Passing the USMLE and getting ECFMG certified are big achievements. But they don’t give you a residency position. For that, you need to apply through ERAS and match through the NRMP. This is where many strong IMGs, including me, make costly mistakes.
This guide explains how the Match works, the key dates for the 2027 Match, what it costs, and how to build an application that gives you a real chance.
Last updated: October 2026. Dates and fees change every year, so always confirm on the official AAMC (ERAS) and NRMP websites.
ERAS and the NRMP: what’s the difference?
- ERAS (Electronic Residency Application Service, run by the AAMC) is where you build and send your application: CV, personal statement, letters of recommendation, USMLE transcript and MSPE.
- NRMP (National Resident Matching Program) runs the Match itself. After interviews, you and the programs each submit a ranked list, and a computer algorithm matches you.
You need to register for both. As an IMG, you also need an ECFMG token to register in MyERAS, and ECFMG sends your documents (USMLE transcript, medical school documents, ECFMG status) to programs for you.
Key dates for the 2027 Match
- June 4, 2026: MyERAS opened. Applicants could start building their applications.
- June 24, 2026: ECFMG released 2027 ERAS tokens for IMGs.
- September 2, 2026: Applicants could start submitting applications to programs.
- September 15, 2026: NRMP registration opened.
- September 23, 2026: Programs began reviewing applications.
- October 2026 to January 2027: Interview season.
- January 29, 2027: Standard NRMP registration deadline (a $50 late fee applies after this).
- January 31, 2027: ECFMG Pathways and OET deadline for the 2027 Match (see my ECFMG guide).
- February 1, 2027: Rank Order List opens.
- March 3, 2027 (9 p.m. ET): Rank Order List certification deadline. You must also have passing Step 1 and Step 2 CK results by now.
- March 15, 2027: Match Week begins. You learn whether you matched (but not where). Unmatched applicants can enter SOAP.
- March 19, 2027: Match Day. You find out where you matched.
- July 1, 2027: Most residencies begin.
Planning for the 2028 Match? Expect a similar calendar: MyERAS opens in early June 2027 and applications go out in early September 2027. Your exams, OET and documents should be ready before September.
How much does it cost?
ERAS charges per program, per specialty:
- First 30 programs: $11 each
- Program 31 and above: $30 each
Because IMGs usually apply to many programs, costs add up fast. For example, 100 internal medicine programs cost about $2,430 in ERAS fees alone. On top of that come the NRMP registration fee, USMLE transcript fees, ECFMG certification costs, and travel if you have in-person interviews. Budget carefully, and apply smart, not just wide.
What are the real chances for IMGs?
In the 2026 Match, a record number of IMGs matched:
- Non-US IMGs (foreign citizens): 6,733 matched, a 56.4% match rate.
- US-citizen IMGs: 2,949 matched, a 70.0% match rate.
- IMGs filled about 42% of first-year internal medicine positions, 35% in pathology, 30% in pediatrics and 22% in neurology.
So the door is open, but roughly 4 out of 10 non-US IMGs do not match. Your strategy makes the difference.
How to build a strong application
1. Choose your specialty realistically
This is the lesson I learned the hard way. I passed the USMLE with high scores, applied only to dermatology, and didn’t match. Dermatology, plastic surgery, orthopedics and similar specialties take very few IMGs. Internal medicine, family medicine, pediatrics, pathology, neurology and psychiatry are far more IMG-friendly. If you want a competitive specialty, apply to a friendly one as a backup in the same season.
2. Get US clinical experience (USCE)
Most programs want to see that you have worked in the US health system: observerships, externships or hands-on electives. Many programs list a minimum number of months. USCE also gives you the most important part of your file: US letters of recommendation.
3. Get strong US letters
You can send up to four letters per program. Letters from US physicians who worked with you directly carry far more weight than letters from home.
4. Make Step 2 CK your strength
With Step 1 now pass/fail, programs use Step 2 CK to compare applicants. A higher score opens more doors. Also, many programs screen out applicants who graduated many years ago, so apply as soon after graduation as you can.
5. Check visa policies before you apply
If you need a visa, only apply to programs that sponsor J-1 and/or H-1B visas. Applying to programs that don’t sponsor wastes money. Check each program’s website or FREIDA listing.
6. Use program signals wisely
Many specialties now let you send a limited number of “signals” to show programs special interest. Signals can help IMGs get noticed. Use them on programs that are realistic for you and where you have a real connection or interest. Check the AAMC signaling page for your specialty’s current rules.
7. Apply early
Submit on the first day applications open in September. Programs start reviewing right away, and many interview spots are filled by October.
8. Rank honestly
Rank programs in the order you truly prefer them. The Match algorithm favors applicants, so ranking strategically doesn’t help you. Rank every program you would be willing to attend. Ranking more programs increases your chance of matching.
If you don’t match: SOAP
If you are unmatched on Monday of Match Week, you can take part in SOAP (Supplemental Offer and Acceptance Program) and apply to unfilled positions that week. Prepare in advance: have your documents ready and know which programs might still have spots. If you don’t match at all, use the year to add US clinical experience, research and new letters, and apply again.
My advice from experience
- Don’t put all your eggs in one basket. Apply to more than one specialty if your first choice is competitive.
- Start early. Your exams, OET and USCE should be done before September.
- Apply where you are wanted. Look for programs with a history of taking IMGs and sponsoring visas.
- Never give up after one season. Many IMGs match on their second or third try with a stronger application.
Practice for USMLE
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This guide is for general information. Always check the official AAMC ERAS and NRMP websites for the latest dates, fees and rules.