For medical students and graduates who completed their degree abroad, researching IMG friendly internal medicine residency programs thoroughly before you apply can be very helpful. Applying to the right residency programs is vital for a non-US international medical graduate who has more obstacles in their path and, according to recent statistics, has less chance of receiving a match. Although the medical field is always competitive, applying to a friendly internal medicine residency can be the ticket to acceptance for an IMG.
In this article, explore some IMG friendly residency programs within internal medicine disciplines that are accommodative to the needs of international medical graduates. We also include useful pointers for how to bolster your application as an IMG.
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IMG Friendly Internal Medicine Residency Programs
When figuring out how to get into residency programs as an IMG, you will notice that primary specialties such as internal medicine will be some of the most IMG friendly programs. However, you will likely still need to pass the necessary exams (such as USMLE Step 1 and Step 2 CK in the United States), acquire the ECFMG certification, and compete with both American and Canadian citizens to be matched to an internal medicine residency program. That being said, it is not impossible to get matched and further your training in any internal medicine subspecialty. Here is a brief list of example IMG friendly internal medicine residency programs in the US and Canada:
List of IMG Friendly Internal Medicine Residency Programs in the United States
1. Rochester Regional Health/Unity Hospital Program
In the state of New York, you will find the most medical schools in the country, but also discover many IMG friendly hospitals. New York is particularly known for its acceptance of IMG applicants. The internal medicine program at Unity Hospital developed through the Rochester Regional Health medical education network is very liberal in its treatment of IMGs. There is no minimum cut-off score for either of the USMLE steps. Clinical experience is preferred, but not listed as a requirement. It is preferred for applicants to have graduated from medical school within the last five years, but once again, this is not a requirement. That is a pretty generous amount of time, which can be a great benefit to IMGs, especially since this Rochester program will also sponsor both the J-1 and H1B visa types. This is a pretty solid example of a residency program that is friendly to their IMG applicants.
Are you an international medical graduate, or IMG, looking to match to your dream residency program in the US or Canada?
2. Florida Atlantic University Charles E. Schmidt College of Medicine Program
Florida is one of the most IMG friendly states. The internal medicine residency affiliated with Florida Atlantic University in Boca Raton also does not have many limitations for IMGs. This program does not have a specific required score for USMLE exams, but they are still required to apply. They also prefer applicants who have previous clinical experience. They sponsor the J-1 visa and accept medical students who have graduated in the last five years. What is also important about their application requirements is that there are no specific limitations for IMGs compared to the domestic applicants they receive. If you have the proper certification, exam scores, and other application documents ready, your application will be considered on the same level as everyone else.
3. Rutgers Health/Newark Beth Israel Medical Center Program
This internal medicine program from the Newark Beth Israel Medical Center has a minimum score of 195 for each of the USMLE steps, which is essentially the equivalent of a passing grade. They do not have official information about whether any clinical experience is required or if they prefer recent graduates, which could work in your favor if you are an IMG. They are not super restrictive when compared to other New Jersey residency programs. Many other programs require much higher USMLE scores. The main drawback about this program is that they do not sponsor any visa types. However, the HB1 visa is not sponsored in many New Jersey programs, meaning this program is not very different in that regard. Those carrying the J-1 visa may want to look elsewhere, as there are more opportunities for them in this state besides this program.
4. CHRISTUS Health/Texas A&M School of Medicine Internal Medicine Residency Program
In Longview, Texas (another IMG friendly state), one place residents could train at for internal medicine is the CHRISTUS Good Shepherd Medical Center. For USMLE Step 1 and Step 2 CK, they prefer a score of 200 on the first attempt, which is pretty generous for residency programs. There is no obvious requirement for clinical experience. This Texas program also has no minimum cut-off for graduation year, meaning any medical graduate can technically apply. IMGs who completed their medical degree some time ago can benefit from the broad nature of these requirements. They will also sponsor both the J-1 and H1B visa types, which could be helpful for a variety of IMGs coming in from abroad to complete their residency.
