Requirements

In the 1990′s, residency program directors were concerned that thousands of International Medical Graduates (IMG’s) entered residency with little or no US clinical experience which led to time being lost at the beginning of the PGY1 year bringing them up to speed with the art of US clinical medicine. The major contributing factors to this included communication difficulties, cultural differences, lack of familiarity with US diagnostics and procedures, poor history taking and physical exams, and an inability to write orders.

Synopsis: Residency programs are requiring IMGs to document U.S. hands-on clinical experience in greater numbers every year.  The majority of programs do not consider research, abstracts, presentations, publications or observerships as hands-on clinical experience.  Consider that an average of 2.5 Abstracts, Presentations and Publications were reported by those who matched, and similarly, 2.7 by those who did not match, according to the National Resident Matching Program’s 2009 Charting Outcomes:  therefore, there is not any real statistical benefit to adding research to a medical residency application.  AmeriClerkships Medical Society offers objectively evaluated, insured, hands-on clinical experiences in five different formats:  Teaching Hospital Guarantee Verified, Teaching Hospital Guarantee, Hospital Guarantee, Nursing Home Guarantee, Premium Elective Specialty, Premium Elective Specialty with 100% Inpatient Hospitalist Experience, and Teaching Attending Physician.

Sample Medical Residency Prerequisites for IMG Applicants

1. University of Buffalo, Family Medicine Residency requires that IMG applicants have six months clinical experience inpatient OR outpatient, in the past 2 years.
2. University of Minnesota, Mankato, Methodist, North Memorial, Smiley’s, St. John’s, and St. Joseph’s, Family Medicine and Community Health requires a minimum of one year of U.S. clinical experience or rotations.
3. Floyd Medical Center, Family Medicine Residency requires IMG applicants to have completed at least one year of documented clinical training in the United States as well as three Letters of Recommendation from faculty who have directly supervised clinical performance.
4. University of California, San Francisco, Family Medicine Residency states that, “Since clinical and cultural preparedness are also a key to success here, prior clinical experience in the United States is helpful.  Letters of Recommendation from these experiences will further strengthen an IMG applicant’s documentation of overall readiness to begin residency training in the U.S.”
5. Oregon Health and Science University, Internal Medicine Residency states that, IMGs must be ECFMG certified at time of application, must have at least one year of clinical experience in the U.S. or in a health care system similar to the U.S. and have graduated from medical school within the last six years. Please note that externships, observerships, or research work do not count as clinical experience.
6. Duke University, Family Medicine Residency requires applicants to have completed at least one year of clinical patient care in an ACGME accredited program in the United States by day one of residency (an observership does not count).
7. Yale School of Medicine, Internal Medicine Residency seeks a minimum of eight weeks of hands-on direct clinical experience in a U.S. or Canadian accredited teaching hospital. We will not interview candidates who have not obtained this required clinical experience.   Observerships without direct clinical responsibility do not meet these criteria.
8. University of Wisconsin Madison, Family Medicine Residency states that interview selection preference is given to applicants who have clinical experience in the United States or Canada that is particularly relevant to Family Medicine (research or observerships do not qualify as clinical experience).
9. Fletcher Allen Healthcare in Alliance with the University of Vermont requires that International Applicants MUST have worked in clinical medicine in the United States within the last two years.  NOTE:  an observership does not fulfill this requirement.
10. University of Washington, Internal Medicine Residency requires eight weeks of clinical experience with direct patient contact and accompanying Letter of Recommendation outlining the type of clinical experience.
11. Harvard University, Massachusetts General Hospital, Internal Medicine Residency considers only those with outstanding Letters of Recommendation and a year or more of clinical or research experience in the U.S. or Canada for interviews.
12. University of Michigan, Internal Medicine Residency states an IMG must possess a letter from an Internal Medicine faculty member who served as supervisor or instructor to the applicant, at a U.S. academic institution attesting to the applicant’s clinical experience and competence at that institution.
13. University of Nebraska Medical Center, Internal Medicine Residency states that while research abilities and experience are valuable, a strong emphasis is placed on recent clinical experience.
14. University of Rochester, Pediatrics Residency states that IMGs must complete at least eight weeks of clinical training in an ACGME-approved pediatric program or a similar program in the United States, Canada or England. Observerships and research are not acceptable as clinical training.
15. University of Pennsylvania, Department of Medicine looks for four weeks of U.S. hands-on clinical experience within the past 6 months (observerships are excluded).
16. University of North Carolina, Chapel Hill, Family Medicine Residency gives preference to candidates with clinical experience in the United States.