Where to start and how to proceed

No foreign education or training beyond your medical school diploma is recognized in the United States. Therefore, if you are planning to move to the US and work there as a physician, it does not make sense to start your specialty training in your home country. Instead, focus your effort on passing the USMLE exams, securing a few clinical rotations in the US, and entering into a good residency program in the United States. It is ideal to start your preparation for the USMLE exam at least 2 years before graduation from your medical school.

How to proceed:

1. First you need to pass the 3 USMLE exams (United States Medical Licensing Examination) that are a part of the ECFMG certification (USMLE exams + your foreign medical diploma recognized by ECFMG (Educational Commission for Foreign Medical Graduates))

2. Then you need to enter into a residency program in the United States and obtain your work permit (J-1 visa). You cannot practice medicine in the United States without graduating from a residency training program in the US. It is not possible to apply to residency programs individually but only through the systems of ERAS and Match (NRMP).

3. Graduate from a residency program (usually 3 years) and pass the Board Certifications exam (specialty exam)

(4. Enter into a fellowship program using similar systems as ERAS and Match. Fellowships are usually 3-year programs allowing a second specialization such as cardiology or gastroenterology after a residency in internal medicine, or thoracic surgery after a general surgery residency. Internal medicine doctors or family physicians are not required to do a fellowship.

Perhaps the most useful website for the first orientation is www.ecfmg.org/applicant-portal.html where you find how to obtain the ECFMG certification, how to apply to a residency program, etc. This website is specifically for foreign medical doctors who wish to enter into the American medical system.