Intended for healthcare professionals

Student Career Planning

Continuing your medical training in the US

BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3989 (Published 30 October 2020) Cite this as: BMJ 2020;371:m3989
  1. Benjamin Patterson, internal medicine residency
  1. NYU School of Medicine, Infectious Disease Fellowship, Columbia University Medical Center, New York, USA
  1. Correspondence to B Patterson b.patterson1@nhs.net

A guide to the practicalities of securing a residency post

Training in the US appeals to many doctors and medical students, with the promise of high quality teaching and research opportunities, affiliation to a world renowned research institution, and the prospect of earning a high income.

Doctors who want to continue their training in the US must secure a residency post. Residency is the first job that a US medical school graduate enters, and, unlike foundation years in the UK, this means training in a chosen specialty for, typically, 3-5 years. Having postgraduate experience does not mean you can join a residency programme in the middle—even those who have practised for years in the UK are likely to have to join the beginning of a residency programme if they want to train in the US.

About a quarter of US residency posts are held by international medical graduates (IMGs); however, achieving one is competitive and expensive. In 2018, 57% of IMG applicants gained a residency post.1

This article gives an overview of the process of applying for a residency post in the US and what to consider along the way. The article does not help you weigh up the pros and cons of training in the US, but if you have decided you would like to continue training there, this article helps you through the process of applying.

When in your career can you apply?

Planning an application needs to start well in advance of the July residency start date. Formal clinical experience in the US in the form of clerkships or observerships strengthens an application and is expected by some programmes. Another key factor is finding the time to prepare for and take the US Medical Licensing Examinations (USMLEs), which can be very time consuming.

You could apply to begin residency immediately after graduating from …

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