Tips for Applying to a Residency Program as an International Medical Student

international medical students

It can be hard to navigate applying to a US Medical Residency if you are an international student. We’ve brought you five tips to help you get the residency you want, no matter what country you’re originally from.

Ace Your Exams

There’s nothing more important than doing well on your exams. At any given time, an individual residency applicant is competing against thousands of others, and your scores are the main thing that will speak for you. This can’t be emphasized enough. Lots of times, this is your only chance at a good first impression. Neither the USMLE Step I or II (or COMLEX Levels I and II) should be taken for granted. This means creating a solid plan during your preclinical years to score high on the USMLE Step I exam. Depending on what school you attend, you may have to take your USMLE Step I exam before or after you start clinical rotations. Plan accordingly.

The USMLE Step II is generally taken after one year of clinical rotations, which is the third year of medical school for most people. Whether or not your school requires the completion of a test after each core rotation, get a question bank to work with throughout the year. Lots of students get a question bank for a year and go through each specialty during the corresponding core rotation.

Lastly, the scheduling of your USMLE Step II tests should be taken into consideration because you’ll need to be ECFMG-certified (Educational Commission for Foreign Medical Graduates) to be considered at most residency programs.

Schedule Meaningful Rotations

Many times, students can’t control what hospital they attend for their core rotations, but you get to choose what hospitals to attend for your elective rotations. Not only should you focus on what specialty you want to cover for the month, but you should be strategic in your hospital choice. For example, attending a hospital that doesn’t have a residency program for the specialty you will be applying to is a total waste of time. It should only be done as a last resort if all else fails. For each elective you schedule ask yourself what you’ll be getting out of it. Fourth-year rotations are called “audition electives” for a reason. At this point, you would likely have completed your USMLE Step II CK and CS exams and be ready to apply for residency. So consider each rotation a sort of interview from the start of your fourth year. Be mindful that the cost of living in different cities or states every other month will be worth more than just completing multiple rotations at a single hospital. Unfortunately, this is an expensive process.

For your electives, request for hospitals that accept foreign graduates into their programs. (Pro tip: plan ahead!) If your school has mandatory sub-internships required for graduation, but not for the specialty you’re applying to, schedule them for after the application season.

Be Proactive During Rotations & Any Hospital Experiences

It’s not enough to just show up during your rotations – make every one of them count. Don’t be the student who only wants to do the bare minimum just to get an average evaluation at the end of the day. Strive to be outstanding at all times because you never know who is watching you.

As a student, don’t see your electives as just a requirement needed to graduate from medical school. This is an important period of your career where you can build a great professional network. Get involved in projects, present on topics being covered in your team, and make yourself an asset as much as you can. After all, you’re going to want an outstanding evaluation or recommendation letter, so let your performance be up to par.

Some hospitals have research departments that accept medical students as volunteers. This is another way to get involved in a medical team and a great avenue to get clinical research publications. You can also request for recommendation letters from your principal investigators since you’ll be working closely with them. Speaking of research, the physician scientist research pathway is something to consider in residency applications for those interested in a PhD or further research training.

There are people you will meet during this time that can offer valuable advice on your specialty choice and guidance on applying to that specialty. Don’t be shy to ask for help or guidance when you need it. Attending physicians and residents are there to help you, but they wouldn’t know what you need unless you ask. These physicians have gone through the whole process and may still be involved in selecting applicants for their programs, so take advantage of the access you have to them.

Join Local & National Chapters Of Specialties Of Interest

What better way to learn more about your field of interest than attending national and local conferences and meetings? There are several ways in which medical students can get involved in activities at these levels. Beyond registering as a member, you can participate in the poster presentations which could be at the local or national level. Some conferences have amazing lectures for medical students on the process of applying for residency. They sometimes have specific events just for students to network with program directors and other attending physicians in small group settings.

Timely Preparation Of ERAS Applications

Recommendation Letters

Your requests for recommendation letters should begin in your third year. For those whose academic year starts in August, the beginning of fourth year is only one month away from the ERAS opening date (September 15th). You should be asking for letters from people you have worked closely with such as doctors who can comment on your distinguishing qualities. It’s always best to ask before you leave for your next rotation; that way, they have ample time to work on the letter. At this point, you should make your LoR request form, personal statement and CV available to the physicians as well. The earlier you start requesting, the higher the chances that you’ll have the required number of letters by the start of the application season. You should consider the fact that attending physicians have very busy schedules and may not get your letter uploaded to ERAS on time. The minimum number of letters required for each program is three, and a mandatory chair letter may be required.

Personal Statements

As mentioned above, you should have your personal statement completed by the time you request a recommendation letter. This gives the letter writer a perspective on why you’re choosing the specialty you’re applying to. Some large programs have several tracks such as global health, research, primary care, and so on. Therefore, your personal statement should be tailored to whatever track you’re applying to. Don’t write something generic that you plan to use for multiple specialties because anyone reading that can tell you’re not as committed as you say you are. As always, start early so you don’t have any delays in submitting your applications.

Program Selection

There is a stark difference in the number of programs that international medical students apply to and that which American Medical School Graduates (AMGs) apply to. A lot of time and effort has to go into the selection of your programs. Students tend to underestimate just how much information is out there with regards to the specialty of their choice. You don’t want to guess the requirements of a program. Most times, the score requirements for IMGs are different from those for AMGs, so this research must be done.

There is a ton of information on the ECFMG, NRMP and ERAS websites, so stay up to date on all the necessary information you need.