There is a fair number of IMG friendly hospitals in the US, but eligibility and application requirements for IMGs vary depending on the hospital, the state, and an applicant’s student status. The US is a great place to complete an international medical graduate residency, and every year thousands of international medical graduate students match to programs at hospitals in the US. Fortunately, many of the top hospitals in the US are IMG friendly and regularly accept students from around the world for post-graduate medical training. However, the process of applying to residency is long and complex, and even more so for IMGs, so its imperative to create a solid timeline, get organized and do your research before you even start applying. In this blog, we’ll look at what makes a hospital IMG friendly, a list of the IMG friendly hospitals in the US, how to apply to residency in the US and Canada and as an IMG and tips for increasing your chances of getting a match.
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What is an IMG friendly hospital?
IMG friendly hospitals are institutions that have high match rates for international medical grads (IMG) and have a history of welcoming IMGs into their post-graduate residency training programs. These hospitals typically are home of the most IMG friendly residency programs.
There are a number of IMG friendly hospitals and residency programs in both the US and Canada, however the IMG eligibility and application requirements can vary depending on the country, state or province and even the hospital or program. International medical graduates who plan to pursue a residency in either the US or Canada need to become certified as an IMG through the ECFMG before they can be considered. They will also need to take and pass medical licensing examinations from the country they plan to apply in.
Getting a residency match in either country is competitive for IMGs, but the US in particular welcomes a large number of international medical grads each year. Most of the around 12,000 IMGs who apply to US residency programs each year match into one of the IMG friendly specialties such as internal medicine, family medicine or pediatrics. Many of these spots are taken by international grads in IMG friendly states such as New York or Florida.
If you’re hoping to train at specific or well-known training hospitals in the US, you can check out this list of the most IMG friendly hospitals in the US and their top medical programs.
IMG friendly hospitals in US
Below is a list of IMG friendly hospitals in the US and their locations. Each hospital on the list accepts both US and non-US IMGs with either H-1B or J-1 visa status. All of these programs have a high percentage of international medical graduates currently enrolled in their residency training programs or have historically welcomed IMGs.
Learn more about the most IMG friendly residency programs in this handy infographic!
IMG friendly hospitals in Canada
While there are IMG friendly hospitals and residency programs in Canada, it is comparatively much harder to get matched into a residency program. The Canadian Resident Match System (CaRMS) only offers around 3,330 residency spots each year, and the vast majority of these are filled by Canadian medical graduates. Only around 10% of these spots are open to be filled by eligible IMGs, and the Canadian government requires applying IMGs to be either Canadian citizens or Canadian permanent residents.
IMGs can apply for a work visa to be considered an eligible IMG, but this will lower your chances of successfully matching and may change your application requirements when it comes to qualifying exams. In general, though, visa holders are not considered eligible. If you are a foreign student who graduated from a medical school in Canada and have permanent residency status, you are not considered an IMG and can apply for residency as a Canadian graduate applicant, as long as you meet the other eligibility requirements. Some IMGs also take their residency training in the US before becoming certified to practice medicine in Canada, since there is a higher chance of success in matching to a US residency.
Residency match rates for IMGs and USMGs in Canada
In previous years, over 400 IMGs did successfully match to residency programs in Canada. The most IMG friendly provinces in Canada are Manitoba, Saskatchewan, and Ontario, which all offer IMG friendly residency programs.
If you do plan to apply for residency in Canada as an IMG, you’ll need to complete the MCCQE Part I exam and the NAC OSCE as part of your requirements. You can enroll in a NAC OSCE prep course to prepare for this clinical evaluation, and there are MCCQE prep courses for international students available, too.
After completing these evaluations, you’ll need to enroll in the CaRMS system and begin preparing your application. This includes gathering your CaRMS reference letters and your CaRMS interview prep. Stellar references and a strong interview performance will go a long way towards helping you match to your desired program in Canada. Be ready for the different types of CaRMS interview questions you’ll be asked as an IMG and make sure you knock your interview out of the park.
Working on your residency application? Learn more about how to match as an IMG.
How to apply for residency at an IMG friendly hospital
If you want to know more about how to get into residency programs as an IMG, the first thing you need to know is that it takes a great deal of preparation. Each hospital, program and US state has requirements for its IMGs and you’ll need to be certain that you qualify before you start applying, otherwise you risk losing a good deal of time and money.
For qualifications, the US distinguishes between US IMGs and non-US IMGs. This means if you are a US citizen with a medical degree awarded from a non-US university, you are considered a US IMG. For non-US citizens, you are considered an IMG only if you completed your medical degree outside the US. Non-US citizens who have a visa or green card and completed their medical degree at a US institution are not considered IMGs.
Some hospitals and residency programs that accept IMGs will only consider you if you have a green card or are a US permanent resident. Others will accept your application if you have an H-1B (temporary worker) or J-1 (exchange visitor) visa. Some IMG friendly hospitals or programs will only accept US IMGs and do not accept foreign students at all. Check with the residency programs you want to apply to in order to make sure your status is eligible.
Below is a guide for what steps you’ll need to take to apply for residency in the US as an IMG.
