IMG Residency Interview Prep Guide

What is Unique About IMG Residency Interviews?

Who is considered an IMG?

Before we begin our discussion of IMG residency interviews, it’s important to identify who is considered as an international medical graduate for residency match in Canada vs the US, and how this affects your chances for matching.

In the US, there are 2 types of international medical graduates. One is called the US IMG and the other one is called the non-US IMG. The former includes American citizens who completed their medical school education outside of the US, while the latter are non-US citizens who completed their medical school education in one of the US or Canadian medical schools that accept international students. This basically means that citizenship does not affect your eligibility to train in the United States, but if you are a non-US IMG, be prepared to discuss your visa or citizenship status in the interview (we will discuss this below).

Take note that programs directors and program faculty do not care about your citizenship, but they do care about your experiences. IMGs are strongly encouraged to gain some exposure to medical practice in the country where they want to stay and work. This means that if you are a US citizen completing your med school education abroad, do your best to gain some clinical exposure in the US if that's where you want to practice. This is where non-US IMGs completing their education in the States have some advantage – they have direct access to these valuable experiences via their med school training. 

In Canada, the situation is quite different. You must be a Canadian citizen or a permanent resident of Canada to participate in the Match. Non-citizens and non-permanent residents are not eligible to participate in CaRMS. This means that if you graduated from a medical school outside of Canada (including the US) but are a Canadian citizen or a permanent resident, you are eligible to participate. However, if you graduated from one of the medical schools in Canada, but are not a citizen or a permanent resident, you are not eligible.

Success rates

It is important to emphasize that the format of the interview will not be any different for IMG candidates. You will be asked many of the same questions and treated just like any other candidate. Just like any other candidate, you should practice answer strategies and approaches you want to use when tackling some of the most challenging questions, whether they are incorporated into an MMI or a traditional interview format.

However, many IMGs feel nervous about their status as international grads. It is true that matching residency as an IMG is slightly more challenging. To give you a comparison, according to the latest NRMP Match data, 98% of US MD and DO graduates who identified internal medicine residency as their only choice matched this specialty, while only 62% of the US IMGs matched internal medicine after identifying this specialty as their only choice. Additionally, only 57% of non-US IMGs matched internal residency after identifying it as their only choice. We use the example of internal medicine here because it’s one of the most IMG-friendly programs out there. The IMG success rate is much lower in most competitive residencies, such as surgical programs.

Curious what the most and least competitive residencies are? Check out this video:

Whether you are an IMG or not, your interview performance counts for almost 100% of your success as a candidate. According to the latest NRMP survey, program directors cite interactions with faculty during the interview and visit as the most important factor in ranking applicants, while interpersonal skills are ranked as a close second. This means that the interview is your ultimate chance to make a great, lasting impression on the admissions committee. In this blog, we will discuss how your unique IMG background, experiences, activities, and skills can be used to stand out from the crowd.

Number of applications you need to submit

Keep in mind that the chance you have at ranking as an IMG also correlates to how many residency programs you apply to. IMGs tend to apply to twice as many programs as their non-IMG counterparts to have the same statistical chance, which means that you could be preparing for close to a hundred applications per cycle. By the time you finish applications, you should be ready to start your residency interview prep accordingly. This is quite a lot of work, so make sure to keep to your ERAS timeline. 

Interview timeline

One additional challenge to keep in mind is that IMGs tend not to have a set window when their interviews take place. For example, in CaRMS, there is an established interview period for Canadian grads, while the interviews for IMGs can take place any time between when file reviews begin and the rank order list deadline. This is a slight inconvenience, but it is important to be ready for your interview at a moment’s notice as you are patiently waiting to hear back from the programs. So it might be wise to start on your ERAS interview prep or CaRMS interview prep, depending on where your interview takes place. And while practicing with mock interviews can start as soon as you hear back from your chosen programs, you should start some of your preparations as soon as you submit your applications, including learning about interview formats and brainstorming answers to some of the most common residency interview questions.

