Medical Residency in the U.S. a comprehensive Guide IMGPrep

A Comprehensive Guide for International Medical Graduates Seeking Residency in the United States

June 9, 2023


Medical Residency in United States Step By Step

As an International Medical Graduate (IMG), gaining medical residency in the United States can be a multi-step, rigorous process. Knowing the requirements and following the correct procedure is essential to succeed in this endeavor. Here’s a step-by-step guide to help you navigate through the residency application process.

1. Register for the USMLE with ECFMG

Start by registering with the Educational Commission for Foreign Medical Graduates (ECFMG), a member of Intealth. This organization certifies the qualifications of IMGs, paving the way for you to embark on your U.S. graduate medical education or “residency” training journey. The registration initiates the Electronic Residency Application Service (ERAS) application process.

2. Pass the USMLE Exams

The United States Medical Licensing Examination (USMLE) is a three-step examination that’s pivotal for medical licensure in the United States.

  • USMLE Step 1 assesses your understanding and application of basic medical sciences.
  • USMLE Step 2 CK evaluates your foundational knowledge of clinical science and patient care. On the other hand, USMLE Step 2 CS tests your capability to apply medical knowledge in a real-life patient-oriented setting.
  • USMLE Step 3, the final exam, tests your ability to provide patient care in an outpatient setting. It can be taken before applying for IMG residency or at the conclusion of an internship year.

3. Gain Valuable Clinical Experience in the U.S.

Securing clinical experience in teaching hospitals and similar organizations in the U.S. can augment your candidacy for residency. Some institutions also offer clinical rotation opportunities, which can provide a practical understanding of the healthcare system.

4. Register with the Association of American Medical Colleges (AAMC)

AAMC provides a centralized online service, MyERAS Portal, for the ERAS, which is used for applying to residency programs. You can also use the AAMC’s FindAResident program, a year-round search tool to find open residency and fellowship positions.

5. Choose a Residency Program

FREIDA Online, an AMA Residency & Fellowship Database, is an excellent resource to help you choose a residency program. It contains profiles of more than 12,000 ACGME-accredited graduate medical education training programs. Your USMLE scores play a crucial role in determining your competitiveness in the residency match.

6. Acquire ECFMG Certification

Acquiring ECFMG certification involves several steps:

  • Pass the USMLE Step 1 and Step 2 (CK) exams.
  • Pass the USMLE Step 2 (CS) clinical skills requirement. If you face difficulties, ECFMG has specific pathways to aid you.
  • Clear any outstanding payments on your ECFMG account to avoid any delay in receiving your ECFMG certification.
  • You will then receive an ECFMG certification application, including a USMLE/ECFMG 14 digit-ID number.
  • Ensure all your identifying information on the ECFMG record is correct, which is crucial for applying for licensure.

7. Submit Your ERAS Application

Once you have identified the medical residency programs that suit your needs and qualifications, apply to them through ERAS. You’ll need to include supporting documents such as a residency personal statement, ERAS Common Application Form, curriculum vitae, and letters of recommendation.

8. Prepare for Medical Residency Interviews

Post submission of your ERAS application, you may be called for interviews at one or more residency programs. Preparing meticulously for this stage is essential. Some organizations offer mock interviews to assist with this process.

9. Register with the National Residency Match Program (NRMP)

The NRMP operates the annual Residency Match, which pairs IMG residency applicants with residency and fellowship programs. The Residency Match uses “rank order lists” submitted by both applicants and program directors to match applicants with programs.

You will need to register with NRMP using the appropriate identification numbers: USMLE® ID for U.S. MD students/graduates, ECFMG ID for IMG, AOA ID, and NBOME® ID for U.S. DO students/graduates.

After registering, update your profile in ERAS with your NRMP ID to allow you to use the ERAS Residency Match.

By adhering to these steps, you can make the challenging process of obtaining a residency in the U.S. more manageable. Don’t forget to refer to the International Medical Graduates toolkit for more detailed information on visas, finding a residency, mentorships, and more. Best of luck with your medical career in the U.S.!

IMGPrep is a leading educational consulting firm dedicated to assisting IMGs in reaching their goals, dreams, and potential. Check out our other Articles and learn more about IMGPrep services at:

IMGprep is not associated with the AAMC® NRMP®the MATCH® or the ECFMG®