The path to a US medical residency is a daunting one, especially as an IMG.  This site is to be used as a guide, compiled from years of experience, to help east that task and sort through the process.  If you are an International Medical Graduate (IMG), this informative guide contains everything you need to know & expect from your medical school graduation, registering for the ECFMG, applying for and taking your USMLES, costs and hidden fees, to getting through the match program & beginning your residency as a US physician. This site contains information from IMGs that have successfully matched, practicing physicians, former program directors, the latest trends and data, and vital reputable sources.

The right information must be absorbed from the outset and all available options must be analyzed to arrive at your favored outcome.  Depending on the program you have started, at this point you should have completed your first two or three years of basic science studies from your non-us based medical school, but your road to becoming a US medical resident is far from over. Many IMGs have a difficult time not only adjusting to the US healthcare system but to the overall culture and process.  This site hopes to provide support from those who have successfully been through the process.

Remember that you are truly a student even throughout residency and the process should be treated as such.  We wish you the best and good luck!


Terms & Abbreviations

There are many terms and abbreviations that are commonly used in the residency process. In combination with the numerous medical abbreviations that a Medical student is required to learn, this can become very tedious and confusing to IMGs.  Below is a listing of some common and important abbreviations and terms to know:

AMG: American Medical Graduate

GME: Graduate Medical Education

COMLEX: Comprehensive Osteopathic Medical Licensure Exam

NRMP: National Residency Match Program

AMA: American Medical Association

LOR: Letter of Recommendation

MD: Allopathic Medical Degree

DO: Osteopathic Medical Degree

Residency Match: In the United States, getting a residency is not simply an application and interview, the process involves an algorithm that matches Residency Directors top choices with physician’s top choices.

SOAP: Supplemental Offer and Acceptance Program

Internist: Someone doing a completely unpaid clinical experience for no school credit.

Clinic: A solely outpatient based medical services facility.

Hospital: A site where both inpatient and outpatient medical care is given.

Residency Relevant: This term is applied to clinical experience, if your experience was done on a site with a residency program in that field, it is known as residency relevant experience, and therefore much more valuable to a medical student.

R3: Registry, Ranking, Results. This is a system within the Match program.

ACGME: The Accreditation Council for Graduate Medical Education (ACGME) is the body responsible for accrediting the majority of graduate medical training program.  Essentially, most of the hospitals we deal with have residency training programs and are ACGME accredited.  This accreditation essentially tells the eventual application reviewer that this student gained training via a teaching hospital and gives it more weight.

“Teaching” hospital: any hospital that trains medical students and/or residents.  This may or may not be ACGME accredited.  A hospital can be a teaching hospital and not ACGME accredited.

“University” hospital: any hospital that is affiliated to a US Medical School.  These are typically attached to the medical school, ie: SUNY Downstate Medical Center is affiliated with the State University of NY (SUNY) Downstate Medical School

Preceptor: a practicing physician giving practical training to a medical student.  Essentially just means “teacher” or “instructor,” which our physicians are to our students.

ERAS: Electronic Residency Application Service (ERAS®) is a service that transmits the MyERAS application and supporting documentation from applicants and their Designated Dean’s Office to program directors.  This service is what our students use to submit their residency program applications.  This service is also where they upload the LORs provided to them by our preceptors

USMLE: there are a couple of things that you need to do before you can be considered eligible to apply for a residency in any specialty in USA. The minimum requirements of which are to pass a series of exams called United States Medical Licensing Exams (USMLE).  These are often referred to as “Steps” because of the exam structure, ie: USMLE Step 1, USMLE Step 2CK, USMLE Step 2CS, USMLE Step 3

ECFMG: If you are a foreign medical student, the organization that conducts these USMLEs is Educational Commission for Foreign Medical Graduates or ECFMG, this organization does not conduct USMLE for US medical students

Board-Certified Physician: Certification by an ABMS Member Board involves a rigorous process of testing and peer evaluation that is designed and administered by specialists in the specific area of medicine.  Not all physicians are board-certified and thus, a recommendation from a board-certified physician, especially one certified in the specific field a student wishes to pursue, is valued much more highly.

USCE: US Clinical Experience – this is what our programs qualify as: “Hands-on US clinical experience” and can be submitted as such on their residency applications.

IMG: International Medical Graduate – even though they are medical school graduates, they are still considered students in the eyes of the US medical system.  You may refer to them as students as well because they technically are in this country.

Basic Sciences: 1st year of medical school, completely class-room based, no clinicals allowed

3rd and 4th year of medical school: students are required to complete clinical rotations as part of their medical education curriculum rotating through core and elective rotations 

MBBS: Bachelor of Medicine, Bachelor of Surgery –> many Indian, Pakistani, and other Asian/Eastern European schools provide MBBS programs.  They are essentially equivalent to MDs and still call them Doctor.  The clinicals portion in an MBBS is completed in their home country, which is why they come to us for USCE. 

Intern Year: many programs abroad require their students to complete an intern year of rotations outside of their home country.  The students that want to come to the US to eventually practice medicine here opt to gain their USCE during their intern year.

WHO database – World Health Organization Database – all accredited international hospitals (our hospitals included) will show up on this list

HIPAA Certification: The Health Insurance Portability and Accountability Act of 1996,  a one-day course in which students examine HIPAA from the perspective of end users, such as nurses and administrators, who are responsible for delivering and supporting health-care related services.

OSHA Certification: (Occupational Safety and Health Standards) Blood Borne Pathogens: this certification applies to all occupational exposure to blood or other potentially infectious materials

Infection Control Certification: as required by NY State education department only; The Infection Control and Barrier Precaution law applies to the following professions: dental hygienists, dentists, licensed practical nurses, optometrists, physicians, physician assistants, podiatrists, registered professional nurses and specialist assistants.

Observership:  only refers to shadowing a physician, no hands-on experience, lowest form of USCE and we do not offer observerships

Clerkship:  refers to clinical experience for current students, typically to satisfy requirements of their medical education for medical school credit.  These are either core or elective courses

Externships:  a clinical experience for graduates.  The hands-on clinical experience is essentially the same, however, these “students” are not attempting to gain medical school credit as they have already graduates.  Most of our programs qualify as externships because most of our clientele is comprised of graduates.

Research Elective:  a research experience that medical students can undertake for academic, publishing, and/or authorship credit. They have no comparison to a Clinical Elective because its not USCE.