Now that you know what to expect, let’s dive into some sample IMG residency interview questions, answers strategies, and sample answers!

Want to know how to prepare for a residency interview? Take a look at this:

“Tell Me About Yourself” Residency Interview Question and Sample Answer for IMGs

We have written extensively on this interview question for both, medical school and residency, so make sure to check out these blogs for more details. Not only is this the most common interview question of all time, but it’s also your chance to break the ice and take the reins of this conversation into your own hands! Essentially, you can use this question to lay out the direction your interview will take. So, what should be your answer strategy as an IMG?

Firstly, remember that the points you use to structure your answer may be brought up during the interview, which means that you should strategically include talking points you would like to discuss further down the line in the interview. For example, in addition to giving a bit of personal background, provide examples of how hard you worked as an IMG to gain clinical experience in the country where you want to practice. Perhaps, while you were a student abroad, you enrolled in an exchange program that allowed you to work in a medical institution in the US or Canada for a semester, or maybe you have been working as a caretaker in a nursing home since you moved to the US or Canada. These will be important to discuss in more detail as the interview goes on, but you can plant these topics for discussion when you are asked to talk about yourself. Remember to always show, rather than tell what you learned via these experiences and how these experiences prepared you for residency training in the US or Canada.

Secondly, be honest. Do not be anyone else but your best self. If you attended medical school abroad because you could not get into medical school in Canada or the US, do not lie and tell the program director that, for example, it was your dream to attend one of the Caribbean medical schools. The journey to becoming a doctor is not easy. It is ok to face obstacles – what’s important is what you take away from your setbacks and how you make the best out of the situation you find yourself in. For example, if you ended up attending a medical school abroad because you could not get into med school in your home country, discuss in a positive light what this experience taught you. Were you exposed to medical training and practice that enriched your understanding of why you want to be a doctor? Did you learn a new language and can communicate with a larger portion of your potential patient population? Were you exposed to diverse populations, which solidified your desire to work with underserved populations in a large urban center? Did the fact that you did not get accepted to medical school on the continent make you work that much harder during medical school, applying to US electives and exchange programs, looking for US mentors who can help you prepare for the Match, and so on?

Essentially, you want to veil any setbacks you may have faced in triumphs, growths, and strengths. Being an IMG, just like being a local residency applicant, is a learning opportunity. What the program directors want to know is how you spent your time in medical school, wherever you attended it. Keep this in mind as you prepare for your interview and this question: while there are medical schools with the best match rates, your school’s name and prestige will not overshadow poor USMLE and MCCQE scores, poor reference letters, or lack of specialty experience. Do not let your IMG status prevent you from being proud of your achievements! The trick to the “tell me about yourself” question is to disclose these achievements concisely and clearly in your answer and to design the track your interview will eventually take. Let’s look at a sample answer:

“I was born and raised in a small town in Ontario in a very fun, loving Irish-Catholic family. My parents were second-generation immigrants, so they have never actually been to Ireland but dreamt of going someday. In school, I had a clear inclination for the sciences and had a lot of success in the district science school Olympics, where I often represented my high school. And since I had a clear proclivity for the sciences, I gave no second thoughts to pursuing a biology major in my undergrad. I greatly excelled in all the courses related to my major and maintained a 3.9 GPA throughout my undergraduate career.

It was during this period that my interest in medicine was born. In my first year of undergrad, one of my instructors was Dr. Smith, a professor Emeritus, who worked as a surgeon all his life. His passion and fascination with human health inspired me to shadow his colleague Mr. Knox, who was also a surgeon. For over a year, I learned of his everyday responsibilities, observed his interactions with patients, and witnessed the real difference he was making in the lives of his patients with chronic pain. This was the experience that solidified my decision to pursue medicine. My relationship with Dr. Knox continued when he offered me a volunteer position in his clinic. For two years, I was able to directly interact with patients as I took down their history, charted their medical records, and joined the rounding in patients’ rooms.

