If you’re an international medical graduate who has graduated from medical school outside the US or Canada, but now want to complete your residency in the US or Canada, this guide is for you. As an IMG looking to match to medical residency programs in Canada or the US, it is important to be aware of the challenges you will have to overcome to match successfully. In this blog, you will learn about the eligibility criteria for IMGs in Canada and the United States, how to prepare your residency application, including your residency personal statement, and how to get ready for those challenging residency interview questions.

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Article Contents
24 min read

What is an IMG? International Medical Graduates: What It's Like Being an IMG? What Are Your Match Chances as an International Medical Graduate (IMG)? Eligibility Requirements for IMGs in the US Eligibility Requirements for IMGs in Canada How to Stand Out as an International Medical Graduate in Your Residency Application FAQs

What is an IMG?

To participate in the residency match in the US and Canada as an IMG, you must first learn what constitutes an IMG in both countries. Let’s start with the US.

International Medical Graduates in the US

International medical graduates aiming to match in America are divided into 2 main groups: US IMGs and Non-US IMGs.

US IMGs are citizens of the United States who graduated from international medical schools. Non-US IMGs are non-US citizens who graduated from international medical schools. Non-US citizens who graduate from US medical schools or medical schools in Canada are not considered IMGs. Essentially, the Unites States considers anyone who graduates from a non-US MD or DO school an international medical graduate, regardless of their citizenship. This means that if you are a US citizen educated in one of the Caribbean medical schools, for example, you are a US IMG. While a student with French citizenship, let's say, who graduated from a medical school in the US is not an IMG.

It's important to note that Canadian citizens are also not considered IMGs in the US, even if they attended Canadian medical schools. Canadians are eligible to apply for residency via the Canadian Resident Matching Service (CaRMS) and the US Electronic Residency Application System (ERAS) at the same time. If you are a Canadian citizen matched to a US residency spot, you will be required to apply to the Educational Commission for Foreign Medical Graduates (ECFMG) and obtain a J-1 visa to be able to train and work in the US. We will outline this process later in this blog.

International Medical Graduates in Canada

In Canada, on the other hand, your citizenship or residency status directly affects your chances to participate in CaRMS. You must be a Canadian citizen or a permanent resident of Canada to be eligible for the match. While there are some Canadian medical schools which accept US students and international applicants, the latter cannot participate in the match unless they become Canadian permanent residents or citizens. Otherwise, any Canadian citizen who graduated from an international medical school (including Canadian-friendly US med schools) is considered an IMG.

So, if you are a Canadian citizen who graduated medical school outside Canada or you are a Canadian medical school graduate without Canadian citizenship, you will be considered an IMG and will not be able to participate in the Canadian residency match. You can, however, apply to residency programs in the US.


  • US citizens who have graduated from international medical school


  • Any med school graduate without Canadian citizenship or permanent residency.


  • Canadian citizens who attended med school in the US, for instance graduates from Canadian-friendly US med schools, and international students who graduated medical school in the US.

Now that we understand what constitutes an IMG in both countries, let’s find out what obstacles we need to watch out for and how you can prepare for your residency application process to increase your Match chances. Dr. Neel Mistry, MD and former resident of the University of Saskatchewan’s Diagnostic Radiology program, one of the most competitive residencies in the US and Canada, has worked and trained with IMGs extensively:

“Making yourself stand out from a large pool of [qualified] applicants is especially tough for IMGs.” – Dr. Neel Mistry, MD

In this article, we will show you how to approach the medical residency application and interview process as an IMG to increase your Match chances and prove yourself to be a stand-out candidate among thousands of other applicants. Let’s dive in!

International Medical Graduates: What It's Like Being an IMG?

“The application process [for IMGs] is [all about] figuring out how to really articulate your own self-narrative" - Ray, IMG from Hong Kong

Leaving your home country to live in another is difficult; but leaving your home country to, hopefully, become a doctor in the US or Canada is fraught with even more difficulties. If you don’t already speak English fluently, you’ll have to learn. You have to overcome the multi-leveled process of applying, which costs time and money and comes with no guarantees that you’ll be matched! You have to contend with leaving your loved ones and your support network behind, which are so crucial to all young doctors-in-training.

