International Medical Graduates & Foreign Medical Graduates face multiple barriers in the pursuit of residency positions in the United States. Historically, many residency programs never accepted International Medical Graduates in the past, and many IMG programs accept U.S. citizens only, despite being able to sponsor visas. Therefore, having knowledge of which programs are the most IMG/FMG friendly can empower you to make better-informed decisions. The great news is the trajectory is currently positive for IMG/FMG’s, and according to the Education Commission for Foreign Medical Graduates (ECFMG), “the success rate for all IMG’s in obtaining first-year residency positions was 58.8%, up from 56.6% in 2018….IMG’s are experiencing the highest match rate in more than 25 years”.

This news is good, so to empower your residency chances, even more, it’s paramount to look at the history of programs you are applying to. We’ve done some of the work for you, but the best ways to gage for an IMG/FMG friendly program are as follows:

Consider where different programs are located

Some regions of the United States tend to be more welcoming to IMG/FMGs than others. According to Dr. John Madden, an Emergency Physician who serves as Associate Dean of Students and Director of the Office of Career Guidance and Student Development at St. George’s University (SGU), the Northeast tends to be most friendly. This includes New York, New Jersey, Pennsylvania, and Connecticut. It is also important to note that most programs are looking for residents who will stay in that area after residency is completed. Therefore, an applicant should think about if the location they are applying to is somewhere they could see themselves permanently living.

Based on the 2020 NRMP Main Residency Match: Match Rates by Specialty and State study, the Top 12 IMG Friendly States are:

  1. New York (1,563)
  2. Michigan (552)
  3. Florida (540)
  4. Pennsylvania (495)
  5. New Jersey (436)
  6. Texas (384)
  7. Illinois (365)
  8. California (364)
  9. Ohio (294)
  10. Massachusetts (259)
  11. Maryland (202)
  12. Georgia (199)

(2019 NRMP report)

Choose your specialty wisely

Some specialties tend to be friendlier to IMGs/FMGs than others. Currently, there is a growing need for more primary care physicians: The Association of American Medical Colleges (AAMC) released a report comparing the supply and demand for physicians. According to the projections, the US is expected to see a shortage of primary care physicians ranging from 14,800 to 49,300 by 2030.

Internal medicine is also known as a friendly specialty for IMG’s; more than 3,200 IMG’s matched for internal medicine in 2019. While these specialties can be more welcoming to IMG/FMGs, that’s not to say an applicant should not pursue their passion. This information is merely to help you make empowered decisions.

One can search for IMG/FMG friendly medical specialties. This requires researching NRMP Match Data and adding together the US and non-US IMGs who obtained a residency position in the specialty and calculated what percent of the total positions filled were IMGs.

Using information provided by the NRMP’s Results and Data 2019 Main Residency Match, an applicant can tally which medical specialties had the highest percentage of US and non-US IMG’s in the positions filled for each specialty.

Using this method, the top 5 most IMG Friendly Medical Specialties are:


General Surgery (Preliminary)

Internal Medicine (Categorical)

Neurology (Categorical)

Family Medicine

*Detailed chart down below.

Seek help from your school 

Accessing resources from your medical school can be beneficial. Connect to an alumni program, visit your school’s counseling department, and browse their website to see if your medical school has any standing relationship with a domestic program.

Network as much as you can

Building and maintaining relationships with classmates, faculty members and researchers can help facilitate introductions. Consider networking at national or regional meetings in the specialty to which you are applying. Face-to-face meetings can plant seeds that could produce favorable outcomes down the line.

Be aware of state limitations and overall IMG friendliness of whole states.

Use data compiled from FREIDA

Using the FREIDA AMA Residency & Fellowship Database is a very powerful tool for IMGs/FMGs. FREIDA allows you to search for a residency or fellowship from more than 12,000 programs – all accredited by the Accreditation Council for Graduate Medical Education (ACGME). Use filters to narrow your search. Users can search for a program by choosing filters based on residency and/or fellowship, specialty, location, application type, program type (university-based, community-based, community-based/university-affiliated, military-based, and osteopathic recognition/focus), special tracks, salary, and average work hours per week. For IMG/FMG’s, the most important tool on this search is the option to filter for Visa’s accepted; H-1B and J-1, and % of IMG’s accepted.

Using the FRIEDA tool, the friendliest programs for Family Medicine are as follows:

  1. University of Alabama Medical Center (Selma Dallas County Program)
  2. The University of Arkansas for Medical Sciences (UAMS) College of Medicine Program
  3. Northeast Iowa Medical Education Foundation Program
  4. Mount Sinai Hospital Medical Center of Chicago Program
  5. University of Illinois College of Medicine (Rockford) Rural Program
  6. Beaumont Health (Grosse Pointe) Program
  7. University of North Dakota School of medicine and Health Sciences Program
  8. BronxCare Health System Program
  9. SUNY Health Science Center at Brooklyn Program
  10. Zucker School of Medicine at Hofstra/Northwell at Glen Cove Hospital Program

Using the same tool, the friendliest programs for Pediatrics are as follows:

  1. Cook County Health and Hospitals System Program
  2. Ascension St. John Hospital Program
  3. Saint Peter’s University Hospital Program
  4. Joseph’s University Medical Center Program
  5. BronxCare Health System Program
  6. Barnabas Hospital Program
  7. Brookdale University Hospital and Medical Center
  8. Maimonides Medical Center/Infants and Children’s Hospital of Brooklyn Program
  9. Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals/Elmhurst) Program
  10. New York Medical College (Metropolitan) Program

Residents Medical suggests using the FREIDA tool for IMG/FMGs currently looking to apply for residency this cycle. It’s important to remember that these programs while being friendly to IMG’s, expect top-tier applicants. Those with multiple USMLE steps and/or large gaps in their medical education will benefit greatly from Residents Medical’s time-tested Road to Residency. Call one of our specialists today.