By the beginning of my fourth year of undergrad, I checked off every box as a perfect medical school candidate but received a rejection from every school I applied to in Canada and the US by the end of August. While this news was upsetting, I decided not to waste another year waiting for my medical school education to start. I had very limited options, but I knew that the deadline for applications for the Atlantic Bridge program was later in the season. This unique opportunity allows students from North America to study medicine in Ireland.

Over the next few weeks after getting rejections from American and Canadian schools, I worked hard to improve my application and was able to submit it to the Atlantic Bridge program with weeks to spare. I was accepted to 4 out of the 5 medical schools in Ireland that I applied to.

While in medical school, I knew that I wanted to return to Canada to practice medicine, which is why I did everything in my power to get exposure to medical practice in Canada. My medical school had a partnership with the X teaching hospital in Ontario where I took electives during my summers after my second and third years. Furthermore, I was able to develop a close relationship with Dr. ABC, who was a senior faculty member at the hospital. He became one of my mentors and referees for this residency position.

While medical school rejection from American and Canadian institutions was a setback, I was prepared to do everything in my power to pursue medicine as a career. To this day, I am very grateful for the opportunity to study medicine in Ireland, a country with exceptional clinical and research facilities. Studying abroad in Ireland was also a reason for my parents to finally visit their ancestral land and to meet the family they have never seen before. When I saw how proud my parents are of me and my pursuit, I knew that I made the right decision to train abroad. This experience taught me that no matter the obstacle, I am committed to my decision to become a physician.” 

What makes this answer good?

This response gives a detailed account of the applicant’s journey to residency. The applicant uses examples of strengths they possess but does not shy away from talking about their setbacks.

Most importantly, the answer also reveals the kind of characteristics and skills the applicant possesses:

“Why Should We Choose You?” Residency Interview Question and Sample Answer for IMGs

If you are an IMG wondering how to tackle this question, you are not alone. Not many of us feel comfortable praising our qualities and experiences, but it’s important to properly reflect on your suitability for your chosen programs to answer this question. This does not mean that you have to boast about how much better you are than other candidates, but you should emphasize your unique experiences and strengths to make a lasting impression.

The number one strategy for answering this question, whether you are an IMG or a local applicant, is to research your chosen program, and using the experiences and achievements from your past, demonstrate in your answer why you would be a great fit for it. For example, if you are interviewing with a program whose mission includes a commitment to serving rural and remote communities, make sure to emphasize your experiences working with such populations and why this program would allow you to learn more about this field of medicine. Even if you have already mentioned your preference for rural medicine in the Supplemental ERAS Application, your interview answer will extrapolate on why and how you are the perfect candidate to contribute to the mission of this program.

Looking for more tips on how to answer residency interview questions as an IMG? Check this out:

If you are under the impression that only US and Canadian experiences will be considered valuable by program directors, think again. While having exposure to the medical field in the country where you want to practice is important, if you are an IMG coming from a medical background in a different country, you have a lot of advantages. In your answer to this question, you can and should use examples of your unique work experiences overseas. Demonstrate your skills and qualities that make you a great fit for your chosen program. For example, let’s continue with the topic of rural and remote medicine. Be mindful that even if you practiced medicine in a different country, the problems experienced in rural and remote areas can overlap. Check out this sample answer:

“I was immediately attracted to your program after reading your mission statement. Your dedication to promoting healthcare and research in remote Northern areas of Canada resonated with me. I worked as a pediatrician for 7 years in X town in Central Siberia. I faced many of the same problems as physicians practicing in northern areas of Canada. Not only did we constantly experience a shortage of medicaments, pharmaceuticals, and other supplies, but we were constantly short-staffed. Moreover, there seemed to be a general lack of understanding and support from the municipal government.

To deepen my expertise and to bring awareness to our problems, I joined the Siberian Branch of the Russian Academy of Sciences as a researcher and published findings on clinical, biochemical, and genetic aspects of cardiovascular diseases in children in Western Siberia. Following this experience, I obtained a position as the head of the pediatrics department of X hospital in my hometown.

