IMGs and the Match: What are my chances?

Much more than US students, IMGs have a much harder to time figuring out a satisfying answer to the “what are my chances?” game. If you haven’t already read it, I’d strongly recommend reading the “Charting Outcomes in the Match for International Medical Graduates” available at

For an example of IMG board score considerations:

Overall, matched U.S. IMGs had mean USMLE Step 1 scores of 224.5 (s.d. = 17.0) and matched non-U.S. IMGs had mean USMLE Step 1 scores of 233.8 (s.d. = 17.1), both well above the 2016 minimum passing score of 192.

Overall, matched U.S. IMGs had mean USMLE Step 2 CK scores of 232.6 (s.d. = 15.0) and matched non-U.S. IMGs had mean USMLE Step 2 CK scores of 238.8 (s.d. = 15.6), both well above the 2016 minimum passing score of 209.

This tells you a couple of important things right off the bat:

  1. Being a US citizen makes a big difference for an IMG. Needing a visa or having your English proficiency called into question requires a bump in your Step scores.
  2. Successful IMGs have higher scores than US medical graduates, but as you can see, not by as much as you might guess.

That being said, averages can be misleading. The average IMG is typically applying to less competitive fields on the whole, so within many specialties, the requirements will be substantially higher.

IMGs will doubly benefit from an “in” or personal connection at a particular program. For better or worse, IMGs have historically been funneled into high-need fields like family medicine and psychiatry. They also make up a disproportionate fraction of residents at less competitive community programs.

Note that there are some exceptions to the need to complete a residency in the states in order to practice in America. For example, radiology has an IMG alternative pathway, which is four years of fellowship at a US institution after completing residency training in a foreign country. While this is functionally equivalent to a radiology residency in duration, the competitiveness is different, as you are applying for generally less-competitive fellowships and not residency spots. See

Ultimately, no one online (definitely not me, and not even most residency consultants, I’d venture) can likely give you a great answer for your particular circumstances. Chances are your school and former classmates know the track record and what their luck has been in recent years. That’s probably your best bet.

With new medical schools opening while residency spots staying flat, competition is such that more and more programs aren’t even reading international applications except on a case by case basis for exceptional (hello research) applicants.

Broad application strategies and backup plans are a must.


Xrayvsn 11.03.18 Reply

IMG students definitely face an uphill battle.

My girlfriend graduated from a Carribean medical school and struggled (life events had her take some time off between graduating medical school and taking the USMLE exams which she had ended up not passing except the clinical one). A lot of her classmates also struggled finding a residency.

What compounds the problem is that these foreign medical schools are often way more expensive than the US counterparts and based on what she told me, do not seem to prepare the students as well. So these graduates have higher debt and a higher likelihood of never getting a job to actually help pay it off.

Zee 08.09.19 Reply

That’s bullshit, your girlfriend obviously did not study – someone who went to a “foreign medical school” and passed step1

Patrick 08.09.19 Reply

1. It’s always a gamble for an American to go to a foreign med school. You may not be able to come back home to practice medicine. Statistically speaking, there are many who don’t make it back, though you rarely hear the failures, whereas you often hear the success stories.

2. Many (not all) foreign med schools have lower admissions standards than American med schools. This means some Americans who attend foreign med schools may not necessarily have the academic chops to make it.

3. Rightly or wrongly, Caribbean med schools have a stigma against them by many US residencies. Same with med schools in other second or third world nations.

4. Also, foreign med schools tend to teach for their own population first, which is fair enough, but the problem for the American is what’s taught may or may not be relevant to the USMLEs, depending on the med school.

5. It can be difficult for Americans to adjust to living in a foreign culture which have their own unique stresses. This can impact how well they perform in med school.

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