Practicing medicine is appeals to many international medical students. Hence, the need to know how to apply for resident medical doctors in the USA is a necessity.
But the U.S. requires these physicians to undergo an extensive process including doing residency abroad in America.
One way to avoid completing two residencies, which could take as long as 10 years, is to complete just one medical residency in the United States.
However, this can be challenging due to a shortage of slots in medical residency programs in many states and roadblocks for international students qualifying for financial aid.
After ECFMG certification, physicians who wish to practice medicine in the United States must complete an accredited residency training program in the United States or Canada.
This process will take at least 3 years. The physician will have to complete a residency program regardless of the training they have received overseas.
Is Choosing a Residency Program in the US the Best?
There are 4 tracks within an internal medicine residency program: transitional, preliminary, categorical, and primary care.
It is best to choose the program that best suits one’s individual needs and goals.
- Transitional programs rotate 1st-year residents through hospitals every 2–3 months. A transitional program counts as 1 year of training, but it may not provide enough credits to move to the 2nd year of training.
- Preliminary programs are 1-year programs for those wishing to specialize and who need a year of internal medicine training.
- Categorical programs are considered more traditional and hospital-based. These are 3-year programs that may allow residents to train up to board eligibility if performance is satisfactory.
- Primary care programs provide increased emphasis on ambulatory care experience in the community and are becoming more prevalent. Those who are sure that they will be working as a generalist are advised to apply to a primary care program.
Who is Qualified for a residency program
International medical graduates who have received a visa are eligible to apply for a residency program in the United States.
It is strongly encouraged that international medical graduates participate in an observership rotation in a clinical setting before applying to a residency program.
This allows international medical graduates to become familiar with clinical practice settings and meet physicians who can be used as references during the residency application process.
International medical graduates (IMGs) can qualify for U.S. medical residencies in some circumstances. An IMG is someone who attended a non-U.S. and non-Canadian medical school.
Everyone who attended one of these schools is considered an IMG, including U.S. and Canadian citizens and permanent residents.
IMGs must apply and qualify for certification by the Educational Commission for Foreign Medical Graduates (ECFMG).
Certification requires applicants to pass a series of examinations called the United States Medical Licensing Examinations.
It also requires them to have attended an educational institution approved by the ECFMG.
With respect to the latter requirement, applicants can consult the World Directory of Medical Schools to find out if their education meets the requirements of the ECFMG.
The examination requirement is split into three parts:
The United States Medical Licensing Examination (USMLE): Part 1
Part 1 is a seven-hour exam that tests the student’s ability to apply scientific concepts to the practice of medicine. It is taken over the course of eight hours.
The United States Medical Licensing Examination (USMLE): Part 2 (Clinical Knowledge)
Part 2 (Clinical Knowledge) is an eight-hour exam administered over the course of 9 hours. It tests the student’s ability to apply medical knowledge and skills in a clinical environment.
The United States Medical Licensing Examination (USMLE): Part 2 (Clinical Skills)
Part 2 (Clinical Skills) requires students to assess standardized patients and gather information from them, perform physical exams, and communicate their findings to patients and colleagues.
According to the American Academy of Family Physicians, it’s important to take Part 2 (Clinical Skills) well before December 31 of the year you’re applying to Match.
The AAFP suggests scheduling it no later than March of the year you intend to apply.
How much are resident doctors paid in the USA?
The average resident salary in 2017 was $57,200, compared with the average pay of $247,319 for licensed medical doctors, with a specialty in internal medicine.
Residents in hematology earn the highest pay at $69,000, followed by those in allergy, immunology, and nephrology, with an annual salary of $65,000.
Obtaining a medical residency
International medical graduates should submit applications to a minimum of 25 programs to have the best chance of being matched to a residency program.
Applicants must register with the National Resident Matching Program (NRMP), which matches applicants and hospital residency programs according to individual preferences.
