Charting Outcomes in the Match:International Medical GraduatesCharacteristics of International Medical Graduates WhoMatched to Their Preferred Specialty in the 2020 MainResidency Match3rd EditionPrepared by:National Resident Matching Programwww.nrmp.orgJuly 2020

Questions about the contents of this publication may be directed to National Resident MatchingProgram, (202) 400-2233 or [email protected] about the NRMP should be directed to Donna L. Lamb, D.HSc., M.B.A., B.S.N.,President and CEO, National Resident Matching Program, (202) 400-2233 or [email protected] 2020 National Resident Matching Program, 2121 K Street, NW, Suite 1000,Washington, DC 20037 USA. All rights reserved. Permission to use, copy and/or distribute anydocumentation and/or related images from this publication shall be expressly obtained from theNRMP.National Resident Matching Program, Charting Outcomes in the Match: Senior Students of U.S.Medical Schools, 2020. National Resident Matching Program, Washington, DC 2020.

2020Table of ContentsIntroduction . iiTables and Charts for All SpecialtiesChart 1. Active Applicants in the 2020 Main Residency Match .2Table 1. Number of Applicants and Positions in the 2020 Main Residency Match.3Chart 2. Ratio of International Medical Graduates Ranking Specialty First / Available Positions .4Chart 3. Match Rates of International Medical Graduates .5Table 2. Summary Statistics on International Medical Graduates .6Chart 4. Median Number of Contiguous Ranks of International Medical Graduates .7Chart 5. Mean Number of Different Specialties Ranked by International Medical Graduates .8Chart 6. USMLE Step 1 Scores of International Medical Graduates .9Chart 7. USMLE Step 2 CK Scores of International Medical Graduates .10Chart 8. Mean Number of Research Experiences of International Medical Graduates .11Chart 9. Mean Number of Abstracts, Presentations, and Publications of InternationalMedical Graduates .12Chart 10. Mean Number of Work Experiences of International Medical Graduates .13Chart 11. Mean Number of Volunteer Experiences of International Medical Graduates .14Chart 12. Percentage of International Medical Graduates Who Have a Ph.D. Degree .15Chart 13. Percentage of International Medical Graduates Who Have Another Graduate Degree .16Tables and Charts for Individual SpecialtiesAnesthesiology .17Child Neurology .30Dermatology .43Diagnostic Radiology .56Emergency Medicine .69Family Medicine .82General Surgery .95Internal Medicine .108Internal Medicine/Pediatrics .121Interventional Radiology . 134Neurological Surgery.147Neurology .160Obstetrics and Gynecology . 173Orthopaedic Surgery .186Pathology .199Pediatrics .212Physical Medicine and Rehabilitation .225Plastic Surgery .238Psychiatry .251Radiation Oncology .264Vascular Surgery .277Copyright 2020 NRMP. Reproduction prohibited without thewritten permission of the NRMP.iCharting Outcomes in the Match:International Medical Graduates, 2020

