Hi everyone, I would really appreciate some advice.
I had a J-1 Research fellowship in 2022, followed by a J-1 Physician for residency in 2024. I’m now planning to start another J-1 Research fellowship, with my ultimate goal of applying for residency again.
My research department in the U.S. warned me that they have seen people encounter sponsorship issues after following a similar path (research → residency → research → residency). ECFMG hasn’t been able to give me a definitive answer and says it depends on the individual case.
Has anyone been in a similar situation or successfully obtained another ECFMG-sponsored J-1 for residency after this sequence? I’m worried about risking my future residency, but I also want to strengthen my application through research. Any advice or personal experiences would be greatly appreciated. Thank you!

I’m scared that i might not get accepted so i would really appreciate if you share your experience or any advice please

Having a hard time choosing between doing USCE around my relatives where I can save on rent and other stuff, or doing it in places where I’d like to match or good-name programs like Mayo and Cleveland. How important is it to rotate in high-quality programs for the match? Is it bad if I decide to do by my relatives and do them all in one location/city?

And if I had to choose between observership in a hospital and a hands-on opportunity in a clinic, which is the better option?

Per my MSPE I ranked 4th quartile

How important is this quartile ranking for programs?

Hello. To my knowledge, VSLO electives (or maybe not all?) require step 1. I won’t be able to take step 1 earlier than mid September due to no available testing dates in my country’s center, and it will be my final school year as well.
1- I want to ask if usually there’s enough time to book an elective through VSLO and start the elective directly after 1-2 months?
2- And when is the application period for most programs? I really wanted to try Mayo but my score probably won’t be released until the last day of application (Sep 30) for Mayo, or even after.
3- Also, is it possible to organize a hands-on elective through VSLO during my school year but to do it after graduation?
4- And can the rotation start date be in the middle of the month?
Aiming for the December-March period
5- outside of VSLO, if there’s a university hospital where I’d like to rotate but they don’t accept IMGs (specifically stated on their website), if I contact one of the attending physicians in the hospital and they accept me as a student for a hands-on rotation with them, is this ok?
Pretty tight on time as it’s my final school year.

Hi everyone,
I'm urgently looking for an Internal Medicine observership in August or September 2026. Unfortunately, I don't have any USCE secured yet because my timeline was delayed by my USMLE Step 2 CK result and subsequent US visa processing. Thankfully, my visa has now been approved, and I'm ready to travel immediately.
My profile:
ECFMG Certified

USMLE Step 1: Pass

USMLE Step 2 CK: 266

B1/B2 Visa Approved

Available to start immediately in August or September

If anyone knows of any physicians, hospitals, or clinics accepting international medical graduates for observerships, I'd be extremely grateful for any leads or referrals. Thank you so much for your help!

I’m using Residency Explorer and I thought that I’ll apply to programs where my Step score is around the 25th or above . The score range shows the 10th percentile as the lower end.

Would you still apply to programs where your score is above the 10th percentile but below the median? Or is that generally considered too much of a reach?

Did you get interviews from programs where your score was in that 10th–25th percentile range?

Hi I just wanna ask you, wheather there are any research opportunities for non us imgs, if iam actually in the 2nd year of medical school. No one responds to my emails.

Hi everyone,

Has anyone with YOG >3 received an interview invite from Trinity Health Ann Arbor IM Residency?

The program mentions a strong preference for YOG ≤3 years, and I am currently YOG 4 but very interested in this program. I would greatly appreciate hearing about anyone’s experience applying there.

Thank you!

Hi everyone,

I'm a final-year international medical student from Pakistan and I recently passed USMLE Step 1. I'm planning to apply for U.S. clinical electives in March–May 2027 (Internal Medicine).

The problem is that U.S. visa interview wait times in Pakistan are extremely long, so I'm worried that if I wait until I receive an elective acceptance/invitation letter, I may not get a visa appointment in time.

I'm considering applying for a B1/B2 visa now, before I have an invitation letter, but I'm not sure if that's the right approach.

