IMG Friendly Residency Programs

April 25, 2024
5 min read


Reviewed by:

Jonathan Preminger

Former Admissions Committee Member, Hofstra-Northwell School of Medicine

Reviewed: 4/25/24

Navigating the world of IMG friendly residency programs is a key step for international medical graduates pursuing a medical career in the US. Let’s get into it. 

If you're an international medical graduate (IMG) dreaming of a medical career in the US, your journey starts with picking the right residency program. This choice can significantly shape your medical career. 

In this blog, we'll explore IMG friendly residency programs, what that means, reveal the top states for IMGs, and help you choose the right medical specialty. Let's begin this journey towards your medical aspirations together.

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What Is IMG?

IMGs are doctors who earned their medical degrees in one country but aim to practice medicine elsewhere. They come from diverse backgrounds and have often studied in countries with different medical systems. There are three main types of IMGs:

  • Foreign Medical Graduates (FMGs): FMGs graduate from medical schools in a different country and usually need to pass additional exams and obtain certifications to practice in their desired location.
  • Caribbean Medical Graduates: Some IMGs graduate from Caribbean medical schools, which may have varying standards compared to North America or Europe. They may face specific challenges when seeking residencies or licensure in countries like the United States or Canada.
  • International Students: IMGs who studied medicine abroad as international students may want to practice either in the host country or their home nation.

To become fully licensed doctors in their new country, IMGs often must pass rigorous medical licensing exams, such as the USMLE in the United States, and complete residency or internship programs. These requirements can differ significantly depending on the country, making the journey unique for each IMG.

What Makes a Residency Program IMG Friendly?

What makes a residency program IMG friendly can vary, but there are several key factors to consider:

Acceptance of IMGs: The most crucial factor is whether the program has a history of accepting international medical graduates (IMGs). This track record demonstrates their willingness to consider applicants from different backgrounds.

USMLE Score Requirements

Many IMG-friendly programs set a minimum score requirement on the United States Medical Licensing Examination (USMLE) exams. Meeting or exceeding this score threshold can boost your chances of being considered.

Visa Sponsorship

Some programs are more open to sponsoring visas for IMGs. It's important to know whether a program is willing to support J1 or H1B visas, depending on your visa status.

Geographical Preferences

Certain programs may have preferences for graduates from specific geographical areas or medical schools. Some might favor Caribbean graduates, while others may accept applicants from Asia or elsewhere.

US Citizenship or Permanent Residence

Programs may differentiate between IMGs with US citizenship or permanent residence and those who require a visa. The latter category can be more competitive, so it's essential to understand the program's stance.

Time Since Graduation

Some programs are more accommodating to IMGs who have been out of medical school for a longer period. Others may prefer more recent graduates.

US Clinical Experience (USCE) Requirements

Check whether the program has specific requirements for US clinical experience. Some IMG friendly programs may have lighter USCE requirements, making them more accessible.

Compatibility Ranking

Consider using compatibility rankings to identify programs that are a good fit for your unique circumstances. These rankings take into account your country of graduation, exam scores, and other relevant factors.

Application Strategy

Be aware that some IMG friendly programs listed in databases like FREIDA and AAMC Residency Explorer receive a high volume of applications, making them highly competitive. Crafting an efficient application strategy is essential.

Paid Lists and Advanced Resources

Some services offer advanced lists and resources that provide comprehensive information about residency programs, including additional requirements, past match insights, and compatibility rankings based on your profile.

To sum it up, IMG friendly residency programs are ones that have a history of welcoming IMGs and are open to candidates with diverse backgrounds and visa needs. 

It's essential to grasp the unique requirements and preferences of each program to enhance your chances of a successful match. Leveraging compatibility rankings and advanced resources can guide you in finding programs that suit your profile and boost your chances of securing a residency position.

List of IMG Friendly Residency Programs in the USA

Here is a list of residency programs in the USA that are known for being IMG friendly, opening doors for international medical graduates to pursue their medical careers in the United States.