Certain residency programs require applicants to apply through the Electronic Residency Application Service (ERAS), administered by the ECFMG for IMGs.
Related post: 10 Best Medical Schools in Tennessee 2020 | Application
Find more information on how to apply for residency programs in the AMA Career Planning Resource.
Preparing for residency doctor application
The process of finding a residency has become increasingly more competitive, therefore international medical graduate applicants should pay more attention to the application itself to stand out. Interviews are granted solely on the basis of the application.
How to Apply for a Medical Residency in the USA
- Present the application neatly and free of grammar and spelling errors. All applications should be original.
- Highlight any unique qualifications, academic experiences, and volunteer work and test scores on the curriculum vitae.
- Gain experience in a U.S. health care facility before applying to a residency to assist in getting a strong letter of recommendation. While letters of recommendation from overseas schools are important, they are not comparable to U.S. schools.
- Ensure the application is filled out correctly, including your NRMP applicant number if you are registered for The Match.
- Write a personal statement that addresses your unique abilities as an applicant, even if a personal statement is required for your application.
- Be prepared to answer questions pertaining to your immigration status and visa status if you are a non-U.S. citizen.
The Cost of Applying for Medical Residency
Though the costs associated with applying for a residency position will be a minor portion of the total cost of your medical education, they can still add up. Because application fees are not always covered by student loans, it is important to develop a plan early on for how you will manage these expenses.
The residency selection process includes application fees for two items: initially ERAS® and later, the NRMP. These application fees are separate from interview expenses which are more varied and driven by geography.
The total cost of the process will fall within a wide range, depending on key factors such as which specialty or specialties the applicant is interested in, how many applications are made and programs ranked, and how close the applicant is to these programs geographically.
The application fees are easier to project, but they will vary depending on the volume of applications and the number of specialties. Use the ERAS Residency Fee Calculator to help plan for your costs.
Number of Programs Per Specialty ERAS Fees
Up to 10 $99
11-20 $16 each
21-30 $20 each
31 or more $26 each
Additional costs associated with the application include the USMLE Transcript fee of $80 and the COMLEX-USA Transcript fee of $80. Both are assessed once per application season.
Medical Residency Requirements: Visa Options
The first step in qualifying for a medical residency program in the United States, after completing the United States Medical Licensing Examination, is to obtain a visa.
A Temporary Employment H-1B visa and an Exchange Visitor (Physician Training) J-1 visa are the most common visas that qualify.
The H-1B is generally more desirable because it doesn’t have the two-year home residency requirement that a J-1 does, which requires you to return to your home country for at least two years before returning to practice in the U.S.
However, it is more difficult to obtain an H-1B visa as a foreign medical resident.
A J-1 visa also requires you to have qualifying J-1 medical insurance before entering the United States.
Tokyo Marine HCC MIS Group offers two international health insurance plans, Atlas Travel and Student Secure, that meet the requirements of the J-1 visa. Both of these plans also provide you with a visa letter which specifies that your coverage meets J-1 visa insurance requirements.
Leading Residency Programs in the USA
For those completely unsure of which residency program to apply for, the AMA Residency and Fellowship Database (FREIDA) allows applicants to search through over 11,000 residency programs available in the United States.
All are accredited by the Accreditation Council for Graduate Medical Education. A candidate’s most desired residency programs will, of course, depend on the specific professional and personal goals of the applicant.
However, some programs are particularly renowned for providing stellar education and bestowing considerable prestige on the resident.
The Interview Process
The interview process is much like the one found in any other professional field. You’re advised to be professional, know your application and the program you’re applying for inside and out, dress formally and be respectful.
National Resident Matching Program
After you obtain a visa, you must register with the National Resident Matching Program, which matches residents with programs on Match Day and helps you track your ranking of programs following your interviews.
When you register with the NRMP, you will also want to select a specialty. According to JAMA, the specialty with the highest percentage of international medical graduates in 2014 was internal medicine (40 percent).