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IMG-Friendly Residency Programs and Specialties

Written by medschoolcoach | Mar 14, 2026 10:05:11 PM
For international medical graduates (IMGs), residencies are statistically more challenging to get into. About 16,000 IMGs apply to residency every year, but only about 9,000 make it in each year.

However, doing your homework — including reading this guide — can increase your chances of continuing into graduate medical education (GME).

There are IMG-friendly residency programs, IMG-friendly specialties, and IMG-friendly states to apply in. There aren’t residency programs designated just for IMGs; rather, there are programs that tend to have higher acceptance rates for IMG applicants.

While some IMGs face unique challenges when it comes to the NRMP Match, many IMGs match successfully each year. You can find success applying to residencies! Just follow our expert tips, and you can ask our Physician Advisors for any more guidance. 

Our Physician Advisors match 99% of US clients and 88% of IMG clients into residency.
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What Makes a Residency Program IMG-Friendly?

Several aspects make a residency program more IMG-friendly, such as:

  • Having a history of higher-than-average acceptance rates for international medical graduates.
  • Being in a state that has a high acceptance rate for IMGs.
  • Having specialty tracks that are generally easier for IMGs to get into.
  • Sponsoring visas for non-U.S. citizen IMGs.
  • Having specific application guidelines that encourage IMGs to apply, or certain admissions criteria that promote higher IMG acceptance (check a program’s website for more details).

Note: Not all international medical graduates are non-U.S. citizens. Being an IMG simply means that you graduated from medical school outside the U.S. This may include U.S. citizens who went outside the country for med school. Non-U.S. citizens who did attend med school within the U.S. are not IMGs.

Also, until recently, Canadian medical schools were treated the same as U.S. medical schools when it came to residency applications. However, as of the summer of 2025, Canadian med school graduates are now considered non-U.S. IMGs.

Learn More: Average Medical Resident Salary

IMG-Friendly States

Certain states in the U.S. have higher rates of IMG acceptance into residency programs. Usually, these IMG-friendly states are larger states with more residency programs and higher populations of non-U.S.-born immigrants and non-U.S. citizens.

Here is a list of IMG-friendly states for residency:

  • Arkansas
  • California
  • Florida
  • Georgia
  • Illinois
  • Louisiana
  • Maryland
  • Michigan
  • New Jersey
  • New York
  • Ohio
  • Pennsylvania
  • Texas

These states have a low number of total positions but a higher-than-average rate of IMG acceptance:

  • Mississippi
  • North Dakota
  • Wyoming

IMG-Friendly Specialties

There are several residency specialties that are easier for IMGs to match into. Primary care positions are less competitive for non-U.S. IMGs. And Internal Medicine has by far the greatest number and percentage of IMG residents.

  • Internal Medicine
  • Family Medicine
  • Pediatrics
  • Psychiatry
  • Neurology
  • Emergency Medicine
  • Anatomical Pathology
  • Clinical Pathology
  • General Surgery (preliminary PGY-1 positions are IMG-friendly, but not categorical positions) 
Watch our free Residency Specialty Spotlight videos to explore the daily life of residents in various specialties and hear practical advice for navigating the match process in each specialty.
Explore Different Specialties

IMG-Friendly Programs

Below are some residency programs that are friendliest to IMG applicants. We’ve also listed the specialties in which they have a significant acceptance rate for IMGs:

  • Icahn School of Medicine at Mount Sinai (Internal Medicine, Psychiatry)
  • Cook County Health and Hospitals System (Anesthesiology)
  • University of Texas Health Science Center at Houston (Vascular Surgery)
  • University of Texas Health Science Center at San Antonio (Plastic Surgery)
  • JFK Medical Center (Neurology)
  • Medical College of Georgia (Anesthesiology)
  • Larkin Community Hospital (Psychiatry)
  • Mercy Catholic Medical Center (Diagnostic Radiology)
  • Lincoln Medical and Mental Health Center (Internal Medicine, Pediatrics)
  • Mayo Clinic College of Medicine and Science (Thoracic Surgery)
  • Harvard Medical School (Nuclear Medicine, Medical Genetics & Genomics)
  • New York Medical College (Ophthalmology, Emergency Medicine)
  • University of Florida College of Medicine Jacksonville (Urology)
  • University of Missouri (Internal Medicine, Pediatrics)
  • Michigan State University (Obstetrics & Gynecology, Internal Medicine)
  • University of Arizona College of Medicine Tucson (Neurological Surgery)
  • SUNY Downstate Health Sciences University (Neurology, Radiology, Pathology, Pediatrics)
  • Damas Hospital (Transitional Year)

Least IMG-Friendly Specialties, Programs, and States

Some of the most competitive specialties are even harder for IMGs to get into. In most cases, we don’t recommend putting all your eggs in one basket; we also suggest applying for less competitive specialties to increase your chances of a successful match.

