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US International Medical Graduates (US IMGs)

US International Medical Graduates are medical students who are US citizens and attended medical school outside of the US. An example of US IMGs are US citizens who attended medical school in the Caribbean, United Kingdom, and beyond. US IMGs are typically in a unique position as residency candidates who do not have to apply for visas but are still categorized as IMGs.


US IMGs by the Numbers

General Facts and Statistics for the 2022 Match

  • Average USMLE® Scores for Matched US IMGs
    • USMLE Step 1: 222
    • USMLE Step 2 CK: 233
  • Match Rate: 61.4%
  • US IMGs averaged 2.5 research experiences, with 84.7% reporting at least one research experience
  • US IMGs reported an average of 4 publications per applicant, 83.7% reported at least one publication
  • US IMGs averaged 5.3 work experiences, 88.6% reported at least one work experience
  • US IMGs averaged 4.7 volunteer experiences, 88% reported at least one volunteer experience

Top 5 Most US IMG Friendly Specialties

  • Specialty (PGY-1) % of positions filled by US IMGs
  • Family Medicine 17.6%
  • FInternal Medicine 12.8%
  • Pathology 10.4%
  • Psychiatry 9.4%
  • Radiology 8.4%

Most US IMG Friendly States

  • State # of US IMGs
  • New York 537
  • Florida 424
  • California 321
  • New Jersey 243
  • Texas 202

Benefits and Challenges of Being a US IMG


  • Do not have to worry about obtaining visas
  • Education is typically comparable to the US
  • Having experience working in environments outside of the US can make you more flexible
  • Clinical rotations are often in the US


  • Still considered IMGs
  • State restrictions such as medical schools not being recognized by state medical boards
  • May have less support throughout the residency application process as Dean’s Offices are far away
  • Higher USMLE® exam score expectations

The Caribbean Myth

Many US International Medical Graduates (US IMGs) are graduates of Caribbean medical schools. This puts them in the unique situation of gaining medical education and training that is similar to US medical graduates but still being considered IMGs. There are a lot of misconceptions about being a Caribbean graduate which can cause a lot of worry and anxiety for Caribbean graduates.

Residency programs value non-Caribbean IMGs over Caribbean IMGs.

Some Caribbean IMGs believe they must find programs that are Caribbean-friendly only, but this is not true. Any IMG-friendly residency programs can consider any IMG residency candidate, but they won’t have the chance to get to know you if you do not apply out of fear or misunderstanding. Your residency program choices should be based on facts and research--not rumors and assumptions.

The residency application process is known to be changeable, therefore, even if a program does not have a history of taking Caribbean IMGs, you could be their first exposure to Caribbean IMGs and applicants from your medical school. If you impress the program, you could open the way for further applicants from your school and change the way a residency program feels about Caribbean IMGs. But, none of this can happen if you do not apply to the program or limit yourself.

Click for more Caribbean IMG information

Tips for US IMGs

It’s always important to have confidence as a residency candidate. Although it may be tempting to become over-confident as a US IMG, you must maintain the perspective of an IMG applicant. Below are some tips and recommendations to help you maximize your application.

Apply to enough programs. Try to apply to a minimum of 100 programs per specialty (or more). This can be expensive, but the more programs you apply to, the more opportunities you are giving yourself.

Check with your medical school. There are a variety of ways your medical school can help you (if willing). They are in charge of your medical school transcript and MSPE document. If possible, ask to review these documents before they get submitted.

Apply to the right residency programs. Even if you are a US citizen, if you got your MD outside of the US, you count as an IMG in the eyes of programs. Focus on IMG-friendly programs only, but keep an eye out for programs with a lot of IMGs and no visa policies. Be sure to review every program you are interested in for their minimum requirements.

Work hard on your ERAS® application. You may want to cut corners or spend less time on certain parts of your application, but try to give every section your full attention. Program Directors see thousands of applications every year, and they can tell when you’re not giving your best effort. Within your application it is important to:

  • Secure specialty specific Letters of Recommendation
  • Write strong, specialty specific Personal Statements
  • Complete the MyERAS Application and ensure it is error free. Do not simply list information in the written sections (such as the Hobbies or Experiences sections); instead offer details