According to a comparative study done by Mexican researchers who surveyed Mexican and other foreign nationals who wanted to enter the US residency system, international medical graduates face a unique set of challenges, compared to US MDs, such as:

  • Integrating and understanding US culture (both social and medical)
  • Racism and xenophobia
  • Language skills 
  • Financial concerns
  • Emotional turbulence

Despite these challenges, international medical graduates continue to apply for the most competitive and least competitive residencies. Over 19,000 US and non-US international medical graduates applied to the Match last year; a figure that has steadily risen every year. So, even though international medical graduates face many obstacles, they continue to apply. They apply even though, by all metrics, international medical graduates have a harder time matching to residency positions in the US and Canada than non-IMGs. Although it is not impossible to get residency as an IMG. In the US, foreign IMGs have a match rate of around 58.5%, while in Canada IMGs have a match rate of around 75.8%

Here are some tips for matching to IMG-friendly residency programs:

What Are Your Match Chances as an International Medical Graduate (IMG)?

As an IMG, you must be wondering what kind of specialties are worth pursuing to increase your Match chances. According to the most recent NRMP Match Data, the following medical specialties are the most popular with both US IMGs and non-US IMGs:


  1. Internal Medicine (Categorical and Primary) - 1,123
  2. Family Medicine - 748
  3. Emergency Medicine - 325
  4. Pediatrics (Categorical and Primary) - 235
  5. Psychiatry - 178


  1. Internal Medicine (Categorical and Primary) - 3,201
  2. Family Medicine - 706
  3. Pediatrics (Categorical and Primary) - 531
  4. Neurology - 254
  5. Psychiatry - 185

Even though the match rates for US and non-US international medical graduates are less than US MDs or Canadian MDs in Canada, many IMGs still match into US and Canadian programs. In fact, the same study that examined the challenges faced by IMGs also found there some specific criteria you can meet to increase your chances to getting matched into a US graduate medical education program:

  • USMLE Step 1 Scores above 250 
  • Clinical rotations done in the US
  • Letters of Recommendation from US doctors
  • Published, peer-reviewed scientific research

The USLME Step 1 score is especially important. The researchers found that international medical graduates with a score between 220 and 229 had only a 51% chance of getting matched. If those scores were above the 250 threshold, your chances of matching as an IMG jumped to 89%, so, if you’re an IMG, you should focus on your board exams before you start sending out applications. Dr. Neel Mistry, MD and our admissions expert, notes:

“Achieving a high USMLE score is one of the many ways [for IMGs to stand out as applicants].” – Dr. Neel Mistry, MD

Eligibility Requirements for IMGs in the US

The Match is a system used to match students with US residency programs. Although not every program uses The Match, most do. Programs that choose to participate are required to register each position and attempt to fill them to ensure a fair process. Before IMGs can start applying for residency positions, they must meet a set of requirements.

These requirements include:

  • ECFMG certification
  • US state medical board requirements
  • Specific residency program requirements
  • US visa requirements

#1: Certification with ECFMG

Submit an application for ECFMG certification before applying for their examination. Consult the World Directory of Medical Schools to confirm that international medical graduates from your school are eligible to match in the US, as there are no residency programs that don’t require ECFMG certification.

The certification process starts when you apply to ECFMG for a USMLE/ECFMG identification number. As soon as you get this number, you can use it to complete the application for certification through one of the ECFMG pathways. Once you submit your application for certification, you may apply for examination. As one of the requirements of certification is the verification of your medical school diploma, you cannot complete the entire certification process until you have graduated. With this said, you can apply for the required examinations as soon as you meet the examination eligibility requirements. All of the required examinations are offered throughout the year.

#2: State-Specific Requirements

The Federation of State Medical Boards (FSMB) publishes US state-specific requirements for medical licensure, including:

  1. Minimum postgraduate training required
  2. Number of attempts at licensing examination allowed
  3. Time limits for completion of licensing examination sequence needed for license eligibility

The FSMB updates state-specific information for residencies. You can use this site to find out if you can get a license in a specific state during residency and to identify the most IMG friendly states in the US. Some states, such as California, have a list of recognized international medical schools that are eligible for licensure in the state. Some states have restrictions on the number of USMLE attempts allowed.

Make sure to check the FSMB website in advance as you don't want to waste your time and money applying in states that limit training permits or recognize fewer international medical schools than the full list of World Directory of Medical Schools. It is crucial to verify your eligibility within each US state and each program before you apply.

You should also take the time to research the most IMG friendly residency programs or IMG friendly hospitals in different US states.

Here's why clinical experience is so important for IMGs:

#3: Residency Program Requirements

Program requirements for each residency position are most often listed on their websites. These may include medical school graduation year, types of visas accepted, or how many USMLE attempts are allowed. Make sure that you understand your program’s residency requirements before applying.

