NRMP/ECFMG - Charting Outcomes in The Match For International Medical Graduates

Charting Outcomes in the Match
International Medical Graduates

Characteristics of Applicants Who Matched to Their Preferred Specialty in the 2013 Main Residency Match 1st Edition
Prepared by: National Resident Matching Program and Educational Commission for Foreign Medical Graduates
January 2014
www.nrmp.org
www.ecfmg.org
Questions about the contents of this publication may be directed to Mei Liang, Director of Research, National Resident Matching Program, (202) 400-2233 or [email protected]. Questions about the NRMP should be directed to Mona M. Signer, Executive Director, National Resident Matching Program, (202) 400-2233 or [email protected]. Questions about the ECFMG data collections may be directed to John R. Boulet, Ph.D., Vice President, Research and Evaluation, Educational Commission for Foreign Medical Graduates, (215) 823-2227 or [email protected]. Copyright 2014 National Resident Matching Program and Educational Commission for Foreign Medical Graduates. All materials subject to this copyright may be photocopied for the purpose of nonprofit, scientific, or educational advancement. Suggested Citation National Resident Matching Program and Educational Commission for Foreign Medical Graduates. Charting Outcomes in the Match for International Medical Graduates, 2014. National Resident Matching Program and Educational Commission for Foreign Medical Graduates. 2014
Table of Contents
Introduction ..................................................................................................................................................... ii Tables and Charts for All Specialties Chart 1. Active Applicants in the 2013 Main Residency Match .................................................................1 Table 1. Number of IMG Applicants and Positions in the 2013 Main Residency Match ...........................2 Chart 2. Ratio - IMG Applicants Ranking Specialty First / Available Positions ......................................3 Chart 3. Match Rates ...................................................................................................................................4 Table 2. Summary Statistics ........................................................................................................................5 Chart 4. Median Number of Contiguous Ranks ..........................................................................................6 Graph 1. Probability of Matching to Preferred Specialty by Number of Contiguous Ranks ......................7 Chart 5. Mean Number of Different Specialties Ranked.............................................................................8 Chart 6. USMLE Step 1 Scores of Matched Applicants .............................................................................9 Graph 2. Probability of Matching to Preferred Specialty by USMLE Step 1 Score .................................10 Chart 7. Mean Number of USMLE Step 1 Attempts ................................................................................11 Graph 3. Probability of Matching to Preferred Specialty by USMLE Step 1 Attempts ............................12 Chart 8. USMLE Step 2 CK (Clinical Knowledge) Scores of Matched Applicants .................................13 Graph 4. Probability of Matching to Preferred Specialty by USMLE Step 2 CK (Clinical Knowledge) Score ......................................................................................................................................14 Chart 9. Mean Number of USMLE Step 2 CK (Clinical Knowledge) Attempts ......................................15 Graph 5. Probability of Matching to Preferred Specialty by USMLE Step 2 CK (Clinical Knowledge) Attempts .............................................................................................16 Chart 10. Mean Number of Attempts at USMLE Step 2 CS (Clinical Skills) or ECFMG CSA (Clinical Skills Assessment) ..................................................................................................17 Chart 11. Mean Number of Months after ECFMG Certification .............................................................18 Chart 12. Mean Number of Years After Graduation ................................................................................19 Chart 13. Percentage of IMG Applicants whose Native Language is English .........................................20 Chart 14. IMG Applicants Citizenship at Birth ......................................................................................21 Chart 15. Country of Medical School.......................................................................................................22 Tables and Charts for Individual Specialties Anesthesiology ..........................................................................................................................................2 Emergency Medicine ................................................................................................................................. Family Medicine........................................................................................................................................5 Internal Medicine.......................................................................................................................................7 Neurology ..................................................................................................................................................8 Obstetrics and Gynecology......................................................................................................................10 Pathology .................................................................................................................................................1 Pediatrics .................................................................................................................................................13 Physical Medicine and Rehabilitation .....................................................................................................15 Psychiatry ................................................................................................................................................16 Radiology ................................................................................................................................................18 Surgery ....................................................................................................................................................
Copyright 2014 NRMP and ECFMG. Copies may be made for educational or noncommercial uses only.
Charting Outcomes in the Match for IMGs, 2014
Introduction
Overview Charting Outcomes in the Match for IMGs is a collaborative publication of the National Resident Matching Program (NRMP) and the Educational Commission for Foreign Medical Graduates (ECFMG). The report focuses on characteristics specific to students and graduates of international medical schools (IMGs) and is derived from the original Charting Outcomes in the Match, a biennial report published by the NRMP and the Association of American Medical Colleges that describes the characteristics of U.S. allopathic senior students and independent applicants* who matched to their preferred specialties in the Main Residency Match. ECFMG and its organizational members define an international medical graduate (IMG) as a physician who received his/her basic medical degree or qualification from a medical school located outside the United States and Canada. The location of the medical school, not the citizenship of the physician, determines whether the graduate is an IMG. Thus, U.S. citizens who graduate from medical schools outside the United States and Canada are considered IMGs. Non-U.S. citizens who graduate from medical schools in the United States and Canada are not considered IMGs. ECFMG Certification International medical graduates must be certified by ECFMG prior to entering accredited residency programs in the United States. Since 2004, to obtain an ECFMG certificate a candidate must (1) document the completion of all requirements for, and receipt of, the final medical diploma, and (2) pass the United States Medical Licensing Examination (USMLE) Step 1 (Basic Science), Step 2 CK (Clinical Knowledge), and Step 2 CS (Clinical Skills). Historically, to achieve ECFMG certification, other examination requirements were in effect. Detailed information on ECFMG certification requirements can be found at: http://www.ecfmg.org. USMLE Step 1 (Basic Science) assesses whether the candidate can understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. USMLE Step 2 CK (Clinical Knowledge) assesses whether the candidate can apply medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision and includes emphasis on health promotion and disease prevention. USMLE Step 2 CS (Clinical Skills) uses standardized patients to test medical students and graduates on their ability to gather information from patients, perform physical examinations, and communicate their findings to patients and colleagues. Detailed information on the USMLE can be found at: http://www.usmle.org. ECFMG Clinical Skills Assessment (CSA) In July of 1998, ECFMG introduced the Clinical Skills Assessment (CSA), a performance test designed to evaluate the clinical skills (e.g., history taking, physical examination, interpersonal skills) of IMGs. The specific purpose of the CSA was to ensure that international medical graduates (IMGs) could demonstrate clinical skills at a level comparable to that of graduating fourth-year U.S. medical students. In 2004, the USMLE introduced Step 2 CS (clinical skills), a similar performance-based examination for U.S. medical students and graduates. At this point, the CSA was discontinued and all IMGs were required to take and pass Step 2 CS to achieve certification. Charting Outcomes for IMGs Charting Outcomes in the Match for IMGs utilizes a different set of measures from the original Charting Outcomes in the Match. Although some applicant characteristics such as number of contiguous ranks, number of specialties ranked, and USMLE scores are included in both reports, other characteristics relevant only to IMGs are added to this report: certification examination attempts, number of months since ECFMG certification, English spoken as a native language, citizenship at birth, country of medical school, and number of years since graduation from medical school.
_____________________________________________________________________________
*Independent applicants include previous graduates of U.S. medical schools, students and graduates of U.S. osteopathic medical schools, U.S. citizen IMGs, non-U.S. citizen IMGs, students and graduates of Canadian medical schools, and graduates of Fifth Pathway programs The Educational Commission for Foreign Medical Graduates (2000). A History: 1956-2000. Educational Commission for Foreign Medical Graduates, Philadelphia, PA
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Charting Outcomes in the Match, IMG, 2014
Introduction (Continued)
Methods Data from the 2013 Main Residency Match, including applicant type, specialties ranked, number of contiguous ranks, and Match results, were obtained from the NRMP Data Warehouse. ECFMG provided characteristics of the 2013 IMG applicants, namely scores and attempts at USMLE or equivalent historical examinations (i.e., Step 1 or equivalent, Step 2 CK or equivalent, and Step 2 CS/ or ECFMG CSA), date of ECFMG certification, year of graduation, English spoken as a native language, and country of medical school. Data from the two sources were matched using unique identifiers. Ten measures are incorporated in the report for specialty-specific analysis. Each measure is explained separately in the All Specialties section. Twelve specialties with 100 or more IMG applicants in the 2013 Main Residency Match are studied individually: Anesthesiology, Emergency Medicine, Family Medicine, Internal Medicine, Neurology, Obstetrics and Gynecology, Pathology, Pediatrics, Physical Medicine and Rehabilitation, Psychiatry, Radiology, and General Surgery. For purposes of this report, match success is defined as a match to the specialty of the applicants first-ranked program because that is assumed to be the specialty of choice. Because preliminary programs provide only one or two years of prerequisite training for entry into advanced specialty training, applicants who ranked a preliminary program first are considered not to have a preferred specialty. Lack of match success includes matching to another specialty as well as failure to match at all. No distinction was made based on whether applicants matched to their first, second, third, or lower program choice. Applicants who obtained positions in the Match Week Supplemental Offer and Acceptance Program (SOAP) were not included in the analyses. Probability analysis is performed on the number of contiguous ranks, Step 1 scores and Step 1 (or equivalent examination) attempts, Step 2 CK scores and Step 2 CK (or equivalent examination) attempts, and combined Step 2 CS/ECFMG CSA attempts. For each of those measures, probability of matching to a preferred specialty is calculated separately using logistic regression. Summary Some general observations apply to all of the specialties in this report. IMG applicants who are successful in matching to their preferred specialty are more likely to: rank more programs within their preferred specialty have higher USMLE scores have fewer attempts at ECFMG certification examinations be U.S. citizens speak English as a native language have obtained ECFMG certification closer to the Match year (2013) have graduated from medical school closer to the Match year (2013) Although some other measures appear to be related to match success, the relationships were not consistent enough to draw broad conclusions across specialties. In addition, the data sources used for this report do not include other important applicant factors such as course evaluations, reference letters, and the Medical Student Performance Evaluation. Despite the fairly strong relationship between USMLE Step scores and match success, the distributions of scores show that program directors consider other qualifications, and high USMLE scores are not a guarantee of success. Even in the most competitive specialties, a few individuals with higher scores are not successful. Neither is a lower score a bar to success. Program directors and applicants will find the tables and charts for the specialties of their particular interest later in this report. For questions, comments or more information, please contact: Mei Liang, Director of Research John R. Boulet, Vice President, Research and Evaluation National Resident Matching Program Educational Commission for Foreign Medical Graduates Tel: (202) 400-2233 Tel: (215) 823-2227 Email: [email protected] Email: [email protected]
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Charting Outcomes in the Match, IMG, 2014
Tables and Charts for All Specialties
Chart 1
Active Applicants in the 2014 Main Residency Match

by Applicant Type
Non-U.S. IMG 7,568
U.S. senior 17,487
U.S. IMG 5,095 Osteopathic 2,677 Canadian 21 U.S. graduate 1,487
U.S. senior 50.9% Non-U.S. IMG 22.0% U.S. IMG 14.8% Osteopathic 7.8% U.S. graduate 4.3% Canadian 0.1% Fifth Pathway 0.1% Total: 100.0%
Fifth Pathway 20
Source: NRMP Data Warehouse
In 2013, 34,355 medical students and graduates participated in the Main Residency Match and submitted certified rank order lists. Half of the applicants (50.9%) were senior students from U.S. allopathic schools. Together, IMGs accounted for more than one third (36.8%) of the applicant pool, including 7,568 non-U.S. citizen IMGs and 5,095 U.S. citizen IMGs.
Table 1
Number of IMG Applicants and Positions in the 2014 Main Residency Match
by Preferred Specialty*
Total Positions Offered 1,653 1,744 3,037 6,612 692 1,237 583 2,699 397 1,362 1,143 1,185 Total Number of Number of Applicants Applicants Per Position 1,846 2,219 4,096 9,193 844 1,613 797 3,258 548 1,921 1,254 1,872 1.1 1.3 1.3 1.4 1.2 1.3 1.4 1.2 1.4 1.4 1.1 1.6 U.S. IMG Matched 95 53 531 841 59 78 46 196 40 203 55 119 Not Matched 65 137 702 753 44 99 69 151 43 256 47 123 Non-U.S. IMG Not Matched Matched 78 31 293 1,690 148 62 151 278 21 163 66 158 85 53 616 1,856 149 120 136 382 26 277 63 150
Preferred Specialty Anesthesiology Emergency Medicine Family Medicine Internal Medicine Neurology Obstetrics and Gynecology Pathology Pediatrics Physical Medicine and Rehabilitation Psychiatry Radiology-Diagnostic Surgery-General
*Preferred specialty is the specialty ranked first on an applicant's rank order list, excluding preliminary programs in specialties except Transitional Year. Note: For those specialties where both exist, PGY-1 and PGY-2 positions have been combined. Only specialties with 100 or more IMG applicants are included Source: NRMP Data Warehouse.
Table 1 provides a summary of applicants and positions for selected specialties. In calculating Total Number of Applicants and Number of Applicants Per Position, all applicant types are considered. For example, 1,846 applicants preferred Anesthesiology (or ranked an Anesthesiology position first), including 160 U.S. IMGs (95 matched and 65 not matched to Anesthesiology) and 163 non-U.S. IMGs (78 matched and 85 not matched to Anesthesiology). For each of the 1,653 Anesthesiology positions there were 1.1 applicants who preferred the specialty. Only those specialties with 100 or more IMG applicants are included in this table.
Chart 2
1.6
Ratio - Applicants Ranking Specialty First / Available Positions

