Which States Are Most IMG-Friendly?

When applying for residency, especially as an international medical graduate (IMG), it is important to apply broadly beyond the state or region that you want to end up, to maximize your chances at getting interviews and matching. Looking at the number of IMGs that match into residency in different states, it is clear that some states are more IMG-friendly than others. When applying for residency, consider applying to these IMG-friendly states, as you’ll have a better chance at getting interview invitations from them. Here, I took the latest 2013 NRMP match data and compiled a ranking of states according to the percentage of newly matched residents who were IMGs in 2013.

Disclaimer: Within states, IMG-friendliness may also vary according to specialty, as some specialties (like family medicine or internal medicine) tend to be more IMG-friendly than others (not a lot of IMGs in orthopedic surgery). Here, I am addressing the IMG-friendliness of states as a whole, regardless of specialty. I define IMG as including both US IMGs as well as foreign IMGs. 

NRMP States IMG friendly full

The most IMG-friendly state is by far New Jersey, where more than half of the newly matched residents were IMGs. States like Wyoming and North Dakota are also IMG-friendly, but they don’t have that many residency positions available. Other very IMG-friendly states include Michigan and New York. Here are some more details that I used to create the above chart:

State Total Matched US IMG Foreign IMG % IMG
New Jersey 769 238 193 56.0%
Wyoming 12 5 1 50.0%
North Dakota 44 3 17 45.5%
Nevada 110 35 11 41.8%
Michigan 1184 180 302 40.7%
New York 3642 559 738 35.6%
Oklahoma 206 33 35 33.0%
Connecticut 586 84 101 31.6%
Arkansas 175 31 24 31.4%
Ohio 1402 145 275 30.0%
West Virginia 169 15 35 29.6%
Florida 880 100 144 27.7%
Georgia 515 75 63 26.8%
Hawaii 71 9 10 26.8%
Arizona 445 68 50 26.5%
Louisiana 497 87 44 26.4%
DC 427 17 91 25.3%
Illinois 1593 157 241 25.0%
Nebraska 173 10 33 24.9%
Mississippi 122 16 14 24.6%
Maryland 623 41 112 24.6%
Pennsylvania 1795 163 261 23.6%
Kansas 195 23 22 23.1%
Kentucky 295 35 32 22.7%
Montana 18 3 1 22.2%
Alabama 341 26 49 22.0%
Iowa 220 13 34 21.4%
South Dakota 38 3 5 21.1%
Texas 1682 130 191 19.1%
Puerto Rico 185 32 3 18.9%
Tennessee 518 52 44 18.5%
New Mexico 141 8 18 18.4%
Virginia 511 66 27 18.2%
Rhode Island 190 8 24 16.8%
Minnesota 503 21 62 16.5%
Missouri 619 26 70 15.5%
Indiana 377 28 26 14.3%
Maine 77 8 2 13.0%
Wisconsin 458 27 28 12.0%
Vermont 67 7 1 11.9%
Idaho 34 4 0 11.8%
New Hampshire 84 4 5 10.7%
North Carolina 712 41 33 10.4%
Massachusetts 1323 57 67 9.4%
California 2593 138 92 8.9%
South Carolina 324 17 7 7.4%
Delaware 68 3 2 7.4%
Oregon 220 2 13 6.8%
Washington 388 11 10 5.4%
Utah 187 3 6 4.8%
Colorado 313 6 3 2.9%
Alaska 9 0 0 0.0%
         
Total 28130 2873 3672 23.3%

 

What should you get out of this?

If you are an IMG and your dream is to match in not-so-IMG-friendly states like Colorado or Utah, you can definitely try applying to these states. Perhaps you’ll be one of of the few lucky IMGs who match there. However, don’t put all your eggs in one basket. Apply to other states that are more IMG-friendly so that you’ll increase your chances of matching.

Best of luck!

Benji

Links for Residency Interview and Match

18 comments to Which States Are Most IMG-Friendly?

