AMWA Supports International Medical Graduates

International Medical Graduates

The American Medical Women’s Association has an active, growing community of International Medical Graduates (IMGs). We recognize the valuable contributions that IMGs bring to the United States’ patient care workforce and want to provide a network of support and resources for IMGs as you seek to practice medicine.

Whether you are an IMG just starting on your journey, a practicing physician who began your career as an IMG, or even a physician who is ready to help mentor IMGs, we hope that you will participate in this effort. IMGs who are looking to complete a residency in the US can become a member of AMWA at the resident rate for a modest flat rate that includes all pre-residency and residency years. The code: IMG gives 15% off. Join here and select resident membership (use code: IMG at checkout).

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Leaders

Leaders

Sheila Toro, MD. Chair

Sheila Toro, MDDr. Toro is an MD from Venezuela currently employed as a Research Fellow in the Spine Division of the Department of Orthopedic Surgery at Rush University. Additionally, she is pursuing a master’s degree in clinical research at the same institution. Her future aspirations include advancing her surgical training and providing healthcare services in underserved populations, building upon the work she initiated in her home country. During her leisure time, she dedicates herself to producing and hosting Pluripotenciales, a Spanish-language podcast that offers career development insights and inspires young physicians to pursue their dream job.

Yazmin Heredia, MD. Observership Subcommittee Leader

Yazmin Heredia, MDYazmin Heredia is a Mexican Medical Graduate from the Universidad Autonoma de Yucatan. She is currently collaborating on diverse projects as Associate Author in First Aid, as a Scholar Rx Student Advisory Council member, and as a leadership team member at The Clinical Problem Solvers. During the past year, she has been an AMWA member and participated in the Anti-Racism Committee and the PATH group as the Public Relations student co-chair. She developed a passion for Public Health, Medical Education, and Health Equity throughout her medical training. As an international graduate, she is eager to further the IMG initiative to provide ethical and accessible assistance to more trainees on their journey. She looks forward to applying to the Internal Medicine Residency in the upcoming Match cycle.

Andrea Mendez, MD, PhD. Research Subcommittee Leader

Andrea Mendez, MD, PhDDr. Méndez Colmenares is a medical doctor and cognitive neuroscientist specializing in advanced white matter imaging. With a Ph.D. in Cognitive Neuroscience from Colorado State University, USA, her research focused on white matter decline and plasticity in aging populations using advanced MRI techniques. Dr. Mendez is currently a postdoctoral researcher at the BRAiN Lab in Colorado. She aims to integrate patient care, research, and education as a physician-scientist in the future. Dr. Mendez is also actively involved in initiatives supporting neurology applicants and research career development for international medical graduates.

Mayver Gonzalez, MD. Education Subcommittee Leader

Mayver Gonzalez, MDMayver Gonzalez MD is a Venezuelan Doctor currently working as Clinical Research Coordinator II at Baylor College of Medicine, specifically at The Treating Obesity with Precision Laboratory (TOP) where her research is focused on Rare Genetic Disorders of Obesity in children and adults, and the development of new treatments to fight against obesity. Dr. Gonzalez is passionate about science, and health disparities in underserved communities, and she advocates for the Latinx culture. She strongly believes knowledge is power. She is committed to helping others to achieve their goals through education. Dr. Gonzalez’s goal is to become a Geriatrician in the United States.

Andrea Anampa-Guzmán, MD. Social Media Subcommittee Leader

Andrea Anampa-Guzmán, MDAndrea Anampa-Guzmán is a medical student at Universidad Nacional Mayor de San Marcos. She performs research for the Department of Medicine at the Roswell Park Comprehensive Cancer Center. Anampa-Guzmán is an assistant producer of the DEI shift, a podcast of the American College of Physicians (ACP). She is part of the team of the #HemOnc Fellows Network. She is interested in medical education, survivorship, and global oncology. Andrea Anampa-Guzmán has published over 20 research articles and numerous awards, including the MOLA-Michael Reese Foundation Scholarship, AACR Global Scholar-in-Training Award, and Conquer Cancer Foundation Annual Meeting Research Award.

Raquel Horowitz, MD. Support for IMGs in Residency Subcommittee Leader

Raquel Horowitz, MDRaquel Horowitz is a graduate of the Central University of Venezuela Medical School. She is passionate about primary care, research, and global health. She is currently a PGY-2 Family Medicine Resident at TBHC in NYC. She participates as a teaching assistant in the PPCR Program at Harvard T.H. Chan School of Public Health. She enjoys volunteering in the Endurance Promise Mission with the US Navy, providing care for low-income populations in South America. Dr. Horowitz is part of the Team producing the Spanish version of the AFP podcast of the American Academic of Family Physicians.

AMWA IMG STUDY GROUPS

AMWA is forming study groups for USMLE Step 1, 2, and 3 and OET Medicine. Looking to push yourself and keep motivated while studying? Join AMWA IMG Study groups to gain support, learn from experts, and develop new skills. Language exchange program beginning soon! For more information, sign up here. For more information, contact img_education@amwa-doc.org.

IMGs in the U.S.

According to the American Medical Association, IMGs represent approximately 25% of licensed physicians in the United States in 2020. The percentage is even higher within certain specialties, like internal medicine, pediatrics, family medicine and psychiatry, though IMGs remain underrepresented in leadership and within medical associations. This Pathway to Medical Licensure in the United States published by the Federation of State Medical Boards provides a good overview of the different tracks for medical training.

The number of women IMGs has continued to rise, though this particular group often faces additional challenges. These challenges may include domestic responsibilities or lack of childcare support in addition to the traditional barriers that many IMG’s encounter — limited networks, difficulties in obtaining U.S. Clinical Experience (USCE), and the penalty that comes from taking “too many” gap years.

