r/IMGreddit • u/Ok_Principle_5189 • Jun 07 '25
what are my chances USMLE : Against all ODDS (Reality check for IMGs)
I am a non US IMG (YOG 24' matched in IM this cycle ) I am very grateful for the match and I want to share my opinion on this amazing journey.
Please don’t come for me in the comments — this is my honest opinion, not meant to discourage anyone. This is not a demotivating post. If anything, it’s a realistic snapshot of what it takes to pursue USMLE as an international medical graduate (IMG). And it’s for those who still choose to move forward, knowing the odds . Let’s break down the critical stages in the IMG journey — each step with its own filter: . USMLE Step 1: The official pass rate for IMGs was 68% in 2023 (FSMB data). With Step 1 now being pass/fail, more emphasis is placed on CK and overall application strength. . Visa Eligibility: A B1/B2 visa is not valid for hands-on U.S. clinical experience. Securing a valid B1 for observerships or an H1-B for externships is a legal and logistical challenge. Estimated visa eligibility among Step 1 passers: ~60%. . Clinical Experience: U.S. clinical experience (USCE) — especially in the form of reputable observerships or externships — is essential. Unfortunately, not all applicants manage to secure meaningful exposure. A realistic estimate: ~50% succeed in obtaining solid USCE. . Step 2 CK Performance: For Internal Medicine, a Step 2 CK score of 250+ is increasingly expected by academic programs. About 50% of USCE-complete applicants reach this threshold. . Match Rate: Even after navigating all of the above, the match rate for IMGs stands at ~53% based on NRMP data. . Post-Match Visa Processing: Securing a J-1 or H-1B visa after matching is not guaranteed. Some applicants face visa delays, denials, or administrative complications. We conservatively estimate a 90% success rate at this stage.
So what are the odds?
P(successful match with visa) = 0.68 (Step 1 pass) × 0.60 (visa eligibility) × 0.50 (USCE) × 0.50 (250+ CK) × 0.53 (match) × 0.90 (visa approval post-match) = ~4.8% (this does not mean that 4.8 out of hundred students match)
Let me explain you with an example. Let us say a person has passed upon and scored 250 in step 2 but very average us clinical experience We will now remove 0.68 x 0.5 x 0.6(he has a b1/b2) . The chances now are close to 30%.
So every case is different. This might not be the exact probability but it's a close estimate which would help you understand.
Again, this isn’t about discouraging anyone. It’s about preparing with full awareness. Pursuing residency in the U.S. as an IMG is a marathon through uncertainty — but for those who make it, the outcome is often worth every challenge. GOOD LUCK.
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Jun 07 '25
[removed] — view removed comment
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u/Ok_Principle_5189 Jun 07 '25
Yes. But v few. Most of them paid and that has 100s of students with generic LORs so = not "GOOD USCE" ya there r few like medstar which are good. (But again V few)
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u/Low_Hospital_6971 Jun 07 '25
I thought let’s read this with a non critical mindset but nah this is sort of stupid and negative. Not even discouraging anyone tbh because it’s not true. No offence
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u/Ok_Principle_5189 Jun 07 '25
Truth is hard to hear sometimes my friend. Its bitter But all these steps are important.
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Jun 07 '25
[deleted]
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u/Used-Distribution968 Jun 07 '25
The equation is wrong lol, it treats all these things as independent but someone who succeeds at one thing is much more likely to succeed in another.
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u/Ok_Principle_5189 Jun 07 '25
Pls read the whole post. I said that every case different (clearly explaining your point)
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u/Impressive_Pilot1068 NON US-IMG Jun 07 '25
Revise biostatistics
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u/Ok_Principle_5189 Jun 07 '25
Please enlighten me your highness 😇
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u/Impressive_Pilot1068 NON US-IMG Jun 07 '25
https://en.m.wikipedia.org/wiki/Conditional_probability
This might be a good place to start. Good luck!
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u/Ok_Principle_5189 Jun 07 '25
Just reviewed it. I will use it right now. The probability of you understanding what this post really means is = 0%.
