International medical graduates (IMGs) are a vital part of the United States’ physician workforce, and that fact is reflected in the physician residency Match.
In 2024, 9,045 IMGs obtained first-year residency positions in accredited U.S. physician residency programs. But the process of landing one of those coveted positions is not easy.
The Match rate for IMGs lags behind that of residency applicants who attend medical school in the U.S. In 2024, 67% of U.S. citizen IMGs matched, as did 58.5% of non-U.S. citizen IMGs. The figure is typically between 90–95% for graduates of U.S. medical schools. What does it take to land a residency spot as an IMG applicant?
Victor Kolade, MD, addressed that question during an episode of the “AMA Making the Rounds” podcast. Here are some of the key tips Dr. Kolade offered IMGs on how to best approach the residency selection process.
Dr. Kolade is a member of the AMA IMG Section, which gives voice to—and advocates on—issues that affect IMG physicians. During IMG Physicians Recognition Week, Oct. 21–25, the AMA will honor and celebrate the IMG physicians who are a vital component of the physician workforce and the AMA. An Oct. 21 webinar, “Physician Journeys and Contributions in the U. S. Health Care System,” will delve into the unique experiences that shape the careers of this diverse set of physicians, from medical school to clinical practice, highlighting the challenges and triumphs along the way. AMA members can register now.
Consider observerships
Dr. Kolade is a U.S. citizen IMG who spent 20 years in Nigeria, where he completed medical school prior to returning stateside to pursue an internal medicine residency. He found that the way medicine is practiced in the U.S. differed from his experiences in Nigeria. That is likely to be the case for most IMG residency applicants.
To get a feel for how care provision works in the U.S., he recommended that IMGs pursue observerships—supervised clinical experiences in which a learner observes a physician's daily activities without direct patient contact.
“I hope people are not going into observerships just to show up and, yes, observe and do what they are allowed to do and to get letters,” said Dr. Kolade, an AMA member who is an internist in Sayre, Pennsylvania.
He advised that the best way to approach an observership is to consider questions such as: “What does this look like? What will this feel like when I start to do it? How hard or easy is it to learn how to use the electronic medical record?”
To get the most out of the experience, it is imperative that IMG residency applicants “be introspective as they do their observerships.”
Explore further with the AMA IMG Toolkit, which helps IMG physicians navigate the path to practicing in the U.S., covering topics such as:
- Types of visas.
- Academic opportunities and scope of practice.
- Finding a residency.
- Mentorship.
- State medical licensure.
- Financial planning.
Be persistent
In a given cycle, about 40% of non-U.S. IMGs don’t match. Three in 10 U.S. citizen IMGs don’t Match. Dr. Kolade himself didn’t earn a residency spot until his second time through the process. Persistence, he said, is key to success.
His first residency-application cycle in family medicine resulted in zero interviews. Dr. Kolade advised applicants who get a discouraging result on their first go-around to sharpen their skills.
“Rather than say to yourself, ‘Oh, this is a bad process, and I don't know why this happened’ what you want to do is turn inward and look at the opportunities that you have to improve yourself,” he said.
Dive deeper:
- Why IMG physicians are vital to U.S. health security
- Easing IMGs’ path to practice: What Congress should do
- How IMGs overcome big barriers to practice medicine in U.S.
- Key advice for IMGs to succeed in U.S. medicine
Follow the road to residency
Get tips and insider advice from the AMA on how to successfully Match to a residency program—delivered to your inbox.
Seek advice
If you fail to match and are looking for reasons why, it might be helpful to reach out to any programs with which you interviewed and get their feedback.
“If you fail to match and there were some programs that you thought you had good vibes about in the process, nothing wrong with sending an email to the staff there and saying, ‘Are you able to tell me what transpired? Is there any advice you have for me in case I want to upgrade my application and come back to you in a coming season?’”
Apply strategically
Dr. Kolade applied to internal medicine programs during his second attempt at the Match. The shift from family medicine to internal medicine was, in part, motivated by the fact that IMGs had higher match rates in internal medicine at the time.
He touted the value of strategic thinking in the application process. That means doing extensive program research that considers factors like IMG acceptance rates and visa sponsorship.
“Look at this Match process as if you're going into an election for something. You may win the election, and then it's easy. You may be the first runner-up or second runner-up, you didn't win the election, but you have a lot of momentum that you have to decide what you're going to do with it later.
“The same way you would strategize to win an election, you would need to strategize to win a residency spot.”
On his second attempt to match, Dr. Kolade applied to 16 programs and earned three interviews. Ultimately, he matched with the program he ranked first. If he can offer one piece of advice to IMG residency applicants, “the key word I would like people to take away is tenacity,” he said.
“Getting a residency spot in the United States is not a right. It's a privilege.”
As applicants embark on the residency selection process, FREIDA™, the AMA Residency and Fellowship Database®, is a comprehensive resource that includes information on more than 13,000 Accreditation Council for Graduate Medical Education-accredited residency programs and offers a streamlined user experience. FREIDA also allows applicants to filter residency and fellowship programs by H-1B and J-1 visa acceptance.