You can find the descriptions of most US residency programs on the following online directories. These include:

  • The Fellowship and Residency Electronic Interactive Database Access (FREIDA) is the online directory of graduate medical education programs sponsored by the American Medical Association (AMA)
  • The Accreditation Council on Graduate Medical Education (ACGME) also offers a residency directory
  • The American Academy of Family Physicians (AAFP) offers an online family medicine residency directory 

Each medical specialty has specific information about individual programs, as well as any general or special requirements for application including whether they admit IMGs. You may also get some insight as to what residency program directors look for in applicants to help you prepare your application.

Application deadlines vary among the programs. Make sure you confirm your program’s deadlines.

#4: Visa Requirements 

In order to participate in American graduate medical programs, international medical graduates who are not citizens or permanent residents must obtain the appropriate visa. The two most common visas are the H1-B (Temporary Worker) or the J-1 (Exchange Visitor). Some institutions will sponsor the visa for residents in the residency program, so it would be wise to check with your program.

The ECFMG is also authorized by the US Department of State to sponsor foreign national physicians for the J-1 visa. Learn more about your visa application process from your residency program, the American embassy or consulate in your country of residence, or the US Citizenship and Immigration Services.

Eligibility Requirements for IMGs in Canada

The Medical Council of Canada (MCC) provides requirements for the residency match process. Make sure to check these requirements on their website before you begin your applications. If you are an IMG wishing to apply for residency in Canada, these are the standard eligibility requirements:

  1. You are a current student or graduate from a school listed in the World Directory of Medical Schools, OR your medical school must be accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS) or the Liaison Committee on Medical Education (LCME) in the U.S., OR your medical school must be accredited as a U.S. School of Osteopathic Medicine.
  2. Written and passed or be scheduled to write the National Assessment Collaboration (NAC OSCE) examination.
  3. Written and passed or be scheduled to write the Medical Council of Canada Qualifying Exam Part I (MCCQE Part I). This examination assesses the critical medical knowledge and clinical decision-making ability of a candidate at a level expected of a medical student who is completing his or her medical degree in Canada.
  4. Must be a Canadian citizen or a permanent resident of Canada. Visa holders are not eligible.

You can choose to take the MCCQE Part 1 and NAC OSCE as an IMG in the order that you prefer. You must also remember to write the examinations before the programs’ deadlines. Please check with your program when the examination results must be submitted and schedule your exam accordingly. You can find important timeline information for your application cycle on the MCC website. Please be aware that the United States Medical Licensing Examination (USMLE) cannot substitute any of these exams.

Need to write the MCCQE? Here's how a prep course can help:

How to Stand Out as an International Medical Graduate in Your Residency Application

According to a study by the NRMP, IMGs that matched to their preferred specialty are most likely to:

  1. Rank more programs within their preferred specialty
  2. Have higher USMLE Step 1 and 2 scores
  3. Be US citizens

When considering how many residency programs to apply to, remember that each application demands a high level of research and preparation. The quality of an application is the most important aspect, so it's better to send fewer high-quality applications instead of more low-quality applications. The Association of American Medical Colleges (AAMC) keeps records of the average number of residency applications per student for different specialties. Some of the most competitive fields, including family medicine residency, psychiatry, internal medicine residency, anesthesiology, and pediatrics, see more than 70 applications from one candidate. So, with all those applications, how can your application stand out? Keep in mind that your preparation for residency applications should start long before you fill out the ERAS or CaRMS application forms. Gaining relevant experiences, developing critical skills, and forming strong relationships with mentors takes time.

Now, let's review our tips to help you craft the best application as an IMG applicant!

1. Show Experience in and Dedication to Your Chosen Specialty

This is perhaps the most important advice our admissions experts had to share with anyone applying to residency. But it is especially poignant for IMGs. Dr. Neel Mistry, MD and our admissions expert, explains that demonstrating your suitability for your chosen specialty is the key to Matching your top-choice residency program:

“Demonstrating preparedness for your specialty is key to convincing the application committee and ultimately securing your top residency program. To do so, you want to highlight specific personal experiences where you have demonstrated key skills required for your specialty. For instance, collaboration, communication, and independent problem solving are essential to the job of a radiologist. I made sure to give specific and different examples to demonstrate how I have developed each of these skills throughout medical school. This helps the selection committee to know that you are aware of what you are getting yourself into. [The] application materials [I used to demonstrate my suitability were the] CV, personal statement, and the interview. – Dr. Neel Mistry, MD

2. Get Competitive USMLE and MCCQE Scores

There is just no way getting around this – you need to get a good UMSLE or MCCQE score to have a better chance of matching as an IMG. These scores have a huge impact on whether you will be invited to an interview, so do not hesitate to invest in a USMLE prep course or MCCQE prep course for IMGs.  

