What are the notable trends in applicants, both US and international medical graduates (IMGs), for US medical residency programs?
If you are an IMG, this is certainly of great importance to you.
You may have heard in the US news about the volatile stock market, closing of a major teaching hospital, changing visa rules but also heard about a future physician shortage in US. So it can become very confusing and many questions come to mind about the ground reality. Are there more or less residency training positions in US? Are there more or fewer IMGs applying for residency programs? How do US medical graduates (USMGs) and IMGs perform in the residency match? Which specialties are IMGs likely to get into? We will be discussing all this and more in this blog post.
To understand the trends, we need to look at available data. The authoritative resources for this data are the NRMP data reports published every year. Let's look at some of the tables and figures now.
First question: Are there more or fewer US medical residency program positions?
The answer is: MORE! The NRMP 2019 data reports that "The 2019 Match offered 35,185 total positions, 2,018 more than last year; of those, 32,194 were PGY-1 positions, 1,962 more than in 2018. The total number of positions and the number of PGY-1 positions were all-time highs." Also, "... more than half the increase was attributable to growth in Family Medicine and Internal Medicine."
Concurrently, there are more applicants (see Figure 1 below). This is great news! It certainly is disheartening for a medical graduate to pursue training in a health care system or country with declining demands for residents. The job market for residents in US is thus growing!
Second question: How many USMGs and IMGs apply for US residency training?
There are 5 types of applicants. Let's make sure we define these types clearly:
I am sure it comes as no surprise to you that US seniors make the bulk of applicants (58.1%) who successfully match into a residency program (see Table 2 above). US seniors are most exposed to the work ethic, training and current medical practices in US hospitals and thus get the highest priority.
Osteopathic medical graduates are physicians with the title D.O. and though their medical school training is a tad different from an allopathic medical school, these graduates constitute a significant proportion of the residency applicants (16.6%).
Non-US IMGs are medical graduates from countries outside US and do not have US citizenship. I am a non-US IMG. Non-US IMGs are an important (13.2%) contribution to the US residency programs.
US citizen IMGs are medical graduates born in US (or naturalized) who chose to train outside US for a variety of reasons such as family reasons, tuition costs or desire for international experience. These graduates have no visa restrictions and are the fourth largest group of applicants (9.8%).
Former US medical graduates are a small number in the applicant pool. These are physicians who did not pursue residency training after graduation but went for other training such as Masters programs (such as Masters in Public Health (MPH), research or military service.
Third question (a very interesting one): Are there more or fewer IMGs applying and matching into US medical residency programs?
This is another important question and so let's look again at the NRMP data tables. The 2019 data show that FEWER US citizen and non-US citizen IMGs applied to US residency programs in 2019 as compared to 2018.
So there were 1.5% fewer IMG applicants (US citizen and non-US citizen) in 2019 when compared with 2018. This can be seen in the cyan bars above.
But wait! There is an encouraging finding (hint: look at the darker blue line in the figure slanting upwards). The success of IMGs in the NRMP match has been the highest (~59%) since the 1990s!
The NRMP 2019 data set reports that "Of the 5,080 U.S. IMGs who submitted rank order lists of programs, 2,997 matched to PGY-1 positions for a match rate of 59.0 percent. Of the 6,869 non-U.S citizen IMGs who submitted rank order lists of programs, 4,028 matched to PGY-1 positions for a match rate of 58.6 percent. The PGY-1 match rates for U.S. citizen IMGs and non-U.S. citizen IMGs were the highest since 1991 and 1990 respectively."
Woohoo! Now the improved match rate for IMGs could be because the denominator (that is total number of IMGs who applied) has decreased. IMHO, I look at thse data very favorably as it indicates to me that IMGs are very much still desirable by US residency programs. So, as an IMG, you still have a great chance to have a successful match in a US residency program especially if you have a stunning portfolio and stellar interview performance.
Fourth question: As a follow-up to the last question, why are there fewer IMGs applying into US residency programs?
The reason for this trend is not entirely clear, though one can speculate that visa difficulties encountered by IMGs from certain countries, improving standard of living and possibly medical training in other countries or need to be close to family in home country are possible reasons.
