting the best of the best. As a foreign physician, you are at a disadvantage. Interviews are granted solely on the basis of application, so it is best to take time to carefully put together your documents. Check out some of our tips below to help turn the tide in your favor and raise your chances of acceptance:

  • It would be wise to gain experience working in a US healthcare facility before applying to a residency. This will help you obtain a stronger letter of recommendation. Letters of recommendation from overseas schools are important, however they are less likely to be accepted compared to letters from US facilities.
  • If you are a non-US citizen, prepare yourself to answer questions regarding your immigration status and visa status.


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  • Hamnvik, O.-P. (2019). Applying for Residency as an International Medical Graduate. Applying for Residency as an International Medical Graduate | NEJM Resident 360. https://resident360.nejm.org/e...
  • Medical Residency in USA - 10 IMG Steps from USMLE to ERAS, Match. IMGPrep. (2020, January 24). https://www.imgprep.com/10-ste...
  • Residency Application Requirements for International Medical Graduates. Residency. (2013, November 8). https://www.aafp.org/medical-s...
  • Residency program requirements for international medical graduates. American Medical Association. https://www.ama-assn.org/educa...