Residency Programs 

It is common knowledge that attending Medical Residency Programs in USA is not only an integral part of medical PG in US, it is also the most significant. You need to understand the complicated process through which you can get into Residency Programs in USA..


Are you an IMG? 

USMLE Step 3

An IMG needs to meet all the specific requirements for medical residency in USA. For an IMG, the NRMP and ECFMG come together to verify her eligibility for consideration for a Match attempt.
Firstly, an IMG has to apply for the Residency Programs after proper analysis. Then, she has to register for the match. These two processes may seem to be overlapping, but they are very distinct. Read on!


The Residency Application process means the procedure through which you apply for various training programs. How to apply for medical residency in USA? This happens through the Electronic Residency Application Service (ERAS).

So, you start by applying for different Residency Programs for foreign medical graduates in USA through ERAS.You can access the list of Residency Programs in offering in FREIDA. Once you apply for the USA medical Residency Programs on ERAS, the Program directors conduct an interview with you (Read below). Then, you must register for a Match in NRMP. You need to go back to ERAS & update your profile here with the NRMP ID that you got after registering in NRMP.

Rank Order List 

After the interviews, the program directors create a Rank Order List (ROL) with their candidate choices arranged in decreasing order of preference. In the same vein, you will also create a ROL with your program choices arranged in a similar order. The system that you will use to create your ROL is the R3 system (Registration, Ranking, and Results) in the NRMP.


The NRMP uses the noble prize-winning ‘Match Algorithm’ to find a Match where the 2 ROLs resonate. In other words, when the extent to which you wish to take up a program matches with the Programs eagerness to take you in, it is a Match! For details on NRMP Application, click here 

Residency Match Process Summary 

Here we have summarized the steps you take after which foreign medical graduates' residency in the USA begins. In short, we present a gist of all that you have to do starting from the 4th year of MBBS to your medical PG year 1.

Starting the Process 

You should start gathering everything that you will need from the end of 3rd year MBBS. These will include Letters of Recommendation, Statement of Purpose (Personal Statement), & an impressive CV. When ready you should log in to ERAS to enroll yourself.


After this, you need to take up a solemn research of all the United States Medical Residency Programs in offer and select the ones you wish to get into. Read below for the things you must keep in mind when you shortlist your preferences. You will be using FRIEDA and its 35 filters to make a wise decision.


The next thing to do would be initiating the Match Process by putting your application on ERAS. Also, you must register with NRMP.


In early October, the Residency Interviews generally begin. When you succeed in an interview, you get an invitation from the Program Coordinators. You should get 10 invitations at least. Otherwise, AAMC will recommend you get an Adviser.

Rank Order List 

Then you prepare your Rank Order List. To know what all you need to keep in mind when you make your ROL, read below. You need to keep in mind that you cannot back off if a Match occurs. Choose the Programs you mention in your ROL after proper consideration.

The only thing that you can do after this is wait. The 3rd week of March is the Match Week. On Monday of this week, you get to know if you matched. On Friday, you get to know the Program you have matched for.
If you don’t match, you still can get help from Supplement Offer & Acceptance Program SOAP. The SOAP matches the unmatched aspirants to the unfilled Residency positions that were not taken up in the first match.

Residency Application 

How to apply for medical residency in the US? Putting it simply, the Residency Application process for IMG presents a comprehensive summary of the academic and professional milestones that you crossed. It is indeed crucial that you do careful research on the available suitable American Residency Programs before applying.

Certainly, you will be using FREIDA which is the database containing a list of all ACGME approved Residency & Fellowship Programs on offer.

An important one of the Residency Application requirements is your personal statement (like an SOP). Experts recommend that your personal statement should contain those aspects of your record & personality that you mention nowhere else in the Application.

It is but logical to mention here that your CV affects your assessment to a great extent. The good news is that Moksh guides you at every step when it comes to your SOP & CV.