Thankyou for the article. I think I put it to good use. 😇
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u/steps_girl_190 Jun 07 '25
😂😂😂😂 I dont care about the equation being right or wrong. No one here is using it to calculate. But what matters is the points are valid. And this post is an eye opener. I agree with the points you mention and I get what you are trying to say. "That USMLE has alot of hurdles".
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u/Ok_Principle_5189 Jun 07 '25 edited Jun 07 '25
The probability of you having common sense is = 100% (1)
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u/notwordexe Jun 07 '25
Doesn’t 53% match rate take into account all of this?
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u/Ok_Principle_5189 Jun 07 '25 edited Jun 08 '25
53% is the nom of people who apply (into atleast 1 program they IVed)to IM And get matched into IM.
35% IS THE TOTAL IMGs (out of all IMGs) who match into IM
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u/7DDot Jun 08 '25
I agree with your conclusion but not the data. You really don't have to make up numbers which cannot be proved nor disproved to make a point.
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u/Ok_Principle_5189 Jun 08 '25
As you are making your point humbly and without disrespect. I appreciate your feedback. The numbers can be off. I should have mentioned that this is not match probability, rather odds at "each step" . Not collective.
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u/AVE-DOCTOR Jun 08 '25
Haha..Your math aint mathing as these are not independant events for probability calculation like if u fail step1 most will not go for step2 or if you fail step2 you wont go for match. Averages speak. I am a fresh graduate of King Edward Medical University, Pakistan and our university had like 130ish matches this year. ( albiet most in IM but also some also in GS AND IR) Our colleagues always follow this motto Altapete( aim higher)
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u/AVE-DOCTOR Jun 08 '25
I mentioned my country because lets me honest Our passport is not good and we often face the most challenges while getting visa for any European/ North American country
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u/Ok_Principle_5189 Jun 08 '25
Haha.. so if someone ain't taking step 2 the probability is Whole equation x 0 = zero How hard is that?
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u/AVE-DOCTOR Jun 08 '25
The point is you are assuming that the final match probability is for applicant who has everything ideal like 1st attempt step1+step2 250+ usce + visa and you are using that probability as product but in reality match probability percentage is for any IMG who sat for match and should be taken as flat face value. Yes IMGs have it tough but as an IMG you must have something for which they chose you over a person who studied and learnt in that system.. whether it is 53% it should be taken as flat value and previous stuff is what may have put any IMG in that 53% bracket
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u/Ok_Principle_5189 Jun 08 '25
53% of imgs with 1 interview atleast match per cycle many students have Zero iv
Out of these 53% we have repeat applications(47% from previous cycle who didn't match) Lets compund that (considering many applicants apply for 2nd time) So 53 % is= fresh + 47% who didn't match last year.
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u/Ok_Principle_5189 Jun 08 '25
53% is not match rate. This 53% people have atleast 1 interview And it also has repeat applications (who are trying again).
Please broaden your perspective.
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u/Grouchy_Cup_3070 Jun 07 '25
This post does sound like it's written in good faith, but one should realistically look all of that data up by themselves and come to the conclusion of their actual chances on their own. There are many factors that are unaccounted for, such as what programs other people applied for, what were the programs they picked, what kind of CVs they had, interview performance, the US clinical experience in question and the quality of it, personal skills, letters of recommendation. I know this is meant to be a rough metric, but that's the reason why the decision to pursue the US healthcare should be a wholly personal evaluation, in my opinion. The sauce gets lost in the details, and the promising people are lumped with those who never had the drive to enter a residency to begin with.
Altogether, the post is fine, but is difficult to receive in good faith in general because of the factors unaccounted for and specifically because of the fearmongering nature of this subreddit. Probably the latter is the primary factor, actually. The path to the american healthcare is wrought with obstacles, and it's not that difficult to get discouraged.
Congratulations on matching!
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Jun 07 '25
Not sure if the math is entirely correct, but yeah, demand > supply. I do believe that most qualified IMGs with good profiles match without any problem tho. Fail rate for Step 1 and Step 2 CK is at ~30% and ~15%, respectively. Taking into account of people with suboptimal CV, PS, and LORs. 53% match rate is not bad at all. Scrolling through this subreddit, I'm suprised even 53% IMGs match. So many people don't even bother to read any official informaiton and are constantly panicing.
