10 Things I Wish I Knew as a Foreign Medical Graduate

Updated: Sep 1, 2019






Two years ago, I left my home country of Trinidad and Tobago. After graduating in 2012 and leaving behind four years of actively practicing medicine, I decided to pursue residency in the United States and migrated with my husband. It was a difficult process, leaving my family and friends but I knew in the long run it would be the best thing for my future and my patients. I always dreamt of specializing internationally and this was my chance. I had no idea what was in store and I’ll admit I was a bit naive. Now, I have learned so much, developed a thick skin, more confidence and I am certain of where I’d like to be as a medical resident and in which specialty. 


Here are some important things I really wish I knew but was not warned of, before starting this chapter of my journey.  


*Before I begin, I’d like to differentiate that I did not attend a medical school which offered any US based exams or rotations. Everything was completely done in Trinidad under a British-based system. I am classified under a Foreign Medical Graduate (FMG) as opposed to an International Medical Graduate (IMG) who attended St. George’s university for example or any other Caribbean medical school which has a US affiliation. However, the terms IMG and FMG are still used interchangeably.


1. This process is expensive

This to me, is the most important thing to keep in mind. It requires support and savings, especially if you come from a developing country. Do not use the last of the money in your bank account as a "leap of faith". The costs add up, for example, Step 1, 2CK, 2CS and Step 3 USMLE exams alone can amount to more than $3000 (USD). Whereas American graduates do these throughout med school until internship, we have to do them back to back. 


Before you apply, you will have to apply to the Educational Commission For Foreign Medical Graduates (ECFMG) which includes getting your medical school on board and paying for official transcripts to be sent to the ECFMG. Then you will have to pay for the application fee for this, exams, materials such as UWORLD, text books, NBME exa