IMG Secrets

Specialties Difficult For IMGs to Match – 2023 Update

I analyzed the most recent National Resident Matching Program (NRMP) data for PGY1. Based on this and my own experience as an IMG of many years in the USA, here are the 11 specialties that are difficult for International Medical Graduates (IMGs) to match. This information will help you focus as you’re going through the matching process.

  1. Thoracic Surgery
  2. General Surgery
  3. Physical Medicine & Rehabilitation
  4. Anesthesiology
  5. Plastic Surgery
  6. Dermatology
  7. Obstetrics Gynecology
  8. Medicine-Pediatrics
  9. Emergency Medicine
  10. Orthopedics
  11. ENT


On the other hand, there are also many IMG friendly specialties. I have left the list of these IMG friendly specialties that you can check here.

Let’s jump to find out the match rate and more information about these specialties that are difficult for IMGs to match.

What are the Specialties Difficult For IMGs to Match?

The following 11 specialties are difficult to match based on my NRMP data analysis and my own experience. I have excluded combined residency programs which in my opinion are not popular amongst IMGs.

11. Thoracic Surgery, Match Rate 6%

Here is the specialty number 11 that is difficult for IMGs to match and it is thoracic surgery. Only six percent of IMGs matched into this. The number of spots in thoracic surgery is also very less. Due to a combination of the low percentage of matching and less number of residency spots, the number of IMGs who are successful in thoracic surgery is less.

Thoracic Surgery also offers an alternate pathway for certification where outstanding specialist IMGs can directly become board certified without repeating residency all over again in the USA.

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10. General Surgery – Categorical, Match Rate 5%

The next specialty is surgery, as a categorical residency. If you’re not familiar with this term, categorical residency means that your internship plus residency will all be done in one hospital. So essentially, you’re in one program. Only five percent of IMGs matched into surgery. I personally know of Surgeons who are IMGs and given the number of spots in surgery, five percent matching I would say is still pretty good.


9. Physical Medicine & Rehabilitation, Match Rate 4%

The next specialty is Physical Medicine and Rehabilitation. Only four percent of non-us IMGs matched into this. The number of spots for this is also less I’m not sure if this is driven by a lack of knowledge about the specialty or just that IMGs are not interested

8. Anesthesiology, Match Rate 4%

The next specialty is anesthesiology. Only four percent of IMGs matched into anesthesiology. Anesthesiology does have more than a thousand Spots. I’m an anesthesiologist, and I have personally seen many IMG anesthesiologists. Based on my experience that anesthesiology is still an IMG friendly specialty, but it is difficult to match because it’s a desirable specialty and many U.S graduates do want to do anesthesiology. I think that probably might be the reason why many IMGs have not been successful in matching for anesthesiology.

Anesthesiology offers an alternate entry path program for outstanding IMGs to directly become a specialist in the USA without repeating residency all over again. I have the details of this pathway that you can check here. 

7. Plastic Surgery, Match Rate 4%

The next on the list is plastic surgery. Only four percent of IMG is matched in plastic surgery. I have rarely come across an IMG plastic surgeon. Plastic Surgery is a desirable specialty for U.S. graduates which makes the competition stiffer. Also, the number of plastic surgery spots is very less. These in effect make plastic surgery a difficult specialty for IMGs to match.


6. Dermatology, Match Rate 3%

The next specialty on the list is Dermatology. Dermatology is another desirable specialty for IMGs but only three percent of IMGs are matched into Dermatology. I’m really surprised by the number of Dermatology residency spots available, it’s less than 50. I didn’t imagine the spots to be so less. I have come across IMGs in dermatology but looks like it’s not very common.


5. Obstetrics & Gynecology, Match Rate 3%

The next on the list is obstetrics and Gynecology (ObsGyn). Three percent of IMGs matched into ObsGyn. The number of OBGYN spots is more than a thousand. Given that three percent match Into ObsGyn, the total number is more. I have personally seen IMGs ObsGyn.

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4. Medicine-Pediatrics, Match Rate 3%

The next specialty is a combined medicine Pediatrics Residency program.  Three percent of IMGs have been successful in matching into this program. Coincidentally I recently met a combined medicine-pediatrics resident who told me the Residency program is mainly focused on Primary Care. Typically, these residents pick either medicine or Pediatrics as one of their primary focuses but they do continue to see patients of all ages.

3. Emergency Medicine, Match Rate 2%

The next on the list is emergency medicine where two percent of IMGs were successful in matching into this Residency program. Emergency medicine does have a few thousand spots, so two percent of a few thousand is still a pretty good number. I have personally seen emergency physicians who are IMGs.

Emergency Medicine also offers combined residency programs with Anesthesiology & Family Medicine.

2. Orthopedics, Match Rate 1%

The next specialty which is difficult to match is orthopedics, only one percent of IMGs are matched into Orthopedic residency. I have come across IMG who are orthopedic surgeons but the number is quite less. The good news is orthopedic surgery offers an alternate entry path program.

1. ENT, Match Rate 0.5%

Finally, the number one specialty which is difficult to match for an IMG is ENT. Only point five percent of total residents are non-us IMGs. I’ve been thinking if I have seen any IMG ENT physicians I have personally not come across any but that doesn’t mean they don’t exist.

This article was initially published in IMGSecrets.com, If this appears anywhere else this is a stolen content.


Check out the other important articles

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

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

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