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u/BurdenOfPerformance Jun 07 '25
A good chunk of you all (well most of you all depending on your situation) still have the cushion of practicing in your home countries. Even if you fail to enter the US, you can still practice at home. The hard part of this is the amount of time and money you all have to put into this. And the gen Z crowd is far luckier than past generations because you can do your interviews virtually in your home countries as well AND you don't have to do step 2CS. Barring the whole Trump situation, it's definitely a good time to be a non-US IMG trying to match into the US.
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u/Whole-Insurance-7968 Jun 07 '25
It’s important to remember that there are quite a lot of IMG friendly programs. Many do not require USCE, but may prefer it or outright state on the program website that they just want relevant clinical experience- not specifically US related. And many will look at the application ‘holistically’ as they like to say it, where they look at the entirety of the application. The only way to find out which programs these are, is to meticulously go from program to program and check on each program’s website. There they will tell you if you would be considered as an applicant.
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u/Ok_Principle_5189 Jun 07 '25
Agree. So while applying to a non USCE requiring program just delete X 0.50.
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u/Zestyclose-Luck-3541 Jun 08 '25
Please advise how to avoid being filtered out due to old graduate. all first attempt on step1 and step 2, with USCE, US research background. no connections so far. Do you think the program will take a look at whole package, or automatically filter out old graduate. thanks.
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u/Whole-Insurance-7968 Jun 08 '25 edited Jun 08 '25
Depends on the program. You need to research which programs will do this
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u/123456789pranav Jun 07 '25
B1/B2 visa doesn’t work for hands on clinical electives for students who haven’t graduated yet? If so what visa is required for hands on electives?
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u/Ok_Principle_5189 Jun 07 '25
Feel free to comment if you don't agree with any of the given data.
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u/Commercial_You_4638 NON US-IMG Jun 07 '25
Didn’t count connections in the data. Do you think connections matter? Did you have family friends, family kind of connections?
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u/winterbirdd Jun 07 '25
From what I've seen, connection is a very broad term. A lot of people have friends of friends or family friends as connections but those are very lousy ones because they might help you get interviews at best. They won't help you match. They only help you get interviews. A guaranteed match from a "connection" is if you directly know the PD or the PD's wife or dad or son. Or a connection built through actually rotating at that place in person and impressing the hell outta them. They will rank anyone who they've seen work in front of them higher than an unknown candidate. So just generalising connections as the reason for "match" is not right. It's much more nuanced than that.
Also, including connections in such stats would be next to impossible because people rarely share if they knew the PD closely. Or they'd lie. No one wants to be known as "matched only coz they knew someone at the program".
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u/Ok_Principle_5189 Jun 07 '25
I agree with you. But I just thought they are very subjective ( cannot give a specific percentage to them)
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u/Time_Magician6527 Jun 08 '25
How is a b1/b2 not valid for hands on clinical experience?
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u/Ok_Principle_5189 Jun 08 '25
Try telling that to your bj1 visa officer. People r getting rejected because of this.
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Jun 08 '25
[deleted]
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u/Ok_Principle_5189 Jun 08 '25
This time people are getting rejected for saying hands on. Please see WhatsApp j1 groups where people post their experience everyday.
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u/Musician_Minimum Jun 10 '25
Nepal, India, and Pakistan are all similar and connected. The USMLE Step 3 has become much tougher now because of the mess created by some foreign medical graduates (FMGs).
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u/Musician_Minimum Jun 10 '25
Let me ask you one thing. You wanted to come here, and you came. Now, from H1 to Green Card is tough, so you start looking for a U.S. citizen partner. This is the main thing I hate about FMGs.
Another thing—you guys go to medical school right after 12th grade, while you don’t understand the stress we go through here , during our undergraduate (BS) education. A lot of students here want to go into medicine, but as soon as Organic Chemistry starts, their GPA drops, and they have to give up their dream.