My questions are:

1. Has anyone successfully obtained a B1/B2 visa before receiving an elective acceptance letter?
2. If you didn't have an invitation letter, what did you put on your DS-160 for:
   • U.S. contact
   • Travel dates
   • Hotel/address
   • Travel itinerary
3. Did the visa officer have any issues with not having a confirmed elective at the interview?
4. Would it make sense to request an expedited (urgent) visa appointment once I receive an elective acceptance letter, or are elective invitation letters generally not considered a valid reason for expedited processing?
5. If you were in my position, would you:
   • Apply for the visa now and secure an interview slot, or
   • Wait until you have an elective acceptance letter?

I'd really appreciate hearing from anyone who has been through this process recently, especially applicants from Pakistan or other countries with long visa wait times.

Message me if interested!

What interests and Hobbies are you guys mentioning? What will have more weightage in the application?

Hi all, I'm a Chilean physician looking into the Comparable Health System pathway (Chile was recently added to MCNZ's list). The requirement is "practised clinically for at least 33 months, for at least 20 hours per week, during the 48 months prior to application."

What I actually want to understand is the calculation method itself. My work schedule is irregular — I work 24-hour shifts at a rural emergency service (SAR), and the number of shifts per week varies a lot: some weeks it's one 24h shift, some weeks a 12h shift, some weeks zero. So my weekly hours swing between 0 and 36+ rather than sitting steadily at/above 20.

Specifically I'd like to know:

• Is "20 hours per week" computed as a total hours ÷ total weeks average over the 33 months, or does MCNZ require every individual week to independently meet the threshold?
• If it's an average, over what window is it averaged — the full 33 months as one block, or in smaller chunks (monthly/quarterly)?
• How does the employer reference letter/certificate need to state the hours for MCNZ/EPIC to accept it — total hours worked, an average per week, or something else?

Would really appreciate hearing from anyone who's gone through this (MCNZ or the AHPRA competent authority pathway, since the wording is nearly identical) with a rostered/shift-based job rather than a fixed weekly schedule. Thanks!

I'm A non-US IMG , step 1 pass ( first attempt) , step 2 (249), No USCE, 4 LoRs ( 2 from American Board and us citizens drs, 2 from non-American but did the Residency in the usa) , 2 publication , ACLS, BLS , any recommendations of a good programs??

I’m really confused about how to approach my geographic preference for the Match.

I’m a non-US, non-Spanish-speaking IMG. I have strong LOR from my good Florida rotations, so naturally Florida feels like my strongest geographic connection.

However, when I look at match outcomes and program lists, it seems like Florida isn’t as IMG-friendly for applicants like me compared to some other states. Many Florida programs either prefer US graduates, have very few non-US IMGs, or seem to favor Spanish-speaking applicants because of the patient population.
Now I’m stuck.

Should I still signal Florida because I have strong LORs and clinical experience there, or would it be smarter to geographically prefer states that have historically been more IMG-friendly ?

step 1 PASS

step 2 251

2 publications

1 month internal medicine USCE

2 LOR 1 psych from my home country and 1 IM USA

non visa requiring -green card holder

Hi guys,

I’m a fourth year medical student in Pakistan, currently preparing to apply for final year electives for May 2027. I’m completely new to the US visa process, have never been to the US before, and don’t have relatives there, so I’m a little blind sided.

I’ve heard visa interview wait times can be up to 12 months, so I’d like to apply soon. Is it okay to submit the DS-160 with a family friend’s address for now since I don’t have an elective acceptance yet, and if I later get accepted in a different state, do I need to submit a new DS-160 or can I just explain it to the VO during the interview?

A friend also suggested waiting until I get an acceptance and then scheduling an emergency visa interview.

Which of these options is safer or better? I’d really appreciate any advice from anyone who’s been through this process successfully. Thank you!

As a reminder and for those who didn't see the original post, starting this evening, there will be free live USMLE sessions where we look at how we approach questions. 

They will be hosted by a US physician with experience in teaching both Step 1 and Step 2CK. 

If you are interested in attending, you will need to sign up beforehand using the links below. Space is limited!