Specialty % of US IMGs % of Non-US IMGs
Anesthesiology 3.4% 4.5%
Emergency Medicine 1.23% 0.5%
Family Medicine 17.4% 9.9%
Internal Medicine 13.9% 25.6%
Medicine Preliminary (PGY-1 only) 5.1% 8.8%
Neurology 6.7% 25.5%
Obstetrics/ Gynecology 3.7% 2.3%
Pathology 11.8% 39.2%
Pediatrics 7.8% 11.5%
Psychiatry 9.2% 7%
Surgery 5.3% 4.6%
Surgery - Preliminary 12.7% 31.2%

To sum it up, these residency programs in the USA are known for their openness to international medical graduates, providing a pathway for IMGs to pursue their medical careers in the United States.

Top 25 IMG-Friendly States

These are the top 25 states in the USA where IMGs can find plenty of opportunities to kickstart their medical careers. Keep in mind that these rankings are based on the number of available residency positions rather than their percentage relative to other specialties or criteria.

  1. New York (1546 IMGs): New York consistently ranks as the top state for IMGs, offering a large number of residency positions.
  2. Florida (712 IMGs): Florida is another popular destination for IMGs, known for its diverse healthcare opportunities.
  3. Pennsylvania (597 IMGs): Pennsylvania offers a significant number of residency positions for IMGs, making it an attractive choice.
  4. Michigan (559 IMGs): Michigan has a strong presence of IMGs in its residency programs, particularly in urban areas.
  5. New Jersey (511 IMGs): New Jersey's proximity to major metropolitan areas like New York City makes it a desirable location for IMGs.
  6. Texas (487 IMGs): Texas offers a range of residency opportunities for IMGs, with several programs across the state.
  7. California (471 IMGs): California's diverse healthcare landscape attracts IMGs looking for various specialties.
  8. Illinois (360 IMGs): Illinois, home to Chicago, provides IMGs with a variety of residency options.
  9. Ohio (348 IMGs): Ohio offers numerous IMG-friendly programs, particularly in cities like Cleveland and Columbus.
  10. Massachusetts (254 IMGs): Massachusetts, with prestigious institutions like Harvard, is a hub for IMGs interested in academic medicine.
  11. Georgia (253 IMGs): Georgia provides opportunities for IMGs in both urban and rural settings.
  12. Connecticut (242 IMGs): Connecticut offers IMGs access to a range of healthcare facilities.
  13. Maryland (202 IMGs): Maryland, home to Baltimore, has several IMG-friendly programs.
  14. Louisiana (169 IMGs): Louisiana provides unique cultural experiences for IMGs along with residency opportunities.
  15. Missouri (134 IMGs): Missouri offers IMGs various programs in cities like St. Louis and Kansas City.
  16. Alabama (133 IMGs): Alabama has IMG-friendly programs for those interested in training in the southeastern US
  17. Arkansas (114 IMGs): Arkansas is known for its friendly atmosphere and offers IMGs a range of specialties.
  18. District of Columbia (104 IMGs): Washington, DC has several IMG friendly programs and provides exposure to policy making.
  19. Virginia (100 IMGs): Virginia offers residency positions for IMGs interested in diverse clinical experiences.
  20. Arizona (90 IMGs): Arizona is a popular choice for IMGs seeking a mix of urban and rural training.
  21. North Carolina (88 IMGs): North Carolina's healthcare institutions have welcomed IMGs in various specialties.
  22. Indiana (85 IMGs): Indiana offers IMGs opportunities for training in both academic and community settings.
  23. Minnesota (82 IMGs): Minnesota provides a variety of IMG friendly programs, including in Minneapolis.
  24. Wisconsin (80 IMGs): Wisconsin offers IMGs positions across different specialties.
  25. Mississippi (73 IMGs): Mississippi has IMG friendly programs with a focus on serving rural communities.