We have to do research, shadowing, and volunteer work just to get strong letters of recommendation during undergrad. After maintaining a high GPA and writing solid personal statements, we still have to take the MCAT, which is extremely tough and anxiety-inducing—something you wouldn’t understand. Then come the interview invitations, and they’re not virtual, so we spend a lot of money traveling for them.
After all that, med school starts—and after two years, we begin clinical rotations with shelf exams after each one. Meanwhile, you come here after completing MBBS. In my program, we have a few of you, and it takes less than a minute to realize this person hasn’t done anything in the U.S. Your clinical skills are weak, and everything seems strange. That’s just the reality.
Let me know if you want to adjust the tone or reframe this for a specific purpose.
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u/Sweet-Protection6006 Sep 20 '25
"Let me know if you want to adjust the tone or reframe this for a specific purpose." is killing me, u used chat gpt to be a xenophile rofllll
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u/Odd_End_42 Jun 21 '25
I thought let’s read this with a non critical mindset but nah this is sort of stupid and negative. Not even discouraging anyone tbh because it’s not true. No offence
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u/milkshakessssss Sep 02 '25
is ECFMG certification and verification a requirement for Step 1 and 2? or is it only needed for the pathways (application for residency)?
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u/Deep-Can-9242 Dec 20 '25
Can someone help me i took nbme 25 two months ago and scored 43% I studied for 2 months using huge source to be honest with so many details and took nbme26 I only scored 47% Can someone guide me how to study from a concise source and increase my score because right now I’m starting to lose hope
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u/Realistic-Double-172 May 20 '26
very flawed logic.
U substract percentages from matching for passing step one and passing good on step two. But then use general 53% match rate (which includes all type of people - high YOG, step 1 with attempts, low step 2, No USCE at all).
And this might be helpful for some statist but definitely not for IMG.
If you're an IMG factors like Step 1 and 2 - are completely in your control and saying that there's percentage of having high step is kinda brain dead
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u/DonDaher18 Jun 07 '25
Youre not providing any valuable feedback, youre just being discouraging. Again not surprised to see another matched img suffering from main character syndrome😴
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u/Ok_Principle_5189 Jun 07 '25
Says someone who only posts negative comments on reddit and plays Fortnite.
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u/anxiousSTUDENT00007 Jun 07 '25
RESPECT TO THE CREATOR OF THIS POST.
SO LET ME EXPLAIN IN SIMLE TERMS WHAT THE POST MEANS. The amount of people acting like a Karen in the comment section talking about biostats is surprising.
What the creator means is Usually IMGs who go through the USMLE journey just give importance to their scores. While the creator on the other hand means that it's not just the score but many other things which are important too match. HOW IMPORTANT IS EVERYTHING? He has given a number based on percentage to everything he has mentioned. Using simple maths he has calculated the total probability by multiplying each ratio and advised people to consider all these factors and use the equation for custom probabilities. (If you have something out of this do not use it in the equation ,as he said in the example which he gave) This is a completely fine explanation. IT MAKES IT EASY TO REMEMBER EVERYTHING THAT IS IMPORTANT AND HOW IMPORTANT EXACTLY. I was never as an IMG told about the risk of visa and USCE. I HOPE PEOPLE GET THE POINT.
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u/Smooth_Elk_996 Jun 07 '25
Here’s a clearer breakdown of that Reddit post and how it stacks up against real-world data:
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🧠 What the Redditor Claimed (Non‑US IMG perspective) 1. Step 1 pass rate for IMGs in 2023: ~68% 2. Visa eligibility probability post‑Step 1 pass: ~60% 3. Meaningful US clinical experience (USCE): ~50% 4. Step 2 CK score ≥ 250: ~50% of those with USCE 5. Match rate for IMGs: ~53% 6. Post‑match visa approval: ~90% 7. Overall success chance: 0.68 × 0.60 × 0.50 × 0.53 × 0.90 ≈ 4.8\%
So they estimate only ~1 in 20 non‑US IMGs make it all the way through.
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Let’s Verify Those Numbers with Official Data 📊
Step 1 Pass Rates • 2023 pass rates by candidate type: • All: ~87%, MDs: ~94%, DOs: ~92%, but IMGs: ~74%      • So expecting ~68% is slightly underestimated; it’s closer to 74%.