by Preferred Specialty
U.S. IMG 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0.0 Anesthesiology Emergency Medicine Family Medicine Internal Medicine Neurology
Non-U.S. IMG
All other applicant types
0.2 0.3 0.1 0.1 0.3
0.1 0.1 0.1 0.1
0.2 0.4 0.1
0.1 0.1
0.2 0.1 0.5 0.2
0.2 0.1
0.5 0.3 1.1 0.9 0.6 0.6
0.4
0.3
1.0 0.8 0.6 0.7
1.1 0.9 0.8
1.1
Obstetrics and Gynecology
Pathology
Pediatrics
Physical Medicine & Rehab
Psychiatry
Radiology
SurgeryGeneral
Chart 2 shows the ratios of applicants preferring each specialty to available positions in that specialty for U.S. IMGs, non-U.S. IMGs, and all other applicant types. The red line marks where the number of preferred applicants equals the number of available positions. For all specialties displayed in the chart, there were more applicants preferring each specialty than there were positions. Overall, General Surgery has the highest ratio of applicants per position; however, the highest ratios for U.S. IMGs are found in Family Medicine and Psychiatry, and for non-U.S. IMGs, in Internal Medicine, Pathology, and Neurology.
Chart 3
100 90 80 70 60 50
Match Rates
Percent Matched by Preferred Specialty and IMG Applicant Type
U.S. IMG
Non-U.S. IMG
59 53 48 48 44 37 32 28 43 48
57 50 44 40 34 53
57 48 42 45 44 37
54
51
49 51
40 30 20 10 0
All Anesthesiology Emergency Specialties Medicine
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
Chart 3 shows the percentages of U.S. IMG and non-U.S. IMG applicants who matched to their preferred specialty. Overall, 48 percent of U.S. IMGs matched to their preferred specialty, ranging from 59 percent (Anesthesiology) to 28 percent (Emergency Medicine). For non-U.S. IMGs, the overall match rate was 44 percent, ranging from 53 percent (Pathology) to 32 percent (Family Medicine). In general, non-U.S. IMG applicants are less successful in matching to their preferred specialty than are U.S. IMGs.
Table 2
Summary Statistics
All Specialties Combined

U.S. IMG Non-U.S. IMG Matched (n=3,219) 6 1.3 227 1.1 233 1.0 1.1 16 4.7 24 Unmatched (n=4,111) 3 1.5 213 1.2 218 1.2 1.3 26 7.5 18
Measure 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Mean number of contiguous ranks Mean number of distinct specialties ranked Mean USMLE Step 1 score Mean USMLE Step 1 attempts* Mean USMLE Step 2 CK score Mean USMLE Step 2 CK attempts** Mean USMLE Step 2 CS or ECFMG CSA attempts Mean number of months since ECFMG certification Mean number of years since graduation Percentage who speak English as a native language
Matched (n=2,369) 7 1.4 217 1.2 224 1.1 1.1 8 1.7 76
Unmatched (n=2,604) 3 1.6 204 1.7 209 1.6 1.4 26 5.7 56
Sources. NRMP Data Warehouse and ECFMG *USMLE Step 1 or equivalent examination **USMLE Step 2 CK or equivalent examination
Table 2 provides summary statistics by IMG applicant type and match outcome on the 10 measures presented in this report. Data on each of these measures are displayed graphically by preferred specialty on the following pages. To be eligible for ECFMG certification and participation in the Main Residency Match, IMGs must satisfy the medical science requirement (USMLE Step 1 and Step 2 CK or equivalent exam) and clinical skills requirement (Step 2 CS or CSA). As a result, there were almost no missing values for USMLE exam scores and number of attempts.
Chart 4
10 8 6 4 2 0
7
Median Number of Contiguous Ranks
by Preferred Specialty, IMG Applicant Type, and Match Status
U.S. IMG
Matched
9 7 5 3 2 2 4 1 1 5 2 7 5 2
Not Matched
9 8
4 1 1 1
4 1
3 1
All Specialties Anesthesiology
Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
Non-U.S. IMG
10 8 6 4 2 0
3 3 1 3 1 2 6 6
Matched
Not Matched
5 2
4 1
4 1
5 3 2
Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
In general, applicants are more likely to be successful if they rank more programs in their desired specialty. The number of contiguous ranks is the number of programs ranked in the first-choice specialty before a program in another specialty appears on the applicant's rank order list. Chart 4 provides the median number of contiguous ranks for U.S. IMG and non-U.S. IMG applicants who matched and did not match to their preferred specialty. Both panels show some variation across the specialties for IMG applicants. For all specialties, U.S. IMGs who matched to their preferred specialty had median contiguous rank lists that were longer than U.S. IMGs who did not match. A similar pattern can be found for non-U.S. IMG applicants, although their lists are somewhat shorter than those submitted by U.S. IMGs. Non-U.S. IMGs who matched also had longer contiguous lists compared with those who did not match to their preferred specialty. The principal message of these graphs is that applicants with longer rank order lists in their preferred specialty are more successful than those with shorter ones. The NRMP has been recommending longer lists for many years, but some applicants apparently do not heed the advice. Others may have shorter lists because they found only a few programs willing to entertain their applications or because they could not afford a large number of interview trips.
Graph 1
1.00
Probability of Matching to Preferred Specialty by Number of Contiguous Ranks

by IMG Applicant Type
0.80
0.60
0.40
0.20
0.00 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Number of Contiguous Ranks

U.S. IMG Non-U.S. IMG
A simple logistic regression is used to calculate the probability of matching to a preferred specialty for different lengths of contiguous ranks. Graph 1 displays the probability curves for U.S. IMG and non-U.S. IMG applicants. This graph confirms the message in Chart 4 that the more programs ranked in the preferred specialty, the higher the probability of matching. For the same number of contiguous ranks, the probability is only slightly higher for U.S. IMGs than for non-U.S. IMGs.
Chart 5
3
Mean Number of Different Specialties Ranked
U.S. IMG
Matched 2.1 2.0 2.0 Not Matched 2.1 1.4
2
1.8
1.8
1.7
1.7
1.8
1.6
1.6
1.7
1.5
1.4
1.5
1.5
1.7
1.3
1.3
1.3
1.2
1.4
Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Pathology
1.1
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
Non-U.S. IMG
3
Matched 1.9
Not Matched 1.9
1.8
1.8
1.7
1.8
1.7
1.5
1.6
1.5
1.4
1.5
1.5
1.7
1.8
1.2
1.4
1.3
1.3
1.3
1.3
1.2
1.3
1.2
1.3
Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
Chart 5 displays the average number of different specialties ranked by IMG applicant type, preferred specialty, and match outcome. With the exception of those who preferred Radiology and PM&R, U.S. IMGs who matched to their preferred specialty ranked fewer specialties than those who did not match to their preferred specialty. In all specialties, matched non-U.S. IMG applicants ranked fewer specialties than those who did not match.
1.2
1.4
1.4
Chart 6
260 250 240 230 220 210 200 190 180
USMLE Step 1 Scores of Matched Applicants

by Preferred Specialty and IMG Applicant Type
U.S. IMG
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
Sources: NRMP Data Warehouse and ECFMG
Non-U.S. IMG
260 250 240 230 220 210 200 190 180
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
USMLE Step 1 scores are a measure of an applicants understanding of important basic science concepts and the ability to apply that knowledge to the practice of medicine. Although such knowledge is only one facet of applicant qualifications considered by program directors in their selection process, it is one that is comparable across applicants and available during the interview season and prior to the NRMPs ranking deadline. Overall, matched U.S. IMG applicants have a mean USMLE Step 1 score of 217 (s.d. = 18) and matched non-U.S. IMG applicants have a mean score of 227 (s.d. = 19), both well above the minimum passing score of 188 since 2010 (marked by the red line in the charts). Chart 6 displays the Step 1 scores for matched U.S. IMGs and non-U.S. IMGs by specialty. The horizontal bars are the median values for successful applicants and the vertical lines show the interquartile ranges (between the 25th and 75th percentile). Scores generally are higher for the
Graph 2
1.00
Probability of Matching to Preferred Specialty by USMLE Step 1 Score

0.80
0.60
0.40
0.20
0.00
180
200
220
240
260
280
STEP 1 Scores
The USMLE Step 1 score is one of the most important criteria that residency programs use in evaluating candidates. A simple logistic regression is used to calculate the probability of matching to a preferred specialty by USMLE Step 1 scores. Graph 2 shows that for the same Step 1 score, U.S. IMGs have a better chance of matching to a preferred specialty than do non-U.S. IMGs. The red line marks the passing score of 188 since 2010. All applicants with Step 1 scores below 188 took the test before January 1, 2010.
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Chart 7
3
Mean Number of USMLE Step 1 Attempts*

U.S. IMG
Matched Not Matched
2.1
1.7
1.7
2.1
1.7
1.4
1.6
1.4
1.7
1.3
1.4
2.2
1.2
1.1
1.1
1.1
1.1
1.1
1.1
1.0
1.0
1.0
1.1
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
Non-U.S. IMG
3 Matched Not Matched
1.4
1.5
1.2
1.2
1.3
1.2
1.2
1.2
1.2
1.2
1.2
1.2
1.4
1.1
1.1
1.1
1.1
1.0
1.0
1.0
1.0
1.0
1.0
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
The number of attempts at USMLE Step 1 (or historical equivalent) was tallied for each IMG applicant. Chart 7 compares the mean number of attempts for matched and unmatched U.S. IMGs and non-U.S. IMGs. Across specialties, matched U.S. IMG and matched non-U.S. IMG applicants made fewer attempts than those who did not match. For U.S. IMGs, the difference in mean number of attempts between matched and unmatched applicants is generally larger than that of the non-U.S. IMGs.
*USMLE Step 1 or equivalent examination

11
1.0
1.1
1.2
1.0
1.2
1.3
Graph 3
1.00
Probability of Matching to Preferred Specialty by Step 1 Attempts*

0.80
0.60
0.40
0.20
0.00 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
STEP 1 Attempts
Probabilities of matching to a preferred specialty also are calculated for Step 1 attempts using a simple logistic regression. Graph 3 displays the probability curves for U.S. IMG and non-U.S. IMG applicants, and shows an inverse association between the number of Step 1 attempts and the probability of matching to a preferred specialty. Although some applicants did match after taking the exam five or six times, applicants should be aware that medical licensure boards in some states impose limits on the number of attempts taken.

12
Chart 8
260 250 240 230 220 210 200 190 180
USMLE Step 2 CK (Clinical Knowledge) Scores of Matched Applicants

U.S. IMG
Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
Non-U.S. IMG
260 250 240 230 220 210 200 190 180
Sources: NRMP Data Warehouse and ECFMG.
Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
USMLE Step 2 scores are a measure of an applicant's ability to apply the medical knowledge, skills, and understanding of clinical science essential for providing patient care. Overall, U.S. IMG applicants had mean USMLE Step 2 CK scores of 224 (s.d. = 19) and non-U.S. IMG applicants had mean scores of 233 (s.d. = 19), both well above the 2012 minimum passing score of 196 (marked by the red lines in the chart). Chart 8 shows the Step 2 CK scores for U.S. IMGs and non-U.S. IMG applicants who matched to their preferred specialty. The horizontal bars are the median values for successful applicants and the vertical lines show the interquartile ranges. As was the case for Step 1 scores, the more competitive specialties have higher average Step 2 CK scores. The interquartile ranges are generally larger for non-U.S. IMGs, especially for Emergency Medicine.
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Graph 4
1.00
Probability of Matching to Preferred Specialty by USMLE Step 2 CK (Clinical Knowledge) Score

0.80
0.60
0.40
0.20
0.00 180
190
200
210
220
230
240
250
260
270
280
STEP 2 CK Scores
Probabilities of matching to a preferred specialty also are calculated for scores on Step 2 CK. Graph 4 presents the probability curves for U.S. IMG and non-U.S. IMG applicants. The red line marks the passing score of 196 in 2012. All applicants with Step 2 CK score below 196 took the test before May 17, 2012, when USMLE announced the plan to raise the passing score from 189 to 196.
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Chart 9
Mean Number of USMLE Step 2 CK (Clinical Knowledge) Attempts*

U.S. IMG
3
Matched
Not Matched
2 1.9 1.6 1.8 1.5 1.5 1.5 1.9 1.4 1.3 1.4
1.3
1.2
1.4
1.2
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.0
1.0
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
1.0
Psychiatry
Radiology
SurgeryGeneral
Non-U.S. IMG
3
Matched
Not Matched
1.3
1.4
1.2
1.2
1.2
1.2
1.3
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
Chart 9 compares the mean number of attempts at Step 2 CK or equivalent historical exams for matched and unmatched U.S. IMGs and non-U.S. IMGs. Across specialties, matched U.S. IMG and matched non-U.S. IMG applicants made fewer attempts than those who did not match. In addition, the difference is generally larger among U.S. IMGs.
*USMLE Step 2 CK or equivalent examination

15
1.0
1.1
1.2
1.0
1.2
Graph 5
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 1
Probability of Matching to Preferred Specialty by USMLE Step 2 CK (Clinical Knowledge) Attempts*

by IMG Applicant Type, and Match Status
10
11
12
13
14
STEP 2 CK Attempts
Probabilities of matching to a preferred specialty are calculated for attempts at Step 2 CK or equivalent historical exams using a simple logistic regression. Graph 5 compares the probabilities of matching for different numbers of attempts. Similar to the Step 1 attempts, this graph shows that the more times the exams are attempted, the lower the probability of obtaining a position in a preferred specialty.

