US students and Foreign Medical Graduates (IMG, FMG acronym used) jump through countless hurdlesin order to qualify for medical residency in the United States. The most popular query they have is how to apply for a residency program in the USA as an international student. While the pathway is not easy, let us make it simpler by outlining the process for you.

How To Apply for Medical Residency in the USA: A Step-by-Step Guide


  1. Work on your academic performance

Work hard on your academic performance during medical school. Submit your application with a letter from MSPE (Medical Student Performance Evaluation), one of the most significant factors in the interview selection process, and your transcript from medical school.

  1. Begin the ECFMG Certification procedure

The Educational Commission for Foreign Medical Graduates® (ECFMG®) must certify your credentials before starting your “Residency,” which is the US graduate medical education. You must register with the ECFMG® before beginning the ERAS® application process.

  1. Start preparing for USMLE

For American medical licences, candidates must pass a three-series exam called the USMLE®. The USMLE Step 1 assesses your understanding of and ability to apply core scientific concepts to the practice of medicine. USMLE Step 2 CK evaluates how effectively you can apply your clinical scientific knowledge and medical training to deliver patient care. The USMLE Step 2 CS measures your ability to apply your medical knowledge and skills in a practical, patient-centred setting. The last exam, USMLE Step 3, emphasises patient care in an ambulatory setting. You can take this exam either after your internship or before you apply for an IMG residency.

  1. Gain clinical experience in the USA

Take part in a top-notch, practical externship in the US. Inquire about opportunities for clinical rotations rather than wasting time on the path to a medical residency if you are still an undergraduate student and have not yet passed the USMLE stages.

  1. Acquire an oficial observership in the USA

This is crucial for graduates applying without any clinical experience in the United States. The program criteria for the hands-on USCE cannot be fulfilled by observers, despite their accessibility. When selecting a residency school in the US, observation is unquestionably preferable to having no clinical experience.

  1. Register with the AAMC

The Electronic Residency Application Service® (ERAS®), a centralised online application system, is managed by the Association of American Medical Colleges® (AAMC®). Use their MyERAS® Portal to submit your applications to residency programs.

  1. Shortlist your residency programs

After passing a few USMLE® Exams, you now know how competitive you are as an IMG for the medical residency match. This will enable you to sort through the numerous US residency programs offered in particular specialties (such as Internal Medicine, Family Medicine, Psychiatry, etc.) to locate those that have the best possibilities of accepting you.

  1. Get your ECFMG® token and register with ERAS®

Take advantage of the OASIS or the MyECFMG mobile app to get your ECFMG® Token. You must have the 14-digit ECFMG Token, which is personal to you, to register with ERAS®.

  1. Find externship

This is still a crucial step for graduates without US clinical experience. Graduates who pass the USMLE exams frequently lack the LORs and clinical experience required to practise in the US. To fill this gap, candidates usually explore new employment alternatives. Finding an externship after graduation can be difficult because graduates cannot enrol in clinical electives.

  1. Finalise documentation and apply to selected programs

You can apply to the medical residency programs for which you are eligible using ERAS® and submit the necessary supporting materials, such as your curriculum vitae, residency personal statement, and letters of recommendation.

  1. Prepare for medical residency interviews

After you submit your ERAS® application, one or more residency programs may get in touch with you to schedule an interview. As it is one of the most significant steps in the process, preparing for your medical residency interview is critical for your ERAS application.

  1. Register with NRMP

The yearly Residency Match is managed by the National Residency Match Program® (NRMP®), which links IMG residency candidates with residency and fellowship institutions. To choose which applications and residency programs should be paired, the Resident Match evaluates ‘rank order lists’ supplied by applicants and residency program directors. Following your interviews, you will assess residency programs according to your choices. To prepare for the ERAS Residency Match, log into ERAS with your NRMP ID and change your profile.

  1. Fill out the rank order list

Use the NRMP R3 system to create a rank order list of your chosen programs once you have received interviews. Programs compile a comparable list of recommended candidates among those who are interviewed. Your rank order list must be certified as ‘final’ to be utilised in the Match once all referred programs have been entered. The completion date for submission is required.

  1. Residency post-match

The NRMP uses rank order lists to determine the list of applicants who have been matched.

If you have an IMG Match, congrats! If you did not match, you still have the chance to compete for the remaining vacant positions in the Residency Match through the post-residency Supplemental Offer and Acceptance Program®, often known as “SOAP®.”

In a nutshell, everything you need to do to obtain a medical residency in the USA is outlined in the step-by-step method mentioned above. It is time to stop asking yourself, “how can I get medical residency in the USA?” and start pursuing your goals with all the necessary resources at your disposal.