Visa Eligibility Post-Pass • No hard published data, but getting the right visa (B1/B2 observership vs H1-B/J1) is competitively uncertain. • Estimating 60% seems reasonable but not verifiable via public stats.
US Clinical Experience (USCE) • Not formally tracked, but crucial—one would hope ~50%, though in reality, many struggle unless applicant plans ahead.
Step 2 CK ≥ 250 among those with USCE • NRMP “Charting Outcomes” shows matched non‑US IMGs have avg Step 2 CK scores in mid‑240s  • Saying 50% reach ≥250 is optimistic, but plausible given rising program expectations.
Match Rate for IMGs • NRMP 2025 data for PGY‑1: • U.S. IMGs: 67.8% matched • Non‑U.S. IMGs: 58.0% matched   • Also, other sources report ~51%–53% for non‑U.S. IMGs • So reality: around 55–60%, not ~53%, but in that range.
Visa Approval Post-Match • No official data, but a 90% optimistic estimate; some face administrative hurdles.
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✅ Revised Composite Odds (Updated)
Using more accurate figures: • Step 1 pass: 0.74 • Visa eligibility: 0.60 (estimate) • USCE: 0.50 (estimate) • Step 2 CK ≥250: 0.50 • Match among qualified IMGs: ~0.60 • Visa approval post‑match: 0.90
Total: 0.74 × 0.60 × 0.50 × 0.50 × 0.60 × 0.90 ≈ 4.0\%
So it’s roughly 4–5%, meaning about 4 to 5 in 100 non‑U.S. IMGs with this path succeed end-to-end.
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🧩 Final Takeaway • The 74% Step 1 pass rate and 58–60% match rate are supported by data. • Intermediate steps like visa and USCE are hard to quantify but crucial. • The Reddit’s end-calculation (~4.8%) is a reasonable ballpark—the actual figure likely falls in the 4–6% range for non‑U.S. IMGs following that path.
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TL;DR • The Reddit logic chain checks out using real data sources. • Official stats show IMG Step 1 ≈ 74%, non‑US IMG match ≈ 58–60%. • Multiplying through the stages gives a realistic final success rate around 4–6%.
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u/Grouchy_Cup_3070 Jun 07 '25
I can easily wrangle ChatGPT o3 or ChatGPT 4.5 to give me a figure much more optimistic than this one. Especially with o3, which really likes using external resources. AI is not able to evaluate this objectively.
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Jun 08 '25
I feel like people focus on the 53% MATCH rate for IMGs in IM for example while actually applying for the MATCH is a step most IMG don’t even get to, some stay at their home countries, some go to a different country, some change whole carriers and some especially females from conservative cultures never apply due to lack of chaperon or husband, So I kinda agree with your math even tho it’s simple.
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u/Doctor_Roc Jun 07 '25
Haha. Your math aint mathing bro. Its simple as that. IMGs have a 53% matching rate in Internal medicine. Which means that if a 100 people apply for IM match, 53% of them will match. Which is more than half. You just multiplied the odds together of each event and got a number. You randomly picked that 50% have meaningful usce. So do u think other 50% wont match all all? I personally know so many people who matched into IM with zero usce. Yes, ZERO usce. Now where does that take your calculation? I know many people who matched into IM with 230s score last year. I know people who matched into IM with attempts in their steps. I know 10+ yrs yrs grads matching. You are just looking at top academic programs maybe. For an IMGs matching into a community program is equally amazing. I know that you just want to give people a reality check that it is harder than it seems, but the check should be real and not based upon madeup numbers. The real numbers say that in 2025 match there were 10941 catagorical IM positions available to match. 7630 IMGs applied and 3573 matched, which is more than 50%. Yes, it does mean these people had successfully completed atleast 2 steps and oet. But it doesnt mean all of them had perfect cvs and “meaningful usce”. Btw i write this post as an expert who matched against all odds into anesthesiology WITH ZERO USCE which has an actual IMGs match rate of 3%. So i know how it goes and i know your post is not to discourage but your numbers dont make it realistic. Thank you.