Medical Doctors with foreign credentials play a vital role in helping nations deal with the shortage of doctors and healthcare providers.  The United States has expressed concern over the nation’s inability to provide quality healthcare services to its citizens, as stated by the Association of Medical Colleges. This prompts more schools to be inviting for international medical students from abroad who have been under-represented in American medical schools.

The United States of America is a country of dreams. Many people from far and near dream of making it to the land of opportunities that a foreign doctor refers to as the US. For many medical grads, this opportunity is a mere dream, not because they are incapable but because they lack information about where to begin preparations. This article will change all that for you.

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How to Become A Doctor in USA for International Students

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The trend of globalization has made it easier for professionals in many fields to find employment opportunities abroad, but this does not necessarily apply to the medical field, particularly when it comes to foreign physicians in the United States. Foreign medical graduates, commonly referred to as FMGs in the American healthcare sector, are often required to take quite a few educational courses that may not have been part of their medical school curriculum overseas.

Where you earn your education as a physician will impact where you can practice medicine. For instance, the education needed to become a practicing physician within the United States (US) requires years of education and clinical hours. For foreign-trained physicians living in the US, they will need to undergo an additional amount of education on top of the degree that they’ve already earned.

The Physician Formation and Education System in the United States

In general, students who wish to practice medicine in the U.S. must first earn a college degree that includes at least three years of what is known as pre-med education. Bachelor of Science degrees in chemistry and biology usually fit into the pre-med mold, and some schools offer programs that are straight pre-med with an eye towards gaining admission into medical school. Once admitted into medical school, the next four years will be spent in pre-clinical and clinical education periods that culminate with graduation and the granting of a Doctor of Medicine degree before heading into internship and residency. Long Description

Educational Differences in the American Physician Training System

Unlike physician training programs in other parts of the world, there is no foundation training in the U.S. because medical students can choose to specialize, or not, upon getting their M.D. degree. The Bachelor of Medicine and Bachelor of Surgery programs often taught in Asian colleges, for example, are unheard of in the U.S. It is not uncommon for an American pediatrician to have earned a Bachelor of Arts in Sociology plus a Master of Health Sciences before qualifying for medical school.

US Medical Licensing Exam Requirements

With the above in mind, it is more likely for an American doctor to be able to practice overseas than for a foreign counterpart to work in the U.S., and this is a matter of licensing and education. FMGs in the U.S. must deal with the Educational Commission for Foreign Medical Graduates.

So how can foreign doctors practice in the US? These are the US medical exam requirements for any for foreign medical graduates and practicing physicians to obtain ECFMG Certification:

• Certifying that the FMG obtained a degree listed on the World Directory of Medical Schools
• Completing missing education requirements
• Medical Science Requirements – You must pass both the USMLE Step 1 and USMLE Step 2 CK (Clinical Knowledge)
• Clinical Skills Requirement – To practice medicine in the US after graduating from med school in another country, you must also pass the USMLE Step 2 CS (Clinical Skills)
• Going through a residency program
• Obtaining final ECFMG certification

Once you pass all three of these US medical licensing exams, you’re eligible for ECFMG certification. You don’t have to wait until you graduate from medical school to apply. Feel free to apply as a med student. However, you won’t receive confirmation until you provide graduation confirmation.

After you receive ECFMG certification, you can begin your residency in the US. But be sure to apply for your residency long before graduation and certification. The application process may take some time.

While it is true that many foreign physicians work and train at U.S. hospitals, they are often enrolled in special cooperation programs that may be sponsored through diplomatic exchange channels or the U.S. Agency for International Development. FMGs who may have already worked at an established practice in other countries will find the equivalency, licensing and certification program to be particularly arduous.

In order to practice clinical medicine in an unsupervised setting (i.e. outside postgraduate training programs), all physicians (international graduates and domestic graduates in USA) must be licensed by the medical licensing board of the state where they plan to practice.