List of IMG Friendly Internal Medicine Residency Programs in Canada
There are fewer residency programs in Canada to match with, and most programs require Canadian citizenship or permanent residency, meaning that it is generally more difficult to receive a match compared to the US depending on the specialty. Thankfully, primary care specialties such as internal medicine are still one of the better options for IMGs attempting to match in a Canadian residency program. Here are some examples of Canadian schools and medical centers that admit IMGs:
1. Internal Medicine Residency Program at the University of British Columbia Faculty of Medicine
When you are researching Canadian residency programs, you will notice that many of them exclusively use CaRMS for their applications. Many specific requirements are found on the CaRMS website or are dependent on the province. While they also offer an IMG friendly family medicine residency program, which accepts the most international applicants, the internal medicine residency program at UBC is still more available to IMGs compared to others within their Faculty of Medicine. It is also one of four postgraduate residency training programs within the faculty that accept international medical graduates in the first iteration of CaRMS. As for supplemental requirements, UBC is one of the programs that requires a signed Return of Service (ROS) contract with the Ministry of Health as a condition of accepting a residency position. More information and criteria can be found through the UBC IMG Office website or CaRMS.
2. Internal Medicine Residency Program at the Queen’s University School of Medicine
Recently recognized as the top graduate postgraduate training program in Ontario by PARO, the internal medicine residency program at Queen’s is also a practical option for IMGs. There are a still few steps to take to be eligible, just like any other program in Canada. Applicants must pass their Medical Council of Canada Qualifying Examination (MCCQE) and the National Assessment Collaboration Objective Structured Clinical Examination (NAC OSCE). Ontario applicants must also complete a Preparation for Residency (PRP) divided into two phases and a 12-week Assessment Verification Period (AVP) required by the College of Physicians and Surgeons of Ontario. Other provinces may not need this exact prerequisite.
3. Internal Medicine Residency Program at the University of Calgary Cumming School of Medicine
The Alberta International Medical Graduate (AIMG) Program works with Alberta residency programs, including the internal medicine residency at the Cumming School of Medicine. Their purpose is to ensure that IMGs residing within the province receive postgraduate medical education. As it stands, internal medicine is the second most-matched specialty through their program, after family medicine. The AIMG program has its own requirements that mirror most residencies in other provinces. These include residence in Alberta, English language proficiency, the MCCQE Part 1 exam, and the NAC OSCE. There are a few options for determining what is meant by residence in Alberta, as detailed on their eligibility and supporting documents requirements page. This option will be vital for any IMG living in Alberta searching for an internal medicine residency.
In general, the landscape for residency program admissions for international medical graduates is rather competitive. It can be very beneficial to know where you have the best chance of matching. Your goal is to find the least competitive environments that give you the greatest opportunity to thrive. While there are ways to improve your residency application after going unmatched, this should not be the objective for any medical student. You’ll want to secure a match in as few attempts as possible and start your professional career.
Additional Tips for Matching as an IMG
1. Get Clinical Experience in the US or Canada
Some schools or residency programs will require a specific amount of clinical experience for applicants to even be considered for acceptance, whether they are an international medical graduate or not. By doing this as an IMG, you will be able to network and make connections in your field. A great opportunity can get you acquainted with potential references for an ERAS letter of recommendation or your CaRMS reference letter.
The main issue with getting the right amount of experience necessary to apply is that it may be difficult to find IMG electives and clinical experience in the first place. Researching your options will be key to achieving this. You may have to contact institutions yourself to find a worthwhile externship, since not all hospitals offer opportunities of this sort to international medical students or graduates.
2. Receiving a Letter of Recommendation from an American or Canadian Professional
Having a strong internal medicine residency letter of recommendation will always be a way to improve your application, but as an IMG, letters from your country of origin may not be viewed as persuasive unless the writer is internationally renowned. There is no doubt you will have potential references from your own country, but at least one of your letters should come from an attending physician or professional in the US or Canada. In this case, admissions committees are more likely to recognize the institution and see the letter as more of a credible source. Moreover, American or Canadian references will inherently be able to write stronger letters of recommendation, as they are more familiar with the admissions systems in North America and know what program directors look for in letters.
