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What Are the Most IMG-Friendly US Specialties (2022 Match)

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by Alec Palmerton, MD in IMG, Residency

Are you an IMG who wants to practice medicine in the US? Is it impossible to match in the US as an IMG like so many people imply? Are you curious about what specialties are actually the most – and least – IMG friendly? Do you have a dream specialty in mind, but are unsure whether you’ll be able to match?

Summary:

  • US specialties vary widely in how IMG-friendly or -unfriendly they are
  • The most IMG-friendly specialties in 2022 include Pathology, Internal Medicine, Neurology, Family Medicine, Pediatrics, Psychiatry, and Child Neurology
  • The least-IMG friendly specialties include Otolaryngology, Orthopedic Surgery, Interventional Radiology, Dermatology
  • However, when looking at the specialties with the highest IMG match rates, you may want to consider Emergency Medicine and Radiation Oncology as well

Table of Contents

What is an IMG Again?

Let’s start with some definitions.

IMG: International Medical Graduate
  • You attended a medical school outside of the United States and Canada
US- vs. Non-US IMGs

IMGs consist of two sub-groups:

  • US-IMGs: US Citizens or permanent residents who attended a “foreign” medical school. Example: someone born in the US but went to a Caribbean medical school (a non-US school).
  • Non-US IMGs: Non-US citizens or permanent residents who attended a “foreign” medical school. Example: someone born in South Korea, who does not have US citizenship or a green card, and who went to medical school in South Korea.
NRMP: “National Resident Matching Program®”
  • The organization that administers the “Match.” In the Match, the NRMP pairs residency applicants with a residency program.

Note that “International Medical Graduate” (IMG) refers to the medical school you attended. Thus, a foreign citizen who attends a US medical school is NOT an IMG. However, a US citizen attending a med school outside the US would be considered an IMG. (Technically, s/he would be a US IMG).

For more on how IMGs can attain residency in the US, see The IMG’s Guide to Obtaining Residency in the United States (2022).

The Most (and Least) IMG-Friendly Specialties in 2022

Looking at the % of spots filled by IMGs in the 2022 Match, we can huge variations in IMG representation.

IMG Friendly Specialties 2022 Match

IMG Friendly Specialties 2022 Match

% Spots Filled by US and non-US IMGs by Specialty (2022 Match)

Here are the “IMG-friendliness” by % spots filled by US and non-US IMGs for the 2022 Match:

 % Spots Filled by IMGs% Spots Filled by US IMGs% Spots Filled by non-US IMGsTotal Positions OfferedTotal # All Applicants
Anesthesiology8%3%4%1,9692,560
Child Neurology15%4%11%188182
Dermatology3%1%1%544834
Diagnostic Radiology8%2%6%1,1551,568
Emergency Medicine7%6%1%2,9212,813
Family Medicine21%13%8%4,9165,055
General Surgery9%3%5%1,6222,400
Internal Medicine36%9%25%9,80911,598
Internal Medicine/Pediatrics5%2%2%392458
Interventional Radiology2%0%2%169226
Neurological Surgery8%1%7%240379
Neurology25%5%18%1,0141,249
Obstetrics and Gynecology5%2%3%1,5032,044
Orthopaedic Surgery2%1%1%8751,435
Otolaryngology
Pathology41%7%31%631827
Pediatrics18%7%11%3,0163,153
Physical Medicine and Rehabilitation6%2%3%532725
Plastic Surgery6%1%4%194340
Psychiatry15%7%6%2,0472,560
Radiation Oncology11%5%7%185162
Vascular Surgery7%0%7%84143
The Most IMG-Friendly Specialties of the 2022 Match

The most IMG-friendly specialties of the 2022 Match were:

  • Pathology (41% spots filled by IMGs)
  • Internal Medicine (36% spots filled by IMGs)
  • Neurology (25% spots filled by IMGs)
  • Family Medicine (21% spots filled by IMGs)
  • Pediatrics (18% spots filled by IMGs)
  • Psychiatry (15% spots filled by IMGs)
  • Child Neurology (15% spots filled by IMGs)
The Least IMG-Friendly Specialties of the 2022 Match

The least IMG-friendly specialties of the 2022 Match were:

  • Otolaryngology (0% spots filled by IMGs)
  • Orthopedic Surgery (2% spots filled by IMGs)
  • Interventional Radiology (2% spots filled by IMGs)
  • Dermatology (3% spots filled by IMGs)

The Specialties with the Highest IMG Match Rates (2022)

We can also assess how “IMG-friendly” a specialty is by looking at the match rate for IMGs. Specifically, we can look at the % of IMGs who ultimately match in a specialty that applied.

The data reveal that some specialties may be more “IMG-friendly” than previously thought.