  • Why am I not surprised that northern states accept more IMGs. The South states need to be more open to accept IMGs especially US IMGs since there are shortage of doctors.

  • Rebecca

    Like Benji said, apply where you want. I matched where I wanted to match and it is not an IMG friendly state. So, do your best and don’t limit yourself.

  • Steven

    Hi Benji,
    Awesome site! It is such a great resource.

    I was wondering if you have any comments or knowledge on the decrease in residency positions that IMGs will be able to secure in the near future? I’ve read on several forums (SDN, etc…) that with the rise in US medical schools and expansion of seats at US med schools, IMGs will be “bottle-necked” out of US residency positions due to preferential treatment given to US students.

    I’d really appreciate any information you can share.

    Thanks.

    • Benji

      Hi Steven,
      It is true that US med schools are expanding enrollment. I was looking at some of the statistics that the AAMC put out. There were 287 more US medical students in 2012 than there were in 2011. There were 538 more students in 2013 than there were in 2012. However, at the same time, residency spots available in the Main Match have also been steadily increasing. 613 more residency positions were added in 2012 (to a total of 24,034 positions), and 2358 more positions were added in 2013 (to a total of 26,392 positions). This sudden increase in number of residency positions in the Main Match in 2013 was probably due to the implementation of the “All-In Policy” in which residency programs have to either fill all their available positions through the Main Match or fill all their positions via Pre-Match (which is only available to IMGs like us). The result is that many of the programs that used to do half Main Match and half Pre-Match decided to fill all their positions through the Match while a minority of other residency programs decided to withdraw completely from participating in the Main Match and do Pre-Match exclusively to fill their residency positions. While it is great for IMGs that there are now more positions in the Main Match than before, it also means there are less positions for IMGs who may want to Pre-Match.

      So given the statistics at the moment, while med school enrollment is increasing (both in the US and in the Caribbean), the number of residency positions are also increasing at the same time. I think it’s hard to say now what the future will be like for IMGs. There may be other factors that I may not be thinking of right now, and federal funding for residency programs as well as policies may change within the next few years. But given the statistical trends I see for the past few years, I think (and I hope) that there won’t be any drastic changes in the matching chances for IMGs in the next few years.
      Benji

  • Summer

    Just out of curiosity where did you get the graph? I have been looking on nrmp and have not been able to find the graph. Thanks!

  • John

    Hi

    I am confused. I am Canadian citizen. Currently I am in school of Pharmacy(2nd yr).I am not accepted this year by any of three med schools I applied in Ontario(These schools allow you to apply if you have taken required courses and have finished 3/4 years of university education. I can’t apply other schools in Canada and US as they require bachelor degree ).

    I have following options:

    1. I can try again with those 3 schools next year
    2. Finish my Pharmacy graduation, I can then apply many Canadian and US schools (But that’s two years from now)
    3. Take Caribbean route this year and save two years and debt made for studying next two years of Pharmacy

    But if I choose fourth option,

    1. How about US clinical rotation if in Caribbean school? I believe Caribbean schools arrange it for you. Is it true?
    2. Is it not uphill battle when it comes to be accepted for residency in US?
    3. I come across some really scary stories of IMGs not getting residency. This(http://thescurlockscene.blogspot.ca/2014/03/the-match-soap-reality-of-being-img.html) is the story of a St. George graduate
    4. What happens with those IMGs who are not getting any residency? They have to wait an year and try again?
    5.What Caribbean schools would you recommend? People say these four (st. George,Ross,AUC and Saba) are top schools.
    5. Finally is it worth taking that Caribbean route in the case like mine?

    • Benji

      Hi John,

      I recommend finish schooling, then apply. Med schools in the US, Canada, and the top four schools in the Caribbean all require at least a bachelor’s degree. Residencies in the US may look at not having a bachelor’s degree as a red flag when they compare candidates. Don’t try to save the money… It’s not worth the risk of going the cheap or quick route when it comes to your education.