3. Gain Clinical Experience Where You Want to Practice

This advice is closely tied to our first tip! As an international medical graduate, you should aim to gain electives and clinical experience in the country to which you're applying. This is important for making your application stand out and for convincing program directors that you’ve taken the necessary steps to transition effectively from a foreign medical graduate to an effective physician in a new country. In addition to gaining first-hand experiences in Canadian or US healthcare systems, this clinical experience will also allow you to secure ERAS letters of recommendation or CaRMS reference letter from faculty members who supervised you and who are familiar with the expectations of US or Canadian residency programs. It is a good idea to consider setting up a clinical externship or enrolling in an elective program that can provide valuable hands-on experience in the American or Canadian medical system. If you are looking at urban vs rural residency programs, note that many programs value residents who want to work in rural or underserved areas in both countries.

If you are currently a medical student, many medical schools offer opportunities for visiting students and clinical away electives. Some programs are free, but most require a fee. Some Canadian medical schools that offer visiting student programs are the University of Toronto med school, Queen’s university med school, UBC medical school and the University of Alberta medical school.

4. Get Strong Letters of Reference in Your Chosen Specialty 

According to one of the latest NRMP director surveys, your letters of reference have one of the highest impacts when it comes to selecting candidates for interviews. Your LORs are only behind your USMLE scores in terms of importance. You need to show that other specialists in your field support you and see you as a great addition to the specialty you are pursuing. Try to have at least 1 letter of reference in your chosen specialty, but 2 would be ideal. Make sure your writers can speak to your suitability and proven track record in the specialty of your choice. Dr. Neel Mistry, MD, shares his experience with writing LORs:

"Approach in a polite and friendly manner; [when I am approached, I like to know] why I would make a good referee and [for you to] provide tangible examples [of when you] went above and beyond in a patient’s care that would warrant a LOR. An approach that would sour me is if a student asks for a LOR despite putting an average or below-average performance during the rotation, if they feel entitled to a LOR, and if the student asks for a LOR after having worked only a few shifts with [me].” – Dr. Neel Mistry, MD

5. Participate in Observerships

If you are no longer in medical school, your chances of obtaining clinical experience in the US is limited, but not impossible. Your best option is to participate in observerships. Similar to physician shadowing, observerships will provide you with an opportunity to learn about the healthcare system in the country you’re applying, make connections, and increase your overall knowledge. 

In some Canadian provinces, IMGs may apply for a clinical observership permit. For example, Nova Scotia issues clinical observership permits to students who were trained outside of Canada and do not yet meet requirements for a license to practice medicine in Nova Scotia. The permits allows you to observe, learn, and gain insight into the practice of medicine in Nova Scotia under the supervision of practicing doctors in hospitals and medical practices. This will be helpful in preparation for your MCC licensing examinations and skill assessment. Keep in mind that the observership permit is not a license to practice medicine, nor is it considered as training or work experience. Dr. Neel Mistry, MD, shares that opportunities for observerships was an important part of why he attended the medical school that he did:

“Having adequate clinical opportunities in the form of observerships and research was important to me. I enjoyed the fact that we were able to do observerships in any specialty we wanted right from the first day of medical school. That is something that not all medical schools offer.” - Dr. Neel Mistry, MD

He claims that observerships really made an impact on his residency CV and made him stand out as an applicant! So make sure to look for observerships as an IMG to showcase your dedication to and interest in your specialty! 

If you want more options for gaining experience as an IMG, you can look at how to apply to pre-residency fellowships as an IMG.