IMGs planning to apply for residency in the US will need to complete the US Medical Licensing Examinations (USMLE) to be considered eligible. Some IMG friendly hospitals may also have minimum accepted scores for their applicants. IMGs will need to have completed the USMLE Step 1 and the USMLE Step 2 CK before they can register as part of the match. All applicants will be required to create an application through ERAS and register with the NRMP.
Other required components of the ERAS application include:
- Medical school transcripts
- ERAS letter of recommendation (at least three)
- Residency personal statement
- ECFMG certification (only for IMGs)
- USMLE scores
- ERAS experience section
You can also include additional documents in your application, such as a residency CV or the ERAS supplemental application. Anything you can add that provides evidence of your ideal candidacy or gives you an edge over US domestic applicants will help you. This includes nailing the ERAS interview and highlighting any clinical experience you have, especially in your chosen specialty. IMG electives and clinical experience are a huge boost to your application, as it may put you above US applicants depending on the breadth and quality of the clinical experience you have. This is especially useful if you’re applying to competitive residency programs or competing against other international grads for limited spots at an IMG friendly hospital.
For applicants who want to apply to residency in Canada, it is possible to obtain an elective placement at programs or IMG friendly hospitals in Canada, which can significantly aid you in finding a match later on, as it can provide letters of reference and open up more opportunities in the province you want to practice in.
Want to gain clinical experience as an IMG? Read this infographic on how it can help you.
Tips for applying to IMG friendly hospitals
Securing one of the limited spots at an IMG friendly hospital is challenging, but not impossible for IMGs. However, your chances can be significantly boosted by creating not only a strong application but by researching exact requirements for a particular hospital program. Residency match services can certainly help you in identifying which hospitals or residency specialties are most likely to accept IMGs and whether their program is open to both US and non-US IMGs. Hiring an IMG residency consultant is also helpful if you want an advisor to walk you through the entire process or provide you with personalized, in-depth feedback on your application.
Some areas where you can improve the strength of your application are:
- Academic scores (medical school grades or exam scores)
- Non-academic experiences or residency CV
- Clinical experience or USCE
- Strong residency personal statement
- Letters of recommendation
Doing thorough research is a must and submitting a great application will get your foot in the door, but the residency interview is essential. It allows residency programs to learn more about you and get to know you as a person and potential resident rather than a name on an application. IMG residency interview prep is important here, so use mock interviews and study potential interview questions for IMGs in advance.
Gaining clinical experience as an IMG is also highly recommended. Residency programs will likely not consider you if you do not have at least some relevant clinical experience, and some will not consider you if you do not have US clinical experience. If you’re short on direct patient experience, learn how to apply for a pre-residency fellowship as an IMG, which can garner you some clinical work in the US and help boost your chances of getting into a US residency.
Conclusion
There are many IMG friendly hospitals to choose from in both the US and Canada, although applying as a resident doctor in either of these countries does mean investing a good deal of time, energy and money. In return, an IMG can receive a first-class residency training at some of the best hospitals and residency programs in the world. IMGs who are considered applying for residency in either country first need to be sure they are eligible to certify as an IMG, meet the necessary requirements at all levels and then complete the necessary licensing exams and applications. Crafting a superb application will significantly increase your chances of matching into your top-choice program or securing a position at the hospital you choose.
FAQs
1. What are the most IMG friendly residency programs?
An internal medicine residency, family medicine residency and pediatrics residency are considered the most IMG friendly residencies since they have historically the highest match rates for IMGs.
2. How many IMGs get residency in the US?
The residency match rate for IMGs in the US varies from as low as 5% for the most competitive residencies, such as surgery, to 60% for the least competitive residencies.
3. How many IMGs get residency in Canada?
The IMG match rate is only around 29% in Canada. For US medical graduates applying to residency in Canada, this number jumps to 59.5%. It is comparatively more difficult for non-US IMGs to get matched to a residency in Canada since they need to be citizens or permanent residents to apply.
4. Do I need USCE to get residency in the US?
Some IMG friendly hospitals will have US clinical experience (USCE) as a requirement for their applicants, and others will not. In general, though, having USCE is a highlight on an IMG residency application.
5. Which country is best for medical residency?
While both the US and Canada are excellent choices to pursue residency training, the US is comparatively friendlier to IMGs and it is much easier to get matched into a program.
6. Which qualifying exams do I need to take?
If you are applying to residency in the US, you’ll need to complete the USMLE Step 1 and USMLE Step 2 CK licensing exams. Canadian applicants need to complete the MCCQE Part I and the NAC OSCE evaluations, on top of any provincial clinical evaluations required for specific programs.
7. Is it difficult to get residency in the US and Canada as an IMG?
It can be challenging to get matched to a residency in the US and Canada as an IMG, but not impossible. The process is usually a bit longer and requires completing additional requirements, but IMGs do have a fair chance of getting matched to their top-choice program with a strong application.
8. How do I increase my chances of a residency match as an IMG?
To better your chances of a residency match as an IMG, you’ll need to stand out and give yourself an advantage over domestic applicants from the US or Canada. Some of the ways you can do so is by gaining quality clinical or elective experience, securing top-notch letters of recommendation, writing an awesome personal statement, earning competitive exam scores and acing the residency interview.
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