16
Chart 10
Mean Number Attempts at of USMLE Step 2 CS (Clinical Skills) or ECFMG CSA (Clinical Skills Assessment)
Matched
U.S. IMG
2
Not Matched
1.6
1.5
1.4
1.4
1.4
1.5
1.3
1.3
1.3
1.2
1.2
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.2
1.0
1.0
All Specialties
Anesthesiology Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
Non-U.S. IMG
2
Matched
Not Matched
1.4
1.4
1.6
1.3
1.3
1.3
1.3
1.3
1.3
1.4
1.2
1.2
1.2
1.3
1.0 1.1
1.1
SurgeryGeneral
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.1
1.1
All Specialties
Anesthesiology Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
1.1
SurgeryGeneral
Passing USMLE Step 2 CS is a requirement for ECFMG certification. Because USMLE reports only pass/fail status on this exam, only the number of attempts at the exam is studied. Chart 10 compares the mean number of attempts at Step 2 CS or equivalent exams for matched and unmatched U.S. IMGs and non-U.S. IMGs. There are limited variations among the specialties. For all specialties except Emergency Medicine, matched U.S. IMG and matched non-U.S. IMG applicants made fewer attempts than those who did not match.
17
1.2
1.2
Chart 11
60 50 40 30 20
Mean Number of Months after ECFMG Certification
U.S. IMG
Matched Not Matched
39.1 25.6 27.4 28.1 22.1 12.7 15.5 8.3 6.8 7.4 9.2 3.9
Obstetrics and Gynecology Pathology
40.5 29.7 21.4 13.4 3.3

Pediatrics
28.3 17.9 13.0 6.6
19.3 7.6
10 0
8.0 3.7
8.6
Family Medicine
Internal Medicine
Neurology
Psychiatry
Radiology
SurgeryGeneral
Source: NRMP Data Warehouse and ECFMG
Non-U.S. IMG
60 50 40 30 20 10 0
Matched
Not Matched
40.8 35.6 29.8 25.6 16.0 11.5 24.1 13.7 31.3 27.3 21.7 14.7 10.1 19.0 29.4 26.4 21.2 12.4 29.9 24.2 22.9 20.4 22.6 16.1 23.8 35.9
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
Chart 11 demonstrates the mean number of months after the applicants obtained ECFMG certification, calculated as the number of months between the date of ECFMG certification and March 1, 2013. There are some variations among the specialties and between the two types of IMG applicants, but no obvious specialty-specific pattern exists. Generally, matched applicants of both applicant types obtained ECFMG certification later than those who did not match to their preferred specialty. The difference is more notable among U.S. IMG applicants, averaging almost 18 month between the matched and unmatched applicants.
18
Chart 12
15
Mean Number of Years After Graduation
U.S. IMG
Matched Not Matched
11.2
10
8.3 5.7 6.1 4.8 1.8 1.7 1.7 2.0 0.9

Neurology Obstetrics and Gynecology Pathology
5.9
5.8 4.6 4.1 0.7
5.8 3.8 1.4 1.8
6.3 2.7 1.4 1.1

SurgeryGeneral
1.7 0.5
0
1.1
Family Medicine
Internal Medicine
Pediatrics
Psychiatry
Radiology
Non-U.S. IMG
15 Matched Not Matched 12.6
10.7
10
11.3 9.4 9.9 7.2 3.9 7.3 6.0 3.3 6.2 4.4 7.9 6.3 7.8 6.6 5.2 3.3 3.6 5.4 4.3 7.7 8.0
7.5
5
7.2
4.7
0 All Anesthesiology Emergency Specialties Medicine Family Medicine Internal Medicine Neurology Obstetrics and Gynecology Pathology Pediatrics Physical Medicine & Rehab Psychiatry Radiology SurgeryGeneral
The number of years after graduation is calculated as the difference between the year of graduation and 2013. Chart 12 shows the mean number of years after graduation for matched and unmatched U.S. IMG and non-U.S. IMG applicants. In general, matched applicants of both applicant types graduated later than those who did not match to their preferred specialty. U.S. IMG applicants showed a larger difference of about 6 years for all specialties than the 3-year difference for non-U.S. IMGs. In addition, the average non-U.S. IMGs graduated earlier than their U.S. IMG counterparts.
19
Chart 13
U.S. IMG
100
Percentage of IMG Applicants whose Native Language is English*

Matched
Not Matched
91
75
76 56
83 72
83
78 54
82 71 51 71 52 62
87 74 53 29
83
74
73 49
73 53
81
74
50
25
Family Medicine
Internal Medicine
Neurology
Pathology
Pediatrics
Psychiatry
Radiology
SurgeryGeneral
Non-U.S. IMG
100
Matched
Not Matched
75
50
53 28 11 36
58 39 19
Family Medicine
25
24
30 17 14 10
38 17 25 9 7 26 16 12
18
14
Psychiatry
21
14
20
21
Internal Medicine
Neurology
Pathology
Pediatrics
Radiology
SurgeryGeneral
Chart 13 summarizes the percentage of applicants by applicant type whose native language is English and who were matched or not matched to their preferred specialties. Not surprisingly, more U.S. IMGs speak English as their native language. In most specialties, a larger percentage of matched applicants speak English as their native language.
* Native languate as English is self-reported

20
Chart 14
U.S. IMG
IMG Applicants' Citizenship at Birth

by IMG Applicant Type and Match Status
Matched
Not Matched
Number of applicants
1,600 1,400 1,200 1,000 800 600 400 200 0
1,583 1,176
298
183
67
73
57
49
39
50
67
76
209
24
27
35
21
17
14
an
18
es
23
36
332
ria
hi na
di a
Eg yp
pi ne
de s
Ira
ub
na
Pa ki st
St at
ig e
In
Ba ng
Ph ilip
Non-U.S. IMG Number of applicants

1,600 1,400 1,200 1,000 800 600 400 200 0
1,346
Matched
Not Matched
860
ni te
Al lO el a zu m
53 32 37 34
Vi et
la
th do Ki ng Ve ne Al lO th er
555 656
260 152
74 170
72 110
96 225
122 202
101 165
254 429
70 45
53 81
74 56
22 48
15 43
24 47
43 38
38 43
39 40
45 55
52 66
34 18
34 21
24 35
34 29
ol in om ic an bi a R ep ub lic Eg yp t G er m an y
Pe Ph ru ilip Sa pin es ud iA ra bi a Sr iL an ka Su da n
ri Pa a ki st an
al
19 32
30 32
ex ic o M ya nm ar
Br az il C an ad a
Ko re
ba no
Li by
Jo r
la
Ba ng
Le
ig e
om
Applicants citizenship at birth is presented in Chart 14. Only countries with at least 50 U.S. IMG applicants or non-U.S. IMG applicants are included. Not counting United States, India contributed the highest number of IMGs to the Match, followed by Pakistan. Other countries with more than 100 applicants in a category include Canada, Nigeria, China, Iran, Iraq, and Egypt. This chart is not presented in specialty-specific analysis.
21
ni te
Sy ria
da n
di a
hi na
Ira
de s
Ira
In
ep
85 99
er
615
Chart 15
1,400 1,200 1,000 800 600
Country of Medical School

U.S. IMG
by IMG Applicant Type and Match Status
Matched
Not Matched
532
438
534
258
207
180
139
139
140
189
84
70
77
79
85
65
58
60
54
46
45
45
42
45
38
36
40
29
21
14
23
33
12
12
35
70
200
90
103
G re n
D om
R ep
Ph ilip
An d
an
Sa
Eu st
C ay m
in ic a
D om
tig
An
Sa
in
tK
ua
i tt
Non-U.S. IMG Number of applicants

1,400 1,200 800 600 116 207 75 174 77 66 71 38 63 67 41 53 46 20 22 46 42 46 24 45 43 37 200 0 53 104 79 192 155 103 82 127 400 12 41 27 31 754 1,000 1,207
Matched
Not Matched
654 789 255 403 52 85 68 29 68 73 23 60 51 64 80 79 35 29
Si nt
An
Si nt
32 41
39 32
An
Match status by country of medical school for U.S. IMG and non-U.S. IMG applicants is presented in Chart 15. Only countries with at least 50 U.S. IMG applicants or non-U.S. IMG applicants are reported. Most U.S. IMGs were trained in the Caribbean countries such as Dominica, Grenada, Antigua and Barbuda, and Sint Maarten. A large number of non-U.S. IMGs were trained in India and Pakistan. Medical schools in Nigeria, China, Grenada, and Egypt also contributed many physicians to U.S. residency programs.
22
Pe Ph r ilip u pi ne s R us Sa si in a tK i tt S s a ba An d N Sa ev ud i iA s So r a bi ut a h Ko re a Sy Ve ri ne a zu el a Al lO th er
na
sh
D bia om in ic an inic a R ep ub lic Eg yp G t er m an y G re na da In di a
ua
An
Ba
D om
tig
C ol
d Jo rd an Le ba no n Li by a M ex M ico ya nm ar N ep al N ig er Pa ia ki st an
da
Ira
Ira
ad e
C hi
rb u
om
Ba
ng l
Ire
la n
30 29
50 32
Al lO th er
an
M ex ic o
na
nd
ia
ia
Is ra e
at iu s
in ic a
ev is
ds
da
yp
ne
ba
lic
In di
Ira
N ig er
an
ub
Pa ki st
la
C hi
rb u
Eg
pi
Sa
uc
Ba
in
M aa
Is l
Po
tL
rte
ad
120
400
252
546
Tables and Charts for Selected Specialties
AN
Anesthesiology
Table AN-1
Anesthesiology
Summary Statistics
U.S. IMG Non-U.S. IMG Matched (n=78) 4 1.7 226 1.1 234 1.0 1.1 24 7.2 28 Unmatched (n=85) 3 1.9 219 1.2 221 1.1 1.3 30 10.7 11
Measure 1. Mean number of contiguous ranks 2. Mean number of distinct specialties ranked 3. Mean USMLE Step 1 score 4. Mean USMLE Step 1 attempts* 5. Mean USMLE Step 2 CK score 6. Mean USMLE Step 2 CK attempts** 7. Mean USMLE Step 2 CS or ECFMG CSA attempts 8. Mean number of months since ECFMG certification 9. Mean number of years since graduation 10. Percentage who speak English as a native language
Sources: NRMP Data Warehouse and ECFMG *USMLE Step 1 or equivalent examination **USMLE Step 2 CK or equivalent examination
Matched (n=95) 9 1.8 234 1.0 239 1.0 1.1 4 0.5 91
Unmatched (n=65) 3 2.1 210 1.7 212 1.5 1.3 27 4.8 72
25
Chart AN-1
50
Number of Contiguous Ranks Within Preferred Specialty

Anesthesiology U.S. IMG
Matched
Not Matched
40 30 20 14 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 9 4 10 10 6 2 7 3 4 1 3 2 3 2 7 4 1 1 0 3 1 1 0 2 3 0 0 0 10 28 19
Contiguous Ranks
Non-U.S. IMG
50 47
Matched
Not Matched
40 30 20 20 10 10 3 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 18 13 11 5 6 2 6 3 3 0 0 0 2 1 0 2 4 0 1 0 0 0 1 0 0 0 1 4
Contiguous Ranks

26
Graph AN-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0
Anesthesiology
Probability of Matching to Preferred Specialty by Number of Contiguous Ranks Probability of Matching
10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG
Source: NRMP Data Warehouse.

27
Chart AN-2
50
Number of Applicants Ranking Different Specialties
Matched
42
Not Matched
40 30 20 10
38
27 20 15 12 4 0
0 1 2 3 4 or More
Number of Different Specialties Ranked

50
Non-U.S. IMG
45 40
Matched
Not Matched
40 30 20 10 4 0 1 2 3 4 or More 19 10 12 5
25

28
Chart AN-3
40
USMLE Step 1 Scores
Matched
Not Matched
30
27
25
20 15 12 10 0 0
<= 180 Between 181 and 190 Between 191 and 200 Between 201 and 210 Between 211 and 220
17 14 9 6 7 7 1
Between 221 and 230 Between 231 and 240 Between 241 and 250
9 1
9 1
>260
0
Between 251 and 260
Score Unknown
Step 1 Scores
Non-U.S. IMG
40
Matched
Not Matched
30
20 11 10 0 0
<= 180 Between 181 and 190 Between 191 and 200
17 13 5 11
16 12
15
15
13 10 5 3
6 0
1
>260
Between 201 and 210
Between 211 and 220
Between 221 and 230
Between 231 and 240
Between 241 and 250
Between 251 and 260
Score Unknown
Step 1 Scores
Source: NRMP Data Warehouse and ECFMG.
29
Graph AN-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00
Anesthesiology
Probability of Matching to Preferred Specialty by USMLE Step 1 Score Probability of Matching
180
200
220
240
260
280
U.S. IMG
Step 1 Score
Non-U.S. IMG
30
Chart AN-4
100

94
USMLE Step 1 Attempts*
Matched
Not Matched
90 80 70 60 50 40 30 20 10 0
1 2 3 4 5 6 and mroe
48
7 1 0
Step 1 Attempts
Non-U.S. IMG
100
Matched
75
Not Matched
90 80 70 60 50 40 30 20 10 0
1 2 3 4 5 6 and mroe
70
6 0
Step 1 Attempts

31
Graph AN-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00
Probability of Matching to Preferred Specialty by Number of Step 1 Attempts*