Passing all four tests of the United States Medical Licensing Exam® (USMLE) sequence is required for any doctor to obtain a license to practice medicine in the United States.

• Students and physicians trained outside the US take the same test, and are scored by the same standard as US medical school students.
• USMLE is designed to test problem solving, not simple memorization.

LICENSING EXAMS

The United States Medical Licensing Examination (USMLE) consists of three steps designed to assess a physician’s ability to apply a broad spectrum of knowledge, concepts, and principles to evaluate the physician’s basic patient-centered skills.

Step 1 (multiple-choice exam)

This exam is designed to test how well the examinee applies basic, integral science concepts to clinical scenarios.

Step 2 (two separate exams)

The Step 2 Clinical Knowledge (CK) is a multiple-choice exam designed to determine whether the examinee possesses the medical knowledge and understanding of clinical science considered essential for the provision of patient care under supervision. The Step 2 Clinical Skills (CS) is a separate “hands-on” exam that tests the examinee’s clinical and communication skills through his/her ability to gather information from standardized patients, perform a physical examination, communicate the findings to the patient, and write a patient note.

Step 3 (multiple-choice exam)

This exam assess the examinee’s ability to apply medical knowledge and the understanding of biomedical and clinical science essential for the unsupervised practice of medicine, with emphasis on patient management in ambulatory settings.

Starting All Over

So, while many foreign physicians will have years of experiences diagnosing, treating patients, and administering medicine, in order to practice as a US doctor, it essentially requires them to start all over again academically, especially when the curriculum differs from overseas qualifications.

FMGs whose medical education is deemed to be insufficient in areas such as algebra, biochemistry, physics, molecular biology, and research writing are bound to feel as if they have to start all over again in the U.S. Many become disillusioned and end up taking other jobs totally unrelated to the medical field, and this is when the movie trope of highly skilled professionals driving cabs in the U.S. becomes an unfortunate reality.

However, experts expect a shortage of both primary-care doctors and specialists to continue in the coming years. By 2025, the American Association of Medical Colleges projects primary care shortfalls ranging from 12,500 to 31,100 doctors, and shortages of non-primary care doctors between 28,200 and 63,700.

Foreign-trained doctors are critical to addressing these shortages, accounting for important shares of primary-care physicians in the United States. Nearly a third (31.8%) of all physicians specializing in family medicine, internal medicine, and pediatrics—three specialties associated with primary healthcare—are foreign-trained.

These 128,099 foreign-trained physicians are among the primary-care doctors recognized by fellow healthcare professionals as “the first line of defense in the healthcare system.” As a result, primary-care physicians deliver most of the country’s preventive and routine services, such as checkups, initial acute-care, and initial diagnoses guiding patients to the appropriate level of care.

For a model of how this would work, in Canada, the government only requires an estimated half of its foreign-trained doctors to get fully retrained. The other half can be rapidly certified to practice medicine by proving that they received their medical training from a list of vetted medical schools in countries such as Algeria, Nepal, Argentina, and Macedonia.

Thankfully, FMGs have better career options to keep them connected to the healthcare industry while pursuing their dream

of becoming American doctors.

What Type of Specialties Can Foreign Physicians Practice?

BioExplorer reports that there are approximately 44 different types of doctors, but as the medical industry continues to evolve, more specializations arise. As a foreign physician, this gives you at least 44 different career options to pursue as a US healthcare practitioner. Here is a short list of just a few of these specialties:

