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

4 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

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