Anesthesiology
Probability of Matching
U.S. IMG
Non-U.S. IMG
Step 1 Attempts

32
Chart AN-5
50 40 40 30 30 20 20 10 10
USMLE Step 2 CK (Clinical Knowledge) Scores
Matched Matched
Not NotMatched Matched
27 27 15 15 9 9 00 00 00
Between 181 Between 181 and 190 and 190
25 25
12 12 6 6
17 17 9 9 7 7
14 14 7 7 1 1
9 9 0 0
Between Between 251 251 and and 260 260
11
Between 191 Between 191 and 200 and 200 Between Between201 201 and and210 210 Between Between211 211 and and220 220 Between Between221 221 and and230 230 Between Between231 231 and and240 240
00
<= 180 <= 180 Between Between 241 241 and and 250 250 >260 Score Unknown
Step Scores Step 22 CK Scores
Non-U.S. IMG
50 40 40 30 30 20 20 10 10 00 00
<= 180 <= 180 Between 181 Between 181 and 190 and 190 Between 191 Between 191 and 200 and 200 Between Between201 201 and and210 210
Matched Matched
17 17 11 11 6 6 00 6 6 44 55
13 13
11 11
16 16
12 12
15 15
15 15
13 13
10 10 5 5 3 3 1 0 0 0
Between Between211 211 and and220 220
>260
Score Unknown

33
Graph AN-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Anesthesiology
160
180
200
220
240
260
280
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
34
Chart AN-6
100 90

94
USMLE Step 2 CK (Clinical Knowledge) Attempts*
Matched
Not Matched
80 70 60 50 40 30 20 10 0
1 2 3 4 5 6 and mroe
48
12 1 0 1 0 2 0 1 0 1
Step 2 CK Attempts
Non-U.S. IMG
100 90
Matched
76 80
Not Matched
80 70 60 50 40 30 20 10 0
2
1 2
0
3
0
4
0
5
0
6 and mroe
Step 2 CK Attempts

35
Chart AN-7
100 90

88
Attempts at USMLE Step 2 CS (Clinical Skills) or ECFMG CSA (Clinical Skills Assessment)
Matched
Not Matched
80 70 60 50 40 30 20 10 0
1 2 3 4 5 6 and mroe
52
8 0
Step 2 CS or ECFMG CSA Attempts
Non-U.S. IMG
100 90
Matched
Not Matched
80 70 60 50 40 30 20 10 0
70
69
10 0 4
3
0
4
0
5
6 and mroe

36
Chart AN-8
60
Number of Months After ECFMG Certification
53
Matched
Not Matched
50 40 30 20 10 10 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 11 6 9 5 10 2 0 29
14
11 0 0
Months after ECFMG Certification
Non-U.S. IMG
60
Matched
Not Matched
50 40 30 20 10 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 8 4 2 5 0 17 16 26 22 16 9 12 2
24

37
Chart AN-9
70 60

67
Number of Years After Medical School Graduation

Matched Not Matched
50 40 30 20 10 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 14 5 0 23
20 12 4 0 7 0 6 0 0
Years after Medical School Graduation
Non-U.S. IMG
70 60
Matched
Not Matched
50 40 30 20 10 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 8 11 5 3 13 28 27 19 10 11 7 0 1 20

38
Chart AN-10
70 60 50 40 30 20 10 0
Matched
Not Matched 40
37 24 20 15
13
11 Sint Maarten
All Other
Dominica Country of Medical School
Grenada
Non-U.S. IMG
70 60 50 40 30 20 10 0 64 50 25 10 All Other China Country of Medical School 14 Matched Not Matched
India

Note: A country is included if it has 10 or more applicants for each category
39
EM
Emergency Medicine
Table EM-1
Emergency Medicine
Summary Statistics
Matched (n=53) 5 1.7 225 1.1 235 1.1 1.1 9 1.1 83
Unmatched (n=137) 3 2.0 215 1.2 223 1.3 1.1 13 1.8 83
41
Chart EM-1
70
Emergency Medicine U.S. IMG

63
Matched
Not Matched
60 50 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 9 10 4 14 8 3 6 3 3 4 4 3 4 2 3 0 0 2 2 0 2 0 1 2 1 0 1 0 0 1 35
Contiguous Ranks
Non-U.S. IMG
70
Matched
Not Matched
60 50 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 6 5 14 6 2 4 1 4 0 1 0 1 1 1 0 0 0 0 0 2 0 0 0 1 1 0 0 0 1 0 0 33
Contiguous Ranks

42
Graph EM-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0

Emergency Medicine
10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

43
Chart EM-2
70
Matched
58 48
Not Matched
60 50 40 30 20 10 0 1 2 25
22
24
5 1 3 4 or More

70
Non-U.S. IMG
Matched
Not Matched
60 50 40 30 21 20 10 0 1 2 3 4 or More 6 4 5 0 21 25

44
Chart EM-3
40
USMLE Step 1 Scores

Matched
Not Matched
30
27 23
28
20
18 15 10 11 6 3 1
Between 211 and 220 Between 221 and 230 Between 231 and 240 Between 241 and 250
12
13
11 3 0
>260
10 0 0
<= 180 Between 181 and 190
7 0 2
Between 191 and 200
Between 201 and 210
Between 251 and 260
Score Unknown
Step 1 Scores
Non-U.S. IMG
40
Matched
Not Matched
30
20 10 6 0
Between 191 and 200 Between 201 and 210 Between 211 and 220
10 4 0 0
<= 180 Between 181 and 190
9 5
10 2
Between 221 and 230
10 4 3 3
0
>260
Between 231 and 240
Between 241 and 250
Between 251 and 260
Score Unknown
Step 1 Scores
45
Graph EM-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00
Emergency Medicine
180
190
200
210
220
230
240
250
260
U.S. IMG
Step 1 Score
Non-U.S. IMG
46
Chart EM-4
120

Emergency Medicine
119
U.S. IMG
Matched Not Matched
100 80 60 40 20 2 0
1 2 3 4 5 6 and mroe
49
12 2 5 0 1 0 0 0 0
Step 1 Attempts
Non-U.S. IMG
120
Matched
Not Matched
100 80 60 45 40 20 1 0
1 2 3 4 5 6 and mroe
30
Step 1 Attempts

47
Graph EM-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Emergency Medicine
U.S. IMG
Non-U.S. IMG
Step 1 Attempts

48
Chart EM-5
50 40 40 30 30 20 20 10 10

Matched Matched
27 27 18 18 7 7 00 00 22
Between 181 Between 181 and 190 and 190 Between 191 Between 191 and 200 and 200
28 23 23 28
15 15
10 10 33
Between Between201 201 and and210 210 Between Between211 211 and and220 220
11 11 6 6
12 12
13 13
11 11 1 1 3 3 0 0 0 0
>260 Score Unknown
00
<= 180 <= 180
Non-U.S. IMG
50 40 40 30 30 20 20 10 10 00 00
Matched Matched
9 9 44 00 00 00
9 9
6 6
10 10 55 2 2
10 10
8 8
10 10 4 4 3 3 3 3 1 1 0 0 0 0
>260
Score Unknown

49
Graph EM-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Emergency Medicine
160
180
200
220
240
260
280
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
50
Chart EM-6
120

110
Matched
Not Matched
100 80 60 40 23 20 3 0
1 2 3 4 5 6 and mroe
50
Step 2 CK Attempts
Non-U.S. IMG
120
Matched
Not Matched
100 80 60 46 40 20 2 0
1 2 3 4 5 6 and mroe
29 5
Step 2 CK Attempts

51
Chart EM-7
140

123
Matched
Not Matched
120
100 80 60 40 20 3 0
1 2 3 4 5 6 and mroe
50
12 0 1 0 1 0 0 0 0
Non-U.S. IMG
140 120
Matched
Not Matched
100 80 60 45 40 20 3 0
1 2 3 4 5 6 and mroe
27 5 1 1 0 0 0 0 0 2

52
Chart EM-8
60

55
Matched
Not Matched
50 40 32 30 20 10 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 19 20 11 5 5 12 3 9 1 11 7 0
Non-U.S. IMG
60
Matched
Not Matched
50 40 30 20 10 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 9 4 4 15 8 7 8 9 1 8 1 10 0 0

53
Chart EM-9
80 70

78

Matched Not Matched
60 50 40 30 20 10 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 13 5 0 12 7 0 2 1 4 0 0 33 34
Non-U.S. IMG
80 70
Matched
Not Matched
60 50 40 30 20 10 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 8 13 7 8 14 9 7 6 1 7 0 1 0 0

54
Chart EM-10

70 60 50 40 30 20 10 0
64
Matched
Not Matched 39
34 17
20
16
All Other
Grenada
Non-U.S. IMG
70 60 50 40 30 20 10 0 Matched 38 15 Not Matched
31
All Other Country of Medical School
Grenada

55
FM
Family Medicine
Table FM-1
Family Medicine
Summary Statistics
Matched (n=531) 6 1.3 206 1.4 213 1.2 1.1 8 1.7 78
Unmatched (n=702) 3 1.5 198 2.1 203 1.9 1.5 28 6.1 54
57
Chart FM-1
400

Family Medicine U.S. IMG
372
Matched
Not Matched
350 300 250 200 150 100 50 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 96 70 57 70 51 24 33 22 33 34 10 13 19 10 22 24 12 20 16 11 10 12 23 19 128
Contiguous Ranks
Non-U.S. IMG
400 379
Matched
Not Matched
350 300 250 200 150 100 100 50 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 49 94 31 41 21 13 19 11 14 8 13 8 9 8 15 23
Contiguous Ranks

58
Graph FM-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0
Family Medicine
10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

59
Chart FM-2
500 450
462 367
Matched
Not Matched
400 350 300 250 200 150 100 50 0
186 146
18 1 2 3
37 0 4 or More 9

500 450
Non-U.S. IMG
394
Matched
Not Matched
400 350 300 250 200 150 100 50 0 1 191
160 91 50 10 2 3 1 4 or More 8

60
Chart FM-3
300
USMLE Step 1 Scores
Matched
270 210
Not Matched
250 200 150 100 55 50 0 0

<= 180 Between 181 and 190 Between 191 and 200 Between 201 and 210 Between 211 and 220 Between 221 and 230 Between 231 and 240 Between 241 and 250 Between 251 and 260 >260 Score Unknown
172 145 132 86 57 36 2 26 23 4 12 0 2 0 0 0 0 1
Step 1 Scores
Non-U.S. IMG
300
Matched
Not Matched
250 200 150 112 100 62 50 0 0

193 136 102 63 55 42 48 28 19 14 4 7 2 1 0 0 0
21 0
Step 1 Scores
61
Graph FM-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00
Family Medicine
160
180
200
220
240
260
280
U.S. IMG
Step 1 Score
Non-U.S. IMG
62
Chart FM-4
500
Matched
403 330
Not Matched
450 400 350 300 250 200 150 100 50 0
183 86 32 95 44 6
3 4
3
5
22
28 1
6 and mroe
Step 1 Attempts
Non-U.S. IMG
500 453
Matched
Not Matched
450 400 350 300 250 200 150 100 50 0

1 2 3 4 5 6 and mroe
254
113 29 39 9 0 3 1 8 0 0
Step 1 Attempts

63
Graph FM-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Family Medicine
U.S. IMG
Non-U.S. IMG
Step 1 Attempts

64
Chart FM-5
300 50 250 40 200 30 150 20 100 10 50

55 210

172 270 270 210 172 145 132 86 55 57 36 26 23 4 4 36 26 23 145 132 86 57
Matched Matched
12 12 2 2
0 0
2 2
1 1
<= 180
Between 221 and 230
Between 231 and 240
Between 241 and 250
Between 251 and 260
>260
Score Unknown
Step Step 2 2 Scores CK Scores
Non-U.S. IMG
300 50 250 40 200 30 150 20 100 10 50 0 0
<= 180
112
62
193
63
136
55
102
Matched Matched
42
48
193 28 21 136 112 62 21 0

Between 181 and 190 Between 191 and 200 Between 201 and 210 Between 211 and 220 Between 221 and 230 Between 231 and 240
102 63 55 42 48 28
19 14 7 19 14 4 4 7 2 2 1 1 0 0 0
Between 241 and 250
Between 251 and 260
>260
Score Unknown

65
Graph FM-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Family Medicine
160
180
200
220
240
260
280
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
66
Chart FM-6
500 450

447 364
Matched
Not Matched
400 350 300 250 200 150 100 50 0

1
193
67 17
2 3
78 39 0
4
0
5
14
14
6 and mroe
Step 2 CK Attempts
Non-U.S. IMG
500 450 479
Matched
Not Matched
400 350 300 250 200 150 100 50 0

1 2 3 4 5 6 and mroe
263
103 25 4 25 1 6 0 3 0 0
Step 2 CK Attempts

67
Chart FM-7
500 450

489 484
Matched
Not Matched
400 350 300 250 200 150 100 50 0

1 2 3 4 5 6 and mroe
152
41 1
48 0 9 0 3 0 6
Non-U.S. IMG
500 450 453
Matched
Not Matched
400 350 300 250 200 150 100 50 0

1 2 3 4 5 6 and mroe
269
118 31 3 0
20

68
Chart FM-8
200 180 160 140 120 100 80 60 40 20 0

167

Matched
179 154 122 81 67 43 36 11 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 20 2 no data 80 145 126
Not Matched
Non-U.S. IMG
200 180
Matched
155 124 94 56 61
Not Matched
162
160 140 120 100 80 60 40 20 0 less than 1 2 to 6 7 to 12 34 25 50
88
32 15 1 13 to 24 25 to 48 more than 48 no data 12

69
Chart FM-9
300

Matched
256
Not Matched
250
234 212
200 150 100 65 50 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 43 26 7 8 1 19 136 92 64 66
Non-U.S. IMG
300 250
Matched
Not Matched
223
200 150 113 100 50 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 95 72 52 35 49 12 13 92 79 59 0 11