Fifth (and last) question: Which countries do IMGs come from?
I was unable to find very recent data from Educational Commission for Foreign Medical Graduates (ECFMG). From available 2014 NRMP data, ECFMG reports that "Not counting United States, India contributed the highest number of IMGs to the Match, followed by Pakistan. Other countries with more than 100 applicants in a category include
Canada, Nigeria, China, Iran, Iraq, and Egypt."
In conclusion, YES, 2020 is a great year for medical residency training in US. IMGs need to stay updated with any changes in visa/immigration rules that could affect their ability to travel and train in US.
That's it in this blog. Please leave your comments and questions below and do join the mailing list to receive the latest blog posts. All the best!
Before you go: Here's your golden opportunity to have your voice heard. Write down your ONE question regarding your US residency program application, personal statement, interviews or anything that has been bothering you and keeping you up at night. You can reply at the end of this blog or post a message at my Facebook page.
The top 10 popular questions will be featured on my next blog posts at https://ed4medllc.blogspot.com/ and the winners will receive a coupon each for a FREE practice interview at Ed4medus.com ! Put those thinking caps on and hurry up!
“If You Are Working On Something That You Really Care About, You Don’t Have To Be Pushed. The Vision Pulls You.” – Steve Jobs
If you are an IMG, this is certainly of great importance to you.
You may have heard in the US news about the volatile stock market, closing of a major teaching hospital, changing visa rules but also heard about a future physician shortage in US. So it can become very confusing and many questions come to mind about the ground reality. Are there more or less residency training positions in US? Are there more or fewer IMGs applying for residency programs? How do US medical graduates (USMGs) and IMGs perform in the residency match? Which specialties are IMGs likely to get into? We will be discussing all this and more in this blog post.
To understand the trends, we need to look at available data. The authoritative resources for this data are the NRMP data reports published every year. Let's look at some of the tables and figures now.
First question: Are there more or fewer US medical residency program positions?
The answer is: MORE! The NRMP 2019 data reports that "The 2019 Match offered 35,185 total positions, 2,018 more than last year; of those, 32,194 were PGY-1 positions, 1,962 more than in 2018. The total number of positions and the number of PGY-1 positions were all-time highs." Also, "... more than half the increase was attributable to growth in Family Medicine and Internal Medicine."
Concurrently, there are more applicants (see Figure 1 below). This is great news! It certainly is disheartening for a medical graduate to pursue training in a health care system or country with declining demands for residents. The job market for residents in US is thus growing!
Second question: How many USMGs and IMGs apply for US residency training?
There are 5 types of applicants. Let's make sure we define these types clearly:
- US seniors: current 4th year medical students who will graduate prior to starting residency.
- US medical graduates: former graduates of US medical schools.
- Osteopathic medical graduates: senior or graduate of US osteopathic medical schools.
- US citizen IMGs: US citizen who attended a medical school outside US.
- Non-US citizen IMGs: non-US citizen who attended a medical school outside US.
I am sure it comes as no surprise to you that US seniors make the bulk of applicants (58.1%) who successfully match into a residency program (see Table 2 above). US seniors are most exposed to the work ethic, training and current medical practices in US hospitals and thus get the highest priority.
Osteopathic medical graduates are physicians with the title D.O. and though their medical school training is a tad different from an allopathic medical school, these graduates constitute a significant proportion of the residency applicants (16.6%).
Non-US IMGs are medical graduates from countries outside US and do not have US citizenship. I am a non-US IMG. Non-US IMGs are an important (13.2%) contribution to the US residency programs.
US citizen IMGs are medical graduates born in US (or naturalized) who chose to train outside US for a variety of reasons such as family reasons, tuition costs or desire for international experience. These graduates have no visa restrictions and are the fourth largest group of applicants (9.8%).
Former US medical graduates are a small number in the applicant pool. These are physicians who did not pursue residency training after graduation but went for other training such as Masters programs (such as Masters in Public Health (MPH), research or military service.
