U.S. IMG vs Non-U.S. IMG 2025 Residency Match: What IMGs Need to Know
April 21, 2025
The 2025 NRMP Main Residency Match was the largest in history, with a record 52,498 applicants vying for 43,237 positions—a 4.2% increase from 2024. But amid rising numbers, what do the outcomes mean for international medical graduates — and how does being a U.S. IMG vs Non-U.S. IMG influence your chances of matching?
Understanding IMG Categories: U.S. IMG vs Non-U.S. IMG
The NRMP defines IMGs in two distinct groups:
- U.S. IMG: A graduate of an international medical school who is a U.S. citizen or green card holder.
- Non-U.S. IMG: A graduate who requires visa sponsorship (typically J-1 or H-1B).
This distinction affects program eligibility and match rates across the board.
1. A Growing Applicant Pool — But Not Evenly Matched
- Non-U.S. IMG match rate: 58.0% (down 0.5%)
- U.S. IMG match rate: 67.8% (up 0.8%)
The data confirms that match outcomes differ significantly for U.S. IMG vs Non-U.S. IMG applicants.
2. U.S. Legal Status: A Hidden Advantage in Program Eligibility
Programs that only consider green card holders or citizens create a smaller applicant pool. For example, a U.S. IMG may be eligible for 150 programs while a Non-U.S. IMG may only qualify for 50. This dramatically shifts the odds.
3. Primary Care is Still the Gateway — But It’s Getting Tougher
- Internal Medicine: 96.8% fill rate
- Family Medicine: 85.0% fill rate (down)
- Pediatrics: 95.3% fill rate (rebounded)
4. IMG-Friendly Specialties in 2025
- Pathology: 27% IMG
- Neurology: 28% IMG
- Psychiatry: Strong uptake
5. Transitional and Preliminary Year Slots: Strategic Entry Points
Over 2,200 Prelim/TY slots were offered — many filled by IMGs using these positions as stepping stones to categorical roles.
6. SOAP is Shrinking — Plan Ahead
Only 2,521 positions were available via SOAP in 2025. That’s down from 2024, despite more total Match positions. It’s not a dependable backup plan.
Top 5 Questions IMGs Are Asking Right Now
- Is it getting harder for Non-U.S. IMGs? Yes — the visa barrier matters more than ever.
- Which specialties are best for IMGs? Internal Medicine, Neurology, Pathology, Pediatrics.
- Does green card or U.S. citizenship help? Absolutely — it opens far more programs.
- Are Prelim/TY years worth it? Yes — for gaining U.S. experience and strong LORs.
- Should I count on SOAP? No — it’s shrinking and hyper-competitive.
About Us
Established in 2005, IMGPrep assists International Medical Graduates in searching for U.S residency positions. We offer a complete set of affordable services. Our experts evaluate each IMG candidate and suggest what is needed for a medical residency match in the USA.