There is also the option of learning how to write your own letter of recommendation. If you have a difficult time finding someone or knowing how to select the best verifiers and referees and ask for reference letters, you can then ask a close connection in the US or Canada to sign it for you.
3. Gather Your Application Documents and Exam Scores
To stand out from both international and domestic applicants, writing a superior IMG personal statement or internal medicine residency personal statement will give you a distinct advantage. The purpose of this application document is to illustrate your skills in your own words and show why you are a great fit for the residency.
Scoring highly on the USMLE steps or MCCQE will also be helpful. Many programs use exam scores to narrow down applicants. You may not be able to move on to the next step of the admissions process if your scores do not make the cut. Enrolling in a USMLE prep course can make the difference and possibly get you matched by improving your score.
4. Ace the Residency Interview
It will never be a hinderance if you brush up on your interview skills. If you are an IMG, you may feel pressure to adapt to an American or Canadian system that is not familiar to you. Try to incorporate IMG residency interview prep into your planning so that you can learn the best strategies to answer any questions that may come your way. Become familiar with common residency interview questions and internal medicine residency interview questions. Learning how to respond to them effectively can be the difference between an acceptance or a rejection. The interview stage is usually near the end of the application process, so it is your last chance to make a great first impression.
5. Plan Your Rank Order List
Your selection of IMG friendly internal medicine residency programs to apply to is inevitably linked to your chances of acceptance. When officially applying, you will be able to list the programs you want to attend from your most desired to your least desired. This residency rank order list (ROL) is important when attempting to identify programs that best suit your needs. Choosing programs that have the fewest restrictions for IMGs and ordering them strategically in your list will strengthen your chances of acceptance.
When you are an IMG, you will evidently encounter more obstacles to receiving a residency match. Even though you are applying outside of your country of origin, there are programs and locations that are much more available to you as a result. These institutions will require less of you throughout the application process. The important thing to remember is that applying strategically will be your best shot at success.
Compiling everything you need for your residency applications as an IMG can be overwhelming, but you do not have to go through it alone. Seeking professional residency help can be a feasible option for organizing yourself and securing an internal medicine residency match.
1. Is internal medicine an IMG friendly specialty for residency?
Along with the other primary care specialties, such as family medicine and pediatrics, internal medicine is not usually considered one of the most competitive residencies. As such, it is usually one of the specialties with the highest match rates for IMGs.
2. Is it more difficult to apply for residency as an IMG?
Due to the additional requirements they often have to meet, the chance of acceptance for IMGs is consistently lower. That being said, it is not impossible to find a residency program as an IMG. Learning which residency programs are IMG friendly is one of the first steps you can take to increase your chances.
3. What exams would I need to complete to apply for residency as an IMG?
Canadian programs require passing both the MCCQE and the NAC OSCE. Programs in the US will have the first steps of the USMLE and other additional specific requirements. Always check out what exactly you will need so that you can prepare yourself effectively.
4. How important are exam scores in determining whether I get accepted?
Really important. Exam scores will help you advance beyond the first few rounds of the application process and into the interview phase, where you will be able to articulate your candidacy.
5. How do I obtain the ECFMG certification?
The first step is to pass the USMLE step 1 and USMLE step 2 as part of the medical science examination requirement. Eligible IMGs will then have to meet the clinical and communication skills requirements by applying to Pathways. This will allow them to compete for positions in graduate medical education programs. To receive the ECFMG certification, you will also need to provide medical school transcripts from an institution listed in the World Directory of Medical Schools.
6. Can I use letters of recommendation from abroad?
Yes, you definitely can. However, it is highly encouraged to have at least one strong letter of recommendation from an American or Canadian medical professional who can attest to your candidacy.
7. How can I get clinical experience in the US and Canada?
Externships are not guaranteed for IMGs, so most of the time you will be looking for them yourself so that you can get experience in another country. There are certain paid placement services that allow you to apply to these types of programs more easily. You can make use of these if they are available to you.
8. Can an IMG residency consultant increase my chances of getting matched?
An IMG residency consultant will help you with every step of your application process. They can provide feedback personalized to your residency application and develop a plan with you to increase your match probability.
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