6. Gain Research Experience

Another way to improve your residency applications, especially for programs that focus on academic progress and training future researchers, is to gain research experience. Our admissions expert Dr. Monica Taneja, MD, shares that her research experience helped her Match her top choice residency program in Psychiatry:

“I showed preparedness and interest in psychiatry by engaging in research [opportunities] offered at my medical school [and beyond]. [This] gave me plenty of stories to talk about how I validated the field and showcase how I see my career progressing in psychiatry.” – Dr. Monica Taneja, MD, Harvard South Shore, Psychiatry

Securing a position as a research assistant will help set you apart from other IMGs as most programs highly value US or Canadian research experience. Try to gain a position where you’ll be testing hypotheses, analyzing results, and preparing reports. Make sure that you form a good bond early on with your research mentor in order to secure an excellent letter of recommendation. If you participated in any premed research opportunities or clinical research as a premed, these are excellent experiences to showcase in your residency application, especially if they were gained in Canada or the US.

7. Strengthen Your Extracurriculars

Extracurricular activities matter for one simple reason: every strong candidate has them. You will not be a program director’s top choice if you have nothing to put in the CaRMS or ERAS experiences section. Clinical experience, volunteering, teaching, and research are great experiences to possess. These activities can make you stand out above other applicants and can be the difference between simply matching and matching with your preferred program. The directors of residency programs will want to see that you are passionate about medicine and your specialty choice and that you’re constantly learning and growing as a person and future physician. It’s important to note that not all extracurriculars have to be related to medicine. Our admissions experts Dr. Neel Mistry and Dr Taneja made sure to highlight their activities outside of medicine:

“[I participated] in quite a few [activities outside of medicine]; it is important to show that you have a life outside of medicine! I took part in a cricket tournament, amateur cooking sessions, and a drop-in karaoke competition.’ – Dr. Neel Mistry, MD

“I really enjoy working with students, so I did a lot of volunteer medical school mock interviewing for my graduate and undergraduate schools. I also continued to participate in my hobbies including photography, which came up a lot during interviews!” – Dr. Monica Taneja, MD, Harvard South Shore, Psychiatry

Showing dedication and a long-term time commitment to activities that are important to you is just as meaningful. For example, commitment to a particular sport, a musical instrument, or even a type of dance. Now, this doesn’t mean that you have to join every single student-run clinic or apply for every leadership program. Make sure that you are only participating in activities that you actually enjoy and are significant to your growth and development. Our student Ray, the IMG from Hong Kong suggests, “a semester or year abroad would be a valuable experience because it will help to expose you to different cultures and different people and it will really help you understand their values.”

8. Demonstrate Physician Competencies

As you craft your application components, keep in mind that your application should demonstrate the qualities and characteristics expected of all physicians in the US and Canada. It is crucial for IMGs to familiarize themselves with Canadian and US guidelines that dictate the expected behavior and abilities of future physicians.

Dr. Neel Mistry suggests reviewing the AAMC core competencies and CanMEDs roles and planning your application with these in mind:

“It is important to create a list of [your] clinical experiences for each [AAMC competency] or CanMEDS competency. Once you have a concrete example for each role, drafting [your application] becomes much easier.” – Dr. Neel Mistry, MD

9. Craft an Eye-Catching Personal Statement

For most residency programs, the personal statement is a key factor in their choice of candidates. It’s important to demonstrate reflection in your personal statement and write concisely. You’ll have to write a separate residency personal statement for each specialty you apply to, but not for each program, so it's important to adhere to any word or character count stated in the program-specific instructions. Dr. Neel Mistry, MD and our admissions expert, had this to say about writing your residency personal statement:

“Writing the personal statement [was the hardest part of the residency application]. These are particularly hard because there is so much you can talk about, and what may appeal to you may not necessarily appeal to the admissions committee. Making the statements convincing while meeting the word limit… can be difficult. It is advisable to start as early as possible (possibly months from due date) so that you can extensively revise the statements, have others review it and provide feedback.” – Dr. Neel Mistry, MD

But most of all, Dr. Mistry says, “the key here is answering the last two questions well (why this program and what sets you apart)”. Most candidates simply highlight what they have done, but do not reflect on it or mention how what they have done has prepared them for a future medical career [in their field].” To do this you should think about questions such as: does the program stress public service or research? Does it seem to highlight specific qualities like interpersonal skills, or academic prowess? Perhaps the description questions candidates’ level of commitment, ability to handle pressure, and communication skills? Decide accordingly what the main message of this description is and what kind of impression you want to make. Ultimately, Dr. Mistry says that “painting a picture in the reader’s mind” will help you create a strong connection between you and the program. 

10. Obtain a Strong MSPE

Your Medical Student Performance Evaluation (MSPE) or Medical Student Performance Record (if you are applying in Canada) showcase an objective review of your suitability for the medical profession and the specialty that you are choosing to pursue. MSPEs are typically created by deans, faculty, and administrators of your medical school. MSPEs are meant to be objective evaluations of your performance as a medical student that help residency programs determine if you’re a good fit.

