International medical school graduates (IMGs) play an integral role in the health care system of the United States and constitute approximately one-quarter of the physician workforce. In 2022, fewer IMGs registered for Match than in 2021, with a match rate of 58.1 percent. The transition to USMLE Step 1 pass/fail, elimination of Step 2 Clinical Science, and implementation of secondary application will likely impact IMGs in their 2023 Match. Here are nine ways IMGs can increase their chances of matching at U.S. residency programs.

1. Use social media effectively. Social media gives a platform to the IMGs to learn from near-peers, attending physicians, and residency programs. Join several social media platforms to connect with organizations and residency programs in their respective specialties. Follow specific hashtags that are resourceful, including but not limited to #Match2023, #InsidetheMatch, #MedTwitter, and #IMG. Create a social media profile that reflects one’s career and engages in conversations with residency programs to increase visibility on social media.

2. Engage in U.S.-oriented clinical or educational research. Find opportunities to engage in scholarly work, such as clinical and medical education research. Medical graduates from the home institution who are matched into U.S. residency can guide with non-funded research experiences. The authorship of abstracts, posters, and peer-reviewed papers in U.S.-based regional or national conferences is valuable to Electronic Residency Application Service (ERAS). If possible, avoid padding and falsifying the work by entering the research’s DOI and URL link in ERAS.

3. Create a digital footprint Build a career-centric digital footprint to use the internet as a platform to leverage professional opportunities in the U.S. Use professional email or an appropriately titled Gmail account. Create a well-written virtual portfolio through LinkedIn to showcase achievements, certifications, and career milestones and network with U.S.-based health care professionals. Develop an academic profile through popular websites such as Google Scholar and Open Researcher and Contributor Identifier (ORCID). Describe your project on ResearchGate and use Publon to track publications, peer reviews, and citation metrics in a single well-maintained profile.

4. Market and network during U.S.-based student-centric regional and national conferences. Develop an “elevator pitch” to succinctly communicate goals and interests with fellow health professionals during in-person or virtual conferences. Furthermore, reach out to the organizers and become part of a student committee to lend a helping hand. Ask specific questions during the seminars and poster sessions to express interest and network with leaders in the respective specialty. Aim to find an attending physician with similar interests who can serve as a guide through the residency match process.

5. Participate in U.S. clinical elective or observership. Explore the Visiting Students Learning Opportunity by the Association of American Medical Colleges (AAMC) for clinical electives between June and October. The commercial observership with fees may not provide the full experience of the ACGME accredited residency. With observership in a hospital being better than an ambulatory experience, an IMG can also pursue working as a medical scribe and medical assistance before residency based on the legal status and work permit.

6. Acclimatize to the diverse, multicultural American society. IMGs are more likely to face language and cultural challenges while interacting with patients in the U.S. To withstand these challenges, an IMG should develop cultural humility and empathy for pluralistic and multicultural American society. Increase cultural competency by exposure to complex health care delivery and insurance system and American sports, food, literature, and daily etiquette. These skills can be enhanced by gaining U.S. clinical elective experience and immersion in iconic American movies and TV shows.

7. Craft a compelling personal statement.- When applying for residency, the applicant’s goal should be to affirm motivation and passion through “aha” moments or slow brewing moments. The personal statement should demonstrate self-reflection by discussing one’s strengths and eagerness to learn more in the field while portraying alignment with the residency program’s specialty, vision, and mission. IMGs should avoid all forms of criticism – including the U.S. health care system, religion, politics, gun safety, and other current highly debatable issues in the U.S. Avoid sounding opportunistic while explaining your “why” for a US-based residency program and invite thorough feedback on your writing.

8. Take advantage of the secondary application process. Residency programs have recently introduced the supplemental application to learn more about students and how they fit with the program’s setting and mission. As IMGs, this may require thoughtful consideration in selecting geography location and signaling based on IMGs friendly programs in the U.S. Be realistic and transparent about the preferences. Moreover, the program directors utilize the AAMC PREview Exam (formerly known as Situational Judgmental Test) to gauge pre-professional behavior. Utilize the free resources provided by the AAMC and review the ethical guidelines to prepare for the exam.

9. Prepare for interviews. Review the residency program website thoroughly before the interview day. The key to a residency interview, whether virtual or in-person, is to practice answering various questions to overcome the language barrier. For a virtual interview, preparing the space, including internet connection, lighting, audio, background, and position, is crucial. Additionally, it is essential to learn about the contemporary health care issues in the U.S., including social determinants of health, diversity, equity and inclusion (DEI) missions, health disparities, intersectionality, and critical race theory. During the interview, evade reading from the notes and try to have a conversation. Prepare a list of 10 to 12 meaningful questions to ask the interviewer and make sure to discuss and reflect on the “elephant in the room.”

Heli Patel is a medical student. Monica van de Ridder is an assistant professor. Vijay Rajput is an internal medicine physician. 

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