• Family Medicine Physician – This type of doctor is most general type of practice that can treat a wide range of patients of all ages. If this kind of doctor finds anything too serious, he or she usually refer their patient to a specialist.
• Gastroenterologist – This kind of doctor focuses on the health of the stomach, the small and large intestines as well as the pancreas and liver.
• Endocrinologist – Studies internal medicine related to the human body’s hormone levels.
• Neurologist – Studies the brain.
• Ophthalmologist – Specializes in the surgical treatment of the eyes.
• Orthopedist – This type of doctor will specialize in the disease, injuries, and treatment of the foot that involve the muscle, nerves, bones, etc.
• Pediatrician – Pediatricians treat children. Since these patients are still developing and growing, this kind of doctor not only focuses on the physical health, but also the emotional and mental well being of children.
• Periodontitis – Studies the health of the mouth.
• Surgeon – While most of these kinds of doctors may be involved in surgical procedures, to pursue a career as a practicing surgeon will keep you heavily involved with removing and/or transplanting body parts and organs.
• Veterinarian – Not all doctors are involved with treating human beings. Veterinarians specialize in treating animals. In this profession, you can specialize in treating farm animals, domestic animals, or exotic animals. Some veterinarians treat all kinds!

Options for Foreign Doctors at Florida National University

Whereas many American doctors can practice in Europe and other places abroad with fewer hurdles, many foreign physicians come to the US on a working Visa. They work as Patient Care Technicians, Medical Assistants, or Registered Nurses. Some might even cross over onto the technical side of the healthcare industry and work as a lab technician. Even with these jobs, a certain amount of education is required.

Most foreign physicians are determined to practice medicine in the US, so the first thing they have to do is earn their pre-med degree. While it is possible to earn your undergraduate degree in Nursing and go on to become a licensed US physician, Florida National University (FNU) challenges you to enroll in our Bachelors of Natural Science program.

We also have a Bachelor of Science in Nursing (BSN) program. While our BSN program will certainly guide you toward a rewarding career in the healthcare industry, the Bachelors in Natural Science will better prepare you to pass your exams and get your physician’s license. You’ll study under the instruction of the professional board of faculty members who have years of experience in the field. The wide variety of courses offered also prevents you from pigeonholing yourself into one particular field of study. With the undergraduate program in Natural Science, you’ll earn a well-rounded degree in a variety of subjects that can catapult you into a licensed doctor practicing in a specialty of your choice.

When the ECFMG determines that a foreign physician living in South Florida must complete the equivalent of a pre-med degree before challenging the USMLE, a smart option is to keep those healthcare skills sharp by means of getting a suitable job within the industry. Florida National University is a private college duly accredited to grant health sciences and technology degrees such as:

• Nursing
• Advanced Respiratory Therapy
• Medical Laboratory Technology
• Physical Therapy
• Radiology
• Patient Care Technician
• Echocardiography

The accreditation entities that recognize FNU as a degree-granting institution include:

• Accreditation Commission for Education in Nursing
• Florida Board of Nursing
• Southern Association of Colleges and Schools
• Florida Commission for Independent Education

FNU recognizes diversity in its student body and the South Florida community; for this reason, the school has an agreement with the National Accreditation and Equivalency Council of the Bahamas. As a school that truly cares about the professional development of international students, FNU recommends the following paths for FMGs:

* Enroll in a healthcare certificate program and work as a technician in this sector. A radiology technologist, for example, can earn an average of $56,000 per year in Miami. This is better than driving a taxi and will allow FMGs to continue working with the ECFMG for final certification or licensing. For more information on this program, contact one of our counselors today.

* Complete the Bachelor of Science in Nursing program, which can be turned into a graduate degree without leaving FNU. The scope of registered nurses in Florida has greatly expanded in recent years, and a few choose to become nursing practitioners and even doctors because of their advanced knowledge in healthcare.

* Complete the Bachelor in Natural Science program, which has many similarities to a straight pre-med degree, and continues to work in the health sciences sector as a skilled FMG. The South Florida region is home to a thriving and very lucrative health sciences industry where employers are constantly looking for job applicants with medical experience. This degree will make it a lot easier for FMGs to pass the USMLE and obtain ECFMG certification.

international medical graduate assistance program

What is an International Medical Graduate (IMG)?

To participate in the Match in the US and Canada as an IMG, you must first learn what constitutes an IMG in both countries. Let’s start with the US.