If your medical school does not traditionally offer MSPEs to their students, you must work hard to obtain this important evaluation. Firstly, you should approach the dean and faculty of your medical school to ask for an MSPE no later than the summer before your ERAS or CaRMS application is due. The more time you give yourself, the better. Explain that you need this assessment in order to match in Canada or the United States. Secondly, explain the format and requirements of the MSPE. Outline the purpose of this evaluation and ask if a similar document can be produced by your medical school. While the format does not have to be exact, the closer it is to the AAMC format or the CaRMS format, the better. It would be ideal if you can sit down with your committee to make sure all the necessary elements of the MSPE/MSPR are included. You can also ask them to emphasize specific rotations, electives, or publications that you are most proud of.

11. Ace Your Interview

The USMLE scores, letters of reference, and personal statement will be used to select candidates for the interview, and it’s important to understand the full importance of the interviews on the rankings created by directors and programs. According to the directors survey, your performance in answering international medical graduate residency interview questions is the number one factor influencing how well you are ranked by the program. Your interpersonal skills, interactions with faculty, feedback from current residents are the top influencing factors when it comes to the programs’ rank order list. Which means that once you get to that interview stage, all you need to do is totally ace it. Dr. Monica Taneja, MD and our admissions expert, also reminds us that a residency interview is more than just Q&A, it’s a chance to get to know each other and create a real conversation:

“I found that the most important piece to residency interviews is having a natural conversation. There is a lot more in common between you and the people you are talking to then when I had medical school interviews. I made sure to know my 2-3 key talking points, but focused on just having a good conversation with my interviewer. This is really important when you are talking to a resident, as the most important thing to them is making sure you would mesh well into the program.” – Dr. Monica Taneja, MD, Harvard South Shore, Psychiatry

Here’re the steps that will help you prepare for your interview and create a great first impression:

Determine your interview format

Review the information you’ve received from the residency program to determine your interview format. You could have a panel interview, traditional one-on-one interview, video interview or multiple mini interview (MMI). The interview format will greatly affect your IMG residency interview prep.

Research programs

It’s essential to do your research before the interview so you know as much about the program as possible. Go into the program’s website to review their mission statement, core values, accomplishments and history. You will almost certainly be asked the “why our program” residency interview question, so you need to develop your own suitable answer to this question. Find out what is important to them, and then highlight your relevant experiences and values that make you a suitable applicant.

Reflect on you

Know yourself. Be confident and aware of what you have to offer. You have acquired a wide range of skills and experiences throughout your education and your training. Be sure that you can articulate experiences you've had, answer why they were important, and what you've learned from them. It is essential to be able to connect your skills to the programs’ expectations.

Highlight key qualities and desirable personality traits

Highlight traits sought by interviewers such as drive, motivation, communication skills, determination, confidence, reliability, honesty/integrity, dedication, analytical skills, listening skills. You should be highlighting some of these qualities in your personal statement but you should also discuss them in your interview.

Practice with residency mock interviews

ERAS interview prep is a long and challenging process. You need to be prepared to answer common residency interview questions such as "tell me about yourself” and "why our program" effectively as these are not easy questions to answer on the spot. For this reason, it's essential that you practice with questions that you're likely to encounter so that you can formulate a strong response early on.

In addition to preparing with practice questions, it is essential to participate in full-length mock interviews in the format of your interview. For example, if you have a MMI, it’s a good idea to participate in a realistic MMI interview in order to understand different types of MMI questions, practice your pace, and receive personalized feedback to strengthen your answers and eliminate any weaknesses or red flag responses.

As you continue to participate in mocks, make sure to check out MMI questions to get you started. If you're applying to CaRMS, check out common CaRMS interview questions and CaRMS interview prep tips. You can even review medical school interview questions to practice answering some of the most common questions faced by future medical professionals. 

Preparing for your interview? Check out sample interview questions and answers:

Gather a list of questions to ask your interviewers

It’s a good idea to have some questions to ask residency programs prepared ahead of time to let your interviewers know that you’ve really given some thought to the qualities of their particular program. Prepare specific questions about the program, location, residents, and school and ask them at the end of your interview. Try to stand out with your questions. Your interviewers are most likely tired of answering the same questions (just like you). You will make a more lasting impression if you come up with memorable inquiries, in addition to those that will help you rank the program effectively.