Residency Interviews 

You can easily gather that the ROLs the Residency Programs upload in the R3 System are created based on the eligibility and suitability of the applicants. The Residency Interviews affect the ROLs very significantly.
When you start preparing for these Interviews, you must keep in mind the below-mentioned factors.

  • Instead of flatly mentioning your academic or professional endeavors, you should make sure your answers clearly convey the consequences of those achievements.
  • All Residency Interviews will be virtual; as an anti-COVID measure. This may be negatively impactful from a few perspectives, but it has one benefit. You will be saving on all that travelling and boarding. You should be well aware of the cost involved in the process so that you take things seriously.
  • During a Residency Interview, you impress the interviewer when you ask questions. This shows your interest and in a subtle manner, influences the panel’s decision of choosing what specialties will be right for you.
  • As mentioned above, the interviews will all be virtual. You must acquaint yourself well in advance to perform in such an online Interview.
  • COVID will come up. Your opinion as a budding physician on the matter will naturally not only be of great significance but also of a lot of consequence.

Choosing a Residency Program

As mentioned earlier, you can’t retreat from a Residency Program once you get a Match. It follows naturally that you must choose the Programs you place in your ROL very wisely. You will definitely need all the guidance and preparation you can get. You must understand and remember the following factors that we arrived at after the analysis of data on successful Matches discloses a pattern. 

Facts from data analysis 

These factors in increasing order of preference are -

  • Almost 75% of the Residents chose those Programs having a career in which seemed to get them more balance between work & life.
  • Almost a % higher in number were those who mentioned that the competency of other Residents who chose that Program was a decisive factor for them.
  • 84.6% chose Programs based on their reputation in the field of Medicine. The more prestigious a specialty, higher the preference.
  • 4.1% more chose those Programs that they found suited their academic and professional disposition.
  • The highest (90.2%) chose those Programs that had a particular geographical location. They chose those hospitals that were close to their homes.

Here is what we think

Your Interest

You should deliberate the most on which specialty you really are interested in. You should consider all the Residency Programs from this perspective. If you are interested, you can very well choose a non-clinical discipline to do your Residency in.

Your needs 

Finding a good fit is also crucial. You must choose as level-headedly as possible. Consider your personal preference, family conditions, your requirements, & so on.


You should not get carried away and choose a specialty just because others say that it is the best. Sometimes, a specialty very attractive to many may not be suitable for you as an individual.

The Peers 

Most importantly, while making your ROL, reflect intensely on your interaction during Residency Interviews or when you interacted with other Residents in the facility. You should feel that you will be comfortable in your Residency being with these people. In short, consider the kind of company you will be landing in when you choose any Residency Program.

Certifying your ROL

Having considered all the factors above, you create your ROL on the R3 System. Now, this ROL needs to be ‘certified’. Certifying your ROL is nothing but a formal confirmation that you are sure about the chosen Programs and the order in which you have placed them in the ROL.

In other words, the Matching Algorithm will process your Match attempt only if you have certified your ROL. It does not require much. You only have to click a tab and you will have certified your List.

Supplemental Offer & Acceptance Program SOAP 

After the Matching Algorithm processes all the ROLs and matches the applicants to the respective Programs, there are some applicants and Programs that never matched. This is where the SOAP comes into play. The purpose of SOAP is to attempt a Match between the remaining applicants and the available Residency positions that are still vacant.


USMLE® is a joint program. The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) are co-sponsors. None of the trademark holders have affiliation with MOKSH Academy or this website.

ACGME® is a registered trademark of the Accreditation Council for Graduate Medical Education.

The ECFMG® is a registered trademark of the Educational Commission for Foreign Medical Graduates.

The Match® is a registered service mark of the National Resident Matching Program® (NRMP®). The NRMP has no affiliation with MOKSH Academy.

Electronic Residency Application Service (ERAS®) is a program of the Association of American Medical Colleges. It has no affiliation with MOKSH Academy.

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