Below are the most competitive specialties, meaning the lowest match rates for IMGs:

  • Thoracic Surgery
  • Orthopedics
  • ENT (Otolaryngology)
  • Plastic Surgery
  • Neurosurgery
  • Dermatology
  • Ophthalmology
  • Urology

Read Next: Least Stressful Specialties

Here are the states where it’s hard to match into as an IMG, mainly because there are so few spots available:

  • Alaska
  • Colorado
  • Idaho
  • Montana
  • New Hampshire
  • Oregon
  • South Dakota
  • Utah
  • Vermont

Identifying IMG-Friendly Programs Yourself

Here’s a practical guide for how you can identify an individual program’s friendliness for IMG applicants:

  • While searching the AMA’s FREIDA database, use the following FREIDA filters to find the IMG-friendliest programs for your unique situation. This includes IMG %, visa options, and location.
  • Check a program’s website for more details. Feel free to contact them using the provided information, such as an email address or phone number, to ask the program director questions about their unique process.
  • Review NRMP Charting Outcomes for IMG statistics on specific programs and specialties.
  • Use a program’s Instagram or LinkedIn to search for IMG representation and to see if you could envision yourself as a resident there.
  • Talk to alumni about a program’s IMG-friendliness. Network with alumni via Reddit, school-specific forums, at virtual networking events, or through social media. You can find out about IMG friendliness, as well as whether the program culture aligns with your needs.

High-Yield Strategies for Matching

Below are some expert tips for IMGs to match into their ideal residency:

  • Get U.S. clinical experience (USCE). Hands-on experience with patient exposure will always be preferable to observerships and basic shadowing. Aim for clinical rotations in your desired specialty.
  • Obtain strong letters of recommendation. These need to be from U.S. healthcare workers. Provide your CV to letter writers so they have more strengths to talk about.
  • Aim for a solid Step 2 CK score. Since Step 1 is now Pass/Fail, your Step 2 score is more important than ever.
  • Write a compelling personal statement. Tailor it to your desired specialty, and weave in a powerful narrative that illustrates why you’re an IMG looking to come to this program.
  • Apply broadly, and apply strategically. You should apply to about 100 programs. However, you should be strategic in applying to IMG-friendly states and specialties, as well as programs that are appropriate for your candidacy strengths. 
  • Use program signals. These are free to use and can increase your odds of getting an interview invite. Some programs do not participate in program signaling.
  • Hone your interview skills. Since the residency interview is even more important for IMGs than U.S. medical graduates, you need to brush up on your interview skills and commonly asked questions. Come up with strong answers to frequently asked questions and practice answering out loud with a peer or mentor. Read this article on the best residency interview tips.
  • Consider sending a letter of intent. An LOI can indicate to one (and only one) program that they are your first choice. Even though it’s not legally binding, an LOI is an ethically binding recognition that you will put this program at the top of your ROL.
  • Know SOAP. Just in case you don’t match at the beginning of Match Week, review the SOAP process of applying to unfilled positions throughout Match Week.

FAQs

International medical graduates (IMGs) primarily use the J-1 Exchange Visitor Visa or the H-1B Temporary Worker Visa for residency. Rarer options include the O-1 Visa.

Here are more details on the different visas: 

  • J-1: ECFMG-sponsored, with a 2-year home residency rule
  • H-1B: hospital-sponsored, no 2-year rule
  • O-1: for extraordinary ability or transitioning from other statuses, like F-1 OPT

Although the average IMG Step 2 CK score is in the 240s, you should aim for higher than 250 to be competitive in most residency specialties. USMLE scores are a major factor for residency applicants to receive an interview invitation — the most significant factor for many residency positions. 

With USMLE Step 1 now graded as Pass/Fail, it’s more important than ever to get good Step 2 scores. Learn more about Step 2 tutoring here.

Certain U.S. states have pathways for IMGs to obtain full or partial medical licensure without completing U.S. residency, often requiring extensive international training or supervised practice. Those states include: 

  • Arizona
  • Arkansas
  • Florida
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Massachusetts
  • Minnesota
  • Nevada
  • North Carolina
  • Oregon
  • Rhode Island
  • Tennessee
  • Texas
  • Virginia
  • Wisconsin

IMGs may face certain challenges when applying to residency programs, including a general bias against accepting international graduates. That said, there are plenty of ways to improve your chances of matching into competitive specialties, including: 

  • Clinical experience in the U.S.
  • Higher than average research hours.
  • 255+ on USMLE Step 2 CK.
  • Strong letter of recommendation from U.S. physicians/faculty.
  • Professionally edited personal statement.
  • Applying to a state that’s friendly to IMGs.

Improve Your Chances of Getting Matched

IMGs face unique challenges when applying to residency, but there are several strategies for increasing your chances of a successful match. You can apply to IMG-friendly programs in IMG-friendly specialties in IMG-friendly states.

You can also seek out application counseling for personal statement editing, USMLE coaching, ERAS advice, and more. MedSchoolCoach has qualified Physician Advisors standing by, ready to help medical students preparing for residency just like you!

We match 99% of US clients and 88% of IMG clients into residency. Build your application alongside a Physician Advisor with admissions committee experience.
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Amar Mandalia, MD

Dr. Mandalia is an accomplished medical writer with multiple manuscripts in peer-reviewed journals and a practicing GI physician in the Orlando area. He is the Admissions Advisor for MedSchoolCoach and has extensive experience helping students get into medical school and residency.
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