A closer look at matching into an IMG-friendly Neurology Program.

“Give me six hours to chop down a tree and I will spend the first four sharpening my axe.”
​- Abraham Lincoln
If you have either started your USMLE journey or in the middle of your trip, then you must read this. Are you pondering over the chances of your match in a Neurology residency program? Asking yourself what must be your approach to win this game and come out victorious? Then   you must read on to understand this game of matching into a Neurology program as an IMG.

1. What is meant by an IMG-friendly specialty?

​Based on the previous records of the percentage of matches of international medical graduates (IMG) in a specialty we try to understand if that very specialty is keen on taking an IMG or not. If any specialty is working with IMGs and is also thriving over the years, they are more likely to follow the same trend. Those specialties that are highly competitive and are only working with American medical graduates (AMG) over the years are also likely to follow the same trend.​

2. Is Neurology IMG friendly?

In 2022 match, the number of total positions  offered in Neurology was  772, and of them 185 were Non-US IMGs & 66 were US IMGs among the total 761 seats filled. Making Neurology one of the top 5 IMG-friendly specialties. ​
Specialty
​Matched
Matched
​US IMG / NON US IMG
Unmatched
US IMG / NON US IMG
Total
US IMG / NON US IMG
Neurology 
66  |  185
56 | 185
​122  | 370

3. What is the overall rate of intake of IMG in Neurology in the last 4 years?

Specialty
2022
2021
2020
2019
2018
Intake in Numbers/Percentage
Numbers/
​Percentage
Numbers/
​Percentage
Numbers/
​Percentage
Numbers/
​Percentage
Numbers/
Percentage
Neurology
772 | 2.1
 715 | 2.0
682 | 2.0
617 |  1.9
552 | 1.8
By studying the match rate for the last 4 years we can easily conclude that the IMG match rate in Neurology remained consistent over the years. ​

4. Who are these IMG-friendly Neurology residency programs?

Even though we can say that Neurology is one of the top IMG-friendly specialties, 43.1% US IMG & 44.8 % Non-US IMG going unmatched clearly shows that not every program is sitting with open arms for IMGs. Things are unlikely to change leaving apart a few happy exceptions. So, identifying an IMG-friendly residency program is crucial to having a successful match. These programs over the years are consistently taking IMGs in their residency program.   ​

5. How do we identify an IMG-friendly residency program?

So naturally, this will be the golden question and the answer to that is the oldest technique which is also the best technique - to get authenticated data. Going to the website of each Neurology program and finding out how many of their current residents are IMGs by looking at their medical school is by far the best technique, even though there are several blogs about the same on the internet. 

Let’s take an example of 2 IMG-friendly programs to understand it better. Go to these 2 programs
1. University of Connecticut Neurology Residency Program and
2. Upstate Neurology Residency program
​
you will find out they are among the few Neurology Programs that have a very high intake of IMGs.​
Example:

6. Which are the most IMG-friendly states? Which states have multiple IMG-friendly residencies programs?

These IMG-friendly Neurology programs are not located in just one state, rather they are scattered all across the United States. Only a few states have multiple programs which are IMG-friendly. Taking a closer look you will find out that New York has eight IMG-friendly neurology programs, Florida has six, Michigan has four and California has three neurology programs that are IMG-friendly.​

7. What are the credentials of an IMG to match into an IMG-friendly residency program?​

Till now the knowledge we have gathered is very important but the most crucial success components of residency match comes down to 4 - Scores, LORs from USCE, Research, and Home country neurology experience if any. So let’s address each of them one at a time.​
  1. Score - Even though all the Neurology program director says that they review each application data holistically and just do not look at the scores but through crude NRMP data we can say people who matched as an IMG in a Neurology program have scored between 220s and 240s in both Step 1 and Step 2 and those who got unmatched have their scores in 210s. Though these are basic generalizations based on the NRMP data there are a lot of happy exceptions. With Step 1 going pass / fail the importance will shift towards Step 2 and Step 3 now.​
  2. LOR -  Letter of Recommendation from the United states clinical experience (USCE) in Neurology is one of the major requirements for applying to Neurology. Though COVID restrictions gave few relaxations things will again move back to normal most likely. 2 or 3 strong US LORs in Neurology will remain one of the strongest pillars of Neurology application.
  3. Research- The majority of Neurology residencies are University-based and they love to see Neurology-based research in their CV. Most Neurology applicants also now do have research in their C.V to stand out among the applicants. But studying match records also shows that applicants have matched without research in their CV.
  4. Home country neurology experience- This is one of the most overlooked criteria and applicants have started understanding its importance after COVID restrictions. A home country neurology experience also significantly improves your C.V as it underlines your interest in the very specific specialty.​​

8. What is meant by a perfect match?

Like a residency program looking for a few criteria an applicant generally also looks for a few criteria before selecting a program.​
  1. Academic environment: That includes education curriculum, conference schedule, research activity, facilities, faculty-to-resident ratios, and availability of neurology subspecialty expertise.
  2. Area of interest: Seeking out programs with a well-developed division in a specific area or facilitating an introduction to research and more specialized practice (e.g., behavioral neurology, epilepsy, movement disorders,). Determining which programs might offer a fellowship in that area after completion of residency is an important criterion to be looked upon.
  3. Size of program & Patient-to-resident ratio: Knowing about the patient-to-resident ratio in the inpatient service, the numbers of consults seen per month for the inpatient consult service, and the numbers of patients seen on an outpatient basis to make sure that you get adequate exposure to a wide variety of patient should also be taken in consideration.​
So researching programs and then identifying professional commonalities is also incredibly important to have a perfect match.​

9. How will this knowledge of the IMG-friendly program help you?

Program directors want residents who will be happy training in their program, will excel in patient care, and help them reach their goals. A residency program director is searching for a perfect fit. A well-researched candidate with stellar scores may not be an ideal fit for a rural community program. A rural program may be looking for a candidate who wants to work or has worked before in such a setting. Completing one rotation or doing multiple rotations is also a strong indicator that you are interested in that program. So identifying these programs way before you apply to them is important. Rotating there will help you build a connection with the residents and faculty members. If you can’t rotate in that specific program you can also rotate in the same state which will show that you are interested in that specific state. Your knowledge about these programs will help you build a connection with them and in this way you can sharpen your ax long before you start cutting the tree.​
We wish you all the best in your journey and hope you will win this game - Sarthi Team ​
Resources
  1. NRMP https://www.nrmp.org ​
​This blog is written by Dr. Subhajit Das.

​To get more program specific details and to see how we can help you match please explore our match plans.