International medical graduates aiming to match in America are divided into 2 main groups: US IMGs and Non-US IMGs. US IMGs are citizens of the United States who graduated from international medical schools, while Non-US IMGs are not US citizens who graduated from international med schools. Non-US citizens who graduate from US or Canadian medical schools are not considered IMGs. Essentially, the Unites States considers anyone who graduates from a non-US MD or DO school an international medical graduate, regardless of their citizenship. This means that if you are a US citizen educated in one of the Caribbean medical schools, for example, you are a US IMG, while a student with French citizenship, let’s say, who graduated from a medical school in the US is not an IMG. It’s important to note that Canadian citizens who graduate from one of the 17 medical schools in Canada are also not considered IMGs. Canadians are eligible to apply for residency via CaRMS and ERAS at the same time. If you are a Canadian citizen matched to a US residency spot, you will be required to apply to the Educational Commission for Foreign Medical Graduates (ECFMG) and obtain a J-1 visa to be able to train in the US. We will outline this process later in this blog.

In Canada, on the other hand, your citizenship or residency status directly affects your chances to participate in CaRMS. You must be a Canadian citizen or a permanent resident of Canada to be eligible for the match. While there are some Canadian medical schools accept US students and international applicants, the latter cannot participate in the match unless they become Canadian permanent residents or citizens. Otherwise, any Canadian citizen who graduated from an international medical school (including the US) is considered an IMG.

Now that we understand what constitutes an IMG in each country, let’s go over how the Match works and what you will need to do as an IMG to increase your chances of matching. 

Eligibility Requirements for IMGs in the US

The Match is a system used to match students with US residency programs. Although not every program uses The Match, most do. Programs that choose to participate are required to register each position and attempt to fill them to ensure a fair process. Before IMGs can start applying for residency positions, they must meet a set of requirements.

As we already discussed, US medical schools have their own definition of international medical graduates. The location and accreditation of the medical school attended determines whether the graduate is an IMG, not the citizenship of the graduate. This means that American citizens who graduated from medical schools outside the United States and Canada are considered IMGs. Non-US citizens who graduated from medical schools in the United States and Canada are not considered IMGs. The Educational Commission for Foreign Medical Graduates (ECFMG) assesses whether IMGs are ready to enter residency programs in the United States. You must be certified by the ECFMG before you can take the USMLE or start a graduate medical education program. The ECFMG coordinates the ERAS application process for international medical graduates.

US graduate medical programs’ directories

You can find the descriptions of most programs on the following online directories. These include:

• The Fellowship and Residency Electronic Interactive Database Access (FREIDA) is the online directory of graduate medical education programs sponsored by the American Medical Association (AMA)
• The Accreditation Council on Graduate Medical Education (ACGME) also offers a residency directory
• The American Academy of Family Physicians (AAFP) offers an online family medicine residency directory 

Each medical specialty has specific information about individual programs, as well as any general or special requirements for application including whether they admit IMGs. Application deadlines vary among the programs. Make sure you confirm your program’s deadlines.

Residency program requirements

Program requirements for each residency position are most often listed on their websites. These may include medical school graduation year, types of visas accepted, or how many USMLE attempts are allowed. Make sure that you understand your program’s residency requirements before applying.

The Federation of State Medical Boards (FSMB) updates state-specific information for residencies. You can use this site to find out if you can get a license in a specific state during residency. Some states, such as California, have a list of recognized international medical schools that are eligible for licensure in the state. Some states have restrictions on the number of USMLE attempts allowed.

Visa requirements 

In order to participate in American graduate medical programs, international medical graduates who are not citizens or permanent residents must obtain the appropriate visa. The two most common visas are the H1-B (Temporary Worker) or the J-1 (Exchange Visitor). Some institutions will sponsor the visa for residents in the residency program, so it would be wise to check with your program.

