If you have done all the steps of USMLE and don’t get residency, what alternatives do you have as an IMG?

If you do not get into a residency (and want to practice medicine), here are your alternatives:

  • Try again next year
  • Go back to your own country and try to get into a residency program there
  • Go to a different country and try to get into a residency program there (australia, NZ, Canada)

If you’re ok with not practicing medicine, you could do almost anything else.

  • Masters in Public Health: become an epidemiologist etc.
  • Master of Science in Clinical Research: work in academia or industry (pharma)
  • Master of Healthcare Administration: Hospital administration or administrative roles in other medical related institutes
  • MBA: Hospital administration or administrative roles in other medical related institutes, consultancy jobs, etc.
  • PhD: hardcore research in academia or industry (pharma), eventually become a consultant or “expert” in your field of research if you publish successfully, teach, etc.

If you do not want to practice medicine, then you can literally switch careers into a completely unrelated field by doing a Masters (in addition to those mentioned above). People in the US switch careers all the time. Related careers offer higher chances of success.

Passing the USMLE and or having the ECFMG certificate is not good for anythign except to get into a residency training program. The ECFMG certification does not allow you to practice in any other capacity in the US or elsewhere. You might be able to use your USMLE steps to get certified for a residency position in New Zealand (their equivalent of ECFMG certification).

Hope that helps.


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If you have done all the steps of USMLE and don’t get residency, what alternatives do you have as an IMG?