International medical school graduates (IMGs) play a vital role in the United States health care system and make up about a quarter of the medical workforce. In 2022, fewer IMGs registered for Match than in 2021, with a match rate of 58.1%. The transition to USMLE Stage 1 pass/fail, the elimination of Clinical Sciences Stage 2, and the implementation of secondary application will likely impact IMGs during their match 2023. Here are nine ways IMGs can increase their chances of being matched with residency programs in the United States.
1. Use social media effectively. Social media provides a platform for IMGs to learn from close peers, referring physicians, and residency programs. Join multiple 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 your career and engage in conversations with residency programs to increase social media visibility.
2. Engage in US-oriented clinical or educational research. Find opportunities to engage in academic work, such as clinical and medical education research. Medical graduates from the home institution who are matched with residency in the United States can guide with unfunded research experiences. Authorship of abstracts, posters, and peer-reviewed papers in US-based regional or national conferences is valuable to the Electronic Residency Application Service (ERAS). If possible, avoid filling out and falsifying the work by entering the DOI and search URL link in ERAS.
3. Create a digital fingerprint Create a career-centric digital footprint to use the internet as a platform to take advantage of professional opportunities in the United States. Use a professional email or appropriately titled Gmail account. Create a well-written virtual portfolio via LinkedIn to showcase accomplishments, certifications, and career milestones and network with US-based healthcare 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 one well-maintained profile.
4. Market and network at regional and national student-centric conferences in the United States. Develop an “elevator pitch” to succinctly communicate goals and interests with other healthcare professionals during in-person or virtual conferences. Also, contact the organizers and become a member of a student committee to lend a hand. Ask specific questions during seminars and poster sessions to express your interest and network with leaders of the respective specialty. Try to find a treating physician with similar interests who can act as a guide through the residency matching process.
5. Participate in a clinical internship or observer status in the United States. Explore the Association of American Medical Colleges (AAMC) Visiting Student Learning Opportunity for Clinical Electives between June and October. Paid Commercial Observer status may not provide the full ACGME accredited residency experience. Since observer status in a hospital is preferable to an outpatient experience, an IMG may also pursue work as a medical scribe and medical assisting prior to residency depending on legal status and work permit.
6. Acclimatize to America’s diverse and multicultural society. IMGs are more likely to face language and cultural challenges when interacting with patients in the United States. To withstand these challenges, an IMG must develop cultural humility and empathy for America’s pluralistic and multicultural society. Increase cultural competence through exposure to the complex healthcare and insurance delivery system and to American sports, food, literature, and everyday etiquette. These skills can be enhanced by gaining elective clinical experience in the United States and immersing yourself in iconic American movies and TV shows.
7. Create a compelling personal statement.- When applying for residency, the candidate’s goal should be to affirm their motivation and passion through “aha” moments or slow-stirring moments. The personal statement should demonstrate self-reflection by discussing one’s strengths and desire to learn more in the field while describing alignment with the specialty, vision, and mission of the residency program. IMGs should avoid all forms of criticism – including the US healthcare system, religion, politics, gun safety, and other highly questionable current issues in the United States. comments on your writing.
8. Take advantage of the secondary application process. Residency programs recently introduced the Supplemental Application to learn more about students and how they fit into the program’s framework and mission. As an IMG, this may require careful consideration when selecting geographic location and signage based on IMG-friendly programs in the United States. Be realistic and transparent about preferences. Additionally, program directors use the AAMC PREview exam (formerly known as the Situational Judgment Test) to assess pre-vocational behavior. Use the free resources provided by the AAMC and review the ethical guidelines to prepare for the exam.
9. Prepare for interviews. Carefully review the residency program website before the day of the interview. 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, the preparation of the space, including internet connection, lighting, audio, background and position, is crucial. In addition, it is essential to learn about contemporary health issues in the United States, including social determinants of health, missions of diversity, equity and inclusion (DEI), disparities in health, intersectionality and critical race theory. During the interview, avoid reading the notes and try to have a conversation. Prepare a list of 10-12 meaningful questions to ask the interviewer and be 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 physician.
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