To sum it up, these states are great options for IMGs in the United States. They provide ample opportunities and a wide range of specialties to choose from. So, if you're an IMG aiming for a residency spot, these states should definitely be on your radar.

Which Specialty Should You Pursue as an IMG?

Selecting the right medical specialty as an international medical graduate is crucial. Here are key factors to help you decide:

  • IMG Friendly Specialties: Consider specialties like family medicine, internal medicine, and pediatrics, which are more welcoming to IMGs.
  • Background and Experience: Your prior medical experience matters. So, if you're experienced in a specific field, explore specialties that are related to it.
  • Clinical Rotations: Consider the rotations where you performed well during medical school; they can help point you in the right direction. 
  • Competitiveness: Be aware of specialty and residency competitiveness. Make sure to research IMG match rates to understand what your chances are and to help you prepare accordingly.
  • Long-Term Goals: Align your choice with your career aspirations, whether it's primary care, specialization, or fellowships. 
  • Geographic Preferences: Consider where you want to practice; some specialties are more in demand in specific regions.
  • Board Certification: Take time to understand the certification requirements for your chosen specialty.
  • Mentorship: Seek guidance from mentors and practicing physicians in your field.
  • Demonstrate Fit: Communicate your passion and qualifications in your application materials, like the personal statement. 
  • Application Strategy: Make sure to apply strategically to programs that match your goals.

Remember, your dedication and preparation are key to your success as an IMG, regardless of your chosen specialty.

Tips to Get Into Best IMG Friendly Residency of Your Choice

To maximize your chances of securing a spot in the best IMG friendly residency programs of your choice, consider these important tips.

Research Extensively

Start by doing your homework. Dive into the vast sea of residency programs and identify the ones that are IMG friendly and align with your chosen specialty. Websites like ERAS and NRMP are your friends here. Don't just focus on IMG friendliness; consider other factors like location, program size, and reputation, too.

Gain Clinical Experience

Having hands-on clinical experience in the US healthcare system is a big plus. Look into observerships, externships, or research opportunities in US healthcare settings. These experiences not only boost your understanding of how things work in the US but also help you make valuable connections with potential mentors and program directors.

Get High USMLE/COMLEX Scores

Scoring well on the USMLE or COMLEX exams is like opening the golden gates to more residency programs. It's a sign of your medical prowess. So, buckle down and study hard for these exams. A good score can make all the difference.

Networking and Letters of Recommendation

Networking isn't just for LinkedIn; it's crucial in the medical world, too. Build professional relationships with physicians, mentors, and faculty members who can write you stellar letters of recommendation. These letters should highlight your clinical skills, work ethic, and commitment to medicine.

Successfully Pass an Interview

Many residency programs require interviews. Don't take them lightly! Prepare thoroughly. Practice answering common interview questions and be ready to discuss your background, experiences, and why you're passionate about your chosen specialty.


If you have questions about IMG friendly specialties, you're in the right place. Explore these frequently asked questions to gain clarity on how to navigate your medical career as an International Medical Graduate.

1. What Is the Easiest IMG Residency Program?

There isn't a one-size-fits-all answer to this question as what's "easy" can vary greatly depending on your background, skills, and interests. What's most important is finding a program that aligns with your strengths and career goals. 

2. Do I Need a Clinical Experience to Match as an IMG?

Yes, clinical experience is essential for IMGs. It enhances your application and provides valuable skills and insights into the healthcare system.

3. How Important Are COMLEX/USMLE Scores?

COMLEX/USMLE scores matter but aren't everything. Clinical experience, letters of recommendation, and your personal statement also play key roles.

4. Is It Important to Have Letters of Recommendation to Match as an IMG?

Yes, letters of recommendation are vital for IMGs. They show your clinical skills and professionalism. Choose recommenders who know your abilities well.

Final Thoughts

To wrap things up, the world of IMG friendly residency programs is full of possibilities. While the journey may have its challenges, it's also filled with opportunities. With determination and a strategic approach, you can boost your chances of finding the right residency program for you.

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