70
Chart FM-10
200
Matched 127 78 63 63 12
Ba rb ud a Ar ub a th er
Not Matched
150 100 50 0
133 111 73 33 49 15
ub a
14
16
Eg yp t
37
32
38 11
Ira n
11
ra el
23
28
16
11
25
10 10
Sa ba
29 35
39 12 14
38 27
la nd s
D om om in in ic a ic an R ep ub lic
In di a
re na da
ex ic o
ta n Ph ilip pi ne s
Po la nd
s N An d ev i
ay m an
An tig ua
Non-U.S. IMG
200 182 140 130 56 10
ig er ia ta n
Matched
Not Matched
150 100 50 0
16
hi na th er
22 24
45 17
Eg yp t
23
45 18
In di a
Sa in t
Ki tts
12
Ira n
20
10
ya nm ar
20
14
si a
re na da
Ira q
Ph ilip pi ne s
Sa ba
om in ic
Pa ki s
us
Al l

71
Sa in t
Ki tts
An d
ev i
Lu ci Si a nt Eu st at iu s Si nt M aa rte n
Pa ki s
Is
Is
An d
Sa in t
Al l
25 15
33 32
IM
Internal Medicine
Table IM-1
Internal Medicine
Summary Statistics
U.S. IMG Non-U.S. IMG Matched (n=1,690) 7 1.3 231 1.0 236 1.0 1.1 15 4.3 19 Unmatched (n=1,856) 3 1.4 217 1.2 221 1.1 1.3 22 6.6 17
Matched (n=841) 8 1.3 221 1.1 228 1.1 1.1 7 1.7 71
Unmatched (n=753) 3 1.6 205 1.6 210 1.4 1.4 22 5.9 51
73
Chart IM-1
1,000
Internal Medicine U.S. IMG
Matched
Not Matched
800 600 421 400 200 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 136 66 49 60 45 33 56 28 44 12 48 16 45 12 43 6 57 13 43 4 41 0 45 1 35 1 29 2 75 8
120
Contiguous Ranks
Non-U.S. IMG
1,000 912
Matched
Not Matched
800 600 400 240 200 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 178 360 182 224 140 125 134 60 125 31 99 34 86 22 89 15 73 19 67 8 66 3 109 33 6 35 5 34 4 28
Contiguous Ranks

74
Graph IM-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0

Internal Medicine
10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

75
Chart IM-2
1,400

Matched
Not Matched
1,200 1,000 800 604 600 405 400 203 200 25 0 1 2 3 4 or More 259 70 9 12

1,400
Non-U.S. IMG
1,317 1,268
Matched
Not Matched
1,200 1,000 800 600 432 400 200 0 1 2 3 4 or More 289 67 123 11 27

76
Chart IM-3
450 400
USMLE Step 1 Scores

Matched
Not Matched
350 300 250 200 150 100 50 0

218 165 112 82 0 3 21 137 175 144 75 23 174 146 76 8 21 5 9 0 0 0
Step 1 Scores
Non-U.S. IMG
450 400
Matched
384 337 281 227 144 86 333 383
Not Matched
340
350 300 250 200 150 100 50 0

<= 180 Between 181 and 190 Between 191 and 200
329 235 163 110
76 33
55 7 0 0
23
Between 201 and 210 Between 211 and 220 Between 221 and 230 Between 231 and 240 Between 241 and 250
Between 251 and 260
>260
Score Unknown
Step 1 Scores
77
Graph IM-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Internal Medicine
160
180
200
220
240
260
280
U.S. IMG
Step 1 Score
Non-U.S. IMG
78
Chart IM-4
1,800

Matched Not Matched
1,600 1,400 1,200 1,000 800 600 400 200 0

1 2 3 4 5 6 and mroe
783 523
40
131 9
50
23
11
15
Step 1 Attempts
Non-U.S. IMG
1,800 1,647 1,632
Matched
Not Matched
1,600 1,400 1,200 1,000 800 600 400 200 0

1 2 3 4 5 6 and mroe
163 39 3 44 1 10 0 3 0 4
Step 1 Attempts

79
Graph IM-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Internal Medicine
U.S. IMG
Non-U.S. IMG
Step 1 Attempts

80
Chart IM-5
50 450 400 40 350 300 30 250 200 20 150 100 10 50 0

Internal Medicine
112
U.S. IMG
82
218
137 165
175 144
174 Matched Matched
75
146 Not Not Matched Matched
76
218 21 112 82 0 3 3 21
23 165 137 175 144 75 23

Between 231 and 240
174 146 76 8 8
Between 241 and 250
21
9 21 5 5 9 0 0 0
<= 180
Between 251 and 260
>260
Score Unknown
Non-U.S. IMG
50 450 400 40 350 300 30 250 200 20 150 100 10 50 0
<= 180
86
76
281
144 337
227 384
333 383 Matched Matched 383 333
340 235 Not Not Matched Matched 340
329 110
163
55
384 337 281 23 144 86 0 0 23

329 33
227
235 163 110
76 33
55
7 7 0 0
Between 221 and 230
Between 231 and 240
Between 241 and 250
Between 251 and 260
>260
Score Unknown

81
Graph IM-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Internal Medicine
160
180
200
220
240
260
280
300
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
82
Chart IM-6
1,800

Matched Not Matched
1,600 1,400 1,200 1,000 800 600 400 200 0

1 2 3 4 5 6 and mroe
804 534
147 28 6 45 2 20 0 7 1 0
Step 2 CK Attempts
Non-U.S. IMG
1,800 1,669 1,693
Matched
Not Matched
1,600 1,400 1,200 1,000 800 600 400 200 0

1 2 3 4 5 6 and mroe
133 20 0 23 1 3 0 1 0 3
Step 2 CK Attempts

83
Chart IM-7
1,600 1,400
Matched
Not Matched
1,200 1,000 800 600 400 200 0

1 2 3 4 5 6 and mroe
791 543
152 45 3 45 1 3 0 3 1 7
Non-U.S. IMG
1,600 1,400 1,534 1,430
Matched
Not Matched
1,200 1,000 800 600 400 200 0

1 2 3 4 5 6 and mroe
353 138 12 61

84
Chart IM-8
800

Matched Not Matched
600
400 269 200 121 306 172 124 61 42 25 to 48
102
141
136 75 13 more than 48 9 23 no data
0 less than 1 2 to 6 7 to 12 13 to 24
Non-U.S. IMG
800 713 575 502 400 201 200 66 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 40 346
Matched
567
Not Matched
600
158
172 35
157 1 13

85
Chart IM-9
700 600

Matched Not Matched
500 400 300 200 100 0
444
237 144
217 87 105 38 125 66 17 11 to 15 18 16 to 25 72 0 16
less than 1
1 to 2
3 to 5
6 to 10
25 or more
Non-U.S. IMG
700 600 656 664
Matched
Not Matched
575
500 400 300 200 100 0 less than 1 138 57
461 325 239 205 82 28 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 101 0 12
25 or more

86
200 400 600 200 400 600 0 0
Chart IM-10
Al l O th er
200 283 10 21 11 16 11 28
Ba rb ud a An d th er
Ba ng la de sh
An tig ua Al l O
136 156
U.S. IMG
50 69
Non-U.S. IMG
C hi na D om in ic a C hi na D
Internal Medicine
Ec ua do r
45 72 18 12 29 16 15 20 14 16 196 90 21 15
Eg yp t G
Ba ng la de C ay sh m an Is la nd s
Et hi op ia G re ec e
40 77 24 15 16 11 50 34
D om om in in ic ic a an R ep ub lic
H ai ti
10 475 583
20
re na da In di a Ira n Is M ra el ex ic o N ig er ia
201 61 27 47
Ira n Ire la nd
25 41 28 44 17 12 14
Matched
Matched
Ja pa n Le ba n on M ex ic o N ep al Pa ki s
16 18
87
55 28 31 19 15 27 19 20 18 30 32 33 45 79
ta n Ph ilip pi ne s Sa in t R Ki tts An d So ut h us N si a ev i
Not Matched
Not Matched
25 20
Pa ki s
17 19 48 178 188 20 16 30 33
ta n Ph ilip pi ne s Po la nd R Sa in t s Ko re a Sy U us si a Ki tts Sa ba An d Sa in t ria kr ai ne Ve ne zu el N ev i
10 13 19 24
17 10 17 29
11 16
29 34
16 26 18 15 12 13 12 15 57 31 11 11 10
a
11
18 10
Lu ci Si a nt Eu st at iu Si s nt M aa rte n
10 63 31
Neurology
Table N-1
Summary Statistics
Neurology
Matched (n=59) 7 1.7 216 1.1 222 1.1 1.1 7 2.0 71
Unmatched (n=44) 2 2.0 203 2.1 206 1.8 1.4 28 5.8 52
89
Chart N-1
100
Neurology U.S. IMG
Matched
Not Matched
90 80 70 60 50 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 14 5 8 3 1 4 2 4 2 3 0 2 0 2 1 1 0 3 0 2 0 3 0 3 1 3 0 4 0 3 0 29
Contiguous Ranks
Non-U.S. IMG
100 96
Matched
Not Matched
90 80 70 60 50 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 25 22 25 16 12 13 5 17 6 7 0 7 2 6 0 10 1 1 0 7 0 4 0 4 0 4 0 2 0 3 2
Contiguous Ranks

90
Graph N-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0

Neurology
10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

91
Chart N-2
80

Neurology U.S. IMG
Matched
Not Matched
70 60 50 40 30 30 20 10 1 0 1 2 3 4 or More 18 17 12 10 11 3

80
Non-U.S. IMG
64 67 63
Matched
57
Not Matched
70 60 50 40 30 20 10 0
16
16 5 6
4 or More

92
Chart N-3
50
USMLE Step 1 Scores

Neurology U.S. IMG
Matched
Not Matched
40 30 20 11 10 0 0
13 10
14 6
12 8 9 4 5 2 4 0 2 0 1 0 0 0
Step 1 Scores
Non-U.S. IMG
50
Matched
Not Matched
40 30 30 21 20 10 0 0
<= 180 Between 181 and 190 Between 191 and 200 Between 201 and 210
36 30 25 21 15 11 8 0 2
Between 211 and 220 Between 221 and 230
34
23 16 10 4 2
Between 251 and 260 >260
9 0 0 0
Between 231 and 240
Between 241 and 250
Score Unknown
Step 1 Scores
93
Graph N-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Neurology
180
200
220
240
260
280
U.S. IMG
Step 1 Score
Non-U.S. IMG
94
Chart N-4
150

Neurology U.S. IMG
Matched Not Matched
120
90 57
60
30
24 11 1 0
2 3
1
4
0
5
0
1 6 and mroe
Step 1 Attempts
Non-U.S. IMG
150 141 132 120
Matched
Not Matched
90
60
30 6 0
1 2 3 4 5 6 and mroe
13 1 2 0 1 0 0 0 1
Step 1 Attempts

95
Graph N-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Neurology
U.S. IMG
Non-U.S. IMG
Step 1 Attempts

96
Chart N-5
50 40 40 30 30 20 20 10 10

Neurology U.S. IMG
Matched Matched
11 11 22
10 10
13 13
14 14 6 6
12 12
8 8
9 9 4 4
5 5
00 00
00
2 2
4 4 0 0
2 2
0 0
<= 180 <= 180
>260
Score Unknown
Non-U.S. IMG
50 40 40 30 30 20 20 10 10 00 00
Matched Matched
36 30 30 21 15 15 8 8 21 11 11 21 21 36 30 30 25 25

34 34 23 23 16 16 10 10 4 4 2 2
9 9 0
>260
00
22
Between Between211 211 and and220 220 Between Between221 221 and and230 230 Between Between231 231 and and240 240
Score Unknown

97
Graph N-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Neurology
180
200
220
240
260
280
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
98
Chart N-6
150

Neurology U.S. IMG
Matched Not Matched
120 90 60 30 0
1 2 3 4 5 6 and mroe
55 25 3 11 1 3 0 3 0 2 0 0
Step 2 CK Attempts
Non-U.S. IMG
150 146 137
Matched
Not Matched
120 90 60 30 2 0
1 2 3 4 5 6 and mroe
10 0
Step 2 CK Attempts

99
Chart N-7
150
Neurology U.S. IMG
Matched
Not Matched
120
90 56 32 30 3 0
1 2 3 4 5 6 and mroe
60
8 0
Non-U.S. IMG
150 129
Matched
Not Matched
120 101 90
60 36 30 17 9 1 0
1 2 3 4 5 6 and mroe

100
Chart N-8
60

Neurology U.S. IMG
Matched Not Matched
50 40 30 20 10 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data
24 18 9 4 3 4 8 9 4 11 1 8 0 0
Non-U.S. IMG
60 57
Matched
45 45
Not Matched
50 40 32 30 20 10 1 0 less than 1 2 to 6 7 to 12 1 17 11
34 26 14 14
0 13 to 24 25 to 48 more than 48 no data

101
Chart N-9
80 70
Neurology U.S. IMG

Matched Not Matched
60 50 40 30 20 10 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 5 14 12 4 10 2 34
9 4
Non-U.S. IMG
80 70 61 60 50 40 40 30 20 10 0 less than 1 1 to 2 3 to 5 5 2 18 32
Matched
Not Matched
57
32 19 12 6 0 6 to 10 11 to 15 16 to 25 1 12
25 or more

102
Chart N-10

Neurology U.S. IMG
80 70 60 50 40 30 20 10 0
Matched 44
Not Matched
39
10 All Other Dominica Country of Medical School
10 Grenada
Non-U.S. IMG
80 70 60 50 40 30 20 10 0 77 63 45 12 India Country of Medical School Iran 14 18 Matched Not Matched 57
11 All Other China
Pakistan