The ECFMG is also authorized by the US Department of State to sponsor foreign national physicians for the J-1 visa. Learn more about your visa application process from your residency program, the American embassy or consulate in your country of residence, or the US Citizenship and Immigration Services.

Eligibility Requirements for IMGs in Canada

The Medical Council of Canada (MCC) provides requirements for the residency match process. Make sure to check these requirements on their website before you begin your applications. If you are an IMG wishing to apply for residency in Canada, these are the standard eligibility requirements:

1. You are a current student or graduate from a school listed in the World Directory of Medical Schools, OR your medical school must be accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS) or the Liaison Committee on Medical Education (LCME) (in the U.S.) OR your medical school must be accredited as a U.S. School of Osteopathic Medicine.
2. Written and passed, or be scheduled to write the National Assessment Collaboration (NAC OSCE) examination.
3. Written and passed, or be scheduled to write the Medical Council of Canada Qualifying Exam Part I (MCCQE Part I). This examination assesses the critical medical knowledge and clinical decision-making ability of a candidate at a level expected of a medical student who is completing his or her medical degree in Canada.
4. Must be a Canadian citizen or a permanent resident of Canada. Visa holders are not eligible.

You can choose to take the NAC exam and the MCCQE Part I in the order that you prefer. You must also remember to write the examinations before the programs’ deadlines. Please check with your program when the examination results must be submitted and schedule your exam accordingly. You can find important timeline information for your application cycle on the MCC website. Please be aware that the United States Medical Licensing Examination (USMLE) cannot substitute any of these exams.

Provincial requirements

The above-mentioned list includes just the basic requirements that would allow IMGs to participate in the CaRMS matching process. The requirements of MCC is just one set of criteria, but you must research the requirements of each province separately in order to apply for positions in those provinces. As an international medical graduate, you may have to take additional steps to verify your medical degree, complete additional examinations, or enter into a service agreement that commits you to practice in a particular area for a specific amount of time. Take into account that meeting certain provincial eligibility requirements for IMGs can be extremely challenging.

You can find help discerning all the provincial requirements by visiting the CaRMS official website where you will find the provincial criteria section. Requirements listed under each province in this section will apply to all programs within that province. Ensure you have read the information provided under the provincial restrictions to meet all the necessary requirements when applying for the programs of your choice. A list of programs with descriptions is also available on the CaRMS website. Each program will indicate what documents are required, which exams need to be passed, and which provincial assessments are preferred. When studying each program, be sure to check both the program’s list of requirements and the criteria of the province in which the program is located.

countries in need of foreign doctors 2020

We will be looking at what medical practitioners they need and how many of them they need. For the amount of foreign-trained doctors presently in each of these countries, we will be using statistics curated by the world atlas.

1. The United Kingdom

Facing one of the most severe healthcare workers shortage in the world is the UK. It has tens of thousands of vacancies for health workers across streams. The Punch Nigeria, on August 12, published an article stating that “”between 2015 and July 2021, a total of 4,528 Nigerian-trained doctors have moved to the United Kingdom to practise.” This excludes those trained in the UK and who are working there.

Already, 28.30% of doctors in the UK are foreign-trained. The NHS revealed that in the first quarter of 2019-20, about 43,000 nurse posts were vacant in England , especially with Covid-19 putting a strain on all healthcare systems. As such, if you are planning to migrate, the UK is a great choice.

2. USA

Even the US’ demand for physicians is greater than its supply. According to data published by the Association of American Medical Colleges, the US could see an estimated shortage of 54,100 to 139,000 physicians by 2033. According to Ross University’s School of Medicine, they are especially in need of physicians in the following specialties:

Family medicine, internal medicine, emergency medicine, psychiatry, obstetrics and gynecology, neurology, radiology, anesthesiology, pediatrics, and cardiology. 25% of doctors in the country are foreign-trained and with this need, you stand a chance.

