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Non-US International Medical Graduates (Non-US IMGs)

Non-US International Medical Graduates (Non-US IMGs) are medical students who are citizens of countries outside of the US and have attended medical schools outside of the US. An example of this is someone who attends medical school in their home country and decides to pursue residency training in the US.


Non-US IMGs by the Numbers

General Facts and Statistics for the 2022 Match

  • Average USMLE® Scores for Matched Non-US IMGs
    • USMLE Step 1: 235
    • USMLE Step 2 CK: 243
  • Match Rate: 58.1%
  • More Non-US IMGs reported having a Ph.D. (2.5%) than US IMGs (1.2%)
  • Non-US IMGs averaged 2.9 research experiences, with 88% reporting at least one research experience
  • Non-US IMGs reported an average of 7.3 publications per applicant, 88.1% reported at least one publication
  • Non-US IMGs averaged 6.3 work experience, 92% reported at least one work experience
  • Non-US IMGs averaged 4.3 volunteer experiences, 90.1% reported at least one volunteer experience

Top 5 Most US IMG Friendly Specialties

  • Specialty (PGY-1) % of positions filled by Non-US IMGs
  • Pathology 30.5%
  • Internal Medicine 28.5%
  • Neurology 20.2%
  • Child Neurology 13.8%
  • Pediatrics 12.5%

Most US IMG Friendly States

  • State # of US IMGs
  • New York 1020
  • Pennsylvania 439
  • Michigan 380
  • Florida 293
  • Texas 288

Benefits and Challenges of Being a US IMG


  • Training often includes lots of diverse experience
  • Much more flexible
  • Has more language proficiencies
  • Typically has more interesting information to put in the Personal Statement


  • Visas with their many rules and stipulations
  • Higher USMLE® score expectations
  • Requires US Clinical Experience (USCE)
  • May be more difficult to acquire application documents

IMGs and Visa Sponsorship

If you are planning on obtaining a US medical residency position and are not a US citizen, do not have a Green Card, Permanent Residency, or an Employment Authorization Document (EAD), you will need to learn about your visa options. There are two main visas Non-US International Medical Graduates (IMGs) can obtain in order to train in the US.

J-1 Visa

General Information:

  • A temporary, non-immigrant visa given for an educational training
  • The J-1 visa is easier to obtain than the H-1B visa
  • Sponsored and regulated by ECFMG®
  • Heavily regulated by the Department of State and ECFMG®
  • Limited to duration of training (Maximum is 7 years)

ECFMG® Requirements:

  • Must fill out Form DS-2019
  • Maintain a valid passport
  • Secure and maintain required health and accident insurance
  • Report any address changes within 10 days to ECFMG® through ECFMG’s On-line Applicant Status and Information System (OASIS) or the MyECFMG mobile app
  • Engage in full-time training at the host institution identified (GME Contract or Offer Letter required)
  • Notify ECFMG® of any proposed changes to your training plan (e.g., training levels, training dates, resignation, etc.)
  • Adhere to all U.S. laws
  • “Statement of Need” from Ministry of Health in the country of most recent legal permanent residence

H1-B Visa

General Information:

  • Must be sponsored by willing residency programs
  • A temporary work visa
  • Much harder to obtain than a J-1 visa
  • Limited to three years with a three year extension possible (Maximum is 6 years)


  • Medical Residency offer from a program that sponsors H1-B visas
  • Graduation from medical school (Copy of medical diploma required)
  • ECFMG® Certification (Copy of ECFMG® Certificate required)
  • USMLE Step 1, USMLE Step 2 CK, and USMLE Step 3 taken and scores reported (Copy of USMLE transcript required)
  • State Medical License or other authorization to practice medicine in the state of intended employment (if such license/authorization is required by the state)
  • Valid passport

J-1 vs. H1-B

State H1-B H1-B
Requires 2-year home residency after training Yes No
Requires ECFMG® Certification Yes Yes
Requires USMLE Step 3 No Yes
Sponsored by ECFMG® Yes No
Sponsored by programs No Yes

Visas and Program Requirements

Visas are a large residency application factor for Non-US IMGs. Non-US IMGs are responsible for researching individual medical residency program’s via policies. For example, some residency programs may:

  • Accept J-1 visas only
  • Sponsor H1-B visas only
  • Accept J-1 visas and sponsor H1-B visas
  • Do not accept J-1 visas nor sponsor H1-B visas

Researching residency programs and their visa policies properly will help Non-US IMGs conserve resources and increase chances of finding the right residency program. Keep in mind you don’t have to do this alone! Match A Resident’s Customized Lists have individualized visa filters to help Non-US IMGs find residency programs, no matter your visa needs.

Tips for Non-US IMGs

The path to success for Non-US International Medical Graduates (Non-US IMGs) may have more twists and turns than a US medical graduate (USMG), but there are tricks Non-US IMGs can incorporate into their residency application efforts to make a greater impact on their chances.

Educate yourself. The residency application process comes with endless procedures and time sensitive activities. The more you learn about the overall residency process, the easier your journey will be and the less chance you have of missing something crucial.

Start early. Applications may not open until early September, but do not underestimate how long it takes to gather all of the ERAS® Application components. There are transcripts, documents, writing, and program research to accomplish. Start in May or June to give yourself enough time. An incomplete or rushed application does not look good to Program Directors.

Get US Clinical Experience (USCE). USCE is defined as hands-on work with patients in a US medical environment. Typically this takes the form of Externships, Clerkships, and/or any clinical rotations you complete in the US. USCE can get you US-based Letters of Recommendation, and many programs require USCE. It is an incredible boost to your ERAS® Application.

Research Programs carefully and apply broadly. NRMP® data supports that successful IMG candidates apply to, interview in, and rank 2-3 medical specialties. Pick your specialties realistically and research each program meticulously. Each program has a unique set of requirements, and you do not want to waste your time and money on incompatible program selections.