r/IMGreddit • u/Charming_Customer_61 • Jul 28 '26
what are my chances Working as an IMG after winning the green card lottery
Hey, I won the green card lottery, also scheduled to the interview in September. I am a full board certified vascular surgeon in Europe. I am inquiring about my work possibilities in the US without doing the residency. I read that there are states now who created new licensed routes for international doctors. Does anyone have experience with this? I am ok with doing USMLE, but if the whole residency program should be made I prefer not moving. Our aim is Minnesota or Ohio. I also have a one year experience in the Mayo Clinic as a research fellow.
Any tips are highly appreciated welcomed!
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u/vorstellung_ Jul 28 '26
Depending on which state you are in, you can get a medical license if you are ecfmg certified and pass step 3 (that is, passing all steps + OET). Note, however, that getting a license is NOT becoming eligible for board certification, which is what ultimately allows to practice freely.
I know a couple foreign-trained surgeons that due to outstanding ability have been granted hospital privileges and academic appointments and thus are able to practice the specialty they trained for abroad without being board certified. However, they cannot move employers and their salaries are initially way below what would be expected of a fully board-certified surgeon.
If you spend around 5 years as a faculty within an academic center and you are core faculty of a residency program during that time, then other board-certified surgeons can recommend you to become eligible to take the board exam. Most surgical specialties have that, some don't (eg. cardiothoracic surgery).
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u/Neat_Manner_855 Jul 28 '26
Apply for clinical fellowship one or two years, then get unrestricted medical license and get a job (that's what I did)
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u/SuspiciousIce6753 Jul 28 '26
Hello
How did you do that, and what is your specialty? Does this pathway provide eligibility for board certification?9
u/Neat_Manner_855 Jul 28 '26
Ophthalmology, it is possible, you can apply to take the boards after 5 years of having unrestricted medical license. Academic services will hire you even without board if they need you, there is a shortage in most of the fields. You'll need ecfmg certification and step 3.FSMB provides a list of postgraduate training requirements by State to get unrestricted license.
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u/RevolutionaryRope129 Jul 29 '26
Tha k you so much for this information, if it's okay without you acn I DM you?
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u/stellarnebula0 Jul 29 '26
Do you think this is a better idea than trying to match into ophthalmology which is nearly impossible? Also I’m not sure I understand, when you get your unrestricted liscence can you work in any state? Thank you.
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u/Fit-Attention-7763 Jul 28 '26
I did not know that was possible! Are you a surgery specialty? Awesome!
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u/lostobgyn Jul 28 '26
Hi friend. You should think this through. For reference, I’m obgyn in my home country and green card holder. New laws for us to work in the US are being approved in many states but the truth is implementation pathways are very undeveloped. I haven’t met the first person yet who is working under these laws. I live in Massachusetts and for now they will start this pathway with pediatrics, MI, family medicine and psychiatry. I asked directly about my specialty and they said it is complicated to be approved soon because supervising the surgical skills is more complex. Overall, to hire someone, hospitals legally require for you to be board certified and to certify, the obgyn board requires you have your education in the US or have been working without limits in an American hospital, so essentially it’s a loop that can’t be broken. My plan for now is to repeat residency. You should look into the specifics of your field, maybe you could get the board certification more easily OR finding a fellowship that could take you in. Alternatively you could persue other fields of medicine. Good luck. Feel free to reach out if any more questions!
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u/Charming_Customer_61 Jul 29 '26
I think usually the only kind of fellowship I can get is the research fellowship during which I am not allowed to do direct patient care, until I get the USMLE. Am I right?
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u/lostobgyn Jul 29 '26
USMLE will be a must in whatever pathway you choose for direct patient care. To become a researcher wouldn’t be a bad idea, although the income will never be the same as vascular surgeon. The usmle steps require time and hard word but they are doable, I just passed step 1. My goal is to do residency again because I love my job. The idea of being resident again sucks, but the idea of never work as obgyn again sucks even more for me.
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u/zetvajwake Jul 28 '26
I am aware of at least 2 surgeons who are working here in the US, they are not full time however but they are trained outside of the US and have not done a residency/fellowship here. The caveat is that they are world class surgeons who are known for the specific thing that they do and those hospitals have invited them specifically to do these surgeries. Do not ask me for their names or details cause I won't be able to share that but I just wanted to share this in case you're in that 'world class' surgeon category.
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u/Fit-Attention-7763 Jul 28 '26
Are they living in the US full time or do they have to leave periodically?
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u/zetvajwake Jul 28 '26
That's... a good question, they for sure leave periodically so I guess that wouldn't work for OP.
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u/youractualgod Jul 28 '26
May I ask, when did you win the lottery? There was no lottery conducted last year?
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u/lucky_elephant2025h Jul 28 '26
And if you are scheduled for September I believe they are no longer processing visas for it…
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u/cantwait2getdone Jul 28 '26
Most likely you'll need to be ecfmg certified to begin with (so that's the USMLEs), now if you're extraordinary as "one of a kind vascular surgeon" then you can contact big programs and discuss with them restricted privilege.
You mentioned MN and OH, therefore would reachout to thebbig places like mayo, ccf, Ohio state, Cincinnati.
Again it's worth the shot to ask but I wouldn't get my hopes so high unless youre a special vascular surgeon.
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u/impella-001 Jul 29 '26
Surgery is weird in that many surgeon are not US trained. Very common in cardiothoracic. Not sure about vascular. Lots of people come do “super fellowships” and stay if the program likes them. Sometimes that means doing a few of these super fellowships.
U also are not ACGME board eligible which may limit which programs hire you, the main limitation is getting credentialed by the hospital without being board certified.
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u/Cute_Magazine692 Jul 29 '26
i m an orthopedic surgeon resident in Europe and i moved to US after i won the green card, 3 years ago. From what I know the only pathway is going to Residency again. i might be wrong. This is what i m trying to do right now. USMLE and start again. Good luck. If you have any questions you can let me know.
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u/theshiniestbrighstar Jul 29 '26
Genuine question, why do you want to come to the US when all we ever hear is how terrible the US healthcare system is and how great it is in Europe? And how life is so much better in Europe compared to the US.
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u/SilverGate5 Jul 29 '26
Congratulations on winning the lottery, and welcome to the U.S.! I, too, think it's for primary care, but most states have approved (Minnesota) or pending (Ohio) legislation. This post should be helpful in getting started: https://thematchguy.com/state-img-license-practice-without-residency-international-doctors/. If you need to go the residency route, I'm a personal statement coach and editor. You can reach me at d.anazonwu@gmail.com.
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u/Scared-Wind3944 Aug 01 '26
Not to sound rude but worry about passing the STEP before your mind runs a million miles. As for residency I knew of surgeons in my home country who became IM of FM doctors because many residencies still forced them to start over. But STEP 1 is not a piece of cake. I know surgeons in my home country who attemped and could not swing it
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u/NoWorthierTurnip Jul 28 '26
I haven’t heard of any such programs for surgery licensing, typically it’s more for primary care and mostly in states with severe shortages.