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Didn’t Match as an IMG: Next Steps to Take

  • by Dr. Mike Ren
  • Mar 30, 2022
  • Reviewed by: Amy Rontal

Practicing medicine is a privilege, and doing so in the US is a coveted one. To practice in the US, medical graduates have to take a long and difficult path. They typically complete their residency in the US to become board certified in their field.

Though international medical graduates (IMGs) undergo a similar application process, they are less likely to fill a spot in the Residency Match. The odds favor US grads: a little less than 70% of IMGs match to US based residency programs on their first attempt, compared to over 90% of US grads.

This post is for international medical graduates who had trouble matching this cycle.  Check out my recent post on an action plan to take for US grads who didn’t match.

First Steps

In case you didn’t match, the first step is the same for US grads and IMGs: do your best to figure out the reason you didn’t match. If that reason is not obvious, have an experienced set of eyes, such as your dean or program director, look over your application. Ask for honest feedback so you know what to improve. Reach out to upperclassmen or classmates who matched and ask for their opinion and applications to use as a comparison. 

Helpful Tools

Utilize tools such as FREIDA – the AMA Residency & Fellowship Database, which includes more than 12,000 ACGME accredited programs. The database provides valuable information, including applicants’ average test scores, hours of US clinical experience, and a number of publications to match successfully.

After reviewing this database, you will be able to work on filling in any missing pieces in your application to make it more competitive. If you want to know the specialties in which IMGs are most likely to match, check out the NRMP data. According to the NRMP, now those specialties include pathology, neurology, family medicine, and internal medicine. 

Ask for help

  • Reach out to classmates and professors.
  • See if there’s a research project you can jump on to squeak out some publications prior to the next application cycle.
  • Apply for an externship to stay clinically relevant and to receive an impressive letter of recommendation.
  • Hone your interview skills and demonstrate your commitment to medicine on your application for the next cycle. 

Prepare For Your Next Match

To increase your chances of matching, cast a wide net and apply to more programs. Furthermore, apply to as many IMG friendly programs as you can. To figure out which programs have historically accepted applicants from your school use the NRMP data. You can also ask your medical school dean for information.

Perhaps rural programs are a more friendly option. If you require a visa, apply to programs that will sponsor your type of visa. Make sure to keep yourself updated, as visa requirements and program policies can change year-to-year. FREIDA allows users to filter and narrow their search results, including the percentage of IMG residents as well as the visas accepted, H-1B vs. J-1.Check out each residency program’s website to see what types of residents it accepts. Do these programs accept many IMGs? Find out who the program director of your desired residency is and send that person an email to show your interest.

Lastly, complete USMLE Step 3; passing this hurdle will assure program directors of your knowledge and test taking skills.  Passing USMLE Step 3 is a good way to show your enthusiasm and passion for medicine, as well as for practicing it according to the US standards. 


About the Author

Mike is a driven tutor and supportive advisor. He received his MD from Baylor College of Medicine and then stayed for residency. He has recently taken a faculty position at Baylor because of his love for teaching. Mike’s philosophy is to elevate his students to their full potential with excellent exam scores, and successful interviews at top-tier programs. He holds the belief that you learn best from those close to you in training. Dr. Ren is passionate about his role as a mentor and has taught for much of his life – as an SAT tutor in high school, then as an MCAT instructor for the Princeton Review. At Baylor, he has held review courses for the FM shelf and board exams as Chief Resident.   For years, Dr. Ren has worked closely with the office of student affairs and has experience as an admissions advisor. He has mentored numerous students entering medical and residency and keeps in touch with many of them today as they embark on their road to aspiring physicians. His supportiveness and approachability put his students at ease and provide a safe learning environment where questions and conversation flow. For exam prep, Mike will help you develop critical reasoning skills and as an advisor he will hone your interview skills with insider knowledge to commonly asked admissions questions.