Becoming a practicing physician in the USA
So, you’ve already completed (or will be completing) your medical training outside of the US, but you want to move to the US and practice medicine. This is a long and sometimes complicated road, but with the right skills and the determination to succeed can be accomplished! This guide is an introduction to some of the basic things you need to know to navigate the complicated waters that an international medical graduate (IMG) needs to complete the process. Many of the rules you need to follow do change over time, so consult the official websites for the various authorities for up to date information.
You CAN make it into a US residency!
There are a huge number of IMGs in US residency programs. IMGs also make up about 24% of ALL practicing physicians in the USA! Many of these positions have been filled in primary care specialties. These include family medicine, internal medicine and pediatrics. Some specialties are called “competitive specialties” especially for IMGs, and these include surgical subspecialties, ophthalmology, radiology, and radiation oncology. These are extra difficult to successfully gain entrance to for a number of reasons. First, there are far fewer open positions available, so naturally, most applicants (US and IMGs) are matching in primary care specialties. Second, many of the most competitive specialties require or strongly recommend elective rotations at their institutions or comparative US hospitals which is often difficult for international graduates to accomplish. This is not to say that it is impossible to match in these competitive areas, but be prepared to have a back up plan, just in case. From the table below, you can see that you have about 6000 spots each year if you’re an IMG.
|
Positions Available
|
Filled by IMG
|
Percentage
|
|
| TOTAL – PGY1 1st Year Positions |
20072 |
6013 |
30.0% |
| Specialty | |||
| Internal Medicine |
4636 |
1968 |
42.5% |
| Family Practice |
2307 |
1184 |
51.3% |
| Pediatrics |
2209 |
541 |
24.5% |
| Psychiatry |
983 |
340 |
34.6% |
| Obstetrics-Gynecology |
1130 |
295 |
26.1% |
| Preliminary (PGY-1 Only) |
1749 |
280 |
16.0% |
| Emergency Medicine |
1218 |
274 |
22.5% |
| Preliminary (PGY-1 Only) |
748 |
268 |
35.8% |
| General Surgery |
1046 |
174 |
16.6% |
| Pathology |
480 |
165 |
34.4% |
| Primary |
284 |
119 |
41.9% |
| Anesthesiology |
539 |
88 |
16.3% |
| Transitional (PGY1-Only) |
972 |
84 |
8.6% |
| Medicine-Pediatrics |
344 |
50 |
14.5% |
| Orthopaedic Surgery |
599 |
48 |
8.0% |
| Physical Medicine & Rehab |
76 |
29 |
38.2% |
| Primary |
86 |
29 |
33.7% |
| Radiology-Diagnostic |
123 |
18 |
14.6% |
| Otolaryngology |
259 |
16 |
6.2% |
| Neurology |
34 |
13 |
38.2% |
| Medicine-Emerg Med |
22 |
5 |
22.7% |
| Peds/Psych/Child Psych |
20 |
2 |
10.0% |
| Dermatology |
30 |
2 |
6.7% |
| Urology |
12 |
1 |
8.3% |
| Neurological Surgery |
16 |
1 |
6.3% |
| Plastic Surgery |
88 |
4 |
4.5% |
| Radiation Oncology |
17 |
0 |
0.0% |
These 2 tables give a great idea on 2 concepts. First you can see the number of open spots for residency each year in a given specialty. The Primary Care specialties are the largest, including Internal Medicine, Family Practice, and Pediatrics. They also have the largest number and percentage of IMG residents in each field. These would be considered less competitive.
In smaller programs such as the surgical subspecialties there are very few positions to begin with and extremely few IMGs match in these specialties. Not to say it’s impossible, but for example, there are only 88 spots offered in plastic surgery and just 4 IMGs were able to match in plastics. No IMGs matched for 1st year Radiation Oncology programs (9 matched for 2nd year positions – in 2006, not shown here.) Smaller programs naturally will be more competitive and more difficult to match in for all applicants, not only IMGs.
Where do the IMGs come from?
If you are curious to know the country of origin of many IMGs in the US, visit our statistics page which details the Top 20 countries IMGs received their medical training. If your country is not listed, this does not mean you are out of luck, remember that it also reflects the sheer number of immigrants and applicants from those countries. Sometimes the “underrepresented” countries do better in the US residency match, especially those from more Western countries where the medical training (and/or language) may be perceived to be more similar to US medical training. If you are from a country which has a similar training or practice structure to the US, you’ll want to emphasize this when you apply.
Top 20 countries where IMGs received medical training
The following list ranks the top 20 countries where the largest numbers of U.S. physicians trained. These data do not represent citizenship or ethnic origin; they only represent the location of the medical school where the U.S. practicing physician obtained their medical degree.
- India – 24.0% (44,585)
- Philippines – 10.6% (19,656)
- Mexico – 6.7% (12,448)
- Pakistan – 5.7% (10,689)
- Dominican Republic – 3.8% (7,147)
- Russia – 2.9% (5,343)
- Grenada – 2.8% (5,196)
- Egypt – 2.6% (4,884)
- Italy – 2.5% (4,755)
- South Korea – 2.5% (4,676)
- China – 2.4% (4,523)
- Iran – 2.3% (4,355)
- Spain – 2.3% (4,332)
- Germany – 2.3% (4,269)
- Dominica – 2.1% (4,050)
- Syria – 1.8% (3,491)
- Israel – 1.6% (3,098)
- Colombia 1.6% (3,095)
- England- 1.6% (3,071)
- Lebanon 1.5% (2,871)
Total IMG population in United States – 23.3% (185,234)