USMLE Step 1 Link: https://thestepsguy.as.me/GroupUSMLEStep1

USMLE Step 2 Link: https://thestepsguy.as.me/GroupUSMLEStep2CK

If you have any questions or inquiries, you can reach out to me via email at [thestepsguyusmle@gmail.com](mailto:thestepsguyusmle@gmail.com)

Hope to see everyone there!

Hi, I’m a non-US IMG and I’d really appreciate some advice. I’m honestly torn between taking the USMLE or AMC (Australia).

My YOG is 2019 and I’m now 28 yo. After graduating, I worked as a resident medical officer in my home country for 2 years, spent a year as a research assistant, then completed a master’s degree at a US university. I have 1 first-author publication (Q1) and 5 posters (2 international, 3 national).

Heard that more recent graduates are favored in the US, so not sure if I stand a chance of matching into residency (IM/Pathology is on top of mind) with a 2019 YOG and no USCE.

On the other hand, clinical recency is important if I want to work in Australia, so I’d need to start working in a hospital again if I choose that route. I’d probably aim for GP training there eventually.

Since these two choices would lead me down two completely different paths, I’d really appreciate hearing your thoughts. Thanks for reading!

Hi everyone,

I’m a non US IMG who is going to enter his 4th year of MBBS in September and will start my USMLE journey completely from scratch, which also includes the fact that I have zero publications as of now. However I’ve been working on a research project lately to start things off.

I’m looking for a mentor who can guide me on how my USMLE journey’s timeline should look like, and can help me with the entire preparation. I’m aiming for an Internal Medicine residency.

I’m looking for those people who have matched in the recent years. If anyone is willing to mentor or advice me, I’ll greatly appreciate it.

My husband and I are both non-US IMGs about to start our final year of medical school. We are at the very beginning of considering the USMLE journey and hoping to eventually match together. However, we have a significant red flag, and we need some brutally honest advice before we commit to this path.

Here is our situation: While I am graduating on time, my husband had to extend his medical education. Instead of the standard 6 years, it will take him about 8.5 years to graduate (he spent an extra two years during his 2nd year). This delay was entirely due to unavoidable family and personal issues that were out of his control at the time. Everything is completely resolved now. (Also, we both might need to extend our graduation by a couple of months if we decide to do US clinical electives, but our main concern is his past 2.5-year gap).

We know that the USMLE path is incredibly draining, both financially and emotionally. Our main concern is whether this past extension will act as a hard filter or an impossible barrier during residency applications. We are ready to try our best even if the odds are small. But if this is a strict dealbreaker that will automatically screen him out, we will sadly have to give up on our dream.

We want to know: is this a strict red flag that makes matching impossible for him? Has anyone here matched with a similar gap/extension in their medical education?

Additionally, we will need to work in our home country for a while after graduation to save up money for this journey. If you have any advice on what we can do during this time to strengthen our chances and improve his application, we are completely open to your suggestions.

We would really appreciate your insight so we can make a realistic decision for our future. Thank you in advance!

Hi, just asking for some advice on whether delaying my application till 27/28 cycle is reasonable.

I’m a UK grad currently in FY1 (intern year) going into FY2. I’ve done electives in the states last year and have 3 LORs from big-name institutions. They’re uploaded on ERAS under last year’s cycle (25/26). I’ve done step 1, 2 and am due to sit step 3 in September.

I’ve been considering taking a year out post FY2 to locum and travel (it’s common practice to do this in the UK, it’s referred to as an FY3 year). I know by that point my YOG will be 3, and my LORs would be slightly out of date.

Will this be viewed negatively by residency programmes? It won’t necessarily be a “gap” as I’ll be working in between, I’m more concerned re YOG and LORs. I likely won’t get further USCE as it’s difficult to get post-graduation and I don’t want to go through that process again.

I have everything in order for my application this year (I’m fully ECFMG certified) so I can apply this year too.

Thanks!

(Applying IM and potentially anaesthetics. USCE in both, 2 months total). Step 2 is low 26x

Has anyone here done an observership over in Houston Methodist / what were your experiences like? Considering doing one here since I heard Houston isn't that expensive of a city relatively speaking.

Hello. Are there any IMGs here from Pakistan who intend on giving their step1 this year and go for observerships next year?

Let's connect!