Applying to residency as a US-IMG medical student

What is more stressful than applying for residency during a pandemic? Applying as an international medical graduate or IMG. IMGs are broken down into two groups, United States (US) vs non-US citizens, and the latter requires a visa to train as a resident in America. Statistically, each year more and more IMGs are accepted into residency programs throughout the nation. Despite this, there are still many stigmas revolving around international medical graduates.


Due to a large number of applications each MATCH season, programs may set filters to screen against IMGs. Therefore, a student who may have stellar board scores, GPA, and amazing letters would be automatically filtered out.



Most of the students that fall into the US-IMG category, including myself – attended a Caribbean medical school. We lived for 2 years on an island in the Caribbean while learning basic sciences and then spent 2 years rotating through different hospitals in the US for our clinical rotations. Although studying while living on an island may seem glamorous, the reality is far from it. We brave regular tropical storms and some of us, even hurricanes. We are removed from our family and friends and are thrown into a new culture and environment.


It is a humbling experience that ultimately shapes us into strong physicians.


But how do we show residency programs these qualities and strengths during the MATCH season?


Typically, away rotations at programs of interest would be the best way to showcase a student’s abilities. Applicants use this opportunity to build relationships, network, and gain valuable letters. Although US-IMGs don’t necessarily have a “home” hospital, we do have various core rotations sites where we spend most of our clinical years.


As an aspiring emergency medicine physician, it was critical to obtain at least 2 SLOE's (standard letter of evaluation) from an accredited emergency medicine residency program. I was fortunate to have had rotated at a site with an emergency medicine residency program, and I managed to attain 1 SLOE. But my subsequent EM rotations were canceled due to COVID, as medical students were removed from rotations. Fortunately, CORD had released a consensus statement for this MATCH season encouraging flexibility with the number of SLOE's and away rotations.


This residency MATCH season is making history as the most unprecedented one, like so many other things this year. But programs are adapting, in the emergency medicine community and most other residency programs, teams are taking their recruitment to the internet with virtual webinars and residency fairs. Although students are unable to physically see the environment they’ll potentially be training in for the next few years, they can meet and speak with program directors, assistant program directors, faculty, and residents from programs all over the country. Something that would have been impossible last year.


The emergency medicine community has been more than creative and adaptive with these new constraints of COVID. EMRA, the emergency medicine residents’ association, is a professional organization for EM which is also free to medical students, recently hosted a virtual residency fair for EM programs all over the nation. It is a free service that allows 4th-year medical students to register for private individual meetings with faculty, program directors, and residents at programs of interest. Also, EMRA regularly hosts IMG advising sessions that are given by program directors and IMG residents.


With the challenges of COVID, this is the year where applicants need to be proactive and research interested programs. As an IMG, it is more important than ever to leave an impression with residency programs. There are so many outlets to network as programs are recruiting through social media outlets such as Instagram and Twitter. Most programs’ residency websites will provide links to their social media accounts. I am no means a social media guru but I had taken the time to make a twitter account, used my professional ERAS photo, and provided a short bio to let programs know my areas of interest. Other than following programs, you can follow faculty or even program directors. Along this trail, I have met multiple fellow EM bound applicants – something in previous years would have occurred through the interview trails.


Fellow IMG applicants – you are so much more than your ERAS application.


It is important to show programs your interests, especially now with the limitation of away rotations. I hope my experiences are helpful to you and future applicants.


COVID has changed the game, and these changes will likely continue in the future. It is important that we be prepared now and as things progress. I wish everyone the best on this year’s residency trail.


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