103
OB
Table OB-1

Summary Statistics
Matched (n=78) 8 1.3 221 1.0 232 1.1 1.0 4 0.9 82
Unmatched (n=99) 3 1.7 207 1.4 213 1.3 1.2 16 4.6 62
105
Chart OB-1
80
Obstetrics and Gynecology U.S. IMG
Matched
Not Matched
70 60 50 40 30 20 10 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 5 5 16 12 3 6 7 3 5 1 5 5 1 3 4 2 4 3 6 0 4 0 4 1 5 0 2 0 8 1 46
Contiguous Ranks
Non-U.S. IMG
80
Matched
Not Matched
70 60 50 40 30 20 10 0 1
69
17 11 11 4 2 3 11 7 6 5 5 6 7 4 6 6 0 7 2 8 3 1 9 1 4 10 0 1 11 0 0 12 0 1 13 0 0 14 0 1 15 0 1 3
16 or More
Contiguous Ranks

106
Graph OB-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0

10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

107
Chart OB-2
80

60
Matched
Not Matched
70 60 50 40 30 20 10 0 1 2 3 4 or More 13 4 26 14 1 4 53

80
Non-U.S. IMG
74
Matched
Not Matched
70 60 50 40 30 20 10 0 1 2 3 4 or More 8 2 0 29 13 4 52

108
Chart OB-3
50
USMLE Step 1 Scores

U.S. IMG

Matched Not Matched
40 30 20 20 14 10 10 0 0
26 21
25 18
10
6 3 0 0 0 0 0 0
Step 1 Scores
Non-U.S. IMG
50
Matched
Not Matched
40 30 24 20 20 11 10 0 0
25 17 14 11 19 9
7 4 1 0
8 2 2 1 0 0 0
Step 1 Scores
109
Graph OB-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00
160
180
200
220
240
260
280
U.S. IMG
Step 1 Score
Non-U.S. IMG
110
Chart OB-4
110

Matched Not Matched
100 90 80 70 60 50 40 30 20 10 0
1 2 3 4 5 6 and mroe
77
75
13 0 0
8 1 0 0 1 0 2
Step 1 Attempts
Non-U.S. IMG
110 102
Matched
Not Matched
100 90 80 70 60 50 40 30 20 10 0
1 2 3 4 5 6 and mroe
61
11 1 0 5 0 2 0 0 0 0
Step 1 Attempts

111
Graph OB-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

U.S. IMG
Non-U.S. IMG
Step 1 Attempts

112
Chart OB-5
50 40 40 30 30 20 20 10 10

Matched Matched
26 20 14 14 20 10 10 10 10 26 21 21
25 25 18 18 8 8 8 8
6 6
6 6 0 0
00 00
00
22
Between 181 Between 181 and 190 and 190 Between 191 Between 191 and 200 and 200 Between Between201 201 and and210 210 Between Between211 211 and and220 220 Between Between221 221 and and230 230 Between Between231 231 and and240 240
3 3 0 0
<= 180 <= 180
>260
Score Unknown
Non-U.S. IMG
50 40 40 30 24 30 20 20 10 10 00 00
Matched Matched
25 25 17 17 11 11 14 14 19 19 11 11 9 9 8 8 2 2
Between Between211 211 and and220 220 Between Between221 221 and and230 230 Between Between231 231 and and240 240 Between Between 241 241 and and 250 250
20 20
24
7 7 11 00
44
7 7
2 2
>260
Score Unknown

113
Graph OB-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

180
200
220
240
260
280
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
114
Chart OB-6
120

Matched Not Matched
100 83 80 60 40 20 2 0
1 2 3 4 5 6 and mroe
75
8 1
Step 2 CK Attempts
Non-U.S. IMG
120 110
Matched
Not Matched
100 80 62 60 40 20 0 0
1 2 3 4 5 6 and mroe
Step 2 CK Attempts

115
Chart OB-7
100 90

87 75
Matched
Not Matched
80 70 60 50 40 30 20 10 0
9 3
1 2
0
3
0
4
0
5
6 and mroe
Non-U.S. IMG
100 90 93
Matched
Not Matched
80 70 60 50 40 30 20 10 0
1 2 3 4 5 6 and mroe
57
18 5 6 0 0 1 0 0 0 2

116
Chart OB-8
50
Matched
Not Matched
40 33 30 20 10 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 29 27 17 7 17
16
15 7 3 0 1 0
Non-U.S. IMG
50
Matched
38
Not Matched
40 30 20 10 0 less than 1 2 to 6 8 19
30
17 7 8
19 15 14
3 7 to 12 13 to 24 25 to 48
1 more than 48
3 0 no data

117
Chart OB-9
60

52

Matched Not Matched
50
40 30 30 21 20 11 10 3 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 0 9 1 8 1 8 0 2 30
Non-U.S. IMG
60 50
Matched
Not Matched
40 30 20 10 0 less than 1 1 to 2 3 to 5 17 9 15 26
36
20 14 13 14 2 6 to 10 11 to 15 12 0 16 to 25 0 2
25 or more

118
Chart OB-10

100
Matched 74 38 14 All Other
Not Matched
80 60 40 20 0
25
26
Grenada
Non-U.S. IMG
100 90 62 30 Matched Not Matched
80 60 40 20 0
All Other Country of Medical School
India

119
PTH
Pathology
Table Summary Statistics PTH-1 Pathology

U.S. IMG Measure 1. Mean number of contiguous ranks 2. Mean number of distinct specialties ranked 3. Mean USMLE Step 1 score 4. Mean USMLE Step 1 attempts* 5. Mean USMLE Step 2 CK score 6. Mean USMLE Step 2 CK attempts** 7. Mean USMLE Step 2 CS or ECFMG CSA attempts 8. Mean number of months since ECFMG certification 9. Mean number of years since graduation 10. Percentage who speak English as a native language
Non-U.S. IMG Matched (n=151) 6 1.3 226 1.0 228 1.1 1.2 21 9.4 9 Unmatched (n=136) 3 1.3 214 1.2 216 1.2 1.6 30 12.6 7
Matched (n=46) 8 1.1 224 1.1 226 1.1 1.2 9 4.1 74
Unmatched (n=69) 3 1.5 204 1.7 205 1.5 1.6 39 11.2 29
121
Chart PTH-1
80
Pathology U.S. IMG
Matched
Not Matched
70 60 50 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 6 10 4 3 4 6 6 4 2 3 0 1 0 0 0 1 0 2 3 5 0 1 0 3 0 1 1 1 5 0 2 41
Contiguous Ranks
Non-U.S. IMG
80 71
Matched
Not Matched
70 60 50 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 25 18 10 4 24 16 17 11 0 11 3 15 3 6 7 2 2 3 4 6 1 5 0 1 0 2 0 2 1 12 5
Contiguous Ranks

122
Graph PTH-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0

Pathology
10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

123
Chart PTH-2
120
Pathology U.S. IMG
Matched
Not Matched
100 80 60 41 40 20 5 0 1 2 3 4 or More 51
8 0

120
Non-U.S. IMG
115 103
Matched
Not Matched
100 80 60 40 20 5 0 1 2 3 4 or More 4 2 1
29
28

124
Chart PTH-3
50
USMLE Step 1 Scores

Pathology U.S. IMG
Matched
Not Matched
40 30 20 20 13 10 0 0
15 8 9 8 4 9 4 6 1 4 1 0 0 0 0
Step 1 Scores
Non-U.S. IMG
50
Matched
Not Matched
40 30 23 20 12 10 0 0
<= 180 Between 181 and 190 Between 191 and 200 Between 201 and 210 Between 211 and 220
35 32 28 23 17 8 0
29 25 15 7 7 3 0
>260
15
Score Unknown
Step 1 Scores
125
Graph PTH-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Pathology-Anatomic and Clinical
160
180
200
220
240
260
U.S. IMG
Step 1 Score
Non-U.S. IMG
126
Chart PTH-4
150

Patholog U.S. IMG
Matched Not Matched
120
90
60
44
47
30 10 0 0
1 2 3 4 5 6 and mroe
Step 1 Attempts
Non-U.S. IMG
150 148 120 120
Matched
Not Matched
90
60
30 3 0
1 2 3 4 5 6 and mroe
9 0
Step 1 Attempts

127
Graph PTH-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Patholog
U.S. IMG
Non-U.S. IMG
Step 1 Attempts

128
Chart PTH-5
50 40 40 30 30 20 20 10 10

Pathology U.S. IMG
Matched Matched
20 20 13 13 22 33
15 15 8 8 9 9 8 8 4 4 9 9 4 4 44 6 6 1 1
44
4 4
00 00
1 1
<= 180 <= 180
>260
Score Unknown
Non-U.S. IMG
50 40 40 30 30 20 20 10 10 00 00
Matched Matched
35

32
28 23 23 12 12 17 17 28 15 15 23 23
35 25 25 15 15 32
29 29
8 8 00
8 8
7 7
7 7 3 3 0 0 0 0
>260
Score Unknown

129
Graph PTH-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Pathology
160
180
200
220
240
260
280
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
130
Chart PTH-6
150

Pathology U.S. IMG
Matched Not Matched
120 90 60 42 30 3 0
1 2 3 4 5 6 and mroe
47
14 1 5 0 1 0 1 0 1
Step 2 CK Attempts
Non-U.S. IMG
150 145 120 120 90 60 30 4 0
1 2 3 4 5 6 and mroe
Matched
Not Matched
12 0 3 2 0 0 0 0 1
Step 2 CK Attempts

131
Chart PTH-7
150
Pathology U.S. IMG
Matched
Not Matched
120
90
60 39 30
46
15 4 2
2 3
1
4
0
5
0
1 6 and mroe
Non-U.S. IMG
150 125
Matched
Not Matched
120
90
78
60 41 30 25 11 1 0
1 2 3 4 5 6 and mroe

132
Chart PTH-8
60
Pathology U.S. IMG
Matched
Not Matched
50 40 30 20 10 0 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 3 17 6 9 3 7 1 1 2 20 18
14
14
Non-U.S. IMG
60 51
Matched
47 41
Not Matched
50 40 30 20 10 10 3 0 less than 1 2 to 6 7 to 12 0 12 28
34 28 21 12 0 13 to 24 25 to 48 more than 48 no data 0

133
Chart PTH-9
60 50
Pathology U.S. IMG

Matched Not Matched
40 30 20 13 10 2 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 9 9 1 2 12 2 10 4 2 5 26 16
Non-U.S. IMG
60 50
Matched
55
Not Matched
40 40 30 20 10 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 8 0 6 26 20 35 33 33 23
4 0

134
Chart PTH-10
Pathology U.S. IMG
80
69
Matched
Not Matched
60 40 20 0 All Other Country of Medical School Grenada 35 11
Non-U.S. IMG
80
69
Matched 62 40 42
Not Matched
60 40 20 0 All Other
28
22
14
10 Iran
China Country of Medical School
India

135
PD
Pediatrics
Table PD-1
Summary Statistics
Pediatrics
Matched (n=196) 9 1.2 216 1.1 224 1.0 1.1 3 0.7 87
Unmatched (n=151) 2 1.5 201 1.7 208 1.4 1.3 21 5.8 53
137
Chart PD-1
250

Pediatrics U.S. IMG
Matched
Not Matched
200 150 100 50 17 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 11 82 36 12 13 9 8 10 2 11 2 12 0 13 2 13 0 14 16 0 2 14 0 8 1 8 0 8 20 1 2
Contiguous Ranks
Non-U.S. IMG
250 222
Matched
Not Matched
200 150 100 50 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 40 39
78 30 30 28 11 29 13
19 4
18 3
10
11
14
10
11
Contiguous Ranks

138
Graph PD-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0
Pediatrics
10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

139
Chart PD-2
300

Pediatrics U.S. IMG
Matched
Not Matched
250 200 163 150 100 50 0 1 2 3 4 or More 92 46 29 3 10 0 1

300
Non-U.S. IMG
258
Matched
Not Matched
250 214 200 150 100 53 50 11 0 1 2 3 4 or More 26 0 9 87

140
Chart PD-3
100 90
USMLE Step 1 Scores

Pediatrics U.S. IMG
Matched
Not Matched
80 70 60 50 40 30 20 10 0
51 30
49 38 37 29 18 9 3 29 11 1 4 0 0 0 0 0
29
8 0 1
Step 1 Scores
Non-U.S. IMG
100 90 95 77 71
Matched
Not Matched
80 70 60 50 40 30 20 10 0
<= 180 Between 181 and 190
60 51 41 34 23 6
57 45 48
22 12 6
4
Between 251 and 260
1
>260
Score Unknown
Step 1 Scores
141
Graph PD-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00
Pediatrics
160
180
200
220
240
260
280
U.S. IMG
Step 1 Score
Non-U.S. IMG
142
Chart PD-4
350

Pediatrics U.S. IMG
Matched Not Matched
300 250 200 150 100 50 11 0

1 2 3 4 5 6 and mroe
180
76 51 4 15 1 5 0 4 0 0
Step 1 Attempts
Non-U.S. IMG
350 332 266
Matched
Not Matched
300 250 200 150 100 50
36 11 1
2 3
10
0
4
0
5
0
1 6 and mroe
Step 1 Attempts

143
Graph PD-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Pediatrics
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
U.S. IMG
Non-U.S. IMG
Step 1 Attempts