Since moving to Canada, I have worked closely with populations in Northern Ontario. In addition to volunteering at local hospitals and observing local physicians, I have obtained a paid clinical position as a Certified Nursing Assistant in a nursing home in Timmins, ON. This experience has allowed me to learn from my Canadian colleagues and take note of the differences between patient interactions in Canada and Russia.

I believe that my extensive experience working in remote, northern parts of Russia can be very useful in working and serving rural Canadian populations. Your mission and values greatly resonate with my dedication to bringing awareness to the problems faced by remote populations all over the world, especially in the most northern areas of our globe. I hope to share my years of experience working with and researching these hardships with your faculty and staff.”

What makes this answer good?

The applicant immediately identifies that the mission to protect and promote the healthcare of remote, Northern populations is what attracted them to this program. They demonstrate their background in this field of medicine using strong and memorable examples. Even though the experience was gained in another country, the applicant identifies clear correlations between their experiences in Russia and the experience of doctors working in the north in Canada. Not only did the applicant work in remote areas, but they participated in research and published findings related to this medical field. Additionally, we can see that they have continued to dedicate their time and career to this mission even after they moved to Canada. This shows true passion and dedication.

Want to practice with 10 more residency interview questions and hear our expert responses? Check out this video:

“What Is Your Visa Status (Non-US IMGs Only)?” Residency Interview Question and Sample Answer for IMGs

If you are a Canadian or a US IMG, this question will not come up during your residency interview, as you are a citizen or a permanent resident of the country where you want to train and practice. But if you are a non-US IMG, be ready to discuss this question.

The reason why programs wonder about your visa status is because not having the appropriate visa can prevent you from starting your residency training. Therefore, if you run into any problems with obtaining the visa, the program that accepts you may lose a resident at the last minute, thus leaving the spot unfilled. This is a great risk.

The good news is that a J1 visa, necessary for participating in residency, is quite easy to obtain. If you are wondering about the most common reasons for J1 visa denial, make sure to do your research and avoid any possible errors in your application. Here’s a list of the items you need for your J1 visa application:

And here’re some tips for making sure everything goes according to plan:

1. Make sure that you are eligible for the visa.
2. Make sure your documents and fees are ready as soon as you receive news on Match Day.
3. Prepare for the J1 interview (if applicable).

In your answer, disclose your current visa status and your plans. For example:

“As a graduate of X college and Y medical school in the United States, I became eligible to apply for a green card just a few months ago. At the moment, I am in the process of applying for it. I would like to stay, practice medicine, and settle in the United States. However, currently, I am here on a J1 visa, which I plan to extend as soon as I receive an offer from a residency program. I have never experienced any issues with obtaining this visa before, and I am certain that I will face no obstacles."

Keep in mind that your visa status should not really affect your chances of matching if you make a great impression on the program directors and faculty. Most residents, once they receive their offers, do not experience any problems obtaining the J1 visa. Most importantly, do not lie about your status.

Conclusion: Is IMG Residency Interview Prep More Difficult?

No, but IMGs should develop approaches to talk about their background and experiences as IMGs. In the interview, you must convince the program directors and faculty that your experiences will bring new perspectives and knowledge to your chosen program. Keep in mind that the IMG status is what can help you stand out in your application and interview.

Remember that to make your answers memorable, you must refer and bring up solid examples from your background that demonstrate your skills and suitability for your chosen specialty and the particular program you are interviewing with. In that regard, being an IMG may play to your advantage! Not everyone will have experience learning and working in environments abroad, not everyone will experience a language barrier or acculturation, not every applicant can say that they have years of medical practice abroad. Your IMG residency interview prep should help you reflect on your achievements and teach you how to skillfully incorporate these unique aspects of your journey in your answers.

FAQs

To your success,

Your friends at BeMo

BeMo Academic Consulting

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