The population of working physicians in the United States is composed of doctors who come from all over the world and train all over the world. About one-quarter of physicians practicing in the U.S. graduated from international medical schools, according to data from the Association of American Medical Colleges.
Despite their critical role within our country’s health system, international medical graduates (IMGs) seeking to practice here are less likely to find a placement in the National Resident Matching Program (NRMP) Main Residency Match than applicants who are matriculating from U.S. medical schools.
In the 2025–2026 cycle, for instance, 94% of U.S. allopathic senior medical students matched and 92% of U.S. osteopathic senior medical students matched. Those numbers are much higher than they were for IMGs—with 70% of U.S. citizen IMGs and 56% of non-U.S. citizen IMGs matching in 2026.
For those still finalizing the list of programs to which they plan to apply, FREIDA™—the AMA Residency & Fellowship Database®—captures more than 13,000 programs, all accredited by the Accreditation Council for Graduate Medical Education (ACGME).
The hurdles to matching as an IMG are numerous, but these four tips can help you successfully leap from an international medical school to a U.S. residency program.
Find programs that historically select IMGs
It’s wise to identify and apply to programs that have a track record of accepting IMGs. FREIDA allows users to narrow their search for programs with 35-plus filters, including the percentage of IMG residents among a group of trainees and visas accepted (H-1B, J-1).
If you’re deciding among a few specialties, you might also consider identifying the more popular options among IMGs. In the 2025–2026 Match cycle, 4,508 IMGs matched in internal medicine residency positions, making up 42% of the entire population in that specialty. Other specialties with heavy IMG representation included family medicine, pediatrics, emergency medicine and psychiatry.
Explore more than 190 specialties and subspecialties on FREIDA’s Specialty Guide which has recently expanded to include important specialty training information such as graduates’ career plans and specialty statistics.
The AMA offers key Match guidance for IMGs, including best practices for residency interviews, and learn more about navigating the process of practicing medicine in the U.S. with the AMA IMG Toolkit (members only).
Interactions matter
Interviewing with a residency program is your best chance to become more than a test score and name on a CV. A survey of residency program directors conducted by the NRMP found that the most significant factor they considered when ranking applicants was interactions with faculty during their interview and visits.
What’s the best way to approach your interview? One veteran of the process believes it is simple: Be yourself.
“Once you have the interview, it’s more about you and not your application,” said AMA member Tani Malhotra, MD. “Just remember that. Let people see you for who you are. I had one interview where I spoke about an escape room for most of the time. I later heard back that I interviewed very well. You can’t fake it. Just be yourself and let people know who you are. It’s kind of like a first date.”
An active voice in organized medicine, Dr. Malhotra is the immediate past chair of the AMA International Medical Graduate Section (AMA-IMGS) Governing Council for the 2025–2026 term.
AMA member Sebastian Arruarana, MD, highlighted the value of networking for IMGs in the Match process.
“It’s very important to build relationships, through mentorship, networking, and community, as it can be just as important as test scores in opening doors,” said Dr. Arruarana, now an internal medicine resident in New York City.
Cast a wide net
As an IMG applicant, Dr. Arruarana tried to keep as many options open as possible. That meant applying to programs in every corner of the country. While many specialties allow applicants to offer geographic preferences as part of their application processes, he thinks doing so may limit options.
As an applicant, his thought process was “I focused on finding a program—that was the best process for me—over focusing on location,” said Dr. Arruarana.
He would have been happy to train in a rural or an urban setting “as long as I’m here to learn, promote education and improve the medical system in my new community.”
When it comes to program signaling, offered in most specialties, Dr. Arruarana said they are most effective if IMG applicants are strategic about how they deploy them.
In some physician specialties, “certain programs are only going to look at you if you signal them, but you have to be smart,” he said. “As an IMG, do you even have a realistic possibility of [matching with] those programs?”
Don’t let a bad result derail your plans
Few people are as familiar with the complexities of going through the Match as Dr. Malhotra, now an academic faculty member practicing maternal-fetal medicine in Cleveland.
As a graduate of a Caribbean medical school, she applied to 137 residency programs during the 2013 Match. She landed seven interview invitations and did not receive an offer. Following that development, she bid her time, did an externship and waited for the chance to reapply.
The following year, after diligent networking, it worked out. She matched in a preliminary position and subsequently transferred into an ob-gyn program in Central Pennsylvania where she completed her residency training.
If you don’t match, the Supplemental Offer and Acceptance Program (SOAP) is a vehicle through which eligible unmatched applicants in the Main Residency Match apply for and are offered positions that were not filled when the matching algorithm was initially processed.
Dr. Malhotra also gives this advice: “Do things that keep you clinically relevant. This could be research in your desired field, giving you points for demonstrating commitment to the specialty. This could be doing additional unpaid clerkships at hospitals you may want to try and match at in the future. Use these as month-long interviews. Or get a job at clinics that require a [medical assistant] or scribes. Anything that keeps your medical knowledge current.”
AMA members who are IMGs can take part in the AMA-IMGS. 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.