3. Australia

By 2025, it is expected that an extra 205,900 healthcare and social assistance workers will need to be added to Australia’s workforce. Presently, 30.50% of Australia’s doctors are foreign-trained and with its rising population, it is expected that there will be a need for about 85,000 nurses by 2025. Although home to many health workers from India and Asia, it is not closed to Africans. 

It is especially open to students who wish to study and practice medicine in the country and there are a host of affordable cities to study in Australia.

It has always made up for its shortages in the healthcare system via immigration. As much as they are currently trying to get more students into vocational studies to meet their needs, it is not proving fruitful yet. Hence, immigrant doctors and nurses are still very much needed. It pays its health workers really well and provides a great working environment which makes it not only one of the countries urgently in need of medical practitioners but one of the highest paying countries for doctors.

4. Spain

Spain has a high demand for doctors presently and has numerous vacancies in its healthcare system. 9.40% of its doctors are foreign-trained but, as much as its welcoming health practitioners, there are limitations. The language barrier remains a big issue but if you speak Spanish and have a Level B2 certificate ascertaining that, you stand a good chance.

5. Canada

Canada is facing a shortage of both doctors and nurses. According to a report released by the Canadian Nurses Association, by 2022, a massive shortage of about 60,000 nurses is expected. To meet its shortages, it is bringing in healthcare practitioners from around the world. According to the World Atlas, 23.50% of its doctors are foreign-trained.

Doctors are in such huge demand that they are on the Canadian NOC list code 3113 and qualified doctors are eligible for full permanent residency in the Federal Skilled Worker Immigration Programme. By the end of this year, Canada expects to have imported at least 1,000,000 skilled migrants. You can be one of them.

6. Luxembourg

Luxembourg is inreal need of doctors. One thing to consider though is that general practitioners and medical specialists must get a license from the Ministry of Health to practise in the country. Preference is given to those from an EU member state or a state of the European Economic Area or doctors from a third world country who already has a valid residence permit or have been granted international protection.

7. Italy

Being one of the hardest-hit countries in the world during this Covid-19 crisis, the virus left this country with a shortage of as many as 73,000 health workers… Although they are in need of healthcare professionals, they don’t exactly want foreign professionals.

According to their laws, non-Italians that can be employed in public roles, including healthcare, must be European citizens, their relatives, or foreigners with long-term residency permit called permesso di soggiorno.

8. Ireland

Already, according to world atlas, of Ireland’s doctor population, 36.10% are foreign-trained doctors who come to the country to fill up the critical gaps in their health service system. This is a viable option for you because aside from the fact that they need medical doctors, they are on the list of top countries that offer a high amount of income to doctors. 

It is also in need of nurses and midwives and is always recruiting from other countries. You can choose to work either in the public or private hospitals based on whatever you have to offer as a health worker.

9. New Zealand

According to the OECD, if they were to meet their need for medical practitioners by 2021, they would need 380 extra specialists every year. By 2030, the same report predicted that the country would need 25,000 more nurses. This is a great place to move to as a health worker because not only does it pay well, it provides one of the best working conditions in the world. Already, 42.60% of doctors are foreign-trained.

10. Israel

Israel is on the lookout for qualified nurses. Although it has a pretty high cost of living, its lucrative wages make living in the country very possible. It is home to many foreign doctors who make up about 58% of its doctor population. With a healthcare system that is on par with those of many developed countries, you will get many of the benefits present in those countries as well.

For nurses willing to consider this option, note that you will have to clear an Israeli licensing exam.

11. Switzerland

Even the city of the Red Cross is short about 10,000 nurses currently and is predicted to need 20% more by 2025. As a registered nurse, Sweden is a great option for you and pays really well. One issue you might face though is language barriers. Hence, medical practitioners looking to practice need to be able to communicate in French, German, and Italian. Presently, 27% of its doctors are foreign-trained.