2020IntroductionBackgroundThe first edition of Charting Outcomes in the Match was published in August 2006 to document how applicant qualifications affect successin the Main Residency Match . The report was published biennially between 2007 and 2011 and was a collaboration of the NationalResident Matching Program (NRMP ) and the Association of American Medical Colleges (AAMC ). Match outcome data from theNRMP were combined with applicant characteristics from the AAMC’s Electronic Residency Application Service (ERAS ) and UnitedStates Medical Licensing Examination (USMLE ) scores from the AAMC data warehouse. In 2013, NRMP collaborated with theEducational Commission for Foreign Medical Graduates (ECFMG ) to produce the first edition of Charting Outcomes in the Match forInternational Medical Graduates using some variables unique to U.S. citizen and non-U.S. citizen students and graduates of internationalmedical schools (IMGs). Starting with the 2014 Main Residency Match, the NRMP added a Professional Profile section to its Matchregistration process to collect USMLE scores and other applicant characteristics, and those have been used to independently produce allsubsequent Charting Outcomes in the Match reports.With the exception of the 2013 report, all versions of Charting Outcomes in the Match published prior to 2016 examined the Matchsuccess of only two applicant groups: senior students from U.S. MD medical schools and independent applicants. Independent applicantsincluded all applicant types other than U.S. MD seniors: graduates of U.S. MD medical schools, students/graduates of U.S. DO medicalschools, students/graduates of Fifth Pathway programs, students/graduates of Canadian medical schools, and U.S. citizen and non-U.S.citizen students/graduates of international medical schools. Because independent applicants are a heterogeneous group, a decision wasmade in 2016 to report data separately for U.S. MD medical school seniors, students/graduates of U.S. DO medical schools, and U.S.citizen and non-U.S. citizen students/graduates of international medical schools. In 2018, reports were further refined to highlight seniorstudents of U.S. DO medical schools separately and eliminating reporting on U.S. DO medical school graduates because their numbers areso small. This report is the third edition of the Charting Outcomes in the Match for International Medical Graduates.Definition of International Medical Graduate (IMG)An international medical graduate (IMG) is a physician who received a basic medical degree or qualification from a medical school locatedoutside the United States and Canada. The location of the medical school, not the citizenship of the physician, determines whether thegraduate is an IMG. Thus, individuals who are U.S. citizens when they graduate from an international medical school are U.S. IMGs, andindividuals who are not U.S. citizens at the time of medical school graduation are non-U.S. IMGs even if they later become U.S. citizens.Non-U.S. citizens who graduate from medical schools in the United States and Canada are not IMGs.DataMatch success, specialty preference, and ranking information were collected through the Main Residency Match. Other applicantcharacteristics, including USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores, academic degrees, publications, research, and workand volunteer experiences, were self-reported through the Professional Profile section of the NRMP’s Applicant Registration Form for theMatch. To complete the form, applicants were asked to answer the questions as they did in their ERAS Common Application Form (CAF).Completion of the form was optional, and applicants who completed the form could consent or decline to participate in NRMP research.Data collection using the self-reported Professional Profile section was granted exemption by the Chesapeake (now Advarra) InstitutionalReview Board (IRB).A total of 12,074 IMG applicants (5,167 U.S. IMGs and 6,907 non-U.S. IMGs) submitted certified rank order lists in the 2020 MainResidency Match. After excluding the 13.3 percent of U.S. IMGs and 9.5 percent of non-U.S. IMGs who did not give consent to participatein NRMP research, 10,735 IMG applicants (4,481 U.S. IMGs and 6,254 non-U.S. IMGs) were included in the final dataset. Missing datawere found in Step 1 scores (7.6% missing for U.S. IMGs and 4.8% for non-U.S. IMGs), Step 2 CK scores (8.3% and 5.1%), number ofresearch experiences (17.4% and 16.0%), number of abstracts, presentations, and publications (18.5% and 15.9%), number of workexperiences (14.3% and 11.2%), number of volunteer experiences (15.3% and 13.5%), Ph.D. degree (8.5% and 6.5%), and other graduatedegree (8.4% and 6.4%).MethodsSpecialties that offered 50 or more positions and had at least 7 matched or unmatched applicants of either applicant type preferring thespecialty in the 2020 Main Residency Match are included in this report. Although Otolaryngology offered more than 50 positions, they areexcluded from the specialty-specific analyses in this report because very few IMGs preferred those specialties. Likewise, specialty-specificanalyses of Dermatology, Radiation Oncology, and Vascular Surgery are excluded for U.S. IMGs because of the small numbers.Transitional Year programs are excluded because they are not viewed as a preferred specialty choice.Copyright 2020 NRMP. Reproduction prohibited without thewritten permission of the NRMP.iiCharting Outcomes in the Match:International Medical Graduates, 2020

2020Introduction (continued)Ten measures are incorporated in this report: number of contiguous ranks in the preferred specialty, number of specialties ranked,USMLE Step 1 and Step 2 CK scores, numbers of research, work, and volunteer experiences, number of abstracts, presentations, andpublications, and Ph.D. and other graduate degrees. In addition, the probability of matching to a preferred specialty is calculated based onUSMLE Step 1 scores and contiguous ranks. Probability analyses were performed using a simple logistic regression model on IMGs whoparticipated in the Match in 2018, 2019, and 2020. The 2013 Charting Outcomes in the Match for International Medical Graduatesincorporated characteristics provided by ECFMG that are not included in this report: attempts at USMLE, number of months afterECFMG certification, number of years since graduation, and English spoken as a native language.It is important to note that for purposes of this report, Match success is defined as a match to the specialty of the applicant’s first-rankedprogram, or "preferred specialty," because that is assumed to be the specialty of choice. Lack of success includes matching to anotherspecialty as well as failure to match at all. No distinction was made based on whether applicants matched to the first, second, third, orlower choice program.SummarySome general observations apply to all specialties in this report. IMGs who are successful in matching to their preferred specialty aremore likely to: Rank more programs within their preferred specialty Have higher USMLE Step 1 and Step 2 CK scores Be U.S. citizensAlthough other measures seem to be related to Match success for some specialties, the relationships are not consistent enough to drawbroad conclusions across specialties. In addition, the data sources used for this report do not include other important applicant factorssuch as course evaluations, reference letters, and the Medical School Performance Evaluation (MSPE).Despite the fairly strong relationship b