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Two Important Updates for Medical Students

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1) Future residency applicants, the USMLE recently announced a significant change to the Step exam calendar – moving from near continuous availability to limited testing dates starting in 2028. There will only be a 45-day window to test. USMLE posits that this change will improve the integrity of the exams. They say they will expand the number of testing centers to mitigate fewer exam dates.

Of note, this will make strategic timing around clerkships, the application season, and the Match more difficult for students.

2) For IMGs applying to residency this year, please note that ERAS tokens are now available through the Intealth portal. If you are applying through ResidencyCAS instead of ERAS (obstetrics and gynecology, emergency medicine), you do not need an ERAS token.

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Steep Fees for H-1B Visas Would be Devastating for International Medical Graduates, the Healthcare Profession, and Patients as a Whole

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The US administration recently implemented a $100,000 fee for initial applications for H-1B visas – to be paid by prospective employers. The American Medical Association is lobbying for an exemption for doctors. Currently, new physicians from international locations represent one in six medical residents and fellows at US teaching hospitals, approximately 15,500 doctors in 2024. See this piece by Roni Caryn Rabin from the New York Times that covers the panic about and resistance to the policy’s application to physicians and nurses. 

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Match 2025 Results Are Out

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The NRMP® has already published data from last month’s Match. Of note, under 80% of the applicants who submitted a certified rank order lists matched to either a categorical or preliminary year. Match rates specifically for US-citizen and foreign national IMGs were 67.8% and 58.0%, respectively.

My field of emergency medicine did quite well this year, a big contrast from two years ago. (The field is notorious for waxing and waning in popularity over the years.) Primary care specialties also eked out a win.

See more Match statistics here.

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¡Ay Caramba!

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More from the AAMC: I read a troubling piece recently regarding a bizarre problem Puerto Rican medical students are having. Apparently, some folks don’t understand that Puerto Rico is part of the United States. Some Puerto Rican students report they are being misidentified as international medical graduates (IMGs).

The crux of the matter is that Puerto Rican medical schools are – like other U.S. allopathic medical schools – accredited by the Liaison Committee on Medical Education (LCME), recognized by the U.S. Department of Education. On the other hand, many medical schools in other parts of the Caribbean are not LCME-accredited and graduate IMGs. 

IMGs have a tougher time matching. In the last cycle, U.S.- citizen IMGs matched at a rate of 67% and non-U.S.-citizen IMGs matched at a rate of 58.5%. On the other hand, U.S. MD graduates matched at a rate of 93.5%. Thus, being misidentified as an IMG is to the detriment of Puerto Rican medical students in the Match.

See Bridget Balch’s interesting article with more details here.

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International Medical Graduate (IMG) 2019 Match Statistics Are Out

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The ECFMG® recently published 2019 Match statistics for International Medical Graduates (IMGs). In the 2019 Match, only 59.0% of U.S. citizen IMG participants were matched to first-year positions. Of those IMG participants who were not U.S. citizens, only 58.6% obtained first-year positions (Source: ECFMG®) While the percentage of IMGs matching was slightly better than last year, IMGs still face large challenges in the residency application process despite the US physician shortage.

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital. She was appointed to the Assistant Residency Director position for the Harvard Affiliated Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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