144
Chart PD-5
50 100 80 40

Pediatrics U.S. IMG
51
49
Matched Matched
38 37 29
30 60 30 40 20 20 10 0 0 0 0
<= <= 180 180 Between 181 and 190
29 51 49 38 37 18
29
30 8 8 1
29 18
29 9 9
29 11 3 3
Between 231 and 240
11 1
Between 241 and 250
4 4
Between 191 and 200
Between 201 and 210
Between 211 and 220
Between 221 and 230
Between 251 and 260
>260
Score Unknown
Step 2 2 CK Scores Step Scores
Non-U.S. IMG
50 100
71 41
95 95
51
77
60 Matched Matched 45
57 Not Not Matched Matched 48
40 80 34 60 30 23 40 20 20 10 0 0
<= 180 Between 181 and 190
77 60 51 57 45 48 22 12 6 6 12 4 4 6 6
71
41
34 23 6 6
22
Between 241 and 250
Between 251 and 260
>260
Score Unknown

145
Graph PD-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Pediatrics
160
180
200
220
240
260
280
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
146
Chart PD-6
350
Pediatrics U.S. IMG
Matched
Not Matched
300 250 200 150 103 100 50 5 0

1 2 3 4 5 6 and mroe
189
35 2 11 0 1 0 0 0 1
Step 2 CK Attempts
Non-U.S. IMG
350 344
Matched
Not Matched
300 250 200 150 100 50
271
32 7 0
2 3
0
4
0
5
0
6 and mroe
0
1
Step 2 CK Attempts

147
Chart PD-7
300 250 200 150
Pediatrics U.S. IMG
Matched
Not Matched
186
114 100 50 9 0
1 2 3 4 5 6 and mroe
25 1 9 0 1 0 1 0 1
Non-U.S. IMG
300 255 250 200 150 100 50 0
1 2 3
285
Matched
Not Matched
80
19
14
0
4
0
5
6 and mroe

148
Chart PD-8
120

Pediatrics U.S. IMG
Matched
92 68
Not Matched
100 80 60 40 20 0
28 15 19
25 16
31
35 11 0 1 more than 48 0 no data
less than 1
2 to 6
7 to 12
13 to 24
25 to 48
Non-U.S. IMG
120 100 111 111
Matched
104
Not Matched
89
80 60 40 20 0 less than 1 2 to 6 7 to 12 18 4 57 33
67 38 18 6 13 to 24 25 to 48 more than 48 1 no data 3

149
Chart PD-9
150 120 90 60

Pediatrics U.S. IMG
139
Matched
Not Matched
42 32 30
40 22 9 4 3 to 5 6 to 10 24 2 11 to 15 16 0 16 to 25 14 0 2
0 less than 1 1 to 2 25 or more
Non-U.S. IMG
150 120 90 60 41 30 9 0 less than 1 1 to 2 3 to 5 85 117
Matched
Not Matched
132
80
57 48
51 21 12 2 1 3
6 to 10
11 to 15
16 to 25
25 or more

150
Chart PD-10

Pediatrics U.S. IMG
180 150 120 90 60 30 0
Matched
Not Matched
83 51 18 All Other 15 38 55 20 19 Grenada Country of Medical School 18 Israel Pakistan 14 16 Sint Maarten
Antigua And Barbuda
Dominica
Non-U.S. IMG
180 150 120 90 60 30 0 170 137 64 13 All Other China 11 Egypt 11 Grenada India 12 10 11 10 19 Nigeria 37 11 Pakistan Philippines 11 Syria 10 Venezuela 123 Matched Not Matched
Jordan Lebanon Libya Country of Medical School

151
PM
Physical Medicine and Rehabilitation
Table PM-1

Summary Statistics
Matched (n=40) 8 1.8 223 1.1 231 1.1 1.0 7 1.4 83
Unmatched (n=43) 3 1.8 207 1.3 212 1.5 1.1 13 1.8 74
153
Chart PM-1
20
Physical Medicine and Rehabilitation U.S. IMG
Matched
Not Matched
18 16 14 12 10 8 6 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 4 2 3 6 2 3 2 0 3 1 3 3 4 1 2 0 4 1 4 2 0 0 0 0 0 0 0 5 2 0 14 12
Contiguous Ranks
Non-U.S. IMG
20
Matched
Not Matched
18 16 14 12 10 8 6 4 2 0 1 4
16
7 4 2 0 2 3 0 4 1 0 5 1 6 4 2 0 7 0 0 8 0 9 2 0 1 10 0 1 11 0 0 12 0 0 13 1 0 14 0 1 15 0 0 0
16 or More
Contiguous Ranks

154
Graph PM-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0

10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

155
Chart PM-2
20 18

17 15
19
Matched
16
Not Matched
16 14 12 10 8 6 4 2 0 1
6 2
1 2 3 4 or More

20 18
Non-U.S. IMG
Matched
Not Matched
16 14 12 10 8 6 4 2 0 1 2 3 4 or More 0 1 5 6 5 10 10 10

156
Chart PM-3
20 18
USMLE Step 1 Scores

U.S. IMG

Matched
17
Not Matched
16 14 12 10 8 6 4 2 0
10 8 5 3 0 0 1 6 7 7 5 3 3 4 0 4 0 0 0 0 0
Step 1 Scores
Non-U.S. IMG
20 18
Matched
Not Matched
16 14 12 10 8 6 4 2 0
9 7 4 2 0 0 0 1 3
8 4 2 2
3 1 0 1 0 0 0 0 0
Step 1 Scores
157
Graph PM-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00
180
190
200
210
220
230
240
250
260
U.S. IMG
Step 1 Score
Non-U.S. IMG
158
Chart PM-4
40

U.S. IMG
38 34

Matched Not Matched
35 30 25 20 15 10
5 5 0
1 2 3
4 0 0
4
0
5
6 and mroe
Step 1 Attempts
Non-U.S. IMG
40
Matched
Not Matched
35 30 25 20 15 10 5 0
1 2 3 4 5 6 and mroe
19
21
Step 1 Attempts

159
Graph PM-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

U.S. IMG
Non-U.S. IMG
Step 1 Attempts

160
Chart PM-5
50 20

17
Matched Matched
40 15 30 10 20 5 5 10 00 00
<= 180 <= 180 Between 181 Between 181 and 190 and 190 Between 191 Between 191 and 200 and 200 Between Between201 201 and and210 210 Between Between211 211 and and220 220 Between Between221 221 and and230 230 Between Between231 231 and and240 240
10 8 6 3 3 8 6 17 10 7 7 7 7 5 3 3 5 3 3 4 4 0 0
4 4 0 0
00
1 1
>260
Score Unknown
Non-U.S. IMG
50 20 40 15 30 10 20 5 10 00 00
Matched Matched
9 7 4 00 00 2 2 1 1 4 3 3 9
8 4 4 2 2 2 2
3 3 1 1 0 0 1 1 0 0 0 0 0 0
>260
Score Unknown

161
Graph PM-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

180
200
220
240
260
280
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
162
Chart PM-6
40

38 31
Matched
Not Matched
35 30 25 20 15 10 5 0
1
6 2
2
5 0
3
0
4
0
5
0
6 and mroe
Step 2 CK Attempts
Non-U.S. IMG
40
Matched
Not Matched
35 30 25 20 20 15 10 5 0
1 2 3 4 5 6 and mroe
22
Step 2 CK Attempts

163
Chart PM-7
50

39
Matched
38
Not Matched
40
30
20
10 1 0
1 2
5 0
3
0
4
0
5
6 and mroe
Non-U.S. IMG
50
Matched
Not Matched
40
30 19 18
20
10 2 0
1 2
7 0
3
0
4
0
5
6 and mroe

164
Chart PM-8
20 18
Matched
16 14 15
Not Matched
16 14 12 10 8 6 4 2 0
6 2
7 3 0 1 more than 48 3
less than 1
2 to 6
7 to 12
13 to 24
25 to 48
no data
Non-U.S. IMG
20 18
Matched
Not Matched
16 14 12 10 8 6 4 2 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 3 3 5 3 3 2 5 4 2 7 3 0 0 7

165
Chart PM-9
30

25

Matched Not Matched
25
22
20 15 10 10 5 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 4 2 0 3 3 0 0 1 0 0 13
Non-U.S. IMG
30 25
Matched
Not Matched
20 15 10 5 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 8 5 3 1 1 2 2 6 3 2 5 1 1

166
Chart PM-10

U.S. IMG
50
Matched 29 29
Not Matched
40 30 20 10 0 All Other Country of Medical School Dominica
11
14
Non-U.S. IMG
50 Matched Not Matched
40 30 20 10 0 All Other Country of Medical School 21 26

167
Psychiatry
Table P-1
Psychiatry
Summary Statistics
Matched (n=203) 6 1.4 205 1.4 211 1.4 1.2 18 3.8 73
Unmatched (n=256) 2 1.4 198 2.2 202 1.9 1.5 41 8.3 49
169
Chart P-1
160

Psychiatry U.S. IMG
147
Matched
Not Matched
140 120 100 80 60 40 20 20 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 51 52 27 22 10 7
16 6
11
13 3
11 1
Contiguous Ranks
Non-U.S. IMG
160 154
Matched
Not Matched
140 120 100 80 60 40 20 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 35 20 16 47 28 10 18 11 10 14 7 11 4 9 1 10 0 4 2 6 1 4 0 5 0 5 1 1 0 2 4
Contiguous Ranks

170
Graph P-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0

Psychiatry
10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

171
Chart P-2
220 200
Psychiatry U.S. IMG
Matched
184
Not Matched
180 160 140 120 100 80 60 40 20 0 1 2 3 4 or More 11 56 50 16 1 4 135

220 200
Non-U.S. IMG
214
Matched
Not Matched
180 160 140 120 100 80 60 40 20 0 1 2 3 4 or More 21 5 41 17 2 4 135

172
Chart P-3
100 90
USMLE Step 1 Scores

Psychiatry U.S. IMG
93 76 64 46 35 37 25 19 10 1 3
Matched
Not Matched
80 70 60 50 40 30 20 10 0
<= 180
26 12 4
Between 231 and 240
0
>260
Between 241 and 250
Between 251 and 260
Score Unknown
Step 1 Scores
Non-U.S. IMG
100 90 83
Matched
Not Matched
80 70 60 50 40 30 20 10 0
57 46 34 36 31 21 10 0 0 49
26 17 12 8 5
Step 1 Scores
173
Graph P-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Psychiatry
160
180
200
220
240
260
280
U.S. IMG
Step 1 Score
Non-U.S. IMG
174
Chart P-4
210

Psychiatry U.S. IMG
Matched Not Matched
180 150 120 90 60 33 30 0

1 2 3 4 5 6 and mroe
147 107 71 38 17 3 21 2 7 1 12
Step 1 Attempts
Non-U.S. IMG
210 206
Matched
Not Matched
180 150 120 90 60 30 0

1 2 3 4 5 6 and mroe
137
51 20 6 14 0
Step 1 Attempts

175
Graph P-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Psychiatry
U.S. IMG
Non-U.S. IMG
Step 1 Attempts

176
Chart P-5
50 100 90 80 40 70 60 30 50 40 20 30 20 10 10 0

Psychiatry U.S. IMG
76 64 93 93 37 64 46 35 37 25 19 1 3 3
46
Matched Matched
76 35
25 19
26
26 10 10
12 12 4 4 2 2 4 4
<= 180
Between 221 and 230
Between 231 and 240
Between 241 and 250
Between 251 and 260
>260
Score Unknown
Non-U.S. IMG
50 100 90 40 80 70 60 30 50 40 20 30 20 10 10 0
<= 180 Between 181 and 190
83 46 83 34 36
57
49 Matched Matched
57 46 34 10 10 0 0
31 49 21 26 17 21 26 17 12 12 8 8 3 3 5 5
36
31
Between 211 and 220
Between 221 and 230
Between 231 and 240
Between 241 and 250
Between 251 and 260
>260
Score Unknown

177
Graph P-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Psychiatry
140
160
180
200
220
240
260
280
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
178
Chart P-6
210

Psychiatry U.S. IMG
Matched
153
Not Matched
180 150 120 90 64 60 36 30 0

1 2 3 4 5 6 and mroe
133
40 7 3 12 3 2 1 5
Step 2 CK Attempts
Non-U.S. IMG
210 204
Matched
Not Matched
180 150 120 90 60 30 0

1 2 3 4 5 6 and mroe
146
54 15 2 16 0 2 0 1 0 0
Step 2 CK Attempts

179
Chart P-7
200 180
Psychiatry U.S. IMG
173 162
Matched
Not Matched
160 140 120 100 80 60 40 20 0

1 2 3 4 5 6 and mroe
72
24 4
17 2 1 0 1 0 3
Non-U.S. IMG
200 180 191
Matched
Not Matched
160 140 120 100 80 60 40 20 0

1 2 3 4 5 6 and mroe
137
69
22 3
14 1 2 0 1 0 0

180
Chart P-8
100 90
Psychiatry U.S. IMG
Matched
Not Matched
82
80 70 60 50 40 30 20 10 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 15 1 6 21 25 27 41 29 23 58 44 26 61
Non-U.S. IMG
100 90
Matched
Not Matched
93
80 70 60 50 40 30 20 10 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 7 4 23 16 14 0 2 33 36 32 51 63 66

181
Chart P-9
140 120
Psychiatry U.S. IMG

Matched Not Matched
100 80 64 60 44 40 20 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 17 26 18 10 11 3 11 71 63 47 35 35
Non-U.S. IMG
140 120
Matched
Not Matched
116
100 80 60 40 20 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 15 8 30 7 37 58 42 17 6 0 2 54 45

182
Chart P-10

Psychiatry U.S. IMG
120 100 80 60 40 20 0
104 82
Matched
Not Matched
34 19 All Other 15 10 Bangladesh 18 Cayman Islands
23
27
14
13
23
25
12
13
16
11
Antigua And Barbuda
Dominica
Grenada
India
Pakistan
Saint Kitts And Nevis
Sint Maarten
Non-U.S. IMG
120 100 80 60 40 20 0 109 114 Matched Not Matched 90 44 16 All Other China India Country of Medical School Nigeria 16 10 Pakistan 41