      You post a lot of questions. Please do a search through my blog. You may find a lot of answers you are looking for in my posts.

      Benji

  • Ash

    Hey Benji,

    Thanks for the blog, very helpful!

    I’m about to attend St James School of Medicine in the fall. I live and plan to match in Michigan. I was accepted holding 90 credit hours. I only have my associates. Is this a major handicap?

    Please tell me any good info recommending St James, if you have any! :)

    • Benji

      Hi Ash, thanks for reading my blog. I would highly recommend finishing at least a bachelor’s degree before med school because you will need that academic experience to feel better prepared for the challenge that is med school. Also many residencies may see not having a Bachelor’s degree as being a red flag. To increase your chances to match in the US, I recommend trying to do your education as similar as possible to what you would do in the US.
      Benji

  • Very interesting information. My husband is a 2014 graduate of SGU. He did not match or SOAP into a spot in the 2014 Match but was able to find a preliminary position post-SOAP at the University of Massachusetts. He did, however, match categorical surgery there this year in the 2015 Match. The information on your blog is great and much needed for any medical student, especially an IMG. I write a blog too (though not predominately medicine based) but I wrote about our Match process here. http://thescurlockscene.blogspot.com/2014/03/the-match-soap-reality-of-being-img.html

    • Benji

      Thanks for sharing Stephanie,
      IMGs definitely have a lot of obstacles to go through and I am so glad to hear that your husband matched into categorical surgery this year! All the best to your beautiful family.
      Benji

  • Sweeja

    Hello Benji,

    Thanks for taking out your time and posting in this blog. It is very useful.
    Im attending Avaoln University School of Medicine (One of the Caribbean Schools). I will finish m core rotations next week. I want to apply for electives in different hospitals, because I finished all my cores in Beckley WV, which is not green book. Would you tell me which schools/hospitals do I need to apply for my electives in order to have a better chance in residency?

    THank you

    • Benji

      Hi Sweeja,
      I cannot tell you every single place that is greenbook. There are too many and I do not know them all. You will have to do some research on the ACGME website to look for hospitals that have residency/fellowship programs. Then you have to contact the programs individually to see if they offer rotations for med students. Or better yet, contact your school to see where other students have done rotations before.
      Benji

  • chiko

    Hey,
    dont wanna be rude but why the heck would someone like to go to utah or colorado^^

    • Benji

      Why would anyone want to go anywhere? I am not from Utah or Colorado but I can probably think of a million reasons. The biggest reason I would imagine anyone wanting to be somewhere is to be close to family and friends. That’s a big reason why I decided to move back to Georgia. People may also like the program that the residency or job offers. Maybe it’s cost of living or standard of living. Maybe it’s the education system, or the churches, or the livability of cities like Salt Lake City or Denver. Perhaps people love hiking, nature, or winter sports.

  • Amari

    Hi Benji,
    Where do you think the old graduate IMGs should apply in term of specialties, where I heard that even Family medicine is getting more popular among the US graduated, anther question do you recommend taking the risk of time adn money to do PTAL to apply to California.
    Thanks

    • Benji

      I’m not sure if I understand your question. I recommend applying to the specialty you want to pursue, and making your best effort to make that happen, including knowing your target exam scores and exceeding them, joining professional societies of your desired specialty, doing electives and getting letters of recommendation from your desired specialty. Write a killer personal essay expressing your passion and commitment to that specialty. As someone who is passionate about Family Medicine, I don’t recommend my specialty for everyone, and certainly not every IMG. I want my specialty to be practiced by people who are truly dedicated and passionate about the field of Family Medicine, and I want to work with colleagues who truly love what they do and do what they love. While I agree that if you desire to apply to a very competitive specialty such as radiology or neurosurgery, you should have a backup. But please choose a backup that you at least would enjoy. It’s not pleasant working with people who don’t enjoy what they do. As for California, apply if you have the desire to end up there. Otherwise there are plenty of states that are more IMG-friendly that you can apply to without a special time consuming expensive application.

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