Third question (a very interesting one): Are there more or fewer IMGs applying and matching into US medical residency programs?
This is another important question and so let's look again at the NRMP data tables. The 2019 data show that FEWER US citizen and non-US citizen IMGs applied to US residency programs in 2019 as compared to 2018.
So there were 1.5% fewer IMG applicants (US citizen and non-US citizen) in 2019 when compared with 2018. This can be seen in the cyan bars above.
But wait! There is an encouraging finding (hint: look at the darker blue line in the figure slanting upwards). The success of IMGs in the NRMP match has been the highest (~59%) since the 1990s!
The NRMP 2019 data set reports that "Of the 5,080 U.S. IMGs who submitted rank order lists of programs, 2,997 matched to PGY-1 positions for a match rate of 59.0 percent. Of the 6,869 non-U.S citizen IMGs who submitted rank order lists of programs, 4,028 matched to PGY-1 positions for a match rate of 58.6 percent. The PGY-1 match rates for U.S. citizen IMGs and non-U.S. citizen IMGs were the highest since 1991 and 1990 respectively."
Woohoo! Now the improved match rate for IMGs could be because the denominator (that is total number of IMGs who applied) has decreased. IMHO, I look at thse data very favorably as it indicates to me that IMGs are very much still desirable by US residency programs. So, as an IMG, you still have a great chance to have a successful match in a US residency program especially if you have a stunning portfolio and stellar interview performance.
Fourth question: As a follow-up to the last question, why are there fewer IMGs applying into US residency programs?
The reason for this trend is not entirely clear, though one can speculate that visa difficulties encountered by IMGs from certain countries, improving standard of living and possibly medical training in other countries or need to be close to family in home country are possible reasons.
Fifth (and last) question: Which countries do IMGs come from?
I was unable to find very recent data from Educational Commission for Foreign Medical Graduates (ECFMG). From available 2014 NRMP data, ECFMG reports that "Not counting United States, India contributed the highest number of IMGs to the Match, followed by Pakistan. Other countries with more than 100 applicants in a category include
Canada, Nigeria, China, Iran, Iraq, and Egypt."
In conclusion, YES, 2020 is a great year for medical residency training in US. IMGs need to stay updated with any changes in visa/immigration rules that could affect their ability to travel and train in US.
That's it in this blog. Please leave your comments and questions below and do join the mailing list to receive the latest blog posts. All the best!
Before you go: Here's your golden opportunity to have your voice heard. Write down your ONE question regarding your US residency program application, personal statement, interviews or anything that has been bothering you and keeping you up at night. You can reply at the end of this blog or post a message at my Facebook page.
The top 10 popular questions will be featured on my next blog posts at https://ed4medllc.blogspot.com/ and the winners will receive a coupon each for a FREE practice interview at Ed4medus.com ! Put those thinking caps on and hurry up!
“If You Are Working On Something That You Really Care About, You Don’t Have To Be Pushed. The Vision Pulls You.” – Steve Jobs
Thank you so much for your blog post. It will be certainly be encouraging to all those international doctors who feel unsure about their chances of matching.
ReplyDeleteThank you englishcoach2007, glad you liked the post!
DeleteThanks for providing such a helpful and informative blog. I really like the complete information in your blog. If someone want medical supplies for hospitals and labs Burke Slater provides these supplies at very genuine rates. Keep sharing such kind of informative blogs.
ReplyDeleteReally interesting blog post Varun! Which of the 5 groups do I fit into: UK trained GP, greencard holder now since marrying my husband and moving to the US? Not technically a Citizen but am I in that 9%?? Thanks in advance! All the very best, @la_bonne_doctor
ReplyDeleteThanks @la_bonne_doctor, that's a tough question. My hunch is that if your medical school training was in the UK, you are a non-US IMG. Typically, when program directors classify an applicant as US IMG, they question (themselves) as to why that applicant didn't pursue med school in the US or if the academic performance was so poor that he/she had to go out of US for med school. Great question - if OK, I would like to post this in my facebook.com/groups/ed4medus/ - do join the group to interact with others wishing to pursuing residency like you.
Delete