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Graduate Medical Education and ECFMG Certification

Graduate medical education is the training that follows medical school and includes both residency and fellowship training in programs accredited by the ACGME (Accreditation Council for Graduate Medical Education).

To be eligible for applying to ACGME accredited residencies or fellowships, IMGs must be certified by the ECFMG (Educational Commission for Foreign Medical Graduates). This section provides resources in the certification process and requirements. Due to COVID-19, the Step 2 Clinical Skills (CS) exam was suspended for 2021, so additional pathways have been offered to achieve ECFMG certification. Starting in 2024, only graduates from a formally accredited medical school will be eligible for ECFMG certification. Learn more about the ECFMG 2024 Accreditation Requirement. The ECFMG Certificate Holders Office provides support and services to ECFMG-certified physicians.

The ECFMG also has specific ERAS® (Electronic Residency Application Service®) Support Services to help graduates in the electronic residency application process.

Visas & Other Documents Required for Work in the U.S.

There are different types of non-immigrant and immigrant visas that IMGs may choose from in order to pursue residency training in the United States. Information about these options is available from the AMA here: Immigration Information for International Medical Graduates. Learn more about the following U.S. Visas here:  B1/B2 Visa, J-1 Visa, H-1B Visa, H-4 Visa, Immigrant Visa.* Individuals who have applied for asylum may apply for permission to work in the United States a year after they file their asylum application.

*This list should be used as reference only and may be subject to change. Please visit governmental websites for additional information.

Building Experience in the U.S. Healthcare System

There are many ways for IMGs to strengthen their applications for a residency position as they pursue continuation of their medical training in the U.S. Clinical opportunities (clerkships, observerships, or externships) are important for IMG’s to gain clinical experience in the U.S. Yet finding these opportunities can be challenging. Clerkships are rotations undertaken as a medical student, while observerships and externships are shadowing experiences and hands-on experience respectively.

Many hospitals have established observership programs, but IMGs have also made their own contacts within the healthcare system to set up individual rotations. The American Medical Association (AMA) maintains a list of Observership Program Listings for International Medical Graduates.

IMGs may take on clinical positions in the U.S. while they are completing the necessary examinations and certification to apply for residency programs. These positions often enable them to gain relevant U.S. clinical experience and support themselves and their families. For example, as trained physicians (some have even completed residencies in their home country), IMGs can often readily gain certification as an medical assistant or surgical technician in most states.
Research

A comprehensive “how to” guide based on personal experience. DOWNLOAD

IMGs may also pursue research to develop expertise in specific areas. Research networks can be a valuable way to advance scholarly work.

Mentorship

One of the greatest challenges that non-U.S. IMGs face upon arrival to the United States is the lack of mentorship. Professional networking for many may begin in college and medical school, and this can represent a disadvantage for those who leave their home country after graduation. Access to mentorship is vital to help bridge the gap between IMGs and U.S. graduates and helps IMGs obtain access to guidance, sponsorships, and opportunities to successfully integrate into the American healthcare system.

Impact of the COVID-19 Pandemic

The COVID-19 pandemic created extra challenges for IMGs looking to continue their medical careers in the U.S. as physicians. There have been changes in (1) certification requirements due to the cancellation of the Step 2 Clinical Skills test, (2) gaining relevant clinical experience due to canceled observerships and externships, (3) delays in visa processing, and (4) restrictions on entry into the U.S. For more information, please visit the ECFMG website.

Resources and Articles

General

Residency Program Requirements for International Medical Graduates (AMA)
Foundation of International Medical Graduates (IMG)
Professional Challenges of Non-US-Born International Medical Graduates and Recommendations for Support During Residency Training (Chen, Curry, et. al., Acad Med)
Immigrant Neurologists in the United States: The Path of Most Resistance (Mahajan, et. al. Neurology)
Charting Outcomes in the Match: International Medical Graduates (National Resident Match Program)
How IMGs Have Changed the Face of American Medicine (Brendan Murphy, AMA)
Why IMG physicians are vital to U.S. health security (Andis Robeznieks, AMA)

Statistics

Active Physicians Who Are International Medical Graduates (IMGs) by Specialty, 2017 (AAMC)
States with Highest Numbers of Exchange Visitor Physicians (ECFMG, 2019)
Specialties Pursued by Exchange Visitor Physicians (ECFMG J1 visa sponsorship, 2019)
Results of the 2020 NRMP Program Director Survey (National Resident Match Program)

Resources by Specialty

Emergency Medicine: International Medicine Graduate (IMG) Emergency Medicine Applying Guide (Council of Residency Directors in Emergency Medicine)
Family Practice: Residency Application Requirements for International Medical Graduates (AAFP)
Internal Medicine: Guidance for International Medical Graduates (IMGs) Matching in Internal Medicine (ACP)
Pediatrics: Section on International Medical Graduates
Psychiatry: Navigating Psychiatry Residency in the United States

Resources for IMGs seeking Asylum

Supporting the Integration of Refugee and Asylum Seeking Physicians Into the US Health Care System (Namak, et. al., J of GME)  
Immigration Service – Q and A: Asylum Eligibility and Applications

Perspectives on the Journey

Applying for Residency as an International Medical Graduate (Ole-Petter R. Hamnvik, MBBCh., BAO., MMS; Jan 2019)
An Informed Transition? International Medical Graduates Settling in the United States and Canada (Rayes, et. al.
Guide to Observership search in US for IMGs (Sivabalan Narayanan)
Path to US Medical Residency for IMG (Sivabalan Narayanan)