IMG Match Rate 2022

IMG Match Rate 2022: % of IMG Applicants Who Matched In Given Specialty

We can see these same under-the-radar IMG-friendly specialties when comparing the IMG match rate with the % of residency spots filled by IMGs.

IMG Match Rate and Spots Filled 2022

IMGs: Match Rate and % Spots Filled in the 2022 Match Show Under-the-Radar IMG-Friendly Specialties

Match Rate for US and Non-US IMGs by Specialty (2022 Match)

Here are the “IMG-friendliness” by match rate and % spots filled by US and non-US IMGs for the 2022 Match:

Medical Specialty% Match Rate IMGs% Match Rate US IMGs% Match Rate Non-US IMGs% Spots Filled by IMGs
Anesthesiology42%45%39%8%
Child Neurology61%50%67%15%
Dermatology34%36%32%3%
Diagnostic Radiology40%37%42%8%
Emergency Medicine76%79%68%7%
Family Medicine54%58%48%21%
General Surgery28%30%26%9%
Internal Medicine58%58%58%36%
Internal Medicine/Pediatrics46%50%43%5%
Interventional Radiology29%0%29%2%
Neurological Surgery35%22%38%8%
Neurology51%54%50%25%
Obstetrics and Gynecology33%34%33%5%
Orthopaedic Surgery37%26%55%2%
Otolaryngology**0%0%0%0%
Pathology55%45%59%41%
Pediatrics65%72%61%18%
Physical Medicine and Rehabilitation42%40%45%6%
Plastic Surgery37%31%41%6%
Psychiatry46%46%46%15%
Radiation Oncology58%67%54%11%
Vascular Surgery30%0%30%7%
Specialties with the Highest IMG Match Rates ≠ Those with Greatest % of Spots Filled

Interestingly, the specialties with the highest match rates for IMGs are:

  • Emergency medicine (76% match rate)
  • Pediatrics (65% match rate)
  • Child neurology (61% match rate)
  • Radiation oncology (58% match rate)

Note that none of these specialties is among the top four with the highest % of spots filled by IMGs.

Are Radiation Oncology and Emergency Medicine IMG-Friendly?

The two specialties that stand out the most when we look at the match rate are radiation oncology and emergency medicine. Despite having fewer than 12% of the spots filled by IMGs, IMGs that applied had a match rate of ≥ 58%. Note the match rates for traditionally IMG-friendly specialties like internal medicine, pathology, and family medicine are all the same or lower.

IMG Matched Scores For Each Specialty (2022 Match)

Another way to look at what IMGs need to be competitive for matching in each specialty is to look at the USMLE scores for successful applicants.

Step 1 Scores for Matched IMGs (US and Non-US)

Here are the 25%ile, median, and 75%ile Step 1 scores for US IMGs in each specialty for which there are data for the 2022 Match:

Step 1 US IMGs, 25%ile, Median and 75%ile for Matched Applicants 2022 Match

Step 1 US IMGs, 25%ile, Median and 75%ile for Matched Applicants 2022 Match

Here are the 25%ile, median, and 75%ile Step 1 scores for non-US IMGs:

Step 1 Non-US IMGs, 25%ile, Median and 75%ile for Matched Applicants 2022 Match

Step 1 Non-US IMGs, 25%ile, Median and 75%ile for Matched Applicants 2022 Match

Step 2 CK Scores for Matched IMGs (US and Non-US)

Here are the 25%ile, median, and 75%ile Step 2 CK scores for US IMGs in each specialty for which there are data for the 2022 Match:

Step 2 CK US IMGs, 25%ile, Median and 75%ile for Matched Applicants 2022 Match

Step 2 CK US IMGs, 25%ile, Median and 75%ile for Matched Applicants 2022 Match

And here are the 25%ile, median, and 75%ile Step 1 scores for non-US IMGs:

Step 2 CK Non-US IMGs, 25%ile, Median and 75%ile for Matched Applicants 2022 Match

Step 2 CK Non-US IMGs, 25%ile, Median and 75%ile for Matched Applicants 2022 Match

For more on Step 1 and Step 2 CK percentiles by specialty, see this article.

Concluding Thoughts

It may feel that the idea of matching in the US as an IMG is impossible. However, it is clear that competitive international grads can match even for the most competitive specialties. If you’re looking for ways to stand out as an IMG, be sure to check out the Yousmle Never Forget Course. Not only will you master – not memorize – for impressive USMLE scores, you’ll also build the foundation to impress attendings on rotations and observerships.

If you’re interested in a trusted residency advisor, check out our residency advisory services.

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Cardiology is key for impressive USMLE scores. Master cardiology from a Harvard-trained anesthesiologist who scored USMLE 270 with these 130+ high-yield flash cards. You’ll be begging for cardio questions - even if vitals make you queasy.

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