IMG Secrets

How Can IMGs Get Pre-residency Fellowship in the USA?

International Medical Graduates (IMGs) can get pre-residency fellowship in the USA by applying to those programs that offer a medical fellowship in the USA hospitals. These IMGs can apply after their post graduate and specialty training in the home country. I have seen many IMGs do this to gain US clinical experience and subsequently use this experience to apply for residency matching of their choice.

Let’s jump to find out more about this pre-residency fellowship including the types, where to apply, how to apply, what is the pay and many more.

What types of pre-residency fellowships are available for international medical graduates (IMGs)?

There are two types of pre-residency fellowship. I have seen IMGs being successful getting into residency using either of these.

  1. Clinical Fellowship
  2. Research Fellowship

If you think about these, your ultimate goal in this example is to match into residency. This fellowship will help you do that.

Clinical Fellow: If you come in as a clinical fellow, you will have to be ECFMG certified which means you have to complete the following USMLE Steps

I recommend, based on the IMGs I’ve seen, that you also complete your USMLE step three. Then this will help you get an H1-B visa & get an independent license when the time comes.

When you come in as a clinical fellow, you will be given a training license. So, once you have step three, this will also help you get an independent license because step three is a must for you to get an independent license which is what consultants used to work as.

Research Fellow: The second option is a research fellow. If you are interested to move into the USA and yet to complete USMLE, then this is an option you can explore. not completed their USMLE yet. But this is a short-term fellowship. If you want to get back to residency, you have to still complete all the USMLE steps, which can be done while you’re doing your research fellowship. Typically research fellowship for those who have completed medical college and have research experience although the latter is not a must.

I have seen some IMGs get residency directly from their home country this is those IMGs who have already finished the residency training, but for the most part, most IMGs will require some kind of experience in the USA. So, when you’re going through your clinical fellowship or research fellowship, you can do the following to make yourself competitive for residency matching.

  • Develop great relationships with US consultants & program directors
  • Attend conferences
  • Publish manuscripts
  • Present lectures
  • Work hard towards your goals
  • Use this as US experience

What kind of pre-residency fellowship should IMGs apply for?

I have seen IMGs apply for all types of fellowships. In general, it is wise to pick a fellowship that is not very competitive. This means the fellowship specialty should not be very well known.

I will give you an example in anesthesia. Fellowships like pain medicine, pediatric anesthesia, cardiac anesthesia are desirable and may be competitive to get. This keeps changing depending on the demand. If cardiac anesthesia stays the most desirable anesthesia fellowship for lets say 5 years, the next 2-3 years it may go down in the number of graduates seeking this. In general, you can pick a fellowship like clinical anesthesia which in my humble personal opinion may not be chosen by many IMGs. Spend time to find fellowships like this. This way you can increase your chances of getting a fellowship.

Where can IMGs apply for a pre-residency fellowship?

Well, not all the programs will take IMGs. Although getting into a fellowship from your home country is not super easy, there are some steps that can be taken to increase your chances.

  • Pick cities where US graduates are less likely to go to. If you think of New York State, it is obvious to think of New York City but this can be competitive and put you at a disadvantage. Instead, pick a city that is not well know. For e.g. in New York State for example, Buffalo & Upstate New York are some options you can explore. Apply a similar strategy for other cities. Is this super easy? NO. But your chances will be much higher here than bigger and well known cities.Β  Niagara falls is in Buffalo and you can get there so frequently. When i lived in Toronto, Canada i used to visit Niagara Falls very frequently & Niagara-on-the-lake and loved it.
  • Pick specializations that are less well known.

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How much salary are IMGs paid for pre-residency fellowship?

I will explain this based on whether this is a clinical or a research fellowship to make it easy for you.

Clinical Fellowship: The salary you’ll be paid as an IMG clinical fellow directly coming from your home country will be equal to any other US graduate doing a clinical fellowship. Here are the differences.

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After your fellowship, the goal is to get back to residency in the USA or Canada. I encourage you to explore the alternate entry path program that you can read about here.Β 

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How do I apply for pre-residency fellowship as an IMG?

To apply for a fellowship, whether it’s research fellowship or a clinical fellowship follow this steps.

The personal statement is just a one-page summary about yourself, where you’re going to highlight all your accomplishments and then give a summary of what you are looking in the fellowship and how the hospital will benefit because they want to hire you.

The CV has to be very nice and crisp without any typos or grammatical errors, make it look very nice and clean, and then send it.


I have applied for fellowship in USA, what next?

Here is a rule of thumb i suggest you follow.

  • Apply for a fellowship by sending the email as above. You get a response, great.
  • Wait for 4-6 weeks. If no response, send them a reminder email
  • Wait for 4-6 more weeks. If no response, make a phone call to express interest to Administrative Assistant & ask if there is an opportunity to speak to the program director or the head of the department
  • You go through the phone call. You don’t hear back in 2-4 weeks. Move on to the next program.

You are dealing with busy people who have a lot of things going on – clinical & administrative. This is why i tell you restrict the number of emails and phone calls. If they are interested you will hear back soon, if you don’t then either they are interested in your application or they may not have a position open. So move on.

If you are selected, then the hospital hiring you will work with you so you get the required training license and visa to work in the USA.Β 

I suggest you definitely explore the alternate entry path program. Through this you can come to the USA as a fellow and directly transition to become a consultant without having to repeat residency all over again. This option is available for many specialties that you can check from the link here. I have also explained the details about anesthesia alternate entry path program in a very detailed way along with my personal experience.

As an IMG, can I directly apply for a sub speciality fellowship in the USA?

Yes you can. I have come across many IMGs who have done this and have been successful. You can use the methods i have explained to apply for the sub specialty fellowship directly from your home country.

This article was originally published on IMGSecrets.com by Dr. Rajeev Iyer. If you find this article elsewhere this is a stolen content.

Check Out Other Content For You To Be Successful As An International Medical Graduate (IMG)

Can IMG Doctors Work in the USA Without Residency or Green Card?

10 Elite US Hospitals open door for IMG Observership

WHO AM I? IMG Secrets: How to be a successful international medical graduate


By Dr. Rajeev Iyer, MBBS, MD, FASA
Associate Professor of Anesthesiology
University of Pennsylvania, USA

The opinion in this article of author’s own and does not represent the opinion of University of Pennsylvania or any other organization.Β 

10 thoughts on “How Can IMGs Get Pre-residency Fellowship in the USA?”

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  4. Thank you for this. This is very enlightening and encouraging. I have just one question though. In applying for a pre- residency fellowship, am I going to be applying to individual programs or applying through ERAS? Thank you

  5. Vincent Obiwuru

    You are a great man.
    Thanks for giving me updates with regards to practicing Anaesthesia in the US as an IMG

  6. Can I apply to fellowship in the US after MBBS or do they require post graduate training ?
    I am a foreign medical graduate and ECFMG certified .

  7. Will passing my step 1 on 2nd attempt in med school affect my chances of matching into post doc fellowship. I am a non us img with great scores on other steps and other good credentials

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