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Old 05-31-2011
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Arrow IMG Participation in NRMP

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Purpose International medical graduates (IMGs) are an important part of U.S. graduate medical education (GME) and medical practice. They make up a significant number of the participants in both the Electronic Residency Application Service (ERAS) and the National Resident Matching Program (NRMP). The authors analyze and report statistics describing the multiple pathways used by IMGs in pursuit of a U.S. residency position.

Although the whole study is quiet lengthy, i'll post the salient points:

The process of seeking a residency position is stressful for all candidates, but it is especially so for international medical graduates (IMGs). Before they are eligible to participate in a residency in the United States, IMGs must pass Step 1 (Basic Science) and Step 2 (Clinical Knowledge and Clinical Skills) of the same United States Medical Licensing Examination (USMLE) required of U.S. graduates, and they must have their credentials verified by the Educational Commission for Foreign Medical Graduates (ECFMG). The pass rate in 2008 for first-time IMG takers of Step 1 was only 73%; for Step 2 Clinical Knowledge it was 81%, and for Step 2 Clinical Skills it was 72%. Many who fail on the first try continue taking the examinations, and some eventually pass.[2]

In the competition for available residency positions, IMGs have a more difficult time because they typically have lower scores on the USMLE, may be graduates of schools unfamiliar to residency program directors, may have problems with visa requirements, and may have to travel much longer distances to interview sites. Even IMGs who are U.S. citizens, many of whom have completed clerkship rotations in the United States, face some of those hurdles. In fact, U.S.-citizen IMGs have lower pass rates on Step 1 and Step 2 Clinical Knowledge than do IMGs who are not U.S. citizens.[2,3] Nevertheless, given the array of factors that come into play in the selection process, U.S.-citizen IMGs, as a group, are still more likely to eventually obtain graduate training positions.[4]
Despite the difficulties they encounter, many IMGs have been capable students, make competent residents,[5] perform well as physicians,[6,7] and help to diversify the physician workforce.[8] They are an important component of the U.S. system of medical care. They make up 23.5% of practicing physicians[9] and 27.6% of residents,[10] but constitute 47.1% of ERAS applicants[11] and 43.8% of NRMP participants.[12] The disproportionate numbers of applicants in relation to practicing physicians reflects not only the failure of many IMGs to find a position but also the fact that many IMGs repeat their efforts in one or more additional years.


IMGs are persistent in their pursuit of GME positions. They usually take advantage of ERAS and participate in the NRMP. If unsuccessful, they try again, often multiple times. Eventually, more than three-fourths of this study cohort successfully entered U.S. GME. Nonetheless, NRMP data demonstrate the declining success rate of IMGs in the Match. Between the 2005 and 2009 Matches, the percentage of IMGs who certified ROLs and matched to first-year residency positions fell from 54.7% to 47.8% for U.S. citizens and from 55.6% to 41.6% for non-U.S. citizens.[12] Because enrollment in U.S. MD-granting and DO-granting medical schools is increasing much more rapidly than the number of entry-level residency positions,[10,14] competition for residency positions will intensify, especially for IMGs.

In a subsequent work, we will compare the characteristics of successful and unsuccessful IMG candidates, including examination performance, and further elucidate the differences between US IMGs and non-US IMGs. Given the contribution of IMGs to the U.S. physician patient care workforce, the data provided in the current report, combined with the results from additional past and future longitudinal investigations, can inform relevant physician workforce policies and help organizations involved with the certification, selection, and education of IMGs to better plan for future activities.
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add1 (05-31-2011)

Old 05-31-2011
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Listen guys....
as steptaker previously mentioned, in order to secure residency:
- Good usmle scores
- US LoRs

So please...just focus on that and don't worry@ good luck
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acr2503 (05-31-2011)
Old 06-01-2011
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give those 10 and 14 references to us mentioned in that stude
they seem to be the most imp part of this study
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Old 06-01-2011
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Originally Posted by rahul usmle View Post
give those 10 and 14 references to us mentioned in that stude
they seem to be the most imp part of this study
Its just tabulated data from NRMP and ECFMG (the Data they release from the
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