IMG Perspectives

Going to America: the IMG Journey

By Fady Akladios

The information in this post is based on material published in the First Aid for the International Medical Graduate, 2nd edition.

As a non-US born IMG, making the decision to pursue postgraduate training in the US is a significant life decision. Not only will you be navigating a challenging certification and training process, but you will be doing so in a country with different customs, laws, people, geography, etc…

Making such a decision should not be done nonchalantly. Before you make your decision, I recommend that you sit down with a piece of paper and jot down the answers to some very important questions:

This is probably the most important question to answer. The decision to embark on this difficult journey should be supported by concrete reasons and goals.

Some of the factors to consider here are the availability of excellent training opportunities, research opportunities, a stable professional future, and a stable future for your family and children. You should also consider the question Why not? There are cons to leaving your home country, like having to get accustomed to an entirely new social and professional environment, leaving your family behind, and many others. In your mind, do the Why’s outweigh the Why not’s?

Define the type of professional opportunity you are seeking. Factors to consider here are medical field(s) of choice, university vs. community-based training, urban vs. rural settings, etc.

Also define your goal(s) after completing your training. Do you plan to settle down in the US, or do you plan to return to your home country? This answer will likely depend on both professional and personal reasons. Having a family will make it harder for you to move back and forth between countries. Being comfortable with the American way of life will make it easier for your to settle. Having more lucrative job opportunities in your home country might attract you to pursue training in the US and leave when that training is complete.

Define your schedule. You need to be aware of the deadlines to register for the USMLE Steps, the time it takes to receive scores, and the deadlines to submit your applications to ERAS. A glitch in this schedule could potentially delay your plans for year(s). We will discuss this further in an upcoming post.

Again, the answer to this question depends on your own personal and professional situation and preferences. Do you like the big city or small town life? Do you have any personal ties in specific cities (family, friends)? Do you want to live somewhere with good schools for your children or job opportunities for your spouse? Some IMG’s prefer to apply to programs where there is extensive clinical exposure or research opportunities in their areas of interest, or in programs where they already have established connections (participated in a research project with the program director, residents from the applicant’s school alumni, etc…)

Define the resources you need to accomplish your journey. You will need textbooks, required visas, important application materials (letters of recommendation, transcripts, etc…), time, and money!

In a future post, I will discuss the main types of IMG’s who seek training in the US and help answer some of these questions for each of those different categories.

Want to share your IMG journey? Email us at

Categories: IMG Perspectives

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