Can an IMG With Good USMLE Scores Get Residency?

In this article you will learn:

  • What an ideal USMLE score looks like
  • If a typical IMG matches
  • How to improve your chances of getting a match

So let’s get started!

Quick Answer

An IMG can get into residency if they have good USMLE scores, it is just a bit harder than non-IMGs.

What Is a “Good” Usmle Score?

Because we are asking a question about if an IMG with a good USMLE score can get residency, it is important to know what counts as “good” in the USMLE scoring system.

Typically, a score of 230-345 on Step 1 is considered a good score.

However, the scores will soon become redundant due to the change of Step 1 to a pass/fail exam.

Typical USMLE scores of IMGs

The average Step 1 score of a matched US IMG around 220. If you are looking for non-competitive specialities like Family Medicine and Psychiatry, the scores can average as low as 205.

For a non-US IMG, the scores are much higher. This is because directors are always biased towards those who are from the US as there are no complications like visa difficulties and bad patient communication skills.

For Step 1, non-US IMGs average 234. If you are going for a competitive speciality, score averages can be as high as 246.

To guarantee a match though, you should be trying to aim for a score of 240 or above. This tends to be enough to get into most specialities.

IMG TypeAverage USMLE Step 1 Score
Non-US IMG234
USMLE Step 1 scores for IMGs

Step 2 is slightly different and tends to have higher scores. A matched US IMG averages 230 for their Step 2 score.

Non-US IMGs average 240.

Remember that Step 2 is much more important from January 2022 when Step 1 will be pass/fail.

IMG TypeAverage USMLE Step 2 Score
Non-US IMG240
USMLE Step 2 scores for IMGs

Please note that the above averages vary depending on which source is used so the numbers I have given are simply estimates. For more detailed numbers and statistics visit these websites:

How Many IMGs Match?

The number of IMGs that match varies.

Here is some 2020 data:

  • In total, 44,959 submitted a Match application.
  • Of these, 5167 were US IMGs and 6907 were non-US IMGs which represents about 27% of the total number that applied.
  • 61% of the IMGs that applied ended up matching.

That is pretty good considering that you can apply for multiple years in a row and therefore increase your chances further.

However, when you compare this to the 90%+ of US applicants that get matched, it is pretty low.

It is especially low if you realise that a lot of IMGs won’t be applying for competitive positions as they know that they have a worse chance. This means the 61% that end up applying are mostly aiming for less competitive jobs.

When this is taken into account, you can see how the numbers aren’t great.

Source = NRMP

Why Is It Hard for IMGs to Get Into America?

It is hard for IMGs for many reasons.

One of the reasons is that program directors that look at people’s applications have a few incentives for hiring US-trained graduates.

First off there is the complicated aspect of having visa and immigration issues. You only apply for visas after getting offered a job, and therefore the people looking at your application will know that there is an inherent risk of giving you the job.

You may find a lot of unexpected hurdles that result in delayed transfer to the US, ultimately impacting both you and your employer.

Another thing to consider is how some countries do not have the same training as US students. Their communication and patient skills may be lacking due to a different culture in their resident country.

Most importantly though, the real reason that program directors don’t hire IMGs as much is that they simply don’t need to.

There are more than enough applicants for the majority to fill their spaces with US graduates that there is never any need to go through the risk of hiring an IMG.

However, even with all of this being said, you shouldn’t get disheartened. 61% of IMGs are still able to match every year and so as long as you optimise your chances of success, you should be able to get in with no problem.

That’s what we will discuss now.

How to Optimise Your Chances of Success

It is hard for IMGs for many reasons.

Here is what you can do to optimise your chances of getting a residency position in America:

Get clinical experience during medical school

If you are still in medical school, try and get some US experience before it’s too late. Once you are a doctor it will be a lot harder to get this experience and it might be the difference between a successful and unsuccessful application.

Start early

It’s never too early to start researching and studying for the USMLE exams. They are going to be your biggest hurdle to applying to America and should be taken extremely seriously.

Find people who are also applying to the US

There are always going to be people in your friend circles who have thought about applying to America. Talk to them, get their advice. They may even know people who are extremely serious and dedicated about the process who can mentor and guide you.

Know your strengths and weaknesses

If you know that studying for the exams is going to be a breeze, you should be spending your time networking and research the plethora of other things that need to be done to make a successful application.

If on the other hand, you feel like the USMLEs are going to be critical to your success then you have to ensure you spend a lot of time preparing for them.

How to Learn More

Applying to the US as an IMG is a long and challenging process. With no one to guide you along, you could waste thousands of dollars on the wrong resources and waste dozens of hours researching material that you should be using to study.

That’s why you should check out this one of a kind course by Liberty Medics. It takes you step-by-step through the process of applying to the US as an IMG and gives you all the up to date information that you need.

If you enjoyed this article and learned something from it then you might like some of my other articles about doctors in America:

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