183
DR
Radiology-Diagnostic
Table DR-1
Summary Statistics
Matched (n=55) 6 2.1 237 1.0 241 1.0 1.1 13 1.4 73
Unmatched (n=47) 3 1.7 223 1.1 223 1.2 1.3 30 6.3 53
185
Chart DR-1
50

Radiology-Diagnostic U.S. IMG
Matched
Not Matched
40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 9 5 8 7 8 5 2 1 5 0 1 0 1 0 2 0 2 1 1 1 3 4 1 1 0 0 1 0 1 0
26
Contiguous Ranks
Non-U.S. IMG
50
Matched
Not Matched
40 30 20 10 0 1
38
15
14 8 7 6 7 2 2 3 4 2 5 3 5 1 6 7 4 0 8
3 0 9
1 10
3 0 11 0 12 0
1 13
0 14
1 15
16 or More
Contiguous Ranks

186
Graph DR-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0
10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

187
Chart DR-2
50
Matched
Not Matched
40 30 22 20 10 0 1 2 3 4 or More 16 14 9 4 8 4
25

50
Non-U.S. IMG
Matched
36
Not Matched
40 33 30 20 10 0 1
19 12 9 10 2 2 3 4 or More

188
Chart DR-3
30
USMLE Step 1 Scores
Matched
Not Matched
25 20 15 15 11 10 5 0 0
13 10 4 9 10 7 3 0 0 0 4 2 4 7 3 0 0 0 0
Step 1 Scores
Non-U.S. IMG
30
Matched
Not Matched
25 20 15 10 10 5 5 0 0
19
12 10 7 4 8 6 10 6
11 6 7 4 2 1 0 0
Step 1 Scores
189
Graph DR-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00
180
200
220
240
260
280
U.S. IMG
Step 1 Score
Non-U.S. IMG
190
Chart DR-4
80
Matched
Not Matched
70 60 50 40 30 20 10 1 0
1 2 3 4 5 6 and mroe
54 42
Step 1 Attempts
Non-U.S. IMG
80
Matched
65 50
Not Matched
70 60 50 40 30 20 10
13 1 0
2 3
0
4
0
5
0
1 6 and mroe
Step 1 Attempts

191
Graph DR-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

0.8
1.2
1.6
2.0
2.4
2.8
3.2
U.S. IMG
Non-U.S. IMG
Step 1 Attempts

192
Chart DR-5
50 40 40 30 30 20 20 10 10
Matched Matched
7 7 33 00 00 00
00
22
44
44
7 7
11 11 4 4
15 15
10 10
13 13
9 9
10 10 3 3 0 0 0 0
00
<= 180 <= 180 Between Between201 201 and and210 210 Between Between211 211 and and220 220 Between Between221 221 and and230 230 Between Between231 231 and and240 240 Between Between 241 241 and and 250 250 Between Between 251 251 and and 260 260 >260 Score Unknown
Non-U.S. IMG
50 40 40 30 30 20 20 10 10 00 00
Matched Matched
19 19 10 10 44 7 7 10 10 8 8 12 12 10 10 11 11 6 6 7 7 2 2
Between Between211 211 and and220 220 Between Between221 221 and and230 230 Between Between231 231 and and240 240 Between Between 241 241 and and 250 250 Between Between 251 251 and and 260 260
55 00 11
6 6
6 6
4 4
>260
Score Unknown

193
Graph DR-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

180
200
220
240
260
280
300
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
194
Chart DR-6
80
Matched
Not Matched
70 60 50 40 30 20 10 0
1 2 3 4 5 6 and mroe
54 41
Step 2 CK Attempts
Non-U.S. IMG
80
Matched
66 56
Not Matched
70 60 50 40 30 20 10
0 0
1 2
0
3
0
4
0
5
0
6 and mroe
Step 2 CK Attempts

195
Chart DR-7
80 70
Matched
Not Matched
60 51 50 40 30 20 10 10 0
1 2 3 4 5 6 and mroe
35
Non-U.S. IMG
80 70 61 60 50 40 30 20 10 0
1 2 3
Matched
Not Matched
46
13 4 1 2 0
4
0
5
6 and mroe

196
Chart DR-8
30

26
Matched
Not Matched
25 20 16 15 10 5 5 1 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 3 3 5 2 6 1 0 13 10 11
Non-U.S. IMG
30
Matched
Not Matched
22
25 20 20 15 10 5 1 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 0 9 5 6 10 8 10 19 18
0 more than 48 no data

197
Chart DR-9
50

41

Matched Not Matched
40 30 20 13 10 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 5 3 3 12 8 3 1 3 1 7 0 1
Non-U.S. IMG
50 40 30 24 20 10 0 less than 1 1 to 2 3 to 5 8 4 1 16 7
Matched
Not Matched
22 18 13 4 4 3
6 to 10
11 to 15
16 to 25
25 or more

198
Chart DR-10
50
47
Matched
Not Matched
40 30 20 10 0 All Other Dominica Country of Medical School Grenada 24 12 19
Non-U.S. IMG
50 47 41 Matched Not Matched
40 30 20 10 0
15
16 10
All Other
India Country of Medical School
Iran

199
GS
Surgery-General
Table GS-1
Surgery-General
Summary Statistics
Matched (n=119) 4 1.2 227 1.0 234 1.0 1.0 8 1.1 81
Unmatched (n=123) 2 1.4 216 1.3 216 1.2 1.2 19 2.7 74
201
Chart GS-1
100

Surgery-General U.S. IMG
Matched
Not Matched
90 80 70 60 50 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 30 24 12 15 15 5 12 3 2 0 7 1 3 5 3 3 34 62
Contiguous Ranks
Non-U.S. IMG
100 94
Matched
Not Matched
90 80 70 60 50 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 or More 47 34 27 22 11 4 24 10 1 6 5 5 3 4 5
Contiguous Ranks

202
Graph GS-1
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00 0
Surgery-General
10
11
12
13
14
15
16
17
18
19
20
U.S. IMG
Non-U.S. IMG

203
Chart GS-2
150
Matched
Not Matched
120 99 90 60 35 30 0 1 2 3 4 or More 18 2 7 0 1 80

150
Non-U.S. IMG
127
Matched
Not Matched
120 103 90 60 30 0 1 2 3 4 or More 26 34 4 9

204
Chart GS-3
50
USMLE Step 1 Scores
Matched
Not Matched
40 31 30 22 20 14 10 10 4 0 0
25
27 24 20 18 19 10 3 2 2 0 0 0
11
Step 1 Scores
Non-U.S. IMG
50
Matched
Not Matched
38 28 39
40 30 20 10 3 0 0
<= 180 Between 181 and 190 Between 191 and 200 Between 201 and 210 Between 211 and 220 Between 221 and 230
25 17 10 7 0 6 16
25 22
24 20 15 7 4 2
>260
Between 231 and 240
Between 241 and 250
Between 251 and 260
Score Unknown
Step 1 Scores
205
Graph GS-2
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00
Surgery-General
180
200
220
240
260
280
U.S. IMG
Step 1 Score
Non-U.S. IMG
206
Chart GS-4
160
Matched
Not Matched
140 120 100 80 60 40 20 2 0

1 2 3 4 5 6 and mroe
117 105
10 0
Step 1 Attempts
Non-U.S. IMG
160 153 134
Matched
Not Matched
140 120 100 80 60 40 20 0

1
12 3
2
2
3
0
4
0
5
6 and mroe
Step 1 Attempts

207
Graph GS-3
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Surgery-General
U.S. IMG
Non-U.S. IMG
Step 1 Attempts

208
Chart GS-5
50 50 40 40
Matched Matched
31 31 30 30 22 22 20 20 14 14 10 10 10 10 44 00 00
<= 180 <= 180 Between 181 Between 181 and 190 and 190 Between 191 Between 191 and 200 and 200 Between Between201 201 and and210 210 Between Between211 211 and and220 220 Between Between221 221 and and230 230 Between Between231 231 and and240 240 Between Between 241 241 and and 250 250 Between Between 251 251 and and 260 260 >260 Score Unknown
25 25
27 27 24 24 20 20 18 18 19 19 10 10 3 3 2 2 2 0 0 0
11 11
00
00
Non-U.S. IMG
50 50 40 40 30 30 20 20 10 10 33 00 00
Matched Matched

38 38 28 28 39 39
25 25 17 17 10 10 77 00 66 16 16
25 25 22 22
24 24 20 20 15 15 7 7 4 2 0 0
>260
Score Unknown

209
Graph GS-4
1.00 0.90 0.80 0.70 0.60 0.50 0.40 0.30 0.20 0.10 0.00

Surgery-General
160
180
200
220
240
260
280
U.S. IMG
Non-U.S. IMG
Step 2 CK Score
210
Chart GS-6
160
Matched
118 105
Not Matched
140 120 100 80 60 40 20 1 0

1 2 3 4 5 6 and mroe
10 0
Step 2 CK Attempts
Non-U.S. IMG
160 153 142
Matched
Not Matched
140 120 100 80 60 40 20 0

1 2 3 4 5 6 and mroe
Step 2 CK Attempts

211
Chart GS-7
140 120

116 103
Matched
Not Matched
100 80 60 40 20 2 0
1 2 3 4 5 6 and mroe
17 1 1 0 0 0 0 0 2
Non-U.S. IMG
140 120 139 120
Matched
Not Matched
100 80 60 40 20 0
1 2 3 4 5 6 and mroe
28 17 2 2 0 0 0 0 0 0

212
Chart GS-8
70

Matched Not Matched
60 50 40 30 20 10 0 less than 1 2 to 6 7 to 12 13 to 24 25 to 48 more than 48 no data 18 39 36 20 21 15 17 10 1 32 16 13 1 3
Non-U.S. IMG
70 60 51
Matched
57 48
Not Matched
50 40 30 20 10 0 less than 1 2 to 6 7 to 12 8 4 16 19 29
36 24 13 2 13 to 24 25 to 48 more than 48 0 no data 1

213
Chart GS-9
80 70

66

Matched
62
Not Matched
60 50 41 40 30 30 20 10 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 6 15 9 4 2 2 0 5 0 0
Non-U.S. IMG
80 70 68
Matched
Not Matched
60 50 40 30 20 10 0 less than 1 1 to 2 3 to 5 6 to 10 11 to 15 16 to 25 25 or more 13 7 36 27 30 14 1 43 47
10
11 0 0

214
Chart GS-10
120 100 80 60 40 20 0
Matched
Not Matched
62 47 31 32 41 19 Grenada Country of Medical School Sint Maarten 10
All Other
Dominica
Non-U.S. IMG
120 100 80 60 40 20 0 97 102 Matched Not Matched
14 All Other Egypt
10
22
22
18 Pakistan
12
11 Venezuela
Grenada India Country of Medical School

215

NRMP/ECFMG - Charting Outcomes in The Match For International Medical Graduates

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Charting Outcomes in the Match

International Medical Graduates

Charting Outcomes in the Match for IMGs, 2014

Charting Outcomes in the Match, IMG, 2014

Charting Outcomes in the Match, IMG, 2014

Tables and Charts for All Specialties

Active Applicants in the 2014 Main Residency Match

Non-U.S. IMG 7,568

U.S. senior 17,487

U.S. IMG 5,095 Osteopathic 2,677 Canadian 21 U.S. graduate 1,487

Source: NRMP Data Warehouse

Charting Outcomes in the Match for IMGs, 2014

Charting Outcomes in the Match for IMGs, 2014

Ratio - Applicants Ranking Specialty First / Available Positions

All other applicant types

0.2 0.3 0.1 0.1 0.3

0.1 0.1 0.1 0.1

0.2 0.4 0.1

0.2 0.1 0.5 0.2

0.5 0.3 1.1 0.9 0.6 0.6

1.0 0.8 0.6 0.7

1.1 0.9 0.8

Obstetrics and Gynecology

Physical Medicine & Rehab

Source: NRMP Data Warehouse

Charting Outcomes in the Match for IMGs, 2014

Percent Matched by Preferred Specialty and IMG Applicant Type

All Anesthesiology Emergency Specialties Medicine

Obstetrics and Gynecology

Physical Medicine & Rehab

Source: NRMP Data Warehouse

Charting Outcomes in the Match for IMGs, 2014

All Specialties Combined

Matched (n=2,369) 7 1.4 217 1.2 224 1.1 1.1 8 1.7 76

Unmatched (n=2,604) 3 1.6 204 1.7 209 1.6 1.4 26 5.7 56

Charting Outcomes in the Match for IMGs, 2014

Median Number of Contiguous Ranks

by Preferred Specialty, IMG Applicant Type, and Match Status

All Specialties Anesthesiology

Obstetrics and Gynecology

Physical Medicine & Rehab

Source: NRMP Data Warehouse

All Specialties Anesthesiology

Obstetrics and Gynecology

Physical Medicine & Rehab

Source: NRMP Data Warehouse

Charting Outcomes in the Match for IMGs, 2014

Probability of Matching to Preferred Specialty by Number of Contiguous Ranks

Number of Contiguous Ranks

Charting Outcomes in the Match for IMGs, 2014

Mean Number of Different Specialties Ranked

by Preferred Specialty, IMG Applicant Type, and Match Status

All Specialties Anesthesiology

Obstetrics and Gynecology

Physical Medicine & Rehab

Source: NRMP Data Warehouse

Not Matched 1.9

All Specialties Anesthesiology

Obstetrics and Gynecology