12. Sweden

The Swedish healthcare system is in high demand for nurses and physicians. Like one Swedish resident said, “it’s proving to be easier to train a foreign doctor to speak Swedish than to take random speakers of Swedish and train them to be doctors.” So, if you are willing to learn a new language, consider Sweden.

13. Denmark

If you are a medical practitioner who speaks Danish, Denmark needs you. It faces a looming nursing shortage and is looking to employ 1000 overseas nurses by the end of 2021. Note that if you do not speak the local Danish language, it will be difficult to get a job there.

14. UAE

If you hold a bachelor’s degree in nursing, the UAE is worth considering. Some recent changes in the rules for overseas nurses led to the churning of many nurses with a diploma certificate in nursing. This created vacancies for nurses in the UAE and you can take advantage of that.

15. Norway

Norway is facing a severe shortage of nurses. According to reports from Norway Today, in 2018, the lack of specialist nurses increased by 47% compared to previous years and with the covid-19 pandemic, it is expected that there is a much greater need now. One hurdle foreign medical practitioners have to overcome is the need to prove efficiency in the local language.

do program for foreign medical graduates

Foreign Medical Graduates (FMGs) have a different path to practicing medicine in the United States than those who were trained in-country. This path is different because it is an attempt at discerning quality education at foreign medical schools. It isn’t that foreign medical schools aren’t as good as American medical schools, but not all medical schools adhere to U.S. standards or higher. The different path FMGs must travel ensures that all physicians practicing in the U.S. have met or exceeded U.S. standards.

The ECFMG

The Educational Commission for Foreign Medical Graduates (ECFMG) is the certifying organization that confirms FMGs are ready to take part in a U.S. residency that is accredited. In order to practice medicine autonomously, FMGs will have to complete a three-year (or more) residency in the U.S. no matter what type of training they received abroad.

The ECFMG makes sure that your medical school is on its World Directory of approved medical schools. It also serves in assisting FMGs with visa applications and licensing examinations. It is a FMG’s first line of support in becoming a practicing physician in the U.S.

USMLE

The United States Medical Licensing Examination (USMLE) is broken into three parts. Step 1 and Step 2 (CK) cover clinical knowledge, and Step 2 (CS) covers clinical skills. Finally, step 3 is the final exam that covers knowledge and skill combined. In order to get ECFMG certification, FMGs must pass steps 1 and 2. In order to qualify to take Step 3, an FMG must have ECFMG certification.

Visas

The J-1 visa is the most common visa used by FMGs to get into residency programs. The ECFMG sponsors physicians with this visa. A FMG must have passed step 1 and 2 of the USMLE in order to apply along with having ECFMG certification. An official letter must be held from a Graduate Medical Education or training program, and the Ministry of Health at the last country of permanent residence must provide a statement of need.

Once the requirements are met for a J-1 visa, the FMG is free to complete a residency program once he or she is Matched. Then, he or she must return to the home country for 2 years before being eligible to return. This ensures that low-income countries do not suffer “brain drain” where physicians leave to obtain premium knowledge but never bring that knowledge and expertise back home.

There are exceptions to the 2 year at-home requirement if there is probably danger or persecution that the FMG will face if returning home. It can also be dropped if it would cause a hardship to a spouse or children. Lastly, there are exceptions available for those who an Interested Governmental Agency has taken interest (i.e. Department of Health and Human Services).

The Match

The National Resident Matching Program (NRMP) is how most residency candidates are matched to a residency program, and the application for the Match is called the Electronic Residency Application Service (ERAS). In order to get into the ERAS program, you must get a token from the ECFMG.

Once you have applied through ERAS, the Match process begins. This includes you evaluating all of the residency programs you are interested in and getting interviews to bolster your chances of matching into a residency program. You make a rank order list with all of your top picks (strategically chosen to increase you chance of acceptance in a program you like). The program directors also make a rank order list. Using algorithms meant to create best-fit matches with residencies and applicants, applicants are matched.