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Medical students are usually anxious on Match day. Two categories of applicants exist in the United States – Foreign Medical Graduates and US Medical Graduates. Foreign medical graduates refer to those who did their medical studies outside the US whether they are US citizens or not. So what are the chances of an FMG successfully matching into a surgery residency? We will examine some facts and figures before getting an answer. Note that over the years, there has been an exponential increase in the number of candidates applying for residency programs in the US.


As of 1975, there were more vacancies than applicants into residency programs. The story changed in 2012 with 40,000 applicants competing for vacancies a little more than half the number of applicants (24,000). About 2,700 IMGs secured seats in PGY-1 while 160 were guaranteed seats in PGY-2. It was an interesting fact that while the number of admitted IMG candidates dropped, there was a rise in that of US graduates. Figures show that the higher the number of applicants, the lower the match percentage. The match percentage for IMGs dropped from 55.57% in 2003 to 48.9% in 2006. In 2012, it steeped to 40.6%. It has been predicted that by next year (2018), the number of US graduates admitted will outweigh that of IMGs for all available positions.


American Medical Graduates have nothing to fear. Research has shown that on match day, more than 90% of AMGs are usually successful. The remnants get positions without a waste of time. However, it seems to be a much arduous task for IMGs. In 2015, about 13,000 IMGs applied for residency programs. It is disheartening to note that just 50% made it through. The truth is it is difficult to get into residency programs as an IMG. Admission into specialties such as Surgery, radiology, obstetrics and gynecology and orthopedics is highly competitive. It is far simpler to match into specialties such as neurology, Internal medicine, Psychiatry, family medicine, and primary care.

The reason for the difference is evident. To be qualified for a residency, all students are required to pass through Medical Institutions in the US and Canada. Additionally, they need to complete the Step 1 and Step 2 CS and CK of USMLE, and they must partake in the NRMP (National Resident Matching Program). An IMG, on the other hand, has a waiting period of 6 months between the completion of his/her studies and commencement of a residency program. Furthermore, studies have shown that a vast number of IMGs fail to get admitted into the surgery residency program. These candidates apply the following year again. Adding this to the number of fresh applicants, one sees that there is an increase of IMGs applying for limited vacancies yearly.

Residency program directors view the IMG situation from a different angle. To them, IMGs are medical graduates who could not secure a seat in any of the US medical institutions. As such, they left to study abroad. To these directors, the US medical curriculum is of a much higher standard than that found elsewhere. Also, there is this idea that IMGs cannot or will not be able to communicate fluently with the American patient. Reasons like these cause the residency directors to keep IMGs at arm's length until more vacancies open up. To get a shot, IMGs must be gifted or extra gifted. They must have all it takes to outshine an AMG (American Medical Graduate). An IMG can stand a chance if he or she gets a magnificent letter of recommendation or has clinical experience it the US. The truth is that each year, the number of IMG applicants gets larger. What makes it worse is that the number of AMG applicants also gets larger making it a game for the fittest.