Obtaining a Residency Position in the US

The process of obtaining graduate medical education (“residency”) in the United States requires a series of steps. The American Association of Medical Colleges (AAMC) has prepared an excellent, detailed description of the process entitled Roadmap to Residency: Understanding the Process of Getting into Residency

Educational Commission for Foreign Medical Graduates (ECFMG)

This is a non-governmental agency that certifies applicants meet United States standards for medical education.
Educational Commission for Foreign Medical Graduates
3624 Market Street
Philadelphia, PA 19104-2685 USA

The ECFMG will review the applicant’s medical school transcripts. It will also arrange for the applicant to take the United States Medical Licensing Exam (USMLE) steps 1 and 2 and Clinical Skills Assessment (CS). This test requires applicants to interview and examine a standardized patient in the presence of evaluators. If these tests are passed, the applicant receives ECFMG certification which allows him or her to apply for an Exchange Visitor Program visa (J-1 visa). This visa allows holders to work in the United States, but requires them to return to their country of origin after completion of the training - ECFMG visa process.

Medical Board of California (MBC)

Effective January 1, 2020, MBC will no longer issue Postgraduate Training Authorization Letters (PTAL). International medical school graduates applying for the 2020 residency match will not require a PTAL and may apply for residency through the Electronic Residency Application Service (ERAS). MBC will recognize an international medical school as meeting the educational requirements for a Postgraduate Training License (PTL)/licensure, if the school is listed on the World Directory of Medical Schools.


Residents for first year residency positions are chosen through a computerized process that matches the applicant’s choices with the program director’s choices. This program is conducted by a non-governmental organization. The application for this matching program should be made starting July 1 for the following year. Almost all specialties accept applications by the Electronic Residency Application Service (“ERAS”).


Selected applicants are invited for interviews at various hospitals between November and January. Applicants are chosen based on the information provided in ERAS.


Almost all positions for residency positions are allocated through a computerized matching system called the National Resident Matching Program (NRMP). You can apply for the NRMP starting about September 1. A list of the applicant’s preferred programs must be submitted electronically between mid-January and mid-February. The results of the match are announced in mid-March.

For further information visit the NRMP or write to:
National Resident Matching Program
2450 N Street, NW, Suite 201
Washington, DC 20037-1141 USA

Program directors determine how to rank candidates in the match for entry into their program. In addition to USMLE scores, program directors seek evidence of clinical skills and personal characteristics needed to function as a resident physician. Certain specialties have many more applicants than they have positions and are highly competitive.

For more information about the relative competitiveness of specialties nationally, visit NRMP.

Residency positions in academic medical centers tend to be more competitive than those at community hospitals.

Loma Linda University Medical Center accepts applications from international medical graduate physicians. It does not sponsor new H1-B visas for residents.

Learn about the various residency programs offered at Loma Linda University Medical Center.

Related Links