Use mock interviews to improve

Once you have your main talking points for answering residency interview questions, you need to rehearse. Practice by saying your answers out loud in front of a mirror, or if you can, record yourself. This will help you look for any nervous or unfavorable behaviors you may be exhibiting such as playing with your hair or pacing. However, we strongly recommend working with experts who can conduct residency mock interviews – this is the ultimate way to prepare for your meetings with program directors and faculty. Here’s what our student Natasha, who matched into her top-choice residency, had to say about the residency mock interview experience:

“For my residency interviews, which were panel interviews, I wanted to be as prepared as possible, so I scheduled three practice sessions with BeMo. Practicing with instructors who had experience interviewing themselves and knew exactly what the interviewers were looking for was invaluable. They also gave me structures to answer any question that came my way, even if I hadn't specifically prepared for it. They also bounced ideas back and forth with me and gave me new ideas for different question answers, so that I had just more things to think about. They kept me in check in terms of timing of my responses and my body language - things that I wouldn't be able to check myself for. So it's super helpful having someone else just interviewing you as practice. Overall, the most important thing that I took away from the sessions was confidence. I shook all my nerves during the practice interview sessions and I walked into the real interview sessions knowing that I had practiced and I practiced these answers with another person who was a professional. They had helped me improve my answers to the best they could be and helped me match into my residency program.” – Natasha, BeMo student

Another important tip for your interview practice: you don't want to memorize your answers, but you want to ensure you’re hitting the most important points during your responses and that you feel comfortable and confident. If you want professional feedback on your interview performance, you can ask an IMG residency consultant for interview prep help.

Send thank-you letters

Remember to send thank-you letters to program directors within 48 hours after your interview. Include your name, interview date, and ideally, the names of your interviewers. Sending thank you letters after an interview is a nice way to leave a good impression!


1. Is there anything else I can do to increase my chances of getting noticed by the program of my choice?

There are some things you can do that could give you a competitive edge, which we outlined above such as getting US or Canadian clinical experience through rotations, getting LORs from American or Canadian physicians, a lot of research experience, and an USMLE Step 1 score above 250. It is a great idea to participate in opportunities that are offered near the place where you would like to practice. For example, during your medical school studies, you can plan to take an elective over the summer in the city where your desired program is located. By getting to know some of the local professionals, you can later ask them for a letter of reference when applying to your desired position. Familiarity with local professionals can increase your chances of getting a desired position. Forming relationships and having a recognizable name with doctors and residents who are related to your desired program could become a great advantage during the application process – you will be more than just a name on a piece of paper. Another tip is to try and reach out to program directors and current residents. This can also help in becoming a candidate who stands out more, plus it will allow you to learn more about the program, and potentially help in getting observerships.

2. What if I get asked about my rank order list during the interview?

For CaRMS, programs and applicants are not obliged to discuss where they are going to be ranking each other. So, generally, for Canadian programs, this is not a question you need to worry about. For US programs, while it is not likely to come up during the interview, let them know that you really enjoyed learning about the program and it's educational components, as well as meeting the faculty and residents, and then state that you will be making decisions about your rank order list once all your interviews are finished. This way, you'll be respectful but honest, and you don't have to state exactly where you'll rank each program.

3. What should I put in my letter of intent?

Review our residency letter of intent blog for details and a full-length example.

4. Is there a limit to how many times I can take the Medical Council of Canada Qualifying Exam Part I (MCCQE Part I)?

You may take the MCCQE Part I a maximum of four times. However, you cannot retake the exam if you have a pass result. A one-year waiting period will be required between the third and fourth attempts. After four attempts, in exceptional personal circumstances, you can request to the Central Examination Committee for special permission to make a fifth attempt.

5. What should I include in my CV when applying to residency programs?

Your residency CV should highlight your skills and experiences and should be constructed in reverse chronological order. In general, it should include the following:

  • Personal data
  • Education
  • Clinical experience
  • Research experience
  • Volunteer experience
  • Awards and scholarships
  • Professional associations and memberships
  • Interests and skills
  • Extracurricular activities
  • Publications/presentations
6. Are there questions my interviewers are not allowed to ask me during the residency interview?

Yes, there are certain questions that you do not have to answer. It is illegal to make employment decisions based on race, color, sex, age, religion, national origin, or disability. A frequent area of concern during the interview process is questions related to parental leave, pregnancy, and child-rearing plans. The prohibition against discrimination on the basis of sex includes discrimination on the basis of pregnancy and child-rearing plans. You do not have to answer questions related to marital status, number of children, or plans to have children, but you may want to prompt a discussion of the provisions for maternity/paternity leave and/or childcare responsibilities in the residency program.

