International Medical Graduate (IMG) Performance in the 2020 Main Residency Match
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More than 7,500 international medical graduates (IMGs) obtained first-year residency positions in U.S. programs of graduate medical education (GME), an increase of 132 from last year, according to results of the 2021 Main Residency Match® announced Friday by the National Resident Matching Program® (NRMP®). The number of first-year residency positions offered in the 2021 Match increased by 928 (2.7%) to 35,194 over 2020.

The 7,508 IMGs who matched represent an overall IMG match rate of 57% in this highly competitive process. Of the IMGs who matched, 3,152 are U.S. citizens, a decrease of two, compared to last year. The number of positions obtained by foreign national IMGs is 4,356, an increase of 134 compared to last year. The match rates for U.S.-citizen and foreign national IMGs are 59.5% and 54.8%, respectively. An infographic on IMG performance in the 2021 Match can be found here.

The journey to the 2021 Match for IMGs was fraught with changes and challenges spurred by the COVID-19 pandemic, including worldwide disruptions to medical education and changes to the certification process for IMGs. Despite the challenges, William W. Pinsky, MD, President and CEO of the Educational Commission for Foreign Medical Graduates | Foundation for Advancement of International Medical Education and Research (ECFMG®|FAIMER®), said that he was pleased with the outcome of the Match for IMGs.

"ECFMG|FAIMER succeeded in ensuring an applicant pool of international medical graduates for the Match that was ample, diverse, and highly qualified, which is vital for the U.S. health care system," Dr. Pinsky said. "IMGs play an important role in providing supervised patient care, contribute much needed diversity to our nation's health care system, and help to address the nation's growing physician shortage that is being exacerbated by the pandemic."

ECFMG|FAIMER assesses the readiness of IMGs before they enter U.S. GME. The program for certifying IMGs is a rigorous process that includes passing components of the United States Medical Licensing Examination® (USMLE®), the same examinations required of U.S. medical school students and graduates, and demonstration of clinical and communication skills. As part of the certification process, ECFMG|FAIMER also verifies the authenticity of IMGs' medical education credentials, including their medical diplomas, directly with the issuing medical schools. Only IMGs who are certified by ECFMG can enter accredited U.S. GME programs.

Beginning in March 2020, the pandemic forced the suspension and eventual permanent discontinuation of the Step 2 Clinical Skills (CS) component of USMLE, which had been used by IMGs to demonstrate the clinical and communication skills required for ECFMG Certification. ECFMG|FAIMER moved quickly to develop five pathways to allow qualified IMGs who had not passed Step 2 CS to meet the requirements for ECFMG Certification and participation in the 2021 Match. The pathways were critical to producing a robust IMG applicant pool for this Match. Approximately 6,000 IMGs who registered for the 2021 Match completed a pathway; this represents one-third of the total number of IMGs in the Match.

"Appropriate clinical and communication skills are essential for physicians who participate in U.S. graduate medical education," Dr. Pinsky said. "The pathways ensure that the U.S. public and the U.S. GME community can continue to rely on ECFMG Certification as an indicator that IMGs are ready to enter U.S. GME and to provide supervised patient care."

For the 2022 Match, ECFMG|FAIMER is expanding the pathways for IMGs to meet the requirements for ECFMG Certification. With the addition of a sixth pathway and changes to certain eligibility requirements, ECFMG|FAIMER expects that more IMGs will be eligible to pursue a pathway for the Match.

"The expansion of the pathways currently underway for the 2022 Match will ensure the continuity and integrity of ECFMG Certification and the vital service it provides to the U.S. public, the U.S. GME community, and to qualified IMGs who pursue training in our nation's teaching hospitals," Dr. Pinsky said.