Are you an undergraduate student considering an international medical school, or an International Medical Graduate (IMG) considering applying to Emergency Medicine? Check out this episode, where Patricia is joined by EM Over Easy host Andy Little and guests Marcus Robinson and Aatish Patel, 2 EM residents who navigated the match as IMGs.
Who are IMGs?
- Anyone who graduated from a medical school outside of the US.
- Some are U.S. citizens, and some are not
- Some of the more popular International Medical Schools that US Citizens will attend who then rotate in the US for their clinical years are St. George’s University Medical School and Ross University Medical School in the Caribbean.
IMGs in EM
- From 2015–2022:
- Only 6% of matched EM applicants were IMGs, with 21% of those being born outside of the US
- In 2023–2025:
- The number of IMGs applying EM doubled to 12%, with 33% being born outside of the US..
- In 2025, IMGs accounted for an all-time high of 15% of matched applicants—a 150% increase compared to the 2015–2022 average.
Why this increase?
- We had more EM residency slots than applicants from 2023 -2025.
- Programs are filling unclaimed spots with IMGs, especially as the pool of US MD applicants has tightened.
- During this time, we have also seen an increase in the number of DOs matching into EM.
Advice for IMGs wanting to pursue EM:
- Understand your why.
- Lock in and take advantage of the opportunity. It is a privilege to get to go to medical school, and you should treat it as such.
- You may have to work harder and score better, but this is an investment in yourself.
- Find a mentor who understands the process. Uses mentorship networks like EMRA, CORD, etc.
- Start thinking about the application process early.
- One of the major challenges of being an IMG is getting away rotations to obtain SLOEs. Apply broadly.
- Check with your school to see if them have any relationships with residency programs where you might be able to go for audition rotations.
- See where people from your school have matched into EM in the past.
- Look for the programs who have IMGs in them.
- When in doubt about whether or not programs accept IMG or will let them rotate, reach out to someone at the program. The worst they can say is no.
What Program Directors Need to Know About IMGs:
- IMGs often work harder and are super teachable.
- There may be a gap in training built in by the school, so keep an eye out for that. It often is built in for test prep time and is not a bad thing or anything the applicant could control.
- IMGs often do better on boards and ITE.
- Be transparent about visa policies and requirements.
- Have an open mind.
Take Home Points:
- Find mentorship!
- Start early!
- Know your why! It’s an investment in yourself.
- Work hard, get involved and get the most out of every rotation.
- Any red flag is going to be even bigger when you’re an IMG.
Post by Patricia Capone, DO PGY-4
About Our Guest:
Marcus Robinson, MD
PGY-2, AdventHealth East Orlando, Emergency Medicine Residency Program
Aatish Patel, MD
PGY-3, Chief Resident, AdventHealth East Orlando, Emergency Medicine Residency Program
References:
- https://www.emra.org/students/newsletter-articles/em-img-2025
- https://journals.lww.com/em-news/fulltext/2025/05000/dos_and_imgs_make_up_the_majority_of_the_2025_em.1.aspx?utm_source=chatgpt.com
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