7. I didn’t match! What do I do?

Don’t panic if you do not get a match. Often, even if an IMG candidate completes all the examinations and other requirements, many IMGs are not successful in their first participation in the matching process. This is mainly due to the limited number of spots assigned to IMGs. Every year there are applicants who don’t match. Many students who don’t get placed through the main matching systems try to obtain positions through alternative avenues, like Supplemental Offer and Acceptance Program (SOAP) but do keep in mind that these are also usually very competitive. Be prepared for your SOAP residency interview questions to increase your chances of success!. If you find yourself with a year off, use that time wisely to improve your residency app after going unmatched. Gain experiences that may give you a competitive edge in your next cycle of applications and reach out for professional help in reviewing your application to ensure it puts forth the best version of yourself. Do not beat yourself up – this is a long and complicated journey. If you’ve come this far, you can overcome this challenge.

8. Is it hard to match as an IMG?

IMGs have a harder time matching to residency positions in the US and Canada than non-IMGs, although it is not impossible to get residency as an IMG. In the US, foreign IMGs have a match rate of around 58.1%, while in Canada IMGs have a match rate of around 33.2%.

9. What kind of US clinical experiences should IMGs have?

There are two types of US clinical experiences. The best type of clinical experience is to take electives at US medical schools as a student. They can be clerkships, externships, sub-internships, etc. Students can enroll in US medical schools' elective clinical rotations during their final year at medical school. Try to find out if your medical school has affiliations or agreements with US medical schools. If your school does not collaborate with any US medical schools, it will be more difficult, so be sure to plan ahead. Student elective clinical rotations last about four weeks, then you move onto the next elective course. These electives will provide you with hands-on experiences. You will first observe a technique or procedure, and then you will perform the task under the guidance of your faculty instructor. One of the great benefits of such electives is that you get to "try on" different departments and programs to help you determine which specialty you'd like to pursue.

The second type of clinical experience is observerships. As previously mentioned, observerships are not hands-on experiences, but they can lead to great opportunities. A good relationship with a faculty member in your observership may flourish into a mentorship. Because observerships generally last longer than electives, they have the benefit of showcasing your growth and productivity over time. If you form strong relationships with your mentors, you'll be able to secure strong letters of recommendation that can help your application stand out. Lastly, observerships will help you transition into US practice.

10. Are observerships paid?

Observerships are meant to benefit the observer and prepare them to enter US clinical practice, unfortunately, they are not paid.

11. As an IMG, who should I ask to write my letters of recommendation?

As an IMG applying to residencies in Canada and the United States, it would be ideal to have references from faculty and physicians from these two countries. This would mean long-term planning on your part. Try taking some electives in the program or state where you’d like to match. Get to know the faculty and physicians. Be sure to keep in touch with them after the elective is over. If you form a good relationship with your US colleagues, they would be the optimal referees for your IMG applications.

Another option is to find observerships in your field in the US and Canada and ask your mentor to provide you with a letter of recommendation. A letter from a specialist from another country who did their residency or fellowship in the US or Canada would also be a good addition. If you don't have letters of recommendation from North American physicians, it does not eradicate your chances of matching. The most important aspect is that your letters are strong and your referees can demonstrate why you would be a good fit in your specialty of choice.

12. Should I pursue an additional degree in the US or Canada to increase my chances of matching?

Additional qualifications do not necessarily increase your chances of getting into residency programs. For this reason, you should only pursue an additional degree in the US or Canada if it is in line with your professional goals, not because you think it will improve your chances of matching to residency programs. You can apply to pre-residency fellowship programs, which can help you increase your chances of matching and provide you with more clinical experience in the country you plan to apply in.

13. Can international medical graduates apply for residency in Canada?

International medical graduates can apply to residency programs in Canada, so long as they are either Canadian citizens or have permanent residency status. IMGs who do not have citizenship or permanent resident status can only apply if they have the appropriate sponsorship through the Postgraduate Medical Education Office in Canada.

14. Can foreign medical graduates do residency in the US?

Yes, residency programs in the US do accept foreign medical graduates, although their status, state-level requirements and individual residency program requirements may affect their application.

To your success,